#obsm Transcript
Healthcare social media transcript of the #obsm hashtag.
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See #obsm Influencers/Analytics.
| Profile | Tweet |
|---|---|
 | #obsm chat @obsmchat Welcome to the #obsm chat. Tonight we're discussing the pros and cons of #BariatricSurgery, including potential #complications and what to do about them. Many thanks to @NeilFlochMD for drafting our blog and chat questions this month. |
| #obsm chat @obsmchat Please take a minute to introduce yourself. Even if only planning to "lurk" (read along without commenting) it’s helpful knowing the faces in the audience :-) Please note #obsm chats do not serve as medical advice. We will introduce the first question in a few minutes. |
 | Michelle Vicari @Eggface Join the conversation #obsm |
 | Arghavan Salles, MD, PhD @arghavan_salles Looking forward to hearing everyone's thoughts tonight! Arghavan Salles from @WashUBariatric here. #obsm |
| #obsm chat @obsmchat Thanks also to @TurnerandPage for all the behind-the-scenes chat magic! #obsm |
 | Neil Floch MD @NeilFlochMD #obsm This is Neil Floch MD @NeilFlochMD |
 | Deborah Greenhouse @greenhousemd @obsmchat Pediatrician in SC, using motivational interviewing and every resource I can find to help families in my community. #obsm |
| Michelle Vicari @Eggface @obsmchat Waving hello from rainy California #OBSM pals, Michelle "Shelly" #BariatricSurgery Post-Op, @ObesityAction Coalition Board Member, Patient Advocate 👋🏽 #OACAction taker |
 | Renee Hilton, M.D. @reneehilton30 Excited for another #obsm tweet chat on #obesity! Renee Hilton joining from @AUG_Health @MCG_Surgery |
| Neil Floch MD @NeilFlochMD RT @obsmchat: Welcome to the #obsm chat. Tonight we're discussing the pros and cons of #BariatricSurgery, including potential #complications and what to do about them. Many thanks to @NeilFlochMD for drafting our blog and chat questions this month. |
 | GeekyGrouch @grouchy_geek @obsmchat @NeilFlochMD Hello obsm chatters... I am back. Bariatric patient. #obsm #tellyourbariatricstory |
| #obsm chat @obsmchat @Eggface @ObesityAction Hi Shelly! #obsm |
 | Ian Patton, PHD @IanPatton55 @obsmchat Hello all, patient advocate from Canada, bariatric patient, and Kinesiologist with background in obesity research, looking forward to the chat #Obsm |
| #obsm chat @obsmchat @reneehilton30 @AUG_Health @MCG_Surgery So glad you're able to be here! #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @WohaibiMD @obsmchat Glad you could join! #obsm |
| Neil Floch MD @NeilFlochMD This is @NeilFlochMD and I look forward to a great discussion tonight #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @greenhousemd @obsmchat Welcome! #obsm |
| #obsm chat @obsmchat @txkyleharris @NeilFlochMD Yes! Great to have patients participating! #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @reneehilton30 @AUG_Health @MCG_Surgery Thanks for joining, Renee! #obsm |
| Renee Hilton, M.D. @reneehilton30 RT @obsmchat: Please take a minute to introduce yourself. Even if only planning to "lurk" (read along without commenting) it’s helpful knowing the faces in the audience :-) Please note #obsm chats do not serve as medical advice. We will introduce the first question in a few minutes. |
 | Janet Elizabeth Childerhose, PhD @JEChilderhose Hi everyone. Janet Childerhose, medical anthropologist. What you may not know is that I also trained in philosophy of science. So I'm interested in probing our assumptions & terms. What do we mean by #complications? What are they, and who has them? #ontology #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @txkyleharris @obsmchat @NeilFlochMD Great to see you here again! #obsm |
| #obsm chat @obsmchat Let's get the discussion going! Please remember to tag all tweets with #obsm so we can see them! Here's the first question. #obsm https://t.co/852kAvFbvA |
| Arghavan Salles, MD, PhD @arghavan_salles @IanPatton55 @obsmchat Thanks for joining us! #obsm |
| #obsm chat @obsmchat @WohaibiMD Good to see you! #obsm |
 | Dr. Aaron Bolduc @DrAaronBolduc @obsmchat @NeilFlochMD #obsm chat! Let’s get in to #BariatricSurgery #complications. Definitely on my mind after that emergency surgery this week! Bariatric Surgeon at @AUG_Health with @reneehilton30 |
| Neil Floch MD @NeilFlochMD RT @obsmchat: Let's get the discussion going! Please remember to tag all tweets with #obsm so we can see them! Here's the first question. #obsm https://t.co/852kAvFbvA |
| #obsm chat @obsmchat @JEChilderhose Good to see you Janet! #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @PitchfordMd @obsmchat Welcome! #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @JEChilderhose Great to have you join us, Janet! #obsm |
| #obsm chat @obsmchat @IanPatton55 Love having our northern neighbors on board. Welcome! #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @obsmchat Nice to be here & join in a #obsm chat. |
 | Bruce Y. Lee @bruce_y_lee Good evening #obsm @bruce_y_lee here: https://t.co/CkhnE4y87x https://t.co/xVQOIsQFl2 |
| #obsm chat @obsmchat @DrAaronBolduc @NeilFlochMD @AUG_Health @reneehilton30 Wonderful! Thanks for joining! #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @NeilFlochMD Hello @NeilFlochMD ! #obsm |
| GeekyGrouch @grouchy_geek @obsmchat Yes, yes, yes. No more T2D, sleep apnea, or HBP. Not to mention the years added to my life and the ability to actually enjoy my life. #obsm #tellyourbariatricstory |
| #obsm chat @obsmchat @PitchfordMd Nice to see you! #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles As a surgeon, I always have a hard time with this. I like to give patients a nearly thorough listing of possible complications for procedures. But I'm not sure that's actually helpful to them. #obsm |
| Neil Floch MD @NeilFlochMD The risks of surgery do not out weigh the benefits of #BariatricSurgery #obsm |
 | Prisma Health–Upstate Dept. of Surgery @PH_Surgery A1: great question. In a nutshell: No #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @bruce_y_lee Thanks for joining, Bruce! #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @txkyleharris: @obsmchat Yes, yes, yes. No more T2D, sleep apnea, or HBP. Not to mention the years added to my life and the ability to actually enjoy my life. #obsm #tellyourbariatricstory |
| #obsm chat @obsmchat @bruce_y_lee Hi Bruce! Glad you're here! #obsm |
 | Heather Logghe, MD @LoggheMD 👇🏻 #obsm chat, happening now 👍🏻 #BariatricSurgery #SurgTweeting #PatientExperience |
| Renee Hilton, M.D. @reneehilton30 The benefits far outweigh the risk. #BariatricSurgery is very safe in the hands of an experienced surgeon. The risks of not receiving surgery is far higher as demonstrated by the Christou study where those who did not receive surgery were almost 9 times more likely to die. #obsm |
| #obsm chat @obsmchat @ZHeatherChamp So glad you made it Heather! #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @bruce_y_lee Hello @bruce_y_lee ! Great to see you. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @ghs_surgery Can you please explain why you don't think the benefits outweigh the risk? Data suggest that for most patients they do. #obsm |
| Ian Patton, PHD @IanPatton55 @obsmchat This really is a person by person issue, for some maybe, for some no. Bariatric surgery is not for everyone but has saved many lives, #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @LoggheMD: 👇🏻 #obsm chat, happening now 👍🏻 #BariatricSurgery #SurgTweeting #PatientExperience |
| #obsm chat @obsmchat RT @reneehilton30: The benefits far outweigh the risk. #BariatricSurgery is very safe in the hands of an experienced surgeon. The risks of not receiving surgery is far higher as demonstrated by the Christou study where those who did not receive surgery were almost 9 times more likely to die. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @reneehilton30: The benefits far outweigh the risk. #BariatricSurgery is very safe in the hands of an experienced surgeon. The risks of not receiving surgery is far higher as demonstrated by the Christou study where those who did not receive surgery were almost 9 times more likely to die. #obsm |
| Neil Floch MD @NeilFlochMD Q1: in the SOS study there were many more deaths from #cancer in people who did not have #bariatricsurgery- #obsm https://t.co/QBmNB9wo4g |
| GeekyGrouch @grouchy_geek @arghavan_salles And I’m sure it makes it even more daunting for those patients that do their research. #obsm #tellyourbariatricstory |
| Arghavan Salles, MD, PhD @arghavan_salles Q1: For most patients the benefits of bariatric surgery outweigh the risks. However, the decision needs to be made on an individual basis. #obsm |
| Neil Floch MD @NeilFlochMD Q1: The SOS study shows us that the risk of NOT having #bariatricsurgery and #dieting is that at 15 years people are 33% more likely to die - Sjostrom 2007 @NEJM - #obsm https://t.co/1PgRdoai38 |
| Deborah Greenhouse @greenhousemd @obsmchat I would think benefits would far outweigh risks but risks need to be taken seriously, especially when considering surgery for adolescents. #obsm |
| Dr. Aaron Bolduc @DrAaronBolduc @obsmchat The short term risks of surgery are lower than having your gallbladder removed! That is thanks to the focus on quality improvements from @asmbs for our field. #obsm |
 | Eyad Wohaibi, MD, FACS, FASMBS. @WohaibiMD RT @NeilFlochMD: Q1: Q1: in the SOS study there were many more deaths from #cancer in people who did not have #bariatricsurgery- #obsm https://t.co/QBmNB9wo4g |
 | Lab is my happy place @profbdcohen A1: I think that there are always inherent risks in any surgery & the population being operated on is also a high-risk population. Still the best overall treatment. #obsm |
 | Crystal Johnson-Mann, MD, MPH, FACS, FASMBS @CJMannMD A1 - Risk/benefit ratio of undergoing major surgery should be in the patient's favor. With that being said, mortality is <1% for patients undergoing bariatric surgery within 30 days. It should be seriously considered for those in need. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @txkyleharris Exactly. We cannot accurately predict who will have problems, so it's important to share what is possible. However, that may end up scaring away people who would benefit from bariatric surgery. #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @IanPatton55 @obsmchat Yes, it is. Not one size fits all. I believe this is where some resistance comes from. And lack of recognition of how serious severe obesity is for some, including #adolescents. It's just not on the radar for some. #obsm |
| Renee Hilton, M.D. @reneehilton30 RT @NeilFlochMD: Q1: Q1: The SOS study shows us that the risk of NOT having #bariatricsurgery and #dieting is that at 15 years people are 33% more likely to die - Sjostrom 2007 @NEJM - #obsm https://t.co/1PgRdoai38 |
| Arghavan Salles, MD, PhD @arghavan_salles RT @DrAaronBolduc: @obsmchat The short term risks of surgery are lower than having your gallbladder removed! That is thanks to the focus on quality improvements from @asmbs for our field. #obsm |
| Michelle Vicari @Eggface @obsmchat For me it was. I chose the helping hand of #BariatricSurgery RNY to treat my #obesity and it resulted in resolution of my #sleepapnea severe #GERD, High BP, off all Rx's, the bonus was 150+#'s lost but the health gains were tremendous #obsm https://t.co/wupPAibfoa |
| Neil Floch MD @NeilFlochMD It’s always an individual decision, that’s why we must help patients to learn the details about the risks and the benefits #obsm |
| Neil Floch MD @NeilFlochMD RT @txkyleharris: @arghavan_salles And I’m sure it makes it even more daunting for those patients that do their research. #obsm #tellyourbariatricstory |
