[DocSanae]

Many of you who have had WLS surgery, or are contemplating the surgery, will have other medical conditions to contend with. For those who have had WLS surgery, you will have to be followed throughout the rest of your life for some of the after effects due to the surgery. Your doctors will indicate your present medical data to you, and discuss your present condition. However, you might be unfamiliar with how you should read and understand the data indicated to you. You may become worried when one data or another is higher/lower than normal, according to you doctor, but it seems that the doctor isn’t worried about the abnormality. Here are some tips that may help you to understand how medical data should be interpreted, and how your doctor goes about assessing the data

[DocSanae]

Many professional medical societies have guidelines on diagnosis and treatment of whatever disease the particular society deals with. These guidelines are utilized by your physicians in diagnosing, managing and treating the respective diseases. Many governments endorse the efforts of such societies and cooperate in making and taking comprehensive courses of action. On a worldwide basis, WHO also has guidelines, which basically are the same as guidelines recommended by international medical societies.

In the US, the various medical societies cooperate with NIH and/or CDC in setting up such guidelines. In the area of obesity, NIH designates the criterion for surgery for morbid obesity, so the first hurdle for the person seeking WLS surgery will be whether he/she meets this criterion. With diabetes mellitus, the American Diabetes Association has a guideline that includes the criteria for diagnosis, management, recommendations for glycemic control, nutritional therapy and physical activity as well as other aspects. There are guidelines for cholesterol management, blood pressure management, and the metabolic syndrome, by the respective societies, or with the cooperation of a number of societies.

However, some of these guidelines may differ in other countries. This is because recent studies indicate that the incidence of certain diseases differ with ethnicity. For instance, the incidence of co-morbidities in obesity goes up at a lower BMI with Asians in comparison to Americans/Europeans. Therefore, the Asian-Pacific Bariatric Surgery Conference recently designated the criteria of WLS surgery with Asians for those without co-morbidities, BMI over 37, and those with more than 2 co-morbidities, BMI over 32. The respective BMIs are 3 lower than the NIH criteria. So, keep in mind that in certain scenarios, your ancestry may become a factor in following these guidelines.

[DocSanae]

Your doctors will tell you the results of your lab work, and say whether they are normal or not. This “normal” sometimes lead to a misunderstanding, since there are actually 2 groups of “normal”.

The first is an absolute range with which, if the numbers are outside the designated range, will indicate that there is some abnormal event going on in your body.

The second is actually an optimal range, the desired range to prevent the onset of more serious conditions. Of course, even with the optimal range, if the results are much higher/lower than desired, then, there may already be a serious change in your body, whether functional or physical.

Blood sugar levels belong in the first group, and cholesterol levels and blood pressures belong in the second group. When your blood sugar level is high, it is an indication that there already is an alteration in the function of your body in keeping your blood sugar level at the desired concentration so your body can work normally.

With cholesterol levels, the normal range is the desired level to prevent cardiovascular events and atherosclerosis which develop in the long term. With blood pressure that is higher than the optimal range, the probability of future cerebro-vascular accidents (in other words, brain stroke) is significantly higher.

There also are “gray” areas with many data, where it is wise to watch where the data will go, but no immediate action is necessary. If you are tested for tumor markers and they turn out high, then, you should be examined further for cancer. So, if your doctor tells you that the result of some of your lab work is abnormal, be sure to ask if it is something that needs immediate attention, or whether you should watch your diet/exercise/lifestyle and then be reassessed. Don’t fret on your own and wonder.

[DocSanae]

Statistics are often difficult to read, and can throw you off the right track.

Always keep in mind that statistics are collective data of a group of people. Furthermore, the particular group may not always represent the average population.

What this means is that whatever the number is, if your result is positive, then it is a 100% event for you. If you run across data that says, 80% survival rate after 5 years, what it means is that out of 100 people who were diagnosed for this disease and received the particular treatment, 80 were alive 5 years later (no matter what their actual health is at the 5 year point) while 20 had died before 5 years had passed. For the person who has survived, the survival rate is 100%, and for the person who has died, the survival rate is 0%.
It doesn’t mean that your health is 80% of completely healthy.
If with surgery data, the statistic says, 5% major complications, it means that 5% of the patients who underwent the surgery had complications, and the remaining 95% had recovered without incident.

Also, even if the statistic says, 100% cure, do not count on it that it really will be so. Often, with such results, the number participating in the particular study was not large, so with a larger group, such ratio will invariably go down, though it probably will stay above 90%.

Another way to look at the statistics is, the more serious your overall condition is, prior to treatment, the more likely it is that the outcome will not be as good as you would desire. If statistical data is not favorable with the particular procedure, the risk for you will be higher than for those who are less compromised. One way to reduce the risk is to bring your medical status as close as can be done to the optimal range. This is the reason, with elective procedures such as WLS surgery, your surgeons and physicians will instruct/treat you in such a way to control the co-morbidities that you have as a prerequisite for your surgery.

[DocSanae]

Remember always, data are just that, data. Numbers are just numbers. To interpret accurately what they indicate and mean, you have to have knowledge and understanding of the entire picture of what your body and health is. So, don’t let the numbers by themselves loom over you and panic you. Whatever you do when you have questions, whether you look up various sources on your own or not, go back to your attending doctor and ask. No doctor can make the correct diagnosis from data only. The final diagnosis can never be made without the doctor seeing you in person.

[DocSanae]

There is something you will need to understand.
That is, the total NUMBER of people having trouble post op will increase, has increased.

The reason behind this is as follows.
10 years ago, the number of weight loss surgery was less than 13,000. Last year, it was up to 177,000.
Now, say, certain post op complications developed in 5% of the post ops 10 years ago. That will put the actual number of people who had the post op complication at 650 persons. Say the ratio of this particular complication was reduced to 1% with the most recent procedures and conscientious follow up and the resulting data has improved. Because the total of surgery is 177,000, 1% of that is 1,770. That's 1,770 people with the said complication from last year, so the number of people with the complication is actually more than twice, closer to three times the number 10 years ago. However, the ratio of complications has come down to 5 times lower than before, which means the results from the surgery are more favorable than 10 years ago.

This can confuse a lot of people when only certain numbers are cited in various data. You will have to look at the number of people included in the entire study, how they were grouped, and what conditions were set in collecting the data. It is very easy to sway the outcome of statistical data when you know how to do it, and how to set up studies so the results will be favorable to a forgone conclusion.
Also, as the absolute number of people with unwanted results from the surgery increases, their voices in experssing opinions will also increase. Those who are satisfied with the results are understandably more silent, for various reasons.

Bad news travels fast, far and wide. Good news don't.