SAN DIEGO -- Though I appreciate the time and effort taken in researching obesity and bariatric procedures and outcomes, some studies make me shake my head in wonder.
For instance, comparing the success rate of bariatric surgery to commercial weight loss programs seems ridiculous. After all, does anybody really think counting POINTS! can hold a candle to rerouting one's digestive tract to reduce capacity and nutrient absorption? That doesn't even seem logical to me, much less a wise use of funding.
Here are two of what I'd call "duh" studies that were presented at the convention this week:
* Bariatric surgery makes people more sensitive to alcohol -- I don't think any of us with gastric bypass needed Stanford researchers to tell us that our rerouted intestinal tract makes us cheap dates when it comes to running a bar tab.
Dr. John Morton, assistant professor of surgery and senior author of the study, was quoted in today's Science Daily as saying, "I've heard the anecdotes of a patient who will drink one glass of wine and get a DUI, but I wanted to know if there is really a difference before and after the surgery."
Dr. Morton later says in the article that most patients aren't aware of this and that Oprah has done the field a favor by pointing it out on her show about the dangers of cross-addiction. I don't know about the rest of the post-ops in the world, but I discovered that fact the first time I tried wine after surgery. I didn't need Oprah or a study to enlighten me. Furthermore, I had been warned by other post-ops about the phenomena long before I ever had surgery, so I don't think it's as big of a mystery as Dr. Morton professes.
* Binge eating and a sweet tooth lead to gastric-band failures -- Just to make sure we're all on the same page here, a team of Swiss researchers reported that those post-ops who binged on food or indulged in sweets experienced a higher incidence of band failure than those who did not. The conclusion? The best candidates for banding are highly motivated patients who don't binge or eat sweets. Wouldn't you say the same thing for any type of bariatric procedure?
Showing posts with label San Diego. Show all posts
Showing posts with label San Diego. Show all posts
Saturday, June 16, 2007
Thursday, June 14, 2007
Candelas San Diego
SAN DIEGO -- Words cannot describe the dinner I experienced this evening. We visited Candelas on Third Avenue. And I say visited, because it was so much more than just a place to eat; it was an all-encompassing environment with an amazing atmosphere, above-par staff and cuisine that was out of this world.
Our party decided on a collection of appetizers and one entree to share, because making a decision was so difficult. We all giggled a bit when our server, Tony, went over his recommendations on the menu. He said everything was "amazing" but suggested the duck, poblano soup and the avocado salad. We thought he was just angling for a good tip -- until we were presented with the incredible dishes we ordered.
The Carpaccio Franco ($12) had fan of paper-thin raw ahi drizzled with a lemon-cilantro mustard sauce served around a salad of marinated bell peppers, baby greens and tequila-marinated pear. The ahi was so tender that it melted on my tongue, but I would have liked a little more of the sauce to enhance its flavor.
Taking Tony's suggestions to heart, we ordered the Estructura de Aguacate ($11.50), which was a stacked salad of avocado, scallops, crap, shrimp, parsely and mild jalapeno with a light drizzle of mango-basil vinaigrette. The presentation was awe-inspiring. The salad was molded into a cylinder in the center of the plate with ribbons of dressing poured around the edges. It had a delicate flavor, with each ingredient complementing one another instead of competing for attention.
The Crema Fabiola ($14.50) is a stellar puree of poblano chile and cream with a half of a lobster tail poised in the center. The color contrast between the pink and white lobster and the sage-green soup was eye-catching but nothing prepared me for the taste of the soup. It was an explosion of flavor that led a few of us to consider licking the bowl when we were finished.
The only entree we ordered, the Pechuga de Pato Lucrecia ($25.50) was another sight to behold. The duck breast was cooked in its own juices until medium rare and then fanned around vegetables and mashed potato with a light passionfruit sauce. The duck barely required a knife to cut and its buttery texture dissolved easily on the tongue. Our only regret was that our pouches forced us to leave one succulent piece on the plate along with the potato. Even Tony remarked it was a crime.
We had planned to pass on dessert until Tony mentioned crepes covered in a goats milk caramel that sounded heavenly. The presentation was simple, two crepes swimming in thick, rich caramel with pecans sprinkled over the top. We each took only one bite, knowing that a second would leave us sick all night. But that one bite was all that was needed for an instant trip to nirvana. It was the type of dessert that makes you not want to put anything else in your mouth so you can savor the flavor as long as humanly possible and then burst into tears once it diminishes.