| #obsm chat @obsmchat @profbdcohen Hi Brian! Good to see you! #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @DrAaronBolduc @obsmchat @asmbs This is correct! The risk of dying within 30 days of surgery is about the same for bariatric surgery as it is for gallbladder removal. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @profbdcohen: A1: A1: I think that there are always inherent risks in any surgery & the population being operated on is also a high-risk population. Still the best overall treatment. #obsm |
| Eyad Wohaibi, MD, FACS, FASMBS. @WohaibiMD RT @NeilFlochMD: The risks of surgery do not out weigh the benefits of #BariatricSurgery #obsm |
 | Carlos Zerrweck @zerrweck In trained hands and well selected patients, the risk of a #Bariatric proceudre is similar than a cholecystectomy #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @CJMannMD: A1 - Risk/benefit ratio of undergoing major surgery should be in the patient's favor. With that being said, mortality is <1% for patients undergoing bariatric surgery within 30 days. It should be seriously considered for those in need. #obsm |
| Renee Hilton, M.D. @reneehilton30 RT @Eggface: @obsmchat For me it was. I chose the helping hand of #BariatricSurgery RNY to treat my #obesity and it resulted in resolution of my #sleepapnea severe #GERD, High BP, off all Rx's, the bonus was 150+#'s lost but the health gains were tremendous #obsm https://t.co/wupPAibfoa |
| Lab is my happy place @profbdcohen Also, hi everyone! #bariatricsurgery patient, obesity researcher, professor. #RNY #OBSM |
| Dr. Aaron Bolduc @DrAaronBolduc RT @LoggheMD: 👇🏻 #obsm chat, happening now 👍🏻 #BariatricSurgery #SurgTweeting #PatientExperience |
| #obsm chat @obsmchat @CJMannMD Thanks for joining Crystal! #obsm |
| Neil Floch MD @NeilFlochMD The risk lies in NOT having surgery as the long term risks of #cancer are much higher if patients don’t lose weight #obsm |
| Dr. Aaron Bolduc @DrAaronBolduc RT @reneehilton30: The benefits far outweigh the risk. #BariatricSurgery is very safe in the hands of an experienced surgeon. The risks of not receiving surgery is far higher as demonstrated by the Christou study where those who did not receive surgery were almost 9 times more likely to die. #obsm |
| Bruce Y. Lee @bruce_y_lee @obsmchat #OBSM The skill & experience of the surgeon & the team probably affects the answer |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @CJMannMD Crystal, does there need to be better translation of the relative risks in language that makes sense for public? For PCPs? I think this is where some of where the controversy lies: distortion of risk. And that to me is a translation challenge. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles Q1: As @NeilFlochMD wrote in the blog, the Swedish Obesity Study has shown that those who have obesity and do not have bariatric surgery are likely to die sooner than those who have bariatric surgery. #obsm |
| #obsm chat @obsmchat RT @JEChilderhose: @IanPatton55 @obsmchat Yes, it is. Not one size fits all. I believe this is where some resistance comes from. And lack of recognition of how serious severe obesity is for some, including #adolescents. It's just not on the radar for some. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @Eggface: @obsmchat For me it was. I chose the helping hand of #BariatricSurgery RNY to treat my #obesity and it resulted in resolution of my #sleepapnea severe #GERD, High BP, off all Rx's, the bonus was 150+#'s lost but the health gains were tremendous #obsm https://t.co/wupPAibfoa |
| #obsm chat @obsmchat RT @zerrweck: In trained hands and well selected patients, the risk of a #Bariatric proceudre is similar than a cholecystectomy #obsm |
| Eyad Wohaibi, MD, FACS, FASMBS. @WohaibiMD RT @NeilFlochMD: Q1: Q1: The SOS study shows us that the risk of NOT having #bariatricsurgery and #dieting is that at 15 years people are 33% more likely to die - Sjostrom 2007 @NEJM - #obsm https://t.co/1PgRdoai38 |
| #obsm chat @obsmchat RT @Eggface: @obsmchat For me it was. I chose the helping hand of #BariatricSurgery RNY to treat my #obesity and it resulted in resolution of my #sleepapnea severe #GERD, High BP, off all Rx's, the bonus was 150+#'s lost but the health gains were tremendous #obsm https://t.co/wupPAibfoa |
| Arghavan Salles, MD, PhD @arghavan_salles @profbdcohen Great to see you here again! #obsm |
| Michelle Vicari @Eggface For those considering #bariatricsurgery a great @ObesityAction resource that looks at the options and pros and cons https://t.co/xKiWW6Z888 #obsm |
| Neil Floch MD @NeilFlochMD I do feel that the evidence supports that it is the only viable option when patients need to lose a significant amount of weight and have failed #diet change #obsm |
| Neil Floch MD @NeilFlochMD RT @arghavan_salles: @ghs_surgery Can you please explain why you don't think the benefits outweigh the risk? Data suggest that for most patients they do. #obsm |
| Neil Floch MD @NeilFlochMD RT @reneehilton30: The benefits far outweigh the risk. #BariatricSurgery is very safe in the hands of an experienced surgeon. The risks of not receiving surgery is far higher as demonstrated by the Christou study where those who did not receive surgery were almost 9 times more likely to die. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @ZHeatherChamp @txkyleharris What do you guys think should be shared with patients prior to bariatric surgery? How much did you want to know? #obsm |
| Neil Floch MD @NeilFlochMD RT @LoggheMD: 👇🏻 #obsm chat, happening now 👍🏻 #BariatricSurgery #SurgTweeting #PatientExperience |
| #obsm chat @obsmchat @zerrweck Happy you could join the chat! #obsm |
 | Dr. Kasey Goodpaster @DrGoodpaster A1. The balance of risks vs benefits depends on the individual, but by the time patients make it into our #bariatric program, they’ve typically debated for months or years and determined that the long-term risks of NOT having surgery are greater than short term risks. #obsm |
 | iamabariatricpatient @JeanineMSherman @obsmchat Hello everyone Jeanine Sherman from Mi. Bariatric patient, patient advocate.#obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @Eggface: For those considering #bariatricsurgery a great @ObesityAction resource that looks at the options and pros and cons https://t.co/xKiWW6Z888 #obsm |
| #obsm chat @obsmchat RT @Eggface: For those considering #bariatricsurgery a great @ObesityAction resource that looks at the options and pros and cons https://t.co/xKiWW6Z888 #obsm |
| Lab is my happy place @profbdcohen @ZHeatherChamp @arghavan_salles @txkyleharris I did research beforehand but I had old sources. I was convinced that the mortality rate was ~10%. I actually asked my surgeon what her mortality rate was and she looked at me like I was from outer space. Having the right information is key. #obsm |
| #obsm chat @obsmchat #obsm https://t.co/lSO10ghoVM |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @NeilFlochMD Neil, I'd like to probe on this. I'm writing a commentary about the need for surgeons to educate clinicians about #BariatricSurgery surgery. Because I believe the evidence doesn't speak for itself. Do surgeons have time to educate PCPs? Pediatricians? #obsm |
| Neil Floch MD @NeilFlochMD Mortality increases dramatically over 15 years in patients who do not have #bariatricsurgery #obsm |
 | Ronnal Vargas MD Msc FASMBS @ronnalvargas RT @NeilFlochMD: Q1: Q1: The SOS study shows us that the risk of NOT having #bariatricsurgery and #dieting is that at 15 years people are 33% more likely to die - Sjostrom 2007 @NEJM - #obsm https://t.co/1PgRdoai38 |
| Neil Floch MD @NeilFlochMD RT @IanPatton55: @obsmchat This really is a person by person issue, for some maybe, for some no. Bariatric surgery is not for everyone but has saved many lives, #obsm |
| iamabariatricpatient @JeanineMSherman RT @Eggface: @obsmchat For me it was. I chose the helping hand of #BariatricSurgery RNY to treat my #obesity and it resulted in resolution of my #sleepapnea severe #GERD, High BP, off all Rx's, the bonus was 150+#'s lost but the health gains were tremendous #obsm https://t.co/wupPAibfoa |
| Neil Floch MD @NeilFlochMD RT @Eggface: @obsmchat For me it was. I chose the helping hand of #BariatricSurgery RNY to treat my #obesity and it resulted in resolution of my #sleepapnea severe #GERD, High BP, off all Rx's, the bonus was 150+#'s lost but the health gains were tremendous #obsm https://t.co/wupPAibfoa |
| Eyad Wohaibi, MD, FACS, FASMBS. @WohaibiMD RT @Eggface: For those considering #bariatricsurgery a great @ObesityAction resource that looks at the options and pros and cons https://t.co/xKiWW6Z888 #obsm |
| #obsm chat @obsmchat @JeanineMSherman Welcome Jeanine! #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @DrGoodpaster This has been my experience as well. If anything, my patients commonly say they wish they had had surgery sooner. #obsm |
| Carlos Zerrweck @zerrweck There’s always a risk, but acting fast makes a difference in outcomes.. mortality has to be extremely rare! 0.1% #obsm #obsmchat |
| Arghavan Salles, MD, PhD @arghavan_salles @JeanineMSherman @obsmchat Hi, Jeanine! #obsm |
| Dr. Aaron Bolduc @DrAaronBolduc RT @arghavan_salles: @ZHeatherChamp @txkyleharris What do you guys think should be shared with patients prior to bariatric surgery? How much did you want to know? #obsm |
| #obsm chat @obsmchat RT @DrGoodpaster: A1. The balance of risks vs benefits depends on the individual, but by the time patients make it into our #bariatric program, they’ve typically debated for months or years and determined that the long-term risks of NOT having surgery are greater than short term risks. #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @arghavan_salles @DrAaronBolduc @obsmchat @asmbs But I don't believe this is widely understood, amongst public or PCPs. What do surveys show? #obsm |
| Lab is my happy place @profbdcohen @arghavan_salles Thanks! Glad to be back. Sorry I was late to the conversation tonight- I was actually out to dinner (something that #RNY patients should be told- you don't have to give up a social life and eating out; it's just different). #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @profbdcohen @ZHeatherChamp @txkyleharris This is a great point. Not everything available on the internet is true... #obsm |
| Neil Floch MD @NeilFlochMD Actually there is data showing that it is less than gallbladder surgery - #bariatricsurgery #obsm |
| Neil Floch MD @NeilFlochMD RT @zerrweck: In trained hands and well selected patients, the risk of a #Bariatric proceudre is similar than a cholecystectomy #obsm |
| GeekyGrouch @grouchy_geek @ZHeatherChamp @arghavan_salles I researched for 2 years. Benefits outweighed the risks dramatically for me. 50+ BMI, 3 co-morbidities, 430+ lbs. couldnt walk 50ft or tie my own shoes without getting winded. #obsm |
| Neil Floch MD @NeilFlochMD RT @arghavan_salles: @DrAaronBolduc @obsmchat @asmbs This is correct! The risk of dying within 30 days of surgery is about the same for bariatric surgery as it is for gallbladder removal. #obsm |
| #obsm chat @obsmchat A question for the group too! #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @JEChilderhose @NeilFlochMD We do this pretty routinely. #obsm |
| Lab is my happy place @profbdcohen @ZHeatherChamp @arghavan_salles @txkyleharris 100% yes. I am convinced no one had ever asked her that before. #obsm |
| Neil Floch MD @NeilFlochMD RT @NeilFlochMD: The risk lies in NOT having surgery as the long term risks of #cancer are much higher if patients don’t lose weight #obsm |
