dras knowledge

Friday, January 26, 2007

Anger Erupts Over Insurance Company's IQ Test for Weight Loss Surgery

http://www.foxnews.com/story/0,2933,246519,00.html

Anger Erupts Over Insurance Company's IQ Test for
Weight-Loss Surgery

>>>>>>>>>snip<<<<<<<<<<<<

In a past life, I was on an insurance medical policy team. I suspect the article took the Tennessee BlueCross policy a little out of context. The current policy at http://www.bcbst.com/mpmanual/WHStart.htm doesn't have the words "IQ test" in it. As the policy reads now, it outlines those candidates that are most appropriate for bariatric surgery based on the available scientific evidence and consensus. Those without a concept of the personal changes it takes for bariatric surgery to be ultimately successful do not make good candidates.

I think insurance companies are trying to create policies that get away from creating comments like this: "I have to gain 10 more pounds before my insurance will let me have the surgery." Insurance companies have seen maverick surgeons and hospitals go willy-nilly with this surgery without much attention to appropriate screening, follow-up, or outcomes. Insurance companies have to cover the "train-wrecks" that can result from these surgeries, as well as the very common complications. It is not a cheap benefit.

A quote in the article:
"For complex procedures like heart transplants that
require elaborate medication regiments after surgery,
those patients don't have to undergo IQ tests to make
sure they're intelligent enough to follow instructions
afterwards..."

Maybe they would if they were screaming at the Insurance company to let them have heart surgery, or pounding down Big Macs with comments like, "I only need two more vessels to become 80% occluded before my Insurance will let me have the surgery."

If we're drawing analogies, why would transplant centers restrict candidates for liver transplants from those with alcohol or substance abuse problems? Isn't that discrimination?

Within the bariatric community, like many medical communities, there are those with strong and vocal convictions. This is not a bad thing, but there is the risk that things will get a little "extremist" (to use the FOXnews term) at times.

Nothing here excuses Insurance companies or insurance benefits from any of the way-out and ridiculous language and criteria that does exist.

N-


addtl info/resources on bariatric surgery:
http://www.facs.org/fellows_info/statements/st-34.html
http://www.facs.org/ahp/testimony/bariatric.html
http://www.asbs.org/html/pdf/2004_ASBS_Consensus_Conference_Statement.pdf
http://www.obesityhelp.com/home/

Thursday, January 25, 2007

Cinnamon for Diabetes, One Study

A friend has asked me about cinnamon for diabetes, citing this report:

http://care.diabetesjournals.org/cgi/content/full/26/12/3215


>>>>>>>>>>>>>>>>>>>>>>>>>


As mentioned, the group tested is very small. I think that there are good indications to have this, or similar study replicated elsewhere before these results can be too credible. In order to understand about any physiologic process of cinnamon, I would like to see: More people studied, better tracking of glucose levels throughout the trial, a diet diary for all groups tested, domestic spice as well as manufactured supplement testing groups, and maybe better blinding. I wonder whether there was any aromatic, taste, or other difference between the cinnamon and wheat flour pills. Per the report, there was hardly any difference in outcomes between the 3 doses of cinnamon. I wonder what we'd see if the intervention was a toothpick dipped in cinnamon oil (a favorite of my father's), or chomping down a Hot Tamale candy or Big Red chewing gum (my favorite) after each meal. Maybe one group could just burn cinnamon candles all day long.

And, even though it's obviously "all-natural", we should look at side-effects as well. A co-worker of mine has an anaphylaxis-type allergy to cinnamon. Is substantial doses of cinnamon hard on the kidneys or liver? Or, how about us GERD folks? I think I would prefer being around the cinnamon-eaters over the garlic-eaters at any rate.

I don't think I could recommend commercial cinnamon supplements based on this report. But, it's indeed worthy of looking into. It would be too cool to find out adding a little cinnamon can make a meaningful impact. Any type II's out there, let's hear your n=1 reports using whatever cinnamon "supplement" you might have handy.

Monday, January 22, 2007

"The Sprue" is the lastest in-vogue medical condition

There is much BOGUS goings on in the world of fringe allergy testing and supposed symptoms of food allergies. Here is but a fractional comment.


Testing specifically for transglutaminase (tTG) antibodies or endomysial autoantibody (EMA) is recommended by the American Diabetes Association for kids newly diagnosed with type 1 diabetes: http://www.guideline.gov/summary/summary.aspx?doc_id=6826 . Testing, when ordered by a competent medical practitioner (probably an MD specialist), and performed at a reputable lab (probably US University Medical Hospital-affiliated/based), can be an important diagnostic tool. (ARUP is a well-known, credible reference lab used by many hospitals and physicians: http://www.arupconsult.com/Topics/Autoimmune_Disease/Celiac_Disease.html)

"The sprue", on the other hand, along with myriads of obscure "food allergies", seems to be making a good comeback as an in-vogue medical condition for those with diet fixations, and those in alternative medicine looking for credible-looking ways to sell supplements and treatment.