I could not even imagine a better way to end the most hectic day of the convention.
Our party decided on a collection of appetizers and one entree to share, because making a decision was so difficult. We all giggled a bit when our server, Tony, went over his recommendations on the menu. He said everything was "amazing" but suggested the duck, poblano soup and the avocado salad. We thought he was just angling for a good tip -- until we were presented with the incredible dishes we ordered.
The Carpaccio Franco ($12) had fan of paper-thin raw ahi drizzled with a lemon-cilantro mustard sauce served around a salad of marinated bell peppers, baby greens and tequila-marinated pear. The ahi was so tender that it melted on my tongue, but I would have liked a little more of the sauce to enhance its flavor.
Taking Tony's suggestions to heart, we ordered the Estructura de Aguacate ($11.50), which was a stacked salad of avocado, scallops, crap, shrimp, parsely and mild jalapeno with a light drizzle of mango-basil vinaigrette. The presentation was awe-inspiring. The salad was molded into a cylinder in the center of the plate with ribbons of dressing poured around the edges. It had a delicate flavor, with each ingredient complementing one another instead of competing for attention.
The Crema Fabiola ($14.50) is a stellar puree of poblano chile and cream with a half of a lobster tail poised in the center. The color contrast between the pink and white lobster and the sage-green soup was eye-catching but nothing prepared me for the taste of the soup. It was an explosion of flavor that led a few of us to consider licking the bowl when we were finished.
The only entree we ordered, the Pechuga de Pato Lucrecia ($25.50) was another sight to behold. The duck breast was cooked in its own juices until medium rare and then fanned around vegetables and mashed potato with a light passionfruit sauce. The duck barely required a knife to cut and its buttery texture dissolved easily on the tongue. Our only regret was that our pouches forced us to leave one succulent piece on the plate along with the potato. Even Tony remarked it was a crime.
We had planned to pass on dessert until Tony mentioned crepes covered in a goats milk caramel that sounded heavenly. The presentation was simple, two crepes swimming in thick, rich caramel with pecans sprinkled over the top. We each took only one bite, knowing that a second would leave us sick all night. But that one bite was all that was needed for an instant trip to nirvana. It was the type of dessert that makes you not want to put anything else in your mouth so you can savor the flavor as long as humanly possible and then burst into tears once it diminishes.
I could not even imagine a better way to end the most hectic day of the convention.
A whirlwind of a day
SAN DIEGO -- Thursday was such a crazy day that it took me until Friday to realize that I didn't publish this post. I'm back-dating it so it's chronological:
I sat in today on an interesting session for primary clinicians. The opening speaker was Dr. Sasha Stiles of Kaiser South San Francisco, where I had my bariatric surgery two years ago. Dr. Stiles is the program's medical director, creating Kaiser's Northern California program with Dr. Prithvi Legha (my surgeon). During my time with Kaiser, I grew to know Dr. Stiles more than Dr. Legha because she is the one who handled my pre-operative screenings and post-operative follow-up. I was very sad when my employer switched from Kaiser coverage, because she is such an amazing doctor. At least I'm still able to be in Dr. Legha's capable hands.
Dr. Stiles provided a brief introduction to the Primary Clinicians Tract that was an overview of the advancements made in the treatment of obesity. For a rail-thin woman, she knows a lot about obesity. She sees 6,000 patients a year through Kaiser's bariatric program, and the South San Francisco facility treats about 200 patients a month.
She didn't report anything that was new or earth-shattering but did pose some interesting questions for the audience to ponder. Her over-arching theme regarding the success of bariatric surgery was that it provides hope for the morbidly obese. Hope, she said, is what motivates patients to make the lifestyle changes required for long-term success.
She called the physicians collectively on the carpet for not doing a good enough job in following up with their patients to ensure long-term success. Studies show that dieting is stressful and that even the most successful weight loss programs have followers who fall off the wagon and start over. Dr. Stiles said anticipating this aspect of human nature can make bariatric programs more successfull, too. After all, if you anticipate that after two years, post-ops will stop attending after-care programs and possibly begin to gain back weight, doctors could then build services into their programs to bring those patients back to the fold in a supportive manner.
Makes sense to me. What do the rest of you think?
