Death and heart complications were 40 percent less common in people with obesity and diabetes when they had bariatric surgery
SEATTLE, September 2, 2019—Weight-loss surgery performed in patients with type 2 diabetes and obesity is associated with a lower risk of death and fewer major adverse cardiovascular events than usual medical care, according to a large Cleveland Clinic study with a Kaiser Permanente Washington Health Research Institute (KPWHRI) coauthor. These patients also lost more weight, had better diabetes control, and used fewer medications for treatment of their diabetes and cardiovascular disease than those undergoing usual medical care.
The observational study looked at nearly 2,300 Cleveland Clinic patients who had metabolic surgery and 11,500 matched patients with similar characteristics who received usual medical care. Patients underwent one of four types of weight-loss surgery (also known as metabolic or bariatric surgery): gastric bypass, sleeve gastrectomy, adjustable gastric banding, or duodenal switch.
Why it matters
These results matter because more than one in three (nearly 40 percent of) Americans has obesity, which is linked to type 2 diabetes heart disease, and stroke. And adults with diabetes are two to four times more likely to die from heart disease than those without diabetes: Heart disease is the leading cause of death for people with obesity and diabetes.
“This is an important paper, validating and extending our prior work in the Health Care Systems Research Network, or HCSRN,” says coauthor David Arterburn, MD, MPH, a KPWHRI senior investigator and internal medicine physician with Washington Permanente Medical Group. “It helps to reinforce the message that patients with type 2 diabetes and severe obesity should be discussing bariatric surgery as a reasonable treatment option for preventing long-term consequences of their diabetes.”
Ed note: Bob Newhart is still going at 90! He attributes laughter as an assist to aging well and a long happy marriage. He’s still fun to watch!
LOS ANGELES in the NYT — Bob Newhart didn’t invent stand-up comedy, but more than any performer he can lay claim to giving birth to the modern industry of the comedy special.
His still-funny 1960 album, “The Button-Down Mind of Bob Newhart,” was arguably the first blockbuster special, selling more than one million copies, hitting No. 1 on the charts and winning the Grammy for best album, beating out Frank Sinatra and Nat King Cole. Since that breakout debut, he has starred in sitcoms and movies, hosted talk shows and even gave the eulogy for Krusty the Clown on “The Simpsons.”
But Newhart still identifies as a stand-up comic, and he returned to the stage this year for multiple dates west of the Mississippi. He turns 90 this week and Newhart, sitting on a couch at his home in Los Angeles, seemed physically slighter but still deployed his distinctive stammer with precision as he looked back at his six decades in comedy and forward to what lies ahead. Here are edited excerpts from our conversation:
What brings you back to stand-up?
What I’ve learned is: I love the danger. This thing I thought I hated all my life, that’s why I was doing it. If the show is at 8, and it’s 6, what will I be doing? Pacing. After 60 years, still pacing. I like that feeling.
Do you feel 90 years old?
My mind doesn’t. I can’t turn it off. The other day, there was a story about a pilot getting arrested for being drunk in the cockpit. I immediately thought: What if he had made it past security, wound up flying the plane and said to the passengers [in a slurred voice]: “Welcome to Delta. Welcome to a flight from Los Angeles to, um, to, um, I have it written down here somewhere, it’s the mountains and then there’s some more mountains and then we’re on the other side of that.”
Thanks to Don Philips for sending this article for us to ponder. I agree that costs in health care are unchecked and a major problem. But the fixes are fraught with all kinds of difficult issues. I don’t think the solutions here will necessarily solve things, though they may help some.
By Douglas M. Parker in RINOcracy: “Jeff Bauer is a Medical Economist and Healthcare Futurist. We have been friends since we met several years ago on a transatlantic voyage, and Jeff is a previous contributor to RINOcracy.com. He submitted this essay at my invitation and I hope you will find it as interesting as I did.
