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Is lipo a lie?

Type “liposuction” on a web search engine and you will immediately find thousands of articles, stories, and testimonials about liposuction. Reactions about liposuction range from positively life-changing transitions to unsafe, risky, or, worse, fatal procedures. Liposuction started in the ’70s but was developed in the ’80s. Increased awareness, social and media influence, and accessibility have made liposuction as one of the most common cosmetic procedures today. The misconceptions about liposuction, however, are also as common. Ask your friends about it, and you’ll surely get more questions than answers. “Isn’t that scary?” “Did you hear what happened to her?” “Can lipo really be fatal?”

What is lipo? Liposuction, also called lipoplasty, suction-assisted lipectomy, or lipo, is a surgical cosmetic procedure that removes fat by inserting a narrow tube or a cannula to drain or remove the fat from the body. The stomach, back, buttocks, arms, neck, and thighs are common areas where liposuction is performed. Contrary to popular belief, however, liposuction is not a procedure to treat obesity. The ideal candidates for liposuction are healthy individuals who have stubborn fat in a specific area of their body.

How is lipo done? To quash the misconceptions about liposuction, it is important to understand how liposuction is performed. There are four types of liposuction techniques:

The Dry Technique requires general anesthesia before it extracts the fat. This is no longer used because it causes extreme blood loss on the patient. The Wet Technique also uses general anesthesia, but local anesthesia is also injected at the site before extraction. While less blood is lost using this technique, it is still significant. The Super Wet Technique still uses general anesthesia, but the blood loss is much lower than the Wet Technique as the amount of local fluid injected is equal to the fat removed. Some or all of the techniques above usually require extended hospital care and/or blood transfusion due to the blood lost. The Dry Technique, Wet Technique, and Super Wet Technique are conventional liposuction procedures under general anesthesia, largely practiced by plastic surgeons. These procedures last for two to three hours, and can remove large amounts of fats and save time for the surgeon.

The following disadvantages, however, can also be seen:

General anesthesia risks plus the requirement for hospitalization
Use of large cannula increases risk of damage to tissues and more bleeding, thus probability of significant blood loss that may need blood transfusions.
Recovery time is slow after general anesthesia.

Meanwhile, the Tumescent Technique differs from the rest as it requires no general anesthesia. A large volume of fluid injected makes blood loss at a minimum, and since no general anesthesia is required, downtime is shorter. There are are fewer side effects and less pain and risks are lower. Tumescent is comparatively slower than the conventional liposuction, taking three to four hours to perform, and the amount of fat to be extracted is most of the time limited to about four to five liters. The term tumescent liposuction excludes the use of additional anesthesia such as intravenous and gaseous anesthesia. It should be noted that compared to conventional liposuction where mortality and severe complications have been reported, the risk of systemic complication with tumescent liposuction was found as low as 0.07 percent (Venkataram, 2008). This technique, introduced by Dr. Jeffrey A. Klein, a dermatologic surgeon, in 1985, is still being used, preferred, and considered as the ideal method to this day. It was previously thought that this technique will only be effective in small amounts of fat removal, but it has been proven that it also works with large volume fat loss. Moreover, dimples and lumps are almost rare in this technique, as compared to previous methods where these irregularities are common.

So, is lipo really fatal? Possibly, depending on the technique used. The techniques discussed above, the Dry, Wet, and Super Wet techniques, all run the risk of becoming fatal due to reasons such as too much fat removal at a time, multiple procedures done at once, general anesthesia complications, excessive blood loss, hemorrhagic necrosis of fat, and pulmonary thromboembolism (blood clot on the lungs), among others. On the other hand, no deaths have yet been reported with the Tumescent Technique. In fact, since no general anesthesia is given, the patient may even stand and assess the target area, minimizing future repeat procedures, which thus, results in higher patient satisfaction.

It’s no big fat lie: liposuction does come with risks, but so do other surgical procedures as well. It is best to always consult a physician or surgeon, especially in surgical procedures like this. Arm yourself with questions, not only about lipo, but about the surgeon’s credentials, too. What liposuction technique will be used? Is the clinic or hospital registered to operate? Is the physician board-certified and trained for the procedure? How many patients has the physician treated? Also, check for before and after photos of your physician’s patients. Risks do come with liposuction, but as long as patients are well-informed, and they have done the right preparations and precautions with proper guidance, then liposuction can just be one of the best decisions and transformations in their lives.

source: Manila Bulletin
http://lifestyle.mb.com.ph/2017/04/25/is-lipo-a-lie/

Snoring is not healthy

There’s a misconception that snoring loudly means one is having a deep, relaxing sleep, and that there’s nothing wrong with it.

But nothing can be farther from the truth. Snoring is not healthy at all!

Snoring intermittently at night may be due to a potentially serious medical condition associated with high blood pressure (BP), diabetes, heart problems and even sudden death while sleeping.