I sat in today on an interesting session for primary clinicians. The opening speaker was Dr. Sasha Stiles of Kaiser South San Francisco, where I had my bariatric surgery two years ago. Dr. Stiles is the program's medical director, creating Kaiser's Northern California program with Dr. Prithvi Legha (my surgeon). During my time with Kaiser, I grew to know Dr. Stiles more than Dr. Legha because she is the one who handled my pre-operative screenings and post-operative follow-up. I was very sad when my employer switched from Kaiser coverage, because she is such an amazing doctor. At least I'm still able to be in Dr. Legha's capable hands.
Dr. Stiles provided a brief introduction to the Primary Clinicians Tract that was an overview of the advancements made in the treatment of obesity. For a rail-thin woman, she knows a lot about obesity. She sees 6,000 patients a year through Kaiser's bariatric program, and the South San Francisco facility treats about 200 patients a month.
She didn't report anything that was new or earth-shattering but did pose some interesting questions for the audience to ponder. Her over-arching theme regarding the success of bariatric surgery was that it provides hope for the morbidly obese. Hope, she said, is what motivates patients to make the lifestyle changes required for long-term success.
She called the physicians collectively on the carpet for not doing a good enough job in following up with their patients to ensure long-term success. Studies show that dieting is stressful and that even the most successful weight loss programs have followers who fall off the wagon and start over. Dr. Stiles said anticipating this aspect of human nature can make bariatric programs more successfull, too. After all, if you anticipate that after two years, post-ops will stop attending after-care programs and possibly begin to gain back weight, doctors could then build services into their programs to bring those patients back to the fold in a supportive manner.
Makes sense to me. What do the rest of you think?
Food, fabulous food
SAN DIEGO -- It occurred to me last night after signing off that I've yet to post about food. One of the reasons I promote Susan Maria Leach's book, "Before and After: Living and Eating Well After Weight Loss Surgery," (revised edition goes on sale in two weeks) is because it proves that enjoying great food does not end when you go under the knife.
A lot of non- and pre-ops I meet fear gastric-bypass surgery means a life without taste, texture and gastronomical pleasure, but nothing could be further from the truth. If anything, most of us become food snobs after weight loss surgery. I ate fast food at least twice a week as a pre-op. Now, I could hardly be paid to eat at McDonalds or Carl's Jr. -- the food doesn't even taste good enough to be pouch-worthy. I can find something to eat just about anywhere, but I'd rather not waste valuable space in my gastric pouch on mediocre food.
So, what does the American Society of Bariatric Surgery have served at its annual conference? Last year, I made the mistake of thinking that because it was an event about bariatrics, the catering would reflect the needs of bariatric patients. Wrong. What I forgot in my naivete is that the conference is geared toward bariatric health care providers -- not patients -- so the food did not match what my pouch could tolerate. If it hadn't been for the BariatricEating.com booth last year, I would have surgery fainted for lack of protein. That's part of the reason I agreed to help Susan at her booth this year -- I owe her a debt of gratitude for saving my pouch last year.
So far this year, I've been pleasantly surprised. Yesterday's breakfast was the obligatory continental convention fare: pastries, muffins, bagels, fruit, juice and coffee. The BE.com gang picked up coffees and went to the booth to make protein lattes and cappuchinos. I enjoyed a delicious latte made up of Nectar Cappuccino, Matrix Chocolate, Micellar Milk and hot water (12 oz offers about 25 grams of protein). For my mid-morning snack, I sipped coffee mixed with vanilla Micellar Milk and a shot of Davinci sugar-free Englis Toffee syrup and Cinnamon Bliss (a sugar-free caramel replacement that tastes just like a spicy cinnamon roll). OK, I'll be honest: I had two of those for about 20 grams of protein combined.
Lunch, however, offered something for everyone. The buffet featured a selection of salads and build your own sandwiches. I enjoyed a small green salad with tomato-basil vinaigrette and swiss cheese rolled up with deli ham and grainy mustard -- fast, filling and delicious. I was wise and steered clear of the decadent desserts.
Back at the booth, we were serving Revial soy chips (I'll have to review those at a later time), parmesan cheese crisps, AchievOne, Nectar Twisted Cherry mixed with Cherry-Pomegranate Crystal Light, ThinkThin bars and New Whey protein bullets in addition to the Micellar Milk lattes. Again, my body has never been so happy. My blood sugar only dipped once all day.
