Teen Bariatric Surgery goesBeynd just weight loss - article

[Guest guest]

From the Pittsburg " Post-Gazette " :

Bariatric surgery for teens goes beyond weight loss

Wednesday, January 07, 2009

By Pohla + Steve Mellon/Post-Gazette

Dr. Anita Courcoulas has looked into the health benefits of bariatric

surgery for adolescent patients. The surgery put type 2 diabetes into

remission for 10 of 11 patients studied and improved cholesterol and

high blood pressure rates. Mike-, of Clairton, did more

than lose 136 pounds after undergoing gastric bypass surgery on Oct.

26, 2006 at the age of 18. She also got healthier.

Her pre-arthritic joints improved; a pre-type 2 diabetes mellitus

condition called insulin resistance and her hypothyroidism went away;

and she was able to go off medication for polycystic ovary syndrome,

a malady in which women develop large ovarian cysts and have

difficulty ovulating.

None of that surprises her surgeon, Dr. Anita Courcoulas, director of

minimally invasive bariatric and general surgery at the University of

Pittsburgh Medical Center.

She was the UPMC author of a small, five medical-center study, or

case series, published in the January issue of Pediatrics, that

showed 10 of 11 extremely obese teenagers who underwent Roux-en-Y

bypass surgery experienced remission of their type 2 diabetes along

with improvements in other well-known risk factors for cardiovascular

disease.

There were no such improvements in the control group, 67 patients

with type 2 diabetes, all at the University of Cincinnati, who were

treated medically but had no surgery.

It was the first such study of younger bariatric surgery patients,

though there is much research available on adults.

" All but one of the 11 ... were able to go off insulin, " Dr.

Courcoulas said. " There were significant improvements in weight

change. The improvement in diabetes was dramatic; cholesterol levels

and blood pressure -- all four significantly improved compared to the

control group. "

Only two of the 11 were UPMC patients; Ms. Mike- was ineligible

for the study because she did not have full-blown type 2 diabetes,

but the positive outcome of her surgery mirrors that of the 10 who

participated successfully.

The results of the case series enabled Dr. Courcoulas' research group

at UPMC's Magee-Womens Hospital and researchers from the universities

of Cincinnati and Alabama-Birmingham; and Texas Children's Hospital

to get funding from the National Institutes of Health for a much

larger, more comprehensive study that will assess the risks and

benefits of gastric bypass surgery on adolescents.

A total of 200 patients are being enrolled and followed for five

years beginning with their surgery. The enrollment actually began two

years ago, and just over 60 patients, 15 from UPMC, already are

participating. Again, Ms. Mike- wasn't eligible because the

study wasn't enrolling at the time of her surgery.

" This will be a very definitive study that will assess the risks and

benefits of the surgery, " Dr. Courcoulas said. " We're looking at a

wide variety of [factors], health improvements, quality of life. "

There is, she added, " slightly greater than 1 percent chance of

surgical complications, like bleeding, blood clots, infection, but we

balance those small surgical risks against health improvements:

dramatic weight change and some of these improvements in diabetes,

high blood pressure and cholesterol. "

And there are more benefits than the improvements listed above.

" This [small] study didn't look at them specifically, but we know of

others in adults: [improvements] in sleep apnea, lower extremity leg

swelling and blood clots, heartburn, polycystic ovary syndrome and

infertility in women, " Dr. Courcoulas said. " Those were not looked at

in the 11 studied but will be in this group. ... as well also will be

quality of life and psychosocial function, which is critical in young

people whose life is just beginning to evolve ... "

Dr. Courcoulas believes those psychosocial improvements are just as

important as the medical. Ms. Mike- believes that for her

they're of even greater import.

Diagnosed as bipolar before she reached her teens, she spent most of

her young life at the depressed end of that mental illness

seesaw. " She was on different medications that made her gain weight, "

said her mother, Kim Mike-, an intensive care nurse from Penn

Hills. " Then she started withdrawing, had poor self-esteem and

started eating more. " It became a vicious circle.

But now, Ms. Mike- is both happy and self-confident, making new

friends, working for a temporary help agency while studying to finish

high school and go on for training in medical coding.

" I'm more happy with my personality change and [improved] self-esteem

than the health thing, " said Ms. Mike-, now 21. " If I had

continued on the path I was on, I would have ended up committing

suicide or doing something stupid that would have caused my dying

because I was so depressed and withdrawn from things. "

Her mother concurs.

" I feel [Dr. Courcoulas] saved that child's life, " Mrs. Mike-

said. " If her health hadn't killed her; she would have committed

suicide. She's a different person. She's off all her psychiatric

medications; in fact, she's off all of her medications. "

And that is the kind of story that Dr. Courcoulas says she and her

colleagues like to hear best.

" Everybody focuses on the pounds and health risks improved ... but

don't pay as much attention to how we impact people's quality of

life, " she said. " That's why we love what we do, because we feel we

have an impact on people's lives. "

[Guest guest]

Thank you Sandy!!