 | John David Scott MD @jdscottmd As a society, benefits far outweigh the risk, but always tailor the conversation to the individual patient. #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @DrAaronBolduc @obsmchat @asmbs I like this analogy...but, I think most patients don't have experience w/ gallbladder surgery. Do we need to generate other risk analogies? #obsm |
| Bruce Y. Lee @bruce_y_lee @obsmchat #obsm more complications may emerge from those who do not have the experience, skill, or qualifications, which may then tilt averages |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @arghavan_salles @NeilFlochMD Can you give examples? What does this education look like? #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @JEChilderhose @DrAaronBolduc @obsmchat @asmbs I think you are right that not everyone is aware of these data. There are many misconceptions out there, based on very old data. #obsm |
| GeekyGrouch @grouchy_geek @arghavan_salles @ZHeatherChamp I want to know it all. I need all info available to make best decision for me #obsm |
 | John Rodriguez @johnrodriguezMD RT @Eggface: @obsmchat For me it was. I chose the helping hand of #BariatricSurgery RNY to treat my #obesity and it resulted in resolution of my #sleepapnea severe #GERD, High BP, off all Rx's, the bonus was 150+#'s lost but the health gains were tremendous #obsm https://t.co/wupPAibfoa |
| Neil Floch MD @NeilFlochMD I believe risk of death and complications are important to every patient #bariatricsurgery #obsm |
| Neil Floch MD @NeilFlochMD RT @Eggface: For those considering #bariatricsurgery a great @ObesityAction resource that looks at the options and pros and cons https://t.co/xKiWW6Z888 #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @profbdcohen No worries! Glad you could make it :). #obsm |
| Neil Floch MD @NeilFlochMD RT @DrGoodpaster: A1. The balance of risks vs benefits depends on the individual, but by the time patients make it into our #bariatric program, they’ve typically debated for months or years and determined that the long-term risks of NOT having surgery are greater than short term risks. #obsm |
| John Rodriguez @johnrodriguezMD RT @NeilFlochMD: It’s always an individual decision, that’s why we must help patients to learn the details about the risks and the benefits #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @txkyleharris: @ZHeatherChamp @arghavan_salles I researched for 2 years. Benefits outweighed the risks dramatically for me. 50+ BMI, 3 co-morbidities, 430+ lbs. couldnt walk 50ft or tie my own shoes without getting winded. #obsm |
| Ian Patton, PHD @IanPatton55 @NeilFlochMD True, evidence suggests that, however it’s not a scaleable treatment, there will never be enough surgeries done to make a dent in the obesity problem, hopefully one day there are other options as well #obsm |
| #obsm chat @obsmchat @jdscottmd Nice to have you here! #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @txkyleharris @ZHeatherChamp Yes, there are so many benefits to bariatric surgery! For many patients, high blood pressure, diabetes, sleep apnea, etc. get better. And they also have more energy and are able to be more active. #obsm |
| John David Scott MD @jdscottmd A2: I like to use some of the risk assessment apps available online like the MBSC risk calculator and the Cleveland clinic tools. #obsm |
| Renee Hilton, M.D. @reneehilton30 A2. 1/ Short term complications include bleeding, infection, staple line leak, VTE, stenosis, and any complications associated with anesthesia. Most complications can be managed conservatively; however, reoperation may be indicated. #obsm |
| Crystal Johnson-Mann, MD, MPH, FACS, FASMBS @CJMannMD @JEChilderhose I think so. A common perception is that there is almost no associated risk which is false. The level of risk depends on multiple factors. It is hard for anyone (other than the surgeon) to really convey risk since it can be fairly individualized. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @jdscottmd Agree completely! #obsm |
 | hrdlckwmn @hrdlckwmn #obsmchat #obsm I researched for 4 years before the stars aligned for my RNY. I did NOT research long term patients who had complications after 4+years. If I had found a large #, I doubt my mind would have changed. |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @arghavan_salles @DrAaronBolduc @obsmchat @asmbs Okay. More surveys. Now I'm morphing from a philosopher of science into a survey methodologist (or fan of) #obsm #beempirical #Data #obsm |
| Neil Floch MD @NeilFlochMD We will not resolve #obesity with surgery but we can resolve or improve it in individuals #obsm |
| Neil Floch MD @NeilFlochMD RT @bruce_y_lee: @obsmchat #obsm more complications may emerge from those who do not have the experience, skill, or qualifications, which may then tilt averages |
| Lab is my happy place @profbdcohen @NeilFlochMD I also think that a good surgeon (and I love mine) is not afraid to lay the risks out there, no matter how small the chance might be. The anesthesia was a bigger concern for me than the actual procedure. #obsm |
| Renee Hilton, M.D. @reneehilton30 RT @txkyleharris: @ZHeatherChamp @arghavan_salles I researched for 2 years. Benefits outweighed the risks dramatically for me. 50+ BMI, 3 co-morbidities, 430+ lbs. couldnt walk 50ft or tie my own shoes without getting winded. #obsm |
| Bruce Y. Lee @bruce_y_lee @obsmchat #obsm Studies have shown that quality post-surgical care makes a big difference https://t.co/AjDT8FAimC |
| Arghavan Salles, MD, PhD @arghavan_salles @JEChilderhose @DrAaronBolduc @obsmchat @asmbs It's true not all patients have had their gallbladder out, but it's such a common procedure many people know someone who has had it done, I think. What do you think might be a better comparison? #obsm |
| Crystal Johnson-Mann, MD, MPH, FACS, FASMBS @CJMannMD RT @arghavan_salles: Q1: Q1: As @NeilFlochMD wrote in the blog, the Swedish Obesity Study has shown that those who have obesity and do not have bariatric surgery are likely to die sooner than those who have bariatric surgery. #obsm |
| John Rodriguez @johnrodriguezMD @JEChilderhose @NeilFlochMD @JEChilderhose I agree that there is still a gap between surgeons and clinicians regarding risks and benefits of #bariatric surgery. We need to do more... #obsm |
| Neil Floch MD @NeilFlochMD @JEChilderhose We do educate and try to as much as possible my partners and I give 9 live seminars a month #obsm |
| #obsm chat @obsmchat RT @jdscottmd: As a society, benefits far outweigh the risk, but always tailor the conversation to the individual patient. #obsm |
| Deborah Greenhouse @greenhousemd @obsmchat The education for pediatricians is starting to get out there. Definitely more presentations at @AmerAcadPeds meetings in the past year or two. @SC_AAP would be a case in point. Live and phone presentations. But still more needed. #obsm |
| #obsm chat @obsmchat @bonuslife Glad you made it Walt! #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @bruce_y_lee @obsmchat The training for bariatric surgeons is pretty rigorous, and to get certified by @asmbs is a reasonably high bar. The health of the patient is probably the best overall predictor of risk of complications, including tobacco, steroids, NSAIDs, etc. #obsm |
 | Hippocrates News @HippocratesNews RT @NeilFlochMD: The risk lies in NOT having surgery as the long term risks of #cancer are much higher if patients don’t lose weight #obsm |
| GeekyGrouch @grouchy_geek @arghavan_salles @JEChilderhose @DrAaronBolduc @obsmchat @asmbs Appendectomy? #obsm |
| #obsm chat @obsmchat RT @bruce_y_lee: @obsmchat #obsm Studies have shown that quality post-surgical care makes a big difference https://t.co/AjDT8FAimC |
 | walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife RT @Eggface: Join the conversation #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @JEChilderhose @NeilFlochMD I don't know about everyone else, but in our practice we go give talks to different practices. Usually safety data are part of the talk. #obsm |
| Neil Floch MD @NeilFlochMD RT @arghavan_salles: @bruce_y_lee @obsmchat The training for bariatric surgeons is pretty rigorous, and to get certified by @asmbs is a reasonably high bar. The health of the patient is probably the best overall predictor of risk of complications, including tobacco, steroids, NSAIDs, etc. #obsm |
| Dr. Aaron Bolduc @DrAaronBolduc @obsmchat #obsm Q2: short and long term complications. Short term: Leak, Blood clot/DVT/PE, heart attack, awesome origin story,having too many extra medications that you don’t need anymore #wls Long term: internal hernias, marginal ulcers, gatrogastric fistula, super hero powers |
| Crystal Johnson-Mann, MD, MPH, FACS, FASMBS @CJMannMD RT @arghavan_salles: @bruce_y_lee @obsmchat The training for bariatric surgeons is pretty rigorous, and to get certified by @asmbs is a reasonably high bar. The health of the patient is probably the best overall predictor of risk of complications, including tobacco, steroids, NSAIDs, etc. #obsm |
| Dr. Kasey Goodpaster @DrGoodpaster @arghavan_salles Same here, though I always say that it’s about not just about whether bariatric surgery is the right choice, but also if it’s the right time. #obsm |
| #obsm chat @obsmchat RT @johnrodriguezMD: @JEChilderhose @NeilFlochMD @JEChilderhose I agree that there is still a gap between surgeons and clinicians regarding risks and benefits of #bariatric surgery. We need to do more... #obsm |
| Lab is my happy place @profbdcohen A2: In terms of long term complications my wife has struggled with anemia caused by malabsorption. Some of the more avoidable ones like dumping or alcohol sensitivity have to be experienced to really understand. #obsm |
| Michelle Vicari @Eggface @JEChilderhose @NeilFlochMD Yes! or to refer patients to those that are specialists in #obesity medicine because patients suffer when they are told "you really need to lose weight" and sent on their way, I "dieted" most of my adult life. #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @CJMannMD So I think this is a challenge to public / PCP endorsement. Do #surgeons need to put more time & energy into translation and communication of risk? Do we have any #risk scientists in the house? #obsm |
| #obsm chat @obsmchat RT @greenhousemd: @obsmchat The education for pediatricians is starting to get out there. Definitely more presentations at @AmerAcadPeds meetings in the past year or two. @SC_AAP would be a case in point. Live and phone presentations. But still more needed. #obsm |
| Neil Floch MD @NeilFlochMD Q2: The risks of #gastricsleeve #vsg are the following: #obsm https://t.co/5hI0diQWXT |
| Ian Patton, PHD @IanPatton55 @obsmchat Need to consider complications for the patient beyond basic medical issues, mental health comes to mind, how are you gonna manage the total mind mess that comes with being suddenly thin after a life of seeing something different in the mirror #obsm |
| #obsm chat @obsmchat RT @arghavan_salles: @bruce_y_lee @obsmchat The training for bariatric surgeons is pretty rigorous, and to get certified by @asmbs is a reasonably high bar. The health of the patient is probably the best overall predictor of risk of complications, including tobacco, steroids, NSAIDs, etc. #obsm |
| Michelle Vicari @Eggface RT @bruce_y_lee: @obsmchat #obsm Studies have shown that quality post-surgical care makes a big difference https://t.co/AjDT8FAimC |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife RT @ghs_surgery: A1: great question. In a nutshell: A1: great question. In a nutshell: No #obsm |