For dinner, we attended the conference's welcome reception. Again, I didn't know what to expect. Imagine my delight when I spied appetizer tables overflowing with oysters on the half shell, succulent shrimp, snow crab claws, cheese trays, canapes and beef and turkey carving stations. I didn't even glance in the direction of the pasta and dessert areas, though I did spy a few people enjoying chocolate-covered strawberries and baklava. But personally, those are treats in which I could never eat just one. Instead, I helped myself to oysters with Tobasco and fresh lemon, shrimp and crab sans cocktail sauce, green olive tapenade eaten with a spoon, Jarlsberg cubes, and melon-wrapped proscuitto and brie with a dab of cream cheese and mandarin orange (it was easy to set aside the little squares of toast atop which the melon and brie canapes were served).
Heavenly food aside, the best part of the cocktail party was that you couldn't easily tell the post-ops from the non-ops. We were mostly all enjoying the same delicious cuisine combined with excellent conversation. And like I told a couple of very handsome Australian surgeons yesterday, that -- to me -- is what the gift of surgical weight loss is all about: looking, acting and living a normal life. I could have kissed just about every doctor there for that blessing.
A lot of non- and pre-ops I meet fear gastric-bypass surgery means a life without taste, texture and gastronomical pleasure, but nothing could be further from the truth. If anything, most of us become food snobs after weight loss surgery. I ate fast food at least twice a week as a pre-op. Now, I could hardly be paid to eat at McDonalds or Carl's Jr. -- the food doesn't even taste good enough to be pouch-worthy. I can find something to eat just about anywhere, but I'd rather not waste valuable space in my gastric pouch on mediocre food.
So, what does the American Society of Bariatric Surgery have served at its annual conference? Last year, I made the mistake of thinking that because it was an event about bariatrics, the catering would reflect the needs of bariatric patients. Wrong. What I forgot in my naivete is that the conference is geared toward bariatric health care providers -- not patients -- so the food did not match what my pouch could tolerate. If it hadn't been for the BariatricEating.com booth last year, I would have surgery fainted for lack of protein. That's part of the reason I agreed to help Susan at her booth this year -- I owe her a debt of gratitude for saving my pouch last year.
So far this year, I've been pleasantly surprised. Yesterday's breakfast was the obligatory continental convention fare: pastries, muffins, bagels, fruit, juice and coffee. The BE.com gang picked up coffees and went to the booth to make protein lattes and cappuchinos. I enjoyed a delicious latte made up of Nectar Cappuccino, Matrix Chocolate, Micellar Milk and hot water (12 oz offers about 25 grams of protein). For my mid-morning snack, I sipped coffee mixed with vanilla Micellar Milk and a shot of Davinci sugar-free Englis Toffee syrup and Cinnamon Bliss (a sugar-free caramel replacement that tastes just like a spicy cinnamon roll). OK, I'll be honest: I had two of those for about 20 grams of protein combined.
Lunch, however, offered something for everyone. The buffet featured a selection of salads and build your own sandwiches. I enjoyed a small green salad with tomato-basil vinaigrette and swiss cheese rolled up with deli ham and grainy mustard -- fast, filling and delicious. I was wise and steered clear of the decadent desserts.
Back at the booth, we were serving Revial soy chips (I'll have to review those at a later time), parmesan cheese crisps, AchievOne, Nectar Twisted Cherry mixed with Cherry-Pomegranate Crystal Light, ThinkThin bars and New Whey protein bullets in addition to the Micellar Milk lattes. Again, my body has never been so happy. My blood sugar only dipped once all day.
For dinner, we attended the conference's welcome reception. Again, I didn't know what to expect. Imagine my delight when I spied appetizer tables overflowing with oysters on the half shell, succulent shrimp, snow crab claws, cheese trays, canapes and beef and turkey carving stations. I didn't even glance in the direction of the pasta and dessert areas, though I did spy a few people enjoying chocolate-covered strawberries and baklava. But personally, those are treats in which I could never eat just one. Instead, I helped myself to oysters with Tobasco and fresh lemon, shrimp and crab sans cocktail sauce, green olive tapenade eaten with a spoon, Jarlsberg cubes, and melon-wrapped proscuitto and brie with a dab of cream cheese and mandarin orange (it was easy to set aside the little squares of toast atop which the melon and brie canapes were served).
Heavenly food aside, the best part of the cocktail party was that you couldn't easily tell the post-ops from the non-ops. We were mostly all enjoying the same delicious cuisine combined with excellent conversation. And like I told a couple of very handsome Australian surgeons yesterday, that -- to me -- is what the gift of surgical weight loss is all about: looking, acting and living a normal life. I could have kissed just about every doctor there for that blessing.