The funny thing is, you don’t even realize that you snore. Ask your sleeping companion if you snore loudly, with intermittent seconds of silence.

The intermittent gaps could also be associated with gasping for breath from time to time.

If you snore, it’s best to consult your doctor, before potentially life-threatening complications develop.

Obstructive sleep apnea

Two of our patients have such a problem. Both have cardiovascular ailments.

The first, a 48-year-old overweight mechanic, has uncontrolled high blood pressure (BP) even if he’s on four anti-hypertensive medicines taken at optimal doses. His family physician was already at his wit’s end and ran out of options to control his elevated BP.

The second patient, whom we haven’t seen for years, came back, suffering from progressive shortness of breath, chest pains and palpitations. Workup on the patient showed an enlarged heart, irregular heartbeat and signs of heart failure.

Both patients had one thing in common—they were loud snorers. We sent them for a “sleep test” or polysomnography, which monitors the breathing pattern during sleep, including the airflow in the nose and mouth, as well as the movement of one’s chest and other respiratory muscles.
These are correlated with the levels of oxygen and carbon dioxide in the blood.

The results of the “sleep test” of both patients showed significant obstructive sleep apnea or OSA.

Apnea means stopping of one’s breathing, and patients with OSA may have several episodes of complete cessation of airflow or stopping of breathing for at least 10 seconds each night when they sleep.

Some may not completely stop breathing and instead have hypopnea, in which the airflow decreases by 50 percent for at least 10 seconds, or decreases by 30 percent with an associated decrease in the oxygen saturation in the blood.

This is then reported as the apnea-hypopnea index (AHI), and, depending on the frequency of their occurrence per hour, the OSA is described as mild, moderate or severe.

Our two patients had severe obstructive sleep apnea. And this was the likely culprit for the first patient’s uncontrolled hypertension and the second patient’s heart disease with progressive heart failure.

In OSA, the snoring has intervals of silence. The silence occurs when the individual is apneic or he/she stops breathing.

OSA patients usually wake up in the morning feeling tired and unrested despite a supposedly long sleep. They may doze off at work, even when someone is talking to them or even while driving. This can lead to serious accidents on the road.

Other symptoms of OSA are headaches, difficulty in concentrating, mood changes such as irritability and depression, forgetfulness, increased heart rate and/or blood pressure, decreased sex drive, unexplained weight gain and heavy night sweats.

OSA is also usually associated with heart diseases, hypertension, diabetes and the so-called metabolic syndrome, which is a clustering of cardiometabolic factors that include being overweight, having increased waist circumference indicating visceral or internal obesity, hypertension, high blood sugar, high triglycerides and low high-density lipoprotein (HDL) cholesterol, which is the “good cholesterol.”

In a study by researchers at the University of Pittsburgh, 800 people between the ages 45 and 74 were surveyed about the quality of their sleep. Three years later, the researchers found out that the people who reported loud snoring were more than twice as likely to have metabolic syndrome, than quiet sleepers.

Metabolic syndrome is characterized by a cluster of cardiometabolic problems including obesity, diabetes, high BP and cholesterol problems.

Individuals with OSA are rarely aware that they have this problem. Some even deny that they snore. The problem is recognized by others, usually the spouses or bed-partners, who see and hear the individual with OSA during episodes.

Symptoms of OSA may go undetected for years or even decades, especially in those who sleep alone.

OSA is actually caused by an obstruction of the airway during sleep. Generally, the muscle tone of the body relaxes during sleep. The airway in the throat is composed of walls of soft tissue and muscles; when these relax, they can collapse, obstructing one’s breathing.

A minor degree of OSA—like a few short episodes of apnea when sleeping—can still be considered part of normal sleep. This may happen when one has nasal and throat congestion due to upper respiratory tract infection.

Transient spells of OSA may also occur due to some drugs (sedatives and tranquilizers) or alcohol.

But when the episodes become longer and more frequent (equal to or more than five times every hour of sleep) and persistent, this type of OSA can develop into something more serious.

Early diagnosis is important. Continuous positive airway pressure (CPAP) therapy is usually prescribed. During sleep, a person with OSA is made to wear a facial or nasal mask which is connected by a hose to a small device at his/her bedside.

CPAP therapy has shown positive results—eliminating snoring and breathing obstructions, improving the quality of nightly sleep, preventing or reversing serious health conditions such as cardiovascular diseases and stroke, lowering the BP during the day and at night, increasing alertness during the day, and decreasing daytime drowsiness.

The device is portable and can easily fit in one’s hand-carry luggage for long-haul trips.

source: Philippine Daily Inquirer
http://lifestyle.inquirer.net/260674/snoring-not-healthy/

Tips on how to check your wellness sins

If rules were made to be broken, chances are, you’re feeling guilty about wellness transgressions. And if you continue your slip-ups in the present, take heart. It is never too late for redemption.