| Neil Floch MD @NeilFlochMD These are the risks of #gastricsleeve #obsm |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife RT @LoggheMD: 👇🏻 #obsm chat, happening now 👍🏻 #BariatricSurgery #SurgTweeting #PatientExperience |
| Arghavan Salles, MD, PhD @arghavan_salles @IanPatton55 @NeilFlochMD I see your point, but if we had that same attitude about heart disease we wouldn't be treating enough people. It would be awesome if there were a pill that could do what bariatric surgery does. But until then, we should probably be doing more surgery. #obsm |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife RT @reneehilton30: The benefits far outweigh the risk. #BariatricSurgery is very safe in the hands of an experienced surgeon. The risks of not receiving surgery is far higher as demonstrated by the Christou study where those who did not receive surgery were almost 9 times more likely to die. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @jdscottmd: A2: A2: I like to use some of the risk assessment apps available online like the MBSC risk calculator and the Cleveland clinic tools. #obsm |
| Eyad Wohaibi, MD, FACS, FASMBS. @WohaibiMD RT @NeilFlochMD: Q2: The risks of #gastricsleeve #vsg are the following: Q2: The risks of #gastricsleeve #vsg are the following: #obsm https://t.co/5hI0diQWXT |
| #obsm chat @obsmchat #obsm https://t.co/K3TEngvQkA |
| Lab is my happy place @profbdcohen @ZHeatherChamp @DrAaronBolduc @obsmchat I certainly feel like a superhero compared to how I felt before surgery! #obsm |
| Ian Patton, PHD @IanPatton55 @arghavan_salles @NeilFlochMD Agree 100%, hope you don’t think I was suggesting otherwise. #obsm |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife RT @DrAaronBolduc: @obsmchat The short term risks of surgery are lower than having your gallbladder removed! That is thanks to the focus on quality improvements from @asmbs for our field. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @bruce_y_lee: @obsmchat #obsm Studies have shown that quality post-surgical care makes a big difference https://t.co/AjDT8FAimC |
| Neil Floch MD @NeilFlochMD @arghavan_salles @IanPatton55 I do not understand the resistance to #bariatricsurgery beyond fear of complications #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @bonuslife Hi!!!! :) #obsm |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife RT @Eggface: For those considering #bariatricsurgery a great @ObesityAction resource that looks at the options and pros and cons https://t.co/xKiWW6Z888 #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @johnrodriguezMD @JEChilderhose @NeilFlochMD What do you think is the best way to disseminate what we know to PCPs? #obsm |
| #obsm chat @obsmchat Something healthcare pros and patients alike need to consider. There's "above-the-neck" work involved with dramatic weight loss. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @ZHeatherChamp Did it go away with time? Or did you have to have something done? #obsm |
| Neil Floch MD @NeilFlochMD These are great points and I believe the mental aspect plays a big part. #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @NeilFlochMD If I was a patient and saw this list, I would say, "No way, Jose." I would want to see relative risk (compared to other procedures) and benefits (compared to not treating obesity). Also, being a #qualitative researcher, I want to hear stories (voices) of others like me. #obsm |
| GeekyGrouch @grouchy_geek @bruce_y_lee @obsmchat Also how much the patient puts into it. My lifestyle changed so much before and after surgery. I figured if I was going to have the surgery I had to make those changes to obtain the full effect. Proudly down 220 lbs and celebrated my 3rd surgiversary in Nov. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @hrdlckwmn @DrAaronBolduc @obsmchat I am also curious about these superhero powers... #obsm |
| #obsm chat @obsmchat @DrGoodpaster @arghavan_salles Any tips for helping patients decide when it's the right time? #obsm |
| Bruce Y. Lee @bruce_y_lee @obsmchat #obsm Medicine is not an assembly line. All surgeons, other doctors, nurses, psychologists, therapists, etc. are not equivalent robots. General % of complications data do not reflect the differences in health professionals & settings. |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @txkyleharris @arghavan_salles @DrAaronBolduc @obsmchat @asmbs Appendectomy: almost everyone can relate. Everyone knows someone. Can we find numbers? #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @obsmchat @DrGoodpaster I think the time is often before they have the referral for bariatric surgery. For the most part both patients and doctors think of surgery later rather than sooner. #obsm |
| Dr. Kasey Goodpaster @DrGoodpaster A2.The downsides of surgery (e.g., nausea,fatigue,pain) often outweigh the benefits in the ~1st month,so it’s common to have “buyer’s remorse” initially. We help patients remember these experiences are temporary & keep in mind the powerful reasons they underwent surgery. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @profbdcohen Is she needing iron infusions or is she able to manage with iron pills? #obsm |
| Lab is my happy place @profbdcohen @NeilFlochMD @arghavan_salles @IanPatton55 There are a lot of lifestyle changes that come with #bariatricsurgery that are very scary, especially without the right information. I thought I would have to give up my favorite foods and my social life. I also didn't know who I was if I wasn't the "funny, fat guy". #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @Eggface: @JEChilderhose @NeilFlochMD Yes! or to refer patients to those that are specialists in #obesity medicine because patients suffer when they are told "you really need to lose weight" and sent on their way, I "dieted" most of my adult life. #obsm |
| Neil Floch MD @NeilFlochMD Question 2: What are the complications of #bariatricsurgery ? How can we help patients who experience complications? #obsm |
| Deborah Greenhouse @greenhousemd I would love to see an infographic of complications vs benefits of #bariatricsurgery for adolescents that I could use in my practice for the discussion prior to referral. #obsm |
| Bruce Y. Lee @bruce_y_lee @obsmchat #obsm one of the most important qualities of a surgeon is knowing when & when not to operate |
| Arghavan Salles, MD, PhD @arghavan_salles @IanPatton55 @obsmchat This is a great point. I would love for insurance to cover psychology visits AFTER surgery for this reason. #obsm |
| Neil Floch MD @NeilFlochMD RT @Eggface: @JEChilderhose @NeilFlochMD Yes! or to refer patients to those that are specialists in #obesity medicine because patients suffer when they are told "you really need to lose weight" and sent on their way, I "dieted" most of my adult life. #obsm |
| hrdlckwmn @hrdlckwmn Question3:: mine have been “rewiring” my mind, learning external things can’t “fix” internal feelings or situations beyond my control. I am learning what I can change & what I can’t. Yet, my inner “hero” still battles to change things for the better for others. #obsm |
| #obsm chat @obsmchat RT @profbdcohen: @NeilFlochMD @arghavan_salles @IanPatton55 There are a lot of lifestyle changes that come with #bariatricsurgery that are very scary, especially without the right information. I thought I would have to give up my favorite foods and my social life. I also didn't know who I was if I wasn't the "funny, fat guy". #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @johnrodriguezMD @NeilFlochMD Yes. I am writing about this now. I don't know if this is b/c of the culture of surgery, or b/c PCPs don't read surgery journals, or b/c behavioral interventions trump surgical interventions. Or b/c surgeons don't take their evidence out of journals. What do you think? #obsm |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife RT @Eggface: @JEChilderhose @NeilFlochMD Yes! or to refer patients to those that are specialists in #obesity medicine because patients suffer when they are told "you really need to lose weight" and sent on their way, I "dieted" most of my adult life. #obsm |
| Lab is my happy place @profbdcohen @arghavan_salles She gets infusions but since we discovered the patches she has not needed them as frequently. Unfortunately the infusions do a real number on her. I have very mild anemia that I have been able to manage with pills (added to my bariatric multivitamin). #obsm |
| Michelle Vicari @Eggface @obsmchat Post #BariatricSurgery anemia has been an issue for me despite faithful iron supplementation and eating an iron-rich diet. Something to be aware of... vitamins and labs post #BariatricSurgery are non-negotiables. #obsm |
| #obsm chat @obsmchat RT @hrdlckwmn: Question3:: Question3:: mine have been “rewiring” my mind, learning external things can’t “fix” internal feelings or situations beyond my control. I am learning what I can change & what I can’t. Yet, my inner “hero” still battles to change things for the better for others. #obsm |
| Crystal Johnson-Mann, MD, MPH, FACS, FASMBS @CJMannMD A3 - depression is common and requires some level of screening at each follow-up visit #obsm |
| Dr. Kasey Goodpaster @DrGoodpaster @arghavan_salles @obsmchat The right time is when all the risks (including psychiatric risks) are mitigated, patients feel they they have exhausted non-surgical lifestyle interventions, and motivation to make change is high. #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @NeilFlochMD Can you say a bit more about your audiences? #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @ZHeatherChamp Why not share? I think more people sharing this openly might decrease the stigma around bariatric surgery. Curious to hear your thoughts. #obsm |
| Ian Patton, PHD @IanPatton55 @obsmchat Relationships change, people around you change, people treat you differently, sometimes for the better but not always, the psychological part is the hardest. #obsm |
| Neil Floch MD @NeilFlochMD Q2: The complications of #gastricbypass are listed here: #obsm https://t.co/53hpKPVkhx |
| Arghavan Salles, MD, PhD @arghavan_salles @txkyleharris @bruce_y_lee @obsmchat Congratulation! #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @txkyleharris: @bruce_y_lee @obsmchat Also how much the patient puts into it. My lifestyle changed so much before and after surgery. I figured if I was going to have the surgery I had to make those changes to obtain the full effect. Proudly down 220 lbs and celebrated my 3rd surgiversary in Nov. #obsm |
| Neil Floch MD @NeilFlochMD Q2: The risks of #LapBand or #gastricband are the following: #obsm https://t.co/i9aenEOtqx |
| GeekyGrouch @grouchy_geek @arghavan_salles @hrdlckwmn @DrAaronBolduc @obsmchat My superhero power is enhanced sense of smell. It’s not a great superpower but I didn’t have it before WLS. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @ZHeatherChamp Ha! Whatever works :). #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @arghavan_salles @NeilFlochMD To family physicians? Pediatricians? Do they ask you to come, or do you propose? #obsm #education |
| Arghavan Salles, MD, PhD @arghavan_salles @bruce_y_lee @obsmchat 100% true #obsm |
| Neil Floch MD @NeilFlochMD RT @IanPatton55: @obsmchat Relationships change, people around you change, people treat you differently, sometimes for the better but not always, the psychological part is the hardest. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @JEChilderhose @txkyleharris @DrAaronBolduc @obsmchat @asmbs Interesting that you guys think that is more common than gallbladder surgery. I don't actually know those numbers, but in my personal practice I do many more gallbladder surgeries. #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @bonuslife @NeilFlochMD Nausea, and pain. What do you mean by "your three and four calibration for people who have fallen off track?" #obsm |