Tuesday, June 12, 2007
Dinner at Henry's
SAN DIEGO -- We ate dinner tonight at Henry's, an Irish Pub near the intersection of Market and Fifth. Though Henry's definitely has a pub atmosphere, the food choices were superb. No bangers and mash on the menu at this place.
Eating among post-ops is such a refreshing change from what I'm used to. Five of us are post-ops -- from two to six years out from surgery -- and discussing what to have for dinner is a fun experience in itself. No mention of pizza or fried foods.
The biggest decision we had was whether to order our own entrees or share. We all decided that we hadn't eaten enough during the day so we opted not to share. Us post-ops were copy cats; we each ordered the salmon with dill cream sauce and a double portion of veggies instead of mashed potatoes. Being the "youngest" post-op in terms of when I had my surgery, I ate the smallest amount but I held my own with the veterans.
What I loved most was watching each of them following the rules even at their stage: No drinking with meals, protein first, eating slowly and chewing each bite thoroughly. We had incredible conversation on topics ranging from WLS issues to work topics to just life in general. It was like a night out with my best girlfriends, except that these girlfriends eat the same way as me.
Eating among post-ops is such a refreshing change from what I'm used to. Five of us are post-ops -- from two to six years out from surgery -- and discussing what to have for dinner is a fun experience in itself. No mention of pizza or fried foods.
The biggest decision we had was whether to order our own entrees or share. We all decided that we hadn't eaten enough during the day so we opted not to share. Us post-ops were copy cats; we each ordered the salmon with dill cream sauce and a double portion of veggies instead of mashed potatoes. Being the "youngest" post-op in terms of when I had my surgery, I ate the smallest amount but I held my own with the veterans.
What I loved most was watching each of them following the rules even at their stage: No drinking with meals, protein first, eating slowly and chewing each bite thoroughly. We had incredible conversation on topics ranging from WLS issues to work topics to just life in general. It was like a night out with my best girlfriends, except that these girlfriends eat the same way as me.
Wednesday, May 16, 2007
ASBS conference
The American Society of Bariatric Surgeons will hosts its annual meeting and conference next month in San Diego. The weeklong event will begin June 11 at the San Diego Convention Center.
ASBS is the only national governing body for bariatric surgeons. It's the group behind the Centers of Excellence distinction that surgical centers strive to achieve. The organization Web site offers a list of Centers of Excellence by state for patients to peruse.
The conference is a big deal. Not only does it allow medical professionals to congregate and network, it provides continuing education courses and panel discussions of interest to those who work with the obese. Surgeons and other bariatric health-care providers will learn the latest surgical techniques and discuss research data on topics such as how access to nutritional supplementation affects compliance in patients and whether preoperative weight loss makes a difference in surgical outcomes.
The conference also features an extensive trade show with vendors showcasing everything from super-size furniture that is comfortable for morbidly obese patients to compression garmets that hold in excess skin so post-ops can achieve a more normal appearance under clothes. There are also vitamin and supplement vendors galore, in addition to advocacy groups. Carnie Wilson was a featured guest at a vendor's booth last year. No word whether she'll attend again this year.
I attended one day of last year's trade show in San Francisco. This year, I'm fortunate enough to spend most of the week at the event. I'll be blogging on the various workshops and educational sessions I attend.
ASBS is the only national governing body for bariatric surgeons. It's the group behind the Centers of Excellence distinction that surgical centers strive to achieve. The organization Web site offers a list of Centers of Excellence by state for patients to peruse.
The conference is a big deal. Not only does it allow medical professionals to congregate and network, it provides continuing education courses and panel discussions of interest to those who work with the obese. Surgeons and other bariatric health-care providers will learn the latest surgical techniques and discuss research data on topics such as how access to nutritional supplementation affects compliance in patients and whether preoperative weight loss makes a difference in surgical outcomes.
The conference also features an extensive trade show with vendors showcasing everything from super-size furniture that is comfortable for morbidly obese patients to compression garmets that hold in excess skin so post-ops can achieve a more normal appearance under clothes. There are also vitamin and supplement vendors galore, in addition to advocacy groups. Carnie Wilson was a featured guest at a vendor's booth last year. No word whether she'll attend again this year.
I attended one day of last year's trade show in San Francisco. This year, I'm fortunate enough to spend most of the week at the event. I'll be blogging on the various workshops and educational sessions I attend.
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