It's difficult to tell these apart sometimes.

Friday, January 19, 2007

Exotic and Hard to Eat = Medical Nutrition Breakthrough

If is sounds exotic, and it's hard to eat, it most likely contains a breakthrough healthy ingredient. From Japan, first it was umeboshi, now it's wasabi and natto. I still have a craving for umeboshi and wasabi now and again, but could never even stand the smell of natto. I remember takoyaki was my favorite at festivals. A large platter at New Years time had fish heads on it - didn't even try those, but I bet there was something epically healthy about eating them.

N

Tuesday, January 09, 2007

When will Chiropractic be Mainstream Medicine?

This comment is rather cynical, in that most EBM enthusiasts think Chiropractic must retire it's sublaxation theory basis before ever being accepted among "legitimate" medical disciplines. -N

I do think it's possible that chiropractic has a chance at mainstream medicine. But, it will not be chiropractic that will change so much as it will be what our society accepts as "Medicine." The fact that someone can go into a chiro office with a bad back and come out feeling fine makes it, in a sense, Medicine, as defined by our culture. And that, really, is all a reformist chiropractor has to prove to whoever is the audience. Isn't It because the emotional, social, and spiritual aspects of our lives are a part of our medical well-being that perhaps MD's don't discourage sCAM modalities? When we accept such ideas of emotional, social, and spiritual well-being as epic in importance to our health, we can accept as "Medicine" any myriad of human ritualistic behaviors on the mere premise that it is healthy or curative.

Chiropractic only has to succeed in creating the idea that chiropractic can be among the accepted medical disciplines. That "evidence-based" means chiropractic is methodically trying to discover what within chiropractic is working the best. That chiropractic is "Medicine" because we can't dispute the fact that people walk out of chiropractic offices feeling better.

Our mainstream medicine only has to change a little more toward a more subjective approach to medical care and chiropractic will be accepted as mainstream. Unfortunately, we risk losing valuable lessons in objective discovery, and I predict our overall health, and pocketbook, will be much less well-off.

Monday, January 08, 2007

On-line Petition to Make AIDS Affordable Overseas (More on Overseas Drug Copyrights)

Please see the Original Message posted below my comments.

This is one issue I'm not sure I understand correctly. Is this truly all about a stingy, heartless drug company? Or, is this a case of a foreign manufacturer side-stepping international trade and patent laws and agreements?

I am no apologist for big drug companies, but just because this is a revolutionary AIDS drug, and not a revolutionary polymer, are they being penalized with no chance to cash in on their invention?

Does it make sense to spend hundreds of millions of dollars (US tax dollars via grants and FDA approval as well as US private investment) to develop a drug, just to have a foreign manufacturer make knock-offs and undermine the world market for it? To allow an Indian manufacturer to market and sell the drug for pennies on the dollar outside the US, is it then fair that US citizens have to continue to pay the full US price?

A humanitarian need truly does exist, but the compulsory giving away of manufacturing and marketing rights of a proprietary product seems like the wrong way to satisfy it. Either way, the US citizen loses. It pays to develop the drug, it pays the higher domestic price for it. But, maybe the world attitude is that the US should pay to ameliorate the world of AIDS (and any other condition for which the price of medicine is cheaper in Canada), without any pretention for foreign government or foreign economic support or help.

N-


----- Original Message ----

Sign-on to help protect access to affordable medicines!!

Pharmaceutical company Novartis is taking the Indian
government to court. If the company wins, millions of
people across the globe could have their sources of
affordable medicines dry up.

Novartis was one of the 39 companies that took the South
African government to court five years ago, in an effort to
overturn the country's medicines act that was designed to
bring drug prices down. Now Novartis is up to it again and
is targeting India.

India produces affordable medicines that are vital to many
people living in developing countries. Over half the
medicines currently used for AIDS treatment in developing
countries come from India and such medicines are
used to treat over 80% of the 80,000 AIDS patients in
Medecins Sans Frontieres projects.

If Novartis is successful in its challenge against the
Indian government and its patent law, more medicines are
likely to be patented in India, making it very difficult
for generic producers to make affordable versions
of them. This could affect millions of people around the
world who depend on medicines produced in India.

Tell Novartis it has no business standing in the way of
people's right to access the medicines they need. Sign on
and urge Novartis to DROP THE CASE against the Indian
government.

To sign the petition, click here:
http://www.msf.org/petition_india/international.html