 | Abdelrahman Ali Nimeri MD @Nimeri_MD RT @arghavan_salles: @bruce_y_lee @obsmchat The training for bariatric surgeons is pretty rigorous, and to get certified by @asmbs is a reasonably high bar. The health of the patient is probably the best overall predictor of risk of complications, including tobacco, steroids, NSAIDs, etc. #obsm |
| #obsm chat @obsmchat RT @bruce_y_lee: @obsmchat #obsm one of the most important qualities of a surgeon is knowing when & when not to operate |
| Dr. Aaron Bolduc @DrAaronBolduc @IanPatton55 @obsmchat I’ve seen relationships end too. It is life changing. #obsm |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife @bruce_y_lee @obsmchat Most of the time it is wait to operate rather than “no operation” #obsm |
| Neil Floch MD @NeilFlochMD RT @arghavan_salles: @ZHeatherChamp Why not share? I think more people sharing this openly might decrease the stigma around bariatric surgery. Curious to hear your thoughts. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @DrGoodpaster Great point! The first month or two can be rough. But usually things get better after that. #obsm |
| Neil Floch MD @NeilFlochMD RT @DrGoodpaster: @arghavan_salles @obsmchat The right time is when all the risks (including psychiatric risks) are mitigated, patients feel they they have exhausted non-surgical lifestyle interventions, and motivation to make change is high. #obsm |
| Neil Floch MD @NeilFlochMD RT @Eggface: @obsmchat Post #BariatricSurgery anemia has been an issue for me despite faithful iron supplementation and eating an iron-rich diet. Something to be aware of... vitamins and labs post #BariatricSurgery are non-negotiables. #obsm |
| Neil Floch MD @NeilFlochMD RT @profbdcohen: @arghavan_salles She gets infusions but since we discovered the patches she has not needed them as frequently. Unfortunately the infusions do a real number on her. I have very mild anemia that I have been able to manage with pills (added to my bariatric multivitamin). #obsm |
| Neil Floch MD @NeilFlochMD RT @JEChilderhose: @johnrodriguezMD @NeilFlochMD Yes. I am writing about this now. I don't know if this is b/c of the culture of surgery, or b/c PCPs don't read surgery journals, or b/c behavioral interventions trump surgical interventions. Or b/c surgeons don't take their evidence out of journals. What do you think? #obsm |
| Eyad Wohaibi, MD, FACS, FASMBS. @WohaibiMD RT @NeilFlochMD: Q2: The complications of #gastricbypass are listed here: Q2: The complications of #gastricbypass are listed here: #obsm https://t.co/53hpKPVkhx |
| Dr. Aaron Bolduc @DrAaronBolduc @txkyleharris @arghavan_salles @hrdlckwmn @obsmchat #truth #obsm https://t.co/RdO34KOHUZ |
| Bruce Y. Lee @bruce_y_lee @arghavan_salles @johnrodriguezMD @JEChilderhose @NeilFlochMD #obsm Too many middle people (e.g., non-clinicians like administrators, etc.) getting in the way of conversations that should be had between surgeons, other doctors, other health professionals, & patients. |
| #obsm chat @obsmchat #obsm https://t.co/qkkckimVpy |
| GeekyGrouch @grouchy_geek @profbdcohen @NeilFlochMD @arghavan_salles @IanPatton55 I gave up some favorite foods by choice but I’m still funny as ever. #obsm |
| #obsm chat @obsmchat RT @DrGoodpaster: A2.The downsides of surgery (e.g., nausea,fatigue,pain) often outweigh the benefits in the ~1st month,so it’s common to have “buyer’s remorse” initially. We help patients remember these experiences are temporary & keep in mind the powerful reasons they underwent surgery. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @greenhousemd I wonder if @MarcMichalskyMD has one? #obsm |
| Ian Patton, PHD @IanPatton55 @profbdcohen @NeilFlochMD @arghavan_salles See, for me, I still see the fat guy in the mirror, he never left even though the weight did. He stuck around with all his head issues, took a long while to figure it out, #obsm |
 | M Shafi Kuchay @drshafikuchay RT @NeilFlochMD: Q1: Q1: The SOS study shows us that the risk of NOT having #bariatricsurgery and #dieting is that at 15 years people are 33% more likely to die - Sjostrom 2007 @NEJM - #obsm https://t.co/1PgRdoai38 |
| Neil Floch MD @NeilFlochMD We need medical doctors and surgeons speaking together in the same room and or the same twitter hashtags but talk they must - Yoda (#obsm) |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @bonuslife @johnrodriguezMD @NeilFlochMD I'm not following. Who thinks it is whose head? #obsm |
| Deborah Greenhouse @greenhousemd @JEChilderhose @arghavan_salles @NeilFlochMD Many pediatricians wouldn't know enough to ask for the presentation because they still wouldn't know that #bariatricsurgery is an option for their patients. #obsm |
| Neil Floch MD @NeilFlochMD RT @obsmchat: #obsm https://t.co/qkkckimVpy |
 | Dr. Miguel Ruiz @DrMikeRuiz RT @NeilFlochMD: These are the risks of #gastricsleeve #obsm |
| Neil Floch MD @NeilFlochMD RT @IanPatton55: @profbdcohen @NeilFlochMD @arghavan_salles See, for me, I still see the fat guy in the mirror, he never left even though the weight did. He stuck around with all his head issues, took a long while to figure it out, #obsm |
| #obsm chat @obsmchat RT @bruce_y_lee: @arghavan_salles @johnrodriguezMD @JEChilderhose @NeilFlochMD #obsm Too many middle people (e.g., non-clinicians like administrators, etc.) getting in the way of conversations that should be had between surgeons, other doctors, other health professionals, & patients. |
| Arghavan Salles, MD, PhD @arghavan_salles @profbdcohen I'm sorry to hear that. Glad that the patches have helped, though. #obsm |
| hrdlckwmn @hrdlckwmn RT @bruce_y_lee: @arghavan_salles @johnrodriguezMD @JEChilderhose @NeilFlochMD #obsm Too many middle people (e.g., non-clinicians like administrators, etc.) getting in the way of conversations that should be had between surgeons, other doctors, other health professionals, & patients. |
| Neil Floch MD @NeilFlochMD That’s great. #obsm |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife @JEChilderhose @NeilFlochMD #obsm follow up is highly variable. And hunger comes back a bit at postop year one. By post op year three and four if people are not exercising and food logging, chaos ensues and then a self blame and shame follow (regain also) |
| Neil Floch MD @NeilFlochMD RT @DrAaronBolduc: @txkyleharris @arghavan_salles @hrdlckwmn @obsmchat #truth #obsm https://t.co/RdO34KOHUZ |
| Arghavan Salles, MD, PhD @arghavan_salles @Eggface @obsmchat Yes, and a study recently showed that those who followed up with their surgeon were less likely to have anemia than those who did not. #obsm |
| Lab is my happy place @profbdcohen @IanPatton55 @NeilFlochMD @arghavan_salles I was just writing about that for A3: I find myself struggling with crowded rooms, sitting in a seat in the middle of a row, getting onto an airplane....I know I'm not as big as I used to be but I still get lost in that sometimes. #obsm |
| Neil Floch MD @NeilFlochMD RT @arghavan_salles: @DrGoodpaster Great point! The first month or two can be rough. But usually things get better after that. #obsm |
| Neil Floch MD @NeilFlochMD RT @DrAaronBolduc: @IanPatton55 @obsmchat I’ve seen relationships end too. It is life changing. #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @greenhousemd Do we even have data? This is the kind of question that interests me. But my sample so far has been small: 7 teens in a qualitative study. Not enough for an infographic. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @DrGoodpaster: @arghavan_salles @obsmchat The right time is when all the risks (including psychiatric risks) are mitigated, patients feel they they have exhausted non-surgical lifestyle interventions, and motivation to make change is high. #obsm |
| Michelle Vicari @Eggface @IanPatton55 @obsmchat it forces you to start (or continue) the above the neck work :) #obsm |
| #obsm chat @obsmchat RT @greenhousemd: @JEChilderhose @arghavan_salles @NeilFlochMD Many pediatricians wouldn't know enough to ask for the presentation because they still wouldn't know that #bariatricsurgery is an option for their patients. #obsm |
| Renee Hilton, M.D. @reneehilton30 RT @NeilFlochMD: We need medical doctors and surgeons speaking together in the same room and or the same twitter hashtags but talk they must - Yoda (#obsm) |
| Deborah Greenhouse @greenhousemd @NeilFlochMD And there's the rub. Very few conferences have primary docs and surgeons speaking together in the same room or using the same hashtags. That's where the conversation has to start. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles Q3: There is a higher incidence of both divorce and marriage after bariatric surgery. #obsm |
| Dr. Aaron Bolduc @DrAaronBolduc @obsmchat Q4: new techniques? YES! Technology is continuing to advance and surgeons are trying new techniques. A lot has changed on 20 years. Just think about how your cellphone has changed! Not playing snake on my Nokia- I’m having an excellent discussion about #wls #obsm |
| GeekyGrouch @grouchy_geek @arghavan_salles @ZHeatherChamp I share with everyone. If it helps just one person, job done. #obsm |
| Lab is my happy place @profbdcohen @bonuslife @JEChilderhose @NeilFlochMD The struggle is real. I'm >5 years out and I have not been able to exercise because of an injury. Even the slightest weight regain triggers the feelings you describe. #obsm |
| Neil Floch MD @NeilFlochMD Although I believe in new techniques and some new procedures may have improved benefits, the #bariatricsurgery we have is safe and effective- we must educate patients and physicians as we continue to improve techniques #obsm |
| Neil Floch MD @NeilFlochMD RT @JEChilderhose: @arghavan_salles @NeilFlochMD To family physicians? Pediatricians? Do they ask you to come, or do you propose? #obsm #education |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @NeilFlochMD @DrMikeRuiz I also think we need to have patient perspectives on risks. These may be clinical or lifestyle. Relationship, managing food, and eating. Or simply categories that clinicians don't imagine. #obsm |
| Ian Patton, PHD @IanPatton55 @Eggface @obsmchat It was eye opening, a whole lot of acceptance and self love goes a long way, talking about it with friends and like minded folks helps #obsm |
| Crystal Johnson-Mann, MD, MPH, FACS, FASMBS @CJMannMD RT @NeilFlochMD: Although I believe in new techniques and some new procedures may have improved benefits, the #bariatricsurgery we have is safe and effective- we must educate patients and physicians as we continue to improve techniques #obsm |
| Deborah Greenhouse @greenhousemd @JEChilderhose Great question. Any answers out there tonight? #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @PitchfordMd @NeilFlochMD In adults? Teens? Or both? #obsm |
| GeekyGrouch @grouchy_geek @DrAaronBolduc @obsmchat While also playing snake. #obsm #multitasking |
 | Janine Kyrillos, MD @JanineKyrillos #OBSM Hi gang. Joining in late. Obesity med doc in Philly. Don’t forget increased fertility and pregnancy after surgery also. |
| Arghavan Salles, MD, PhD @arghavan_salles @profbdcohen @IanPatton55 @NeilFlochMD This seems to be pretty common. I often hear that people still see a previous version of themselves in the mirror. #obsm |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife @profbdcohen @JEChilderhose @NeilFlochMD #obsm Exercise definitely is the factor that keeps my stress from becoming toxic |