Time to own up to your weaknesses. Rather than punish yourself with guilt, you can do something about your lapses before the results of your negligence reflect in your next executive checkup.

Here’s a checklist of omissions and commissions:

1. “I’m too lazy to exercise. The last time I visited the gym was six months ago.”

When laziness takes hold of you, it can be extremely difficult to get back on track. But not to worry. Bring out your fitness shoes and gear, where you can see them daily. Then, one day, you will get dressed to exercise.

Try basic walking for 20 minutes daily. This should get you going. Increase your exercise time the next day. Put it in your head that exercise is a daily must-do.

2. “Food bingeing is my midnight habit. As a result, I have gained 20 lb.”

Every bingeing episode— whether a bowl of pasta, a box of chocolates, cake or ice cream, puts stress on your stomach, pancreas and liver. There is just too much to digest.

3. Giving your tummy some rest time is crucial to digestive health.
It pays to eat less— whether during regular meals or not. Learn to cut back on the quantity of your food intake.

There will be no urge for midnight snacking if you had your meals on time. Should cravings overcome you by 11 p.m., try to outwit your body (and mind) by getting to bed by 10 p.m.

You may also opt for something light to check your bingeing.

Suggestions: multigrain crackers and 2 tbsp tuna; 2 pc sardines; 1 glass warm milk with 1 banana; ½ apple with walnuts or cashews.

Skin rescuers

4. “Sun worshipping is second-nature to me. I enjoy baking myself under the sun.”

It seems you might be guilty of abusing your skin and complexion. Even if you’ve been wearing sunblock, perhaps you didn’t reapply the lotion as frequently as required. You might have sunspots and blemishes. It is best to consult a dermatologist.

Dr. Mary Jane Torres of Zen Institute says there are skin-rescuers that can address the problem of sun-damaged skin.

Before applying anything, allow your skin to cool down. Stay indoors for one week. Stop sunbathing.

If you have to go outdoors for some reason, then wear protection—sunblock, long-sleeved shirts, hat, sunglasses, umbrella.

To heal the skin slowly, apply virgin coconut oil liberally on the face and body.

Increase vitamin C dosage or go for intravenous therapy of vitamin C and glutathione.

When your skin is no longer red and begins to flake, have a diamond peel. Try this immediate facial mask called Carboxy. This is a breakthrough carbon dioxide therapy which creates bubbles to increase oxygen.

The results are visible after one 30-minute treatment— skin hydration and moisturizing, tightening of pores, reduced pigmentation. Your face will look well-rested.

Call Zen Institute at 4411712 or 8562027.

5. “I always fight off sleepiness with coffee because it’s at night when I catch up on movies.”

All it takes is one cup of coffee to keep you awake for 8 hours. So, if you drink more after your first cup, you will have difficulty sleeping.

Try to watch your movies by 6 p.m. so that, by 11 p.m., you can hit the sack. Retrain yourself to sleep earlier each night.

Sleep deprivation can lead to cardiovascular disease, diabetes, cancer and depression.

Unwind slowly

6. “When I get home exhausted from work, I sometimes fall asleep with my work clothes and makeup on.”

No matter how tired you are after work, you need to unwind slowly. The worst thing you can do is to sleep without removing your makeup. You will develop skin rash or allergy from your cosmetics.

It would be nice to have a warm shower and cleanse your face. This ritual will relax your tense muscles and lead to a good sleep.

source: Philippine Daily Inquirer
http://lifestyle.inquirer.net/260672/tips-check-wellness-sins/

Diet and gut bacteria linked with blood clots

Consuming too much choline, a nutrient sold in over-the-counter dietary supplements, can boost the risk for blood clots, researchers warn.

That’s because bacteria in the intestines interact with choline to produce a compound that encourages platelets to clump together and form clots.

Choline is found in a variety of foods including meat, eggs and milk. It’s what’s known as an essential nutrient, which means the body can’t make enough choline on its own and so it must be provided in food.

But “unless prescribed by your doctor, avoid supplements with choline,” said senior study researcher Dr. Stanley L. Hazen of the Cleveland Clinic in Ohio, in a statement.

Hazen and colleagues had previously shown that bacteria in the intestines interact with choline and other dietary nutrients to produce a substance called TMAO, and they linked high levels of TMAO in the blood to an increased risk of cardiovascular diseases.

Also, in studies in animals, they linked higher levels of TMAO to a higher risk for blood clots.

Their latest research, reported in the American Heart Association’s journal Circulation, shows that choline in food can affect blood clotting risk in humans, and in some cases, that risk can be minimized by taking low-dose aspirin.

