Americans by the millions are going on diets, running, stepping and crunching to
work off those excess pounds. Unfortunately, there are many young to middle-aged
adults whose health is being jeopardized by morbid obesity—people who are at
least 100 pounds overweight or twice their ideal weight. This excess weight often
limits their ability to succeed and move ahead in both business and social
situations. They also risk such life-threatening conditions as diabetes,
cardiovascular disease, hypertension, orthopedic problems, gall bladder disease and
sleep apnea.

Bariatric Surgery offers new hope

While numerous medical therapeutic approaches to morbid obesity have been
advocated, including low-calorie diets, drugs, behavioral modification and exercise
therapy, the majority of patients fail to maintain the reduced body weight. The only
treatment proven effective in the long-term management of morbid obesity is
bariatric surgery—such as a gastric bypass or the new gastric banding procedure.

New non-invasive techniques allow for faster, better recovery

Many morbidly obese patients are reluctant to undergo gastric bypass surgery—
traditionally an open, invasive procedure. But thanks to new, minimally invasive
surgical techniques, this “last-resort” procedure has become more appealing.
The non-invasive techniques use tiny slits in the abdomen that allow a surgeon to
insert a camera-equipped scope and surgical instruments to perform surgical
procedures. These techniques are equally successful and offer many added patient
benefits. These benefits include less post-operative pain, reduced risk of wound
infection, a shorter hospital stay, faster recovery and a more rapid improvement in
quality of life. There are basically two types of laparoscopic surgeries to treat
extreme weight loss.

Gastric Bypass…proven, effective, but irreversible

The most commonly known, Roux-en-Y gastric bypass, involves refashioning the
stomach into a small pouch and bypassing part of the small intestine. This not only
limits the absorption of food but also produces a feeling of fullness in less time.
Although Roux-en-Y has been used for years with clinical results attesting to its
effectiveness, the procedure is irreversible and patients are advised to thoroughly
discuss its risk factors with their physicians.

Lap-Band Surgery…simpler, reversible with less risk

A newer, less extreme alternative is Lap-Band surgery, or adjustable gastric
banding. Approved by the FDA just last year, the procedure involves less risk than
the Roux-en-Y. Instead of bypassing the stomach, a “balloon” is banded around the
stomach to produce an early feeling of fullness. The balloon-like device is inserted
through a small incision and inflate it with saline solution to cinch the stomach and
limit its capacity. The operation takes about 60 minutes and usually requires a one-
day hospital stay. The band can later be tightened or loosened as needed—without
further surgery—by adjusting the amount of saline solution through a portal under
the patient’s skin. The device can even be removed entirely if necessary. Reduced
risk, simplicity and reversibility make the Lap-Band more attractive to today’s
patients.

How much weight will I lose? How soon?

Results depend on a variety of factors and vary with each patient.
Most gastric bypass patients experience fairly rapid weight loss in the first three to
six months after surgery. Weight loss slows, but generally continues up to 12 to 18
months after surgery, averaging 65 to 75 percent of excess body weight. With the
Lap-Band, weight loss is generally slower and more gradual compared to the gastric
bypass. Typically, patients lose up to 55 percent of their excess body weight within
18 months following laparoscopic adjustable gastric banding surgery. The normal
hospital stay for Lap-Band patients is one day with a return to most activities in
seven days.

Surgery is only the first step

Regardless of procedure, a team approach is recommended for solving a patient’s
weight problem. This includes a comprehensive evaluation and support before and
after surgery for the greatest chance of weight loss success. The operation itself is
not the whole answer. A multidisciplinary approach—surgeon, internist, dietician
and psychiatrist—is needed to help the patient lose and keep weight off. The goal is
not only weight loss, but the reversal of serious medical conditions.

Is it covered by my insurance?

Most insurance carriers will cover a laparoscopic gastric bypass if you are eligible
for the procedure. Insurance coverage for laparoscopic adjustable gastric banding is
variable and will depend on your insurance.

About the Author

Alex Kecskes is a former ad agency Copy Chief who has created effective copy and
concepts for a wide range of ad agencies, Fortune 500 companies and startups. As
owner of ak creativeworks, Alex provides brand names, as well as strategic copy for
brochures, mailers, multimedia, articles, newsletters, PR and web content. He has
published articles in a variety of publications about health, business and
technology–this includes copy for over 130 different products and services. He has
won such national awards as the Andy, Belding and One Show. For more information
and samples, please visit:
akcreativeworks.com akcreativeworks.com

Studies revealed that 90% of people with lupus experience joint and/or muscle pain at some time during this illness.Very often, the aching pain in joints and muscles can determine the patient believe he has a viral or flu-like illness, while other patients may have symptoms similar with those produced by arthritis. There exist also another category of patients with intense muscle inflammation, and they can also experience progressive weakness and loss of strength.