| #obsm chat @obsmchat Patients need health care professionals to break down these sorts of silos and work together for the benefit of their patients. #obsm |
| Dr. Kasey Goodpaster @DrGoodpaster Some patients experience emotional distress in the context of grieving the loss of food, relationship & body image changes, malabsorption of psych meds and/or the mental energy devoted to adjusting to a whole new lifestyle. ...Just to name a few challenges! #obsm |
 | منيرة بنت عمر بن عبيد @M_BinObaid RT @NeilFlochMD: Although I believe in new techniques and some new procedures may have improved benefits, the #bariatricsurgery we have is safe and effective- we must educate patients and physicians as we continue to improve techniques #obsm |
| #obsm chat @obsmchat RT @DrAaronBolduc: @obsmchat Q4: @obsmchat Q4: new techniques? YES! Technology is continuing to advance and surgeons are trying new techniques. A lot has changed on 20 years. Just think about how your cellphone has changed! Not playing snake on my Nokia- I’m having an excellent discussion about #wls #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose Asking @davearterburn @drtominge @KimSteeleMD #obsm |
| Neil Floch MD @NeilFlochMD That’s shocking #obsm |
| Neil Floch MD @NeilFlochMD RT @greenhousemd: @JEChilderhose @arghavan_salles @NeilFlochMD Many pediatricians wouldn't know enough to ask for the presentation because they still wouldn't know that #bariatricsurgery is an option for their patients. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @greenhousemd @JEChilderhose There are data on complications for adolescents who have bariatric surgery. https://t.co/Tl3k8YLUke #obsm |
| #obsm chat @obsmchat RT @greenhousemd: @JEChilderhose Great question. Any answers out there tonight? #obsm |
| Michelle Vicari @Eggface @IanPatton55 @obsmchat It sure is. #obsm |
 | Ryan Ash @RyanAsh58225737 RT @profbdcohen: @arghavan_salles She gets infusions but since we discovered the patches she has not needed them as frequently. Unfortunately the infusions do a real number on her. I have very mild anemia that I have been able to manage with pills (added to my bariatric multivitamin). #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @greenhousemd @NeilFlochMD Agree. #obsm |
| Ryan Ash @RyanAsh58225737 RT @Eggface: @obsmchat Post #BariatricSurgery anemia has been an issue for me despite faithful iron supplementation and eating an iron-rich diet. Something to be aware of... vitamins and labs post #BariatricSurgery are non-negotiables. #obsm |
| #obsm chat @obsmchat @JanineKyrillos Welcome Janine -- any time you can make it we love having your input! #obsm |
| Ryan Ash @RyanAsh58225737 RT @DrGoodpaster: @arghavan_salles @obsmchat The right time is when all the risks (including psychiatric risks) are mitigated, patients feel they they have exhausted non-surgical lifestyle interventions, and motivation to make change is high. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @txkyleharris @ZHeatherChamp Thank you! #obsm |
| Ryan Ash @RyanAsh58225737 RT @arghavan_salles: @ZHeatherChamp Why not share? I think more people sharing this openly might decrease the stigma around bariatric surgery. Curious to hear your thoughts. #obsm |
| Bruce Y. Lee @bruce_y_lee @arghavan_salles @obsmchat @asmbs #obsm are there any statistics on how many bariatric surgery procedures are performed by those who did not go through such training & are not @asmbs certified? |
| #obsm chat @obsmchat #obsm https://t.co/paTrEBvHOB |
| Arghavan Salles, MD, PhD @arghavan_salles @profbdcohen @bonuslife @JEChilderhose @NeilFlochMD There is so much shame and blame in our culture that it's hard to keep it from being internalized. #obsm |
| #obsm chat @obsmchat RT @arghavan_salles: @greenhousemd @JEChilderhose There are data on complications for adolescents who have bariatric surgery. https://t.co/Tl3k8YLUke #obsm |
 | Moein Surgical Arts @DrBabakMoein RT @AskDr_Rachel: Many people do consider #bariatricsurgery before knee replacement surgery or to decrease pain. Thank you @nyulangone for adding this article to your December issue of News & Views! #wls #obsm #obesity #qol #weightloss @obsmchat @asmbs @ASMBSIH #weight #healthbenefits https://t.co/p7ekREttDT |
| Neil Floch MD @NeilFlochMD We have excellent data from Dr Inge from the Cincinati Childrens Hospital With data on adolescent #bariatricsurgery. #obsm |
| Neil Floch MD @NeilFlochMD RT @JEChilderhose: @greenhousemd Do we even have data? This is the kind of question that interests me. But my sample so far has been small: 7 teens in a qualitative study. Not enough for an infographic. #obsm |
| Neil Floch MD @NeilFlochMD RT @greenhousemd: I would love to see an infographic of complications vs benefits of #bariatricsurgery for adolescents that I could use in my practice for the discussion prior to referral. #obsm |
| Neil Floch MD @NeilFlochMD RT @arghavan_salles: @greenhousemd @JEChilderhose There are data on complications for adolescents who have bariatric surgery. https://t.co/Tl3k8YLUke #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @JanineKyrillos Thanks, @JanineKyrillos! #obsm |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife RT @arghavan_salles: @profbdcohen @bonuslife @JEChilderhose @NeilFlochMD There is so much shame and blame in our culture that it's hard to keep it from being internalized. #obsm |
| #obsm chat @obsmchat Researchers? @asmbs folks? Any thoughts? #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @obsmchat: Patients need health care professionals to break down these sorts of silos and work together for the benefit of their patients. #obsm |
| Neil Floch MD @NeilFlochMD RT @DrGoodpaster: Some patients experience emotional distress in the context of grieving the loss of food, relationship & body image changes, malabsorption of psych meds and/or the mental energy devoted to adjusting to a whole new lifestyle. ...Just to name a few challenges! #obsm |
| Moein Surgical Arts @DrBabakMoein RT @arghavan_salles: @greenhousemd @JEChilderhose There are data on complications for adolescents who have bariatric surgery. https://t.co/Tl3k8YLUke #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @DrGoodpaster: Some patients experience emotional distress in the context of grieving the loss of food, relationship & body image changes, malabsorption of psych meds and/or the mental energy devoted to adjusting to a whole new lifestyle. ...Just to name a few challenges! #obsm |
| Lab is my happy place @profbdcohen A5: Follow up. There is nothing more important (says the guy who knows he needs to check in with the office) because physicians can't help what they don't know about. #obsm |
| GeekyGrouch @grouchy_geek @obsmchat Yes, yes, yes. No more T2D, sleep apnea, or HBP. Not to mention the years added to my life and the ability to actually enjoy my life. #obsm |
| Ryan Ash @RyanAsh58225737 RT @IanPatton55: @obsmchat Relationships change, people around you change, people treat you differently, sometimes for the better but not always, the psychological part is the hardest. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @DrGoodpaster Thank goodness for people like you to help, @DrGoodpaster! #obsm |
| Moein Surgical Arts @DrBabakMoein RT @NeilFlochMD: It’s always an individual decision, that’s why we must help patients to learn the details about the risks and the benefits #obsm |
| GeekyGrouch @grouchy_geek @obsmchat Yes, yes, yes. No more T2D, sleep apnea, or HBP. Not to mention the years added to my life and the ability to actually enjoy my life. #obsm |
| #obsm chat @obsmchat RT @profbdcohen: A5: A5: Follow up. There is nothing more important (says the guy who knows he needs to check in with the office) because physicians can't help what they don't know about. #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @NeilFlochMD Okay. I'm definitely submitting this commentary on the evidence gap to unnamed #surgery journal, possibly in the top 5. Yes, this is real. There is a remarkable lack of awareness amongst pediatricians that teens are eligible for BS & can benefit from it. #obsm |
| Ian Patton, PHD @IanPatton55 @arghavan_salles @profbdcohen @NeilFlochMD Yes, something many of my peers discuss. Just wish I had known to expect it or that it was normal and how to address it, I am glad I am mindful of it but I feel like I wasted a lot of time struggling in silence with it #obsm |
| Deborah Greenhouse @greenhousemd @arghavan_salles @JEChilderhose Thank you! Great article. #obsm |
| Neil Floch MD @NeilFlochMD Q4: A Gastro-gastricfistula can be closed with endoscopic techniques #obsm This is a great technique with minimal risk - same day https://t.co/GOpoiFtE3N |
| Dr. Kasey Goodpaster @DrGoodpaster @arghavan_salles Thank you! I’m so impressed with our patients’ strength and resilence. It’s an honor to be along for the ride. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @bruce_y_lee @obsmchat @asmbs Great question! I have not looked into it. @NeilFlochMD do you know? #obsm |
| Michelle Vicari @Eggface Some Post- #BariatricSurgery Money Saving Tips: https://t.co/APEo1iXqH6 including vitamin assistance programs, free resources, etc. #obsm |
| Bruce Y. Lee @bruce_y_lee @obsmchat #obsm Silos are a major problem in medicine. The health care system & professional societies just don't encourage mixing and conversations among disciplines/specialties |
| Neil Floch MD @NeilFlochMD We are here Because we want to help #obsm |
| Neil Floch MD @NeilFlochMD RT @profbdcohen: @IanPatton55 @NeilFlochMD @arghavan_salles I was just writing about that for A3: @IanPatton55 @NeilFlochMD @arghavan_salles I was just writing about that for A3: I find myself struggling with crowded rooms, sitting in a seat in the middle of a row, getting onto an airplane....I know I'm not as big as I used to be but I still get lost in that sometimes. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @profbdcohen Yes, thank you for this! The time to see your surgeon is when you're struggling--otherwise, we can't help. #obsm |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife RT @Eggface: Some Post- #BariatricSurgery Money Saving Tips: Some Post- #BariatricSurgery Money Saving Tips: https://t.co/APEo1iXqH6 including vitamin assistance programs, free resources, etc. #obsm |
| Neil Floch MD @NeilFlochMD RT @IanPatton55: @NeilFlochMD True, evidence suggests that, however it’s not a scaleable treatment, there will never be enough surgeries done to make a dent in the obesity problem, hopefully one day there are other options as well #obsm |
| Ian Patton, PHD @IanPatton55 @obsmchat Talk! Be open, know what complications medical and psychological are and know that it is safe and appropriate to speak up and ask early, many complications are made worse by waiting to long #obsm |
| Neil Floch MD @NeilFlochMD RT @bruce_y_lee: @obsmchat #obsm Silos are a major problem in medicine. The health care system & professional societies just don't encourage mixing and conversations among disciplines/specialties |
| Arghavan Salles, MD, PhD @arghavan_salles @IanPatton55 @profbdcohen @NeilFlochMD Great point. I certainly can start discussing this preemptively with my patients. #obsm |
| Neil Floch MD @NeilFlochMD RT @Eggface: Some Post- #BariatricSurgery Money Saving Tips: Some Post- #BariatricSurgery Money Saving Tips: https://t.co/APEo1iXqH6 including vitamin assistance programs, free resources, etc. #obsm |
| #obsm chat @obsmchat RT @bruce_y_lee: @obsmchat #obsm Silos are a major problem in medicine. The health care system & professional societies just don't encourage mixing and conversations among disciplines/specialties |