In the current study, they gave oral choline supplements to 18 volunteers and then measured TMAO levels, along with the responses of platelets, tiny particles involved in clotting.

After taking the supplements for up to two months, participants had more than 10-fold increases in blood levels of TMAO. The tendency of their platelets to clump together and form clots was also significantly increased, in direct proportion to the increases in TMAO levels.

Aspirin, which reduces the stickiness of platelets, reduced both the increases in TMAO and the increases in platelet clotting associated with choline, but it didn't completely eliminate them, the researchers found.

The findings are of particular concern in people at high cardiovascular risk, whose increased risk of blood clots may not be overcome by low-dose aspirin. The researchers recommend further study.

They also say it's worth exploring whether low-dose aspirin is beneficial in otherwise healthy people with high TMAO in the blood – although at this point, they can’t explain why the aspirin seemed to bring down TMAO levels.

Dr. Herbert Tilg from Medical University Innsbruck, Austria, who has studied the link between gut microbes and blood clots, told Reuters Health by email, “This and earlier studies show that we now definitely have to consider dietary aspects in this context, i.e., diet drives thrombosis risk.”

“These associations are totally new and unexpected: a link between diet - gut microbiota - and thromboembolic events,” he said.

“They are extremely relevant for the public and in medicine,” given that clots are “very, very common” and can be fatal, he said.

Tilg added that “preventive strategies are needed, and probably aspirin is not sufficient. This needs further studies.”

source: Reuters Health
http://www.reuters.com/article/us-health-diet-blood-clots-idUSKBN17Q274

Omega 3 fatty acid found to stop liver damage from getting worse

A new study done with laboratory animals suggests that one type of omega 3 fatty acid offers people, who are obese or have a poor diet, a chance to avoid serious liver damage.

The findings, published Wednesday by researchers from Oregon State University (OSU) in PLOS ONE, offer something that no available drug can accomplish, as millions of people in the developed world try, and fail, to sustain weight loss or eat an optimal diet.

Supplements of docosahexaenoic acid (DHA), one of the most critically important of the omega 3 fatty acids, were shown to stop the progression of nonalcoholic steatohepatitis (NASH), into more serious and life-threatening health problems such as cirrhosis or liver cancer.

Characterized by liver inflammation, oxidative stress and fibrosis, NASH is a substantial risk factor for cirrhosis and liver cancer.

It is predicted to be the leading cause of liver transplants by 2020, and the U.S. Food and Drug Administration (FDA) currently has no approved medical treatments for it.

Based in large part on consuming the “western diet,” one that is high in fat, sugar and cholesterol, nearly 80 million adults and 13 million children in the United States are obese, and about 30 percent of the nation’s population is estimated to have some form of chronic fatty liver disease.

“Considering there are no FDA-approved ways to stop NASH progression, other than weight loss therapy, this supplement may be of significant help,” said Donald Jump, a professor in the OSU College of Public Health and Human Sciences, and principal investigator with the Linus Pauling Institute.

“In the time frame that we studied, DHA supplementation was not able to achieve full remission of NASH, but it did stop it from getting worse,” Donald Jump said.

And it took place even with the continued consumption in lab animals of a “western diet.”

Over one 10-year study period, cirrhosis and liver-related deaths occurred in 20 percent and 12 percent of NASH patients, respectively. And when humans with NASH are examined, they have very low levels of omega 3 fatty acids. When those levels are raised, the disease progression stops.

Omega 3 fatty acids regulate important biological pathways, including fatty acid synthesis, oxidation, and breakdown of triglycerides, or fats in the blood. DHA appears to be one of the most significant of the omega 3 fatty acids, and plays a role in repairing liver damage.

The highest levels of DHA are found in oily fish such as salmon, mackerel, tuna and sardines, and to a much lesser extent in some foods such as poultry, liver, egg yolks, and some types of algae.

It is increasingly being included in some prenatal vitamin and mineral formulas because of studies showing its critical importance to a developing fetus.

DHA is a readily available supplement and safe to use. Referring to the use of DHA supplementation to address problems with NASH, the researchers said in their study that “this scenario will likely be used clinically since patient compliance to low-fat, low-sucrose dietary recommendations has historically been poor.”

The current medical approach to NASH is based on lifestyle management, including diet and exercise. If successful and sustained, research indicates such approaches can completely reverse liver damage.

However, in this study researchers noted that “this treatment, while ideal for clinical use, is likely not sustainable in NASH patients due to poor compliance.”

Eicosapentaenoic acid (EPA), another valuable omega 3 fatty acid, has not been found to lower liver fat and fibrosis in humans, Jump was quoted as saying in a news release, probably due to the poor conversion in humans of EPA to DHA.

source: Manila Bulletin
http://lifestyle.mb.com.ph/2017/04/20/omega-3-fatty-acid-found-to-stop-liver-damage-from-getting-worse/