It must be said that muscle and joint pains are symptoms of lupus but usually it’s not the systemic lupus erythematosus responsible for them. They are more frequently caused by other illnesses.

Usually, the joint pain caused by lupus arthritis comes, may last for days or weeks, and then disappear, returning at a later time. It is known that the joints farthest from the trunk of the body are most frequently affected. Characteristic to lupus is stiffness and pain in the morning which improves during the day and can return later in the day when the person is tired, and also the fact that the pain is usually symmetrical, similar joints on both sides of the body are affected. It is good to know that even if a person has been diagnosed with lupus, there can appear pains that have nothing to do with this disease. For example, backaches or neck pains, a single, chronically painful are not provoked by lupus.A fact that also should be remembered is that usually, lupus arthritis doesn’t cause deformities or destruction of the joints.Best clues in order to determine if the pain is caused by the systemic lupus erythematosus is the pattern of joint pain and the setting in which it occurs.There can be made X-ras of the painful joints and an examination of the synovial fluid within a swollen joint, to rule out other possible causes for the joint. It is known that if arthritis is the only symptom of lupus, diagnosis can be extremely difficult.It is good to mention that sometimes, performing the anti-nuclear antibody test and the test for rheumatoid factor can be helpful.

For treating lupus arthritis, there are usually used non-steroidal, anti-inflammatory medications like ibuprofen, naproxen or aspirin. Usually, these medications have effect, but if this therapy is not effective, there can be added antimalarial drugs such as hydroxychloroquine.In rare cases, if the joints remain swollen and painful despite other treatment, there begins the treatment with corticosteroids.It is important that people learn joint protection procedures in order to rest the joints during flares of lupus arthritis, and another fact that must be known is that cytotoxic medications should not be used to treat only lupus arthritis.

It is known that the systemic lupus erythematosus can seriously damage the muscles, and as a result, there can appear muscle weakness and loss of strength. Inflamed muscles can be painful and tender to the touch, but the most common symptom that lupus myositis shows is muscle weakness. Usually, the muscles at he trunk of the body are affected , such as neck, pelvic girdle and thighs, shoulder girdle and upper arms.

There are some tests that can determine the severity of muscle involvement. These tests measure the level of some chemical enzymes in the blood. Normally, that enzymes are being concentrated within muscle fibers. They escape into the blood circulation when the muscle fibers are being damaged by inflammation.There can also be made an electromyogram to determine the character of muscle damage in lupus myositis, and also biopsy may be performed in order to confirm the presence of inflammation and to identify how severe it is.

As a treatment, corticosteroids are used initially in high doses, to keep the inflammation under control, and then, after it subsides, it is gradually reduced. Most of the patients responde well to this treatment, but there are rare cases when it is necessary to add cytotoxic or immunosuppressive medications.A well directed exercise program should be started after the inflammation passed, in order to regain normal muscle strength and function.

It may happen when the patient is prescribed high doses of corticosteroids with or without cytotoxic agents to appear bone damage and muscle weakness. These complications in rare cases appear due to the effects of the medications alone, they usually come because of a combination of factors.It was found that patients with systemic lupus erythematosus which took steroids for a long time can develop ischemic necrosis of bone. Altered blood flow to a portion of bone causes the death of that area, and as the bone repairs the area, a weakening of the bone occurs and a portion of the bone surface may collapse. Most affected are the hips, shoulders and knees.The first symptom of ischemic necrosis is pain when the joints are being moved or bearing weight, and the pain can be felt even when the person is resting, at night, when the condition progresses.Osteoporosis can also appear if a patient uses corticosteroids for a long time. Having osteoporosis means that the bone mass is decreased and a higher risk of bone fracture and compression of vertebrae in the spine appears. It is known that women are at a higher risk of developing osteoporosis and using calcium and vitamin D in addition to regular exercise may help prevent osteoporosis.

It is important to remember that people with lupus myositis should take a regular, well-designed exercise program in order to prevent muscle weakness.

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