| Arghavan Salles, MD, PhD @arghavan_salles @greenhousemd @JEChilderhose There are more--just the easiest one to find :). #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @DrGoodpaster Agree--we work with some of the strongest, most dedicated patients around. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @Eggface: Some Post- #BariatricSurgery Money Saving Tips: Some Post- #BariatricSurgery Money Saving Tips: https://t.co/APEo1iXqH6 including vitamin assistance programs, free resources, etc. #obsm |
| Dr. Aaron Bolduc @DrAaronBolduc @obsmchat #obsm |
| Neil Floch MD @NeilFlochMD Question 5 - What can Patients and their Physicians do to limit #bariatricsurgery complications? #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @PitchfordMd @bonuslife I do not dissect the crura unless there is a hernia. #obsm |
| Neil Floch MD @NeilFlochMD RT @arghavan_salles: @profbdcohen Yes, thank you for this! The time to see your surgeon is when you're struggling--otherwise, we can't help. #obsm |
| Bruce Y. Lee @bruce_y_lee @obsmchat #obsm Develop a rapport with each other so that patients feel comfortable sharing all details about their progress, even seemingly "little" issues |
| Arghavan Salles, MD, PhD @arghavan_salles @bruce_y_lee @obsmchat and certainly no one facilitates them... #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @IanPatton55: @obsmchat Talk! Be open, know what complications medical and psychological are and know that it is safe and appropriate to speak up and ask early, many complications are made worse by waiting to long #obsm |
| #obsm chat @obsmchat RT @bruce_y_lee: @obsmchat #obsm Develop a rapport with each other so that patients feel comfortable sharing all details about their progress, even seemingly "little" issues |
| Neil Floch MD @NeilFlochMD Q5: Don’t eat off the prescribed menu as getting food stuck can lead to vomiting and obstruction after #bariatricsurgery #obsm |
 | ℳartha 🪷 @DraDominguez_ RT @NeilFlochMD: Q4: Q4: A Gastro-gastricfistula can be closed with endoscopic techniques #obsm This is a great technique with minimal risk - same day https://t.co/GOpoiFtE3N |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife @arghavan_salles @PitchfordMd Agree #obsm - but late GERD usually has a hernia anyhow! |
| Crystal Johnson-Mann, MD, MPH, FACS, FASMBS @CJMannMD A5 - Patients: don't be afraid to ask questions, especially right before surgery and anytime in the postoperative period. Physicians: track outcomes, collaborate w/ colleagues, never stop learning. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @DrAaronBolduc @obsmchat Yes! Communication is hugely important, particularly early on after surgery. Of course we also try to use standard techniques and provide adequate educational materials for patients. #obsm |
| #obsm chat @obsmchat RT @NeilFlochMD: Q4: Q4: A Gastro-gastricfistula can be closed with endoscopic techniques #obsm This is a great technique with minimal risk - same day https://t.co/GOpoiFtE3N |
| Neil Floch MD @NeilFlochMD Do patients have difficulty following the menu? #obsm |
| Bruce Y. Lee @bruce_y_lee @obsmchat #obsm Oh, and to emphasize this again. This cannot be done in just 15 minute appointments. This limit is one of the biggest things preventing appropriate relationships & discussions btw doctors & patients and makes no sense: https://t.co/CHGxjzCW0K |
| Michelle Vicari @Eggface @obsmchat Some wonderful resources on the internet @ObesityAction @asmbs etc. but also some scary ones... be sure you are getting your info from trusted sources and ultimately talking with YOUR doctor who will be basing his advice on you and your health #obsm |
| Ian Patton, PHD @IanPatton55 @KimFraser62 @arghavan_salles @profbdcohen @NeilFlochMD What’s worse is when they keep saying that and you have been struggling with a bit of regain and you mind is running overtime trying to get it back on track #obsm |
| #obsm chat @obsmchat Closing thoughts on pros and cons of #BariatricSurgery? #obsm |
| Neil Floch MD @NeilFlochMD Q5: Patients must ambulated as staying still helps to promote blood clots in the legs that can gontonthe lungs after #bariatricsurgery #obsm |
| Neil Floch MD @NeilFlochMD Q5: Patients need to stay well hydrated after surgery- drinking 32 to 64 ounces of fluids at least. After #bariatricsurgery #vsg #gastricbypass #obsm |
| #obsm chat @obsmchat RT @NeilFlochMD: Although I believe in new techniques and some new procedures may have improved benefits, the #bariatricsurgery we have is safe and effective- we must educate patients and physicians as we continue to improve techniques #obsm |
| Lab is my happy place @profbdcohen @NeilFlochMD In my experience, not initially but at some point I got a little too comfortable and my pouch had to remind me who was actually in charge. :) #obsm |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife I always tell patients that our best reason we have that lower risk and gallbladder surgery is smoking cessation and optimizing/stabilizing blood pressure and diabetes - We don’t get that chance in the urgent situation with gallbladder #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @Eggface: @obsmchat Some wonderful resources on the internet @ObesityAction @asmbs etc. but also some scary ones... be sure you are getting your info from trusted sources and ultimately talking with YOUR doctor who will be basing his advice on you and your health #obsm |
| #obsm chat @obsmchat RT @CJMannMD: A5 - Patients: A5 - Patients: don't be afraid to ask questions, especially right before surgery and anytime in the postoperative period. Physicians: track outcomes, collaborate w/ colleagues, never stop learning. #obsm |
| GeekyGrouch @grouchy_geek And while I have the opportunity, can we have a chat or something similar with a registered dietician and maybe a chef. Food substitution, good carbs vs bad carbs, etc. @eggface has a great blog for Bariatric friendly recipes but I would like to see more on health cooking #obsm |
| Deborah Greenhouse @greenhousemd @NeilFlochMD The general pediatric view is that surgery should typically be the last option, if it is an option at all, after everything else has failed over a long period of time. That philosophy doesn't necessarily hold up for obesity. That's where the education needs to come in. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @bruce_y_lee: @obsmchat #obsm Oh, and to emphasize this again. This cannot be done in just 15 minute appointments. This limit is one of the biggest things preventing appropriate relationships & discussions btw doctors & patients and makes no sense: https://t.co/CHGxjzCW0K |
| #obsm chat @obsmchat RT @Eggface: @obsmchat Some wonderful resources on the internet @ObesityAction @asmbs etc. but also some scary ones... be sure you are getting your info from trusted sources and ultimately talking with YOUR doctor who will be basing his advice on you and your health #obsm |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife @IanPatton55 @KimFraser62 @arghavan_salles @profbdcohen @NeilFlochMD #obsm - And trying to do it abruptly with Boot Camp mentality is the worst way |
| #obsm chat @obsmchat RT @bruce_y_lee: @obsmchat #obsm Oh, and to emphasize this again. This cannot be done in just 15 minute appointments. This limit is one of the biggest things preventing appropriate relationships & discussions btw doctors & patients and makes no sense: https://t.co/CHGxjzCW0K |
 | Prakay Cc @CcPrakay RT @NeilFlochMD: Q5: Q5: Patients need to stay well hydrated after surgery- drinking 32 to 64 ounces of fluids at least. After #bariatricsurgery #vsg #gastricbypass #obsm |
| Bruce Y. Lee @bruce_y_lee @arghavan_salles @obsmchat #obsm another reason why medicine & health care systems need more innovative & diverse leadership who are willing to shake things up |
| Dr. Kasey Goodpaster @DrGoodpaster Follow up per the protocol or more often as needed, whether you’re struggling (& the team will help) or you’re doing well (you may still hear important refreshers, & maintaining connection to the program increases willingness to reach out if problems arise later). #obsm |
| Dr. Aaron Bolduc @DrAaronBolduc @obsmchat I have never performed a surgery that has positively impacted a patient as much as #bariatricsurgery! Life changing. #obsm #wls @AUG_Health @reneehilton30 @arghavan_salles @rachelmooremd @NeilFlochMD |
| Neil Floch MD @NeilFlochMD I bring my patients in frequently and when they start to regain a little we place them on weight loss medications such as #Phenteramine #Contrave #Belviq #qysmia or #Topamax - #Saxenda is best -#obsm along with nutrition and counseling- #obsm |
| Neil Floch MD @NeilFlochMD RT @bruce_y_lee: @obsmchat #obsm Oh, and to emphasize this again. This cannot be done in just 15 minute appointments. This limit is one of the biggest things preventing appropriate relationships & discussions btw doctors & patients and makes no sense: https://t.co/CHGxjzCW0K |
| Arghavan Salles, MD, PhD @arghavan_salles The most important take-home message, I think, is that there is risk with any surgery. Bariatric surgery can seem scary, but outcomes are quite good. The decision to proceed or not should be made between the patient and the surgeon. #obsm |
| Neil Floch MD @NeilFlochMD RT @IanPatton55: @KimFraser62 @arghavan_salles @profbdcohen @NeilFlochMD What’s worse is when they keep saying that and you have been struggling with a bit of regain and you mind is running overtime trying to get it back on track #obsm |
| Neil Floch MD @NeilFlochMD RT @Eggface: @obsmchat Some wonderful resources on the internet @ObesityAction @asmbs etc. but also some scary ones... be sure you are getting your info from trusted sources and ultimately talking with YOUR doctor who will be basing his advice on you and your health #obsm |
| Crystal Johnson-Mann, MD, MPH, FACS, FASMBS @CJMannMD RT @arghavan_salles: The most important take-home message, I think, is that there is risk with any surgery. Bariatric surgery can seem scary, but outcomes are quite good. The decision to proceed or not should be made between the patient and the surgeon. #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @txkyleharris: And while I have the opportunity, can we have a chat or something similar with a registered dietician and maybe a chef. Food substitution, good carbs vs bad carbs, etc. @eggface has a great blog for Bariatric friendly recipes but I would like to see more on health cooking #obsm |
| Neil Floch MD @NeilFlochMD RT @CJMannMD: A5 - Patients: A5 - Patients: don't be afraid to ask questions, especially right before surgery and anytime in the postoperative period. Physicians: track outcomes, collaborate w/ colleagues, never stop learning. #obsm |
| Ian Patton, PHD @IanPatton55 @obsmchat Bariatric surgey saves my life and the lives of many others, it is the gold standard obesity treatment and pros often outweigh the cons, but for optimal success, we need to remember obesity is a chronic disease and surgery is not a cure, but a management tool #obsm |
| Michelle Vicari @Eggface @obsmchat Keep your head in the game. Find your tribe. Highly recommend patient groups like @ObesityAction @ObesityCan @EASOpatients, attending events like https://t.co/T0u6IGfYpU and taking part in #obsm tweet chats every 2nd Sunday of the month. |
| Neil Floch MD @NeilFlochMD RT @NeilFlochMD: Q5: Q5: Don’t eat off the prescribed menu as getting food stuck can lead to vomiting and obstruction after #bariatricsurgery #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @txkyleharris @Eggface Great idea! Thank you. #obsm |