Teen Bariatric Surgery goesBeynd just weight loss -

article

From the Pittsburg " Post-Gazette " :

Bariatric surgery for teens goes beyond weight loss

Wednesday, January 07, 2009

By Pohla + Steve Mellon/Post-Gazette

Dr. Anita Courcoulas has looked into the health benefits of bariatric

surgery for adolescent patients. The surgery put type 2 diabetes into

remission for 10 of 11 patients studied and improved cholesterol and

high blood pressure rates. Mike-, of Clairton, did more

than lose 136 pounds after undergoing gastric bypass surgery on Oct.

26, 2006 at the age of 18. She also got healthier.

Her pre-arthritic joints improved; a pre-type 2 diabetes mellitus

condition called insulin resistance and her hypothyroidism went away;

and she was able to go off medication for polycystic ovary syndrome,

a malady in which women develop large ovarian cysts and have

difficulty ovulating.

None of that surprises her surgeon, Dr. Anita Courcoulas, director of

minimally invasive bariatric and general surgery at the University of

Pittsburgh Medical Center.

She was the UPMC author of a small, five medical-center study, or

case series, published in the January issue of Pediatrics, that

showed 10 of 11 extremely obese teenagers who underwent Roux-en-Y

bypass surgery experienced remission of their type 2 diabetes along

with improvements in other well-known risk factors for cardiovascular

disease.

There were no such improvements in the control group, 67 patients

with type 2 diabetes, all at the University of Cincinnati, who were

treated medically but had no surgery.

It was the first such study of younger bariatric surgery patients,

though there is much research available on adults.

" All but one of the 11 ... were able to go off insulin, " Dr.

Courcoulas said. " There were significant improvements in weight

change. The improvement in diabetes was dramatic; cholesterol levels

and blood pressure -- all four significantly improved compared to the

control group. "

Only two of the 11 were UPMC patients; Ms. Mike- was ineligible

for the study because she did not have full-blown type 2 diabetes,

but the positive outcome of her surgery mirrors that of the 10 who

participated successfully.

The results of the case series enabled Dr. Courcoulas' research group

at UPMC's Magee-Womens Hospital and researchers from the universities

of Cincinnati and Alabama-Birmingham; and Texas Children's Hospital

to get funding from the National Institutes of Health for a much

larger, more comprehensive study that will assess the risks and

benefits of gastric bypass surgery on adolescents.

A total of 200 patients are being enrolled and followed for five

years beginning with their surgery. The enrollment actually began two

years ago, and just over 60 patients, 15 from UPMC, already are

participating. Again, Ms. Mike- wasn't eligible because the

study wasn't enrolling at the time of her surgery.

" This will be a very definitive study that will assess the risks and

benefits of the surgery, " Dr. Courcoulas said. " We're looking at a

wide variety of [factors], health improvements, quality of life. "

There is, she added, " slightly greater than 1 percent chance of

surgical complications, like bleeding, blood clots, infection, but we

balance those small surgical risks against health improvements:

dramatic weight change and some of these improvements in diabetes,

high blood pressure and cholesterol. "

And there are more benefits than the improvements listed above.

" This [small] study didn't look at them specifically, but we know of

others in adults: [improvements] in sleep apnea, lower extremity leg

swelling and blood clots, heartburn, polycystic ovary syndrome and

infertility in women, " Dr. Courcoulas said. " Those were not looked at

in the 11 studied but will be in this group. ... as well also will be

quality of life and psychosocial function, which is critical in young

people whose life is just beginning to evolve ... "

Dr. Courcoulas believes those psychosocial improvements are just as

important as the medical. Ms. Mike- believes that for her

they're of even greater import.

Diagnosed as bipolar before she reached her teens, she spent most of

her young life at the depressed end of that mental illness

seesaw. " She was on different medications that made her gain weight, "

said her mother, Kim Mike-, an intensive care nurse from Penn

Hills. " Then she started withdrawing, had poor self-esteem and

started eating more. " It became a vicious circle.

But now, Ms. Mike- is both happy and self-confident, making new

friends, working for a temporary help agency while studying to finish

high school and go on for training in medical coding.

" I'm more happy with my personality change and [improved] self-esteem

than the health thing, " said Ms. Mike-, now 21. " If I had

continued on the path I was on, I would have ended up committing

suicide or doing something stupid that would have caused my dying

because I was so depressed and withdrawn from things. "

Her mother concurs.

" I feel [Dr. Courcoulas] saved that child's life, " Mrs. Mike-

said. " If her health hadn't killed her; she would have committed

suicide. She's a different person. She's off all her psychiatric

medications; in fact, she's off all of her medications. "

And that is the kind of story that Dr. Courcoulas says she and her

colleagues like to hear best.

" Everybody focuses on the pounds and health risks improved ... but

don't pay as much attention to how we impact people's quality of

life, " she said. " That's why we love what we do, because we feel we

have an impact on people's lives. "

[Guest guest]

I was about to email this directly to you, but i see you already saw it!

How is it going getting approval fo your daughter to be banded?

Sandy

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> Thank you Sandy!!

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