| Dr. Aaron Bolduc @DrAaronBolduc RT @arghavan_salles: The most important take-home message, I think, is that there is risk with any surgery. Bariatric surgery can seem scary, but outcomes are quite good. The decision to proceed or not should be made between the patient and the surgeon. #obsm |
| Neil Floch MD @NeilFlochMD RT @arghavan_salles: @bruce_y_lee @obsmchat and certainly no one facilitates them... #obsm |
| Neil Floch MD @NeilFlochMD RT @bruce_y_lee: @obsmchat #obsm Develop a rapport with each other so that patients feel comfortable sharing all details about their progress, even seemingly "little" issues |
| Neil Floch MD @NeilFlochMD RT @arghavan_salles: @PitchfordMd @bonuslife I do not dissect the crura unless there is a hernia. #obsm |
| #obsm chat @obsmchat RT @arghavan_salles: The most important take-home message, I think, is that there is risk with any surgery. Bariatric surgery can seem scary, but outcomes are quite good. The decision to proceed or not should be made between the patient and the surgeon. #obsm |
| Neil Floch MD @NeilFlochMD RT @arghavan_salles: @IanPatton55 @profbdcohen @NeilFlochMD Great point. I certainly can start discussing this preemptively with my patients. #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose I ran out of characters. #obsm What I mean is: we need the bigger picture from pt perspective, not just clinical outcomes. |
| Neil Floch MD @NeilFlochMD RT @IanPatton55: @obsmchat Talk! Be open, know what complications medical and psychological are and know that it is safe and appropriate to speak up and ask early, many complications are made worse by waiting to long #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @bruce_y_lee @obsmchat Yes! #obsm |
| Neil Floch MD @NeilFlochMD RT @NeilFlochMD: We are here Because we want to help #obsm |
| Neil Floch MD @NeilFlochMD RT @DrGoodpaster: @arghavan_salles Thank you! I’m so impressed with our patients’ strength and resilence. It’s an honor to be along for the ride. #obsm |
| Neil Floch MD @NeilFlochMD RT @NeilFlochMD: Q4: Q4: A Gastro-gastricfistula can be closed with endoscopic techniques #obsm This is a great technique with minimal risk - same day https://t.co/GOpoiFtE3N |
| Neil Floch MD @NeilFlochMD RT @IanPatton55: @arghavan_salles @profbdcohen @NeilFlochMD Yes, something many of my peers discuss. Just wish I had known to expect it or that it was normal and how to address it, I am glad I am mindful of it but I feel like I wasted a lot of time struggling in silence with it #obsm |
| Neil Floch MD @NeilFlochMD RT @txkyleharris: @obsmchat Yes, yes, yes. No more T2D, sleep apnea, or HBP. Not to mention the years added to my life and the ability to actually enjoy my life. #obsm |
| Neil Floch MD @NeilFlochMD RT @arghavan_salles: @DrGoodpaster Thank goodness for people like you to help, @DrGoodpaster! #obsm |
| Neil Floch MD @NeilFlochMD RT @txkyleharris: @obsmchat Yes, yes, yes. No more T2D, sleep apnea, or HBP. Not to mention the years added to my life and the ability to actually enjoy my life. #obsm |
| Janine Kyrillos, MD @JanineKyrillos So happy to hear this. How many surgery programs prescribe meds? #obsm |
| Neil Floch MD @NeilFlochMD RT @profbdcohen: A5: A5: Follow up. There is nothing more important (says the guy who knows he needs to check in with the office) because physicians can't help what they don't know about. #obsm |
| #obsm chat @obsmchat RT @IanPatton55: @obsmchat Bariatric surgey saves my life and the lives of many others, it is the gold standard obesity treatment and pros often outweigh the cons, but for optimal success, we need to remember obesity is a chronic disease and surgery is not a cure, but a management tool #obsm |
| Neil Floch MD @NeilFlochMD RT @obsmchat: Researchers? @asmbs folks? Any thoughts? #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles RT @IanPatton55: @obsmchat Bariatric surgey saves my life and the lives of many others, it is the gold standard obesity treatment and pros often outweigh the cons, but for optimal success, we need to remember obesity is a chronic disease and surgery is not a cure, but a management tool #obsm |
| Neil Floch MD @NeilFlochMD RT @NeilFlochMD: We have excellent data from Dr Inge from the Cincinati Childrens Hospital With data on adolescent #bariatricsurgery. #obsm |
| Neil Floch MD @NeilFlochMD RT @arghavan_salles: @profbdcohen @bonuslife @JEChilderhose @NeilFlochMD There is so much shame and blame in our culture that it's hard to keep it from being internalized. #obsm |
| Neil Floch MD @NeilFlochMD RT @bruce_y_lee: @arghavan_salles @obsmchat @asmbs #obsm are there any statistics on how many bariatric surgery procedures are performed by those who did not go through such training & are not @asmbs certified? |
| Neil Floch MD @NeilFlochMD RT @NeilFlochMD: That’s shocking #obsm |
| #obsm chat @obsmchat That’s a wrap! Thanks, everyone, for another great #obsm chat! Special thank you to the patients who shared their experiences and expertise. Hope you will join us for the next #obsm chat Sunday, March 10, at 9pm EST. |
| Neil Floch MD @NeilFlochMD RT @JEChilderhose: Asking @davearterburn @drtominge @KimSteeleMD #obsm |
| Neil Floch MD @NeilFlochMD RT @obsmchat: Patients need health care professionals to break down these sorts of silos and work together for the benefit of their patients. #obsm |
| GeekyGrouch @grouchy_geek @profbdcohen @NeilFlochMD Call my sleeve ALMFIM (angry little mf’er inside me). He always reminds me when I eat too much or too fast. #obsm |
| Neil Floch MD @NeilFlochMD RT @arghavan_salles: @profbdcohen @IanPatton55 @NeilFlochMD This seems to be pretty common. I often hear that people still see a previous version of themselves in the mirror. #obsm |
| Renee Hilton, M.D. @reneehilton30 RT @DrAaronBolduc: @obsmchat I have never performed a surgery that has positively impacted a patient as much as #bariatricsurgery! Life changing. #obsm #wls @AUG_Health @reneehilton30 @arghavan_salles @rachelmooremd @NeilFlochMD |
| Arghavan Salles, MD, PhD @arghavan_salles RT @obsmchat: That’s a wrap! Thanks, everyone, for another great #obsm chat! Special thank you to the patients who shared their experiences and expertise. Hope you will join us for the next #obsm chat Sunday, March 10, at 9pm EST. |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife Good night! #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @bonuslife @NeilFlochMD What is happening with Aspire Assist? Does anyone know? Clinical trials? #obsm |
| Neil Floch MD @NeilFlochMD RT @obsmchat: That’s a wrap! Thanks, everyone, for another great #obsm chat! Special thank you to the patients who shared their experiences and expertise. Hope you will join us for the next #obsm chat Sunday, March 10, at 9pm EST. |
| Deborah Greenhouse @greenhousemd @bruce_y_lee @arghavan_salles @obsmchat Always happy to shake things up from the pediatric end of things. #obsm |
| Neil Floch MD @NeilFlochMD RT @JanineKyrillos: So happy to hear this. How many surgery programs prescribe meds? #obsm |
 | Turner & Page @TurnerandPage @obsmchat It seems the hour goes by faster every month. Thanks, everyone. I'll tweet after a while when the transcript is up. #obsm |
| Neil Floch MD @NeilFlochMD RT @JEChilderhose: I ran out of characters. #obsm What I mean is: we need the bigger picture from pt perspective, not just clinical outcomes. |
| Neil Floch MD @NeilFlochMD RT @Eggface: @obsmchat Keep your head in the game. Find your tribe. Highly recommend patient groups like @ObesityAction @ObesityCan @EASOpatients, attending events like https://t.co/T0u6IGfYpU and taking part in #obsm tweet chats every 2nd Sunday of the month. |
| #obsm chat @obsmchat RT @TurnerandPage: @obsmchat It seems the hour goes by faster every month. Thanks, everyone. I'll tweet after a while when the transcript is up. #obsm |
| Neil Floch MD @NeilFlochMD So beautifully said - thank you all for tweeting tonight #obsm #bariatricsurgery #Obesity |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife @JEChilderhose @NeilFlochMD I think the device is wonderful, but practically it is unattractive to most people, and the folks I have put it in have had some surprising struggles. Not what you would think though. I really think it is a legitimate approach but with need for total close follow up #obsm |
| Arghavan Salles, MD, PhD @arghavan_salles @greenhousemd @bruce_y_lee @obsmchat I'm with you! #obsm |
| Michelle Vicari @Eggface @obsmchat Looking forward to reading through all the tweets that I missed 🌪️🌪️🌪️ #obsm Special wave and thanks to the #patients sharing their experiences! |
| Dr. Aaron Bolduc @DrAaronBolduc RT @obsmchat: That’s a wrap! Thanks, everyone, for another great #obsm chat! Special thank you to the patients who shared their experiences and expertise. Hope you will join us for the next #obsm chat Sunday, March 10, at 9pm EST. |
| Dr. Aaron Bolduc @DrAaronBolduc @obsmchat Great chat! Thanks everyone for sharing your thoughts! #obsm |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @bonuslife @NeilFlochMD This is a really interesting and unexpected response. Thank you. I'd love to know more. #obsm |
 | Antonio Montecalvo @montecalvoaarq RT @bruce_y_lee: @obsmchat #obsm Oh, and to emphasize this again. This cannot be done in just 15 minute appointments. This limit is one of the biggest things preventing appropriate relationships & discussions btw doctors & patients and makes no sense: https://t.co/CHGxjzCW0K |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife @JEChilderhose @NeilFlochMD I have not seen any of what you would consider an eating disorder type approach at all. #obsm. Everyone likes to blow it off by describing it like bulimia. It is exactly the opposite - does not work with large feeds, encourages regular meal structure and planning, gives satiety! |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @bonuslife @NeilFlochMD That is absolutely fascinating and contrary to popular opinion. We need #evidence not bias. #obsm |
| Prakay Cc @CcPrakay RT @Eggface: Some Post- #BariatricSurgery Money Saving Tips: Some Post- #BariatricSurgery Money Saving Tips: https://t.co/APEo1iXqH6 including vitamin assistance programs, free resources, etc. #obsm |
| Prakay Cc @CcPrakay RT @bruce_y_lee: @obsmchat #obsm Silos are a major problem in medicine. The health care system & professional societies just don't encourage mixing and conversations among disciplines/specialties |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife @JEChilderhose @NeilFlochMD #obsm University of Colorado has the dream team for aspire and pediatric surgical |
 | sarahkbingler @sarahkbingler RT @Eggface: @JEChilderhose @NeilFlochMD Yes! or to refer patients to those that are specialists in #obesity medicine because patients suffer when they are told "you really need to lose weight" and sent on their way, I "dieted" most of my adult life. #obsm |
| Dr. Aaron Bolduc @DrAaronBolduc @JEChilderhose @bonuslife @NeilFlochMD Not a fan of the idea of Aspire Assist. If overeating was the only cause of obesity then it might make sense, but we have learned that developing obesity is much more complicated that that. #obsm |
| walt medlin KILL THE FILIBUSTER, Statehood DC, PR @bonuslife @DrAaronBolduc @JEChilderhose @NeilFlochMD #obsm Have you studied it? The FDA trial was quite convincing for satiety |
| Janet Elizabeth Childerhose, PhD @JEChilderhose @bonuslife @DrAaronBolduc @NeilFlochMD No! But I am aware there has been a clinical trial w/ teens in the Czech Republic. That's it. Sounds like you are very current. #obsm |
| Eyad Wohaibi, MD, FACS, FASMBS. @WohaibiMD RT @NeilFlochMD: Mortality increases dramatically over 15 years in patients who do not have #bariatricsurgery #obsm |
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