“As a disaffected Democrat, I appreciate the opportunity to share my perspectives on Medicare for All (MfA) with Rinocracy’s disaffected Republicans. However, I can only address MfA in general; there’s no specific definition in proposals being discussed by presidential candidates, and nobody knows how the concept will evolve if a pro-MfA candidate occupies the White House and Democrats control Congress after the 2020 elections. All I can say is that the general concept is deeply flawed—and add that health reform proposals from the Party of Trump are at least as ill-conceived. Essential transformation of the way we deliver health care could be set back many years if either camp prevails in 2020 and subsequently delivers on its campaign promises. (For what it’s worth, the last four presidents have pursued health policies quite different from what they promised as candidates. Recent history would suggest that MfA is more likely to be implemented if Trump is re-elected, a bizarre possibility enhanced by his unpredictability.)
Here’s a brief report. Over the past month the average views of the blog have been about 75/day with a high of 210 and a low of 48. Subscribers to the blog number 88 – and get notified with each posting (you can sign up on the blog). Please remember you can view the Brief Bios, Skyliner, etc. by clicking on the pages at the top of the blog. Ask your friends or look in the mail room if you can’t remember the password for protected pages.
Thanks to all of you who send in jokes and articles. I really try to have the blog be a community (not complaint) forum. And if you are a writer and want to be a contributor please let me know.
All this said, your editor is going “silent” until September 5th by sneaking away for an R&R. Yes, it’s sure hard work being here at Skyline!
COPENHAGEN (The Borowitz Report)—After rebuffing Donald J. Trump’s hypothetical proposal to purchase Greenland, the government of Denmark has announced that it would be interested in buying the United States instead.
“As we have stated, Greenland is not for sale,” a spokesperson for the Danish government said on Friday. “We have noted, however, that during the Trump regime pretty much everything in the United States, including its government, has most definitely been for sale.”
“Denmark would be interested in purchasing the United States in its entirety, with the exception of its government,” the spokesperson added.
A key provision of the purchase offer, the spokesperson said, would be the relocation of Donald Trump to another country “to be determined,” with Russia and North Korea cited as possible destinations.
If Denmark’s bid for the United States is accepted, the Scandinavian nation has ambitious plans for its new acquisition. “We believe that, by giving the U.S. an educational system and national health care, it could be transformed from a vast land mass into a great nation,” the spokesperson said.
Andy Borowitz is a Times best-selling author and a comedian who has written for The New Yorker since 1998. He writes The Borowitz Report, a satirical column on the news.
From Betsy Hanson: To get in the swing of things, please start right now to screen your bookshelves for all your surplus books and DVDs. The collection box will be out on Sept. 8th, and you know how time flies at our age – so this is a great time for further downsizing! The event on Sunday Sept. 15th will again be held in the Bistro, where all residents, staff and guests may select as many free books as desired. Its success depends on your donations, so start making space for your new additions now. Books not selected by the Library Committee or claimed at the Give-away will be delivered to the Seattle Public Library’s Book Sale.
Posted inBooks|Comments Off on Our 5th Annual Book Give-away will be on Sunday Sept.15.
Ed Note: As we age and begin to give up our cars, we do have some alternatives at Skyline and thank goodness for Ben during the hours he is available. But what about other times? Not all of us are familiar with apps and smartphones, so Uber and Lyft can be intimidating. Actually did you know that if our transportation isn’t available that the Skyline can help residents schedule Lyft rides and then bill them later on their monthly statement?The Concierge does this evenings and weekends. During the daytime of the week, we have our driver Ben; however, if someone needs Lyft, the Lifestyle people will schedule it for you. If you have Uber or Lyft concerns, schedule tech help – and hit the road!
Seniors need transportation alternatives more than ever, but many are intimidated by ride-hailing apps.
By Paula Span from the NYT.Martin Gerstell treasures his Thursday morning volunteer stint at the National Gallery of Art, where he fields questions at the main information desk. He patiently responds when visitors ask about the current exhibits, whether the paintings are real, where the bathrooms are.
Usually, fellow volunteers give him a ride from his assisted living residence in northwest Washington to the museum downtown, and home again. But when they can’t, Mr. Gerstell, 94, uses the Uber app his granddaughter installed on his iPhone.
“They appear very quickly, and they’re very helpful,” Mr. Gerstell said of his Uber drivers, who fold and stash his walker in the trunk. Summoning a taxi, his previous option, usually took 15 to 20 minutes; Uber arrives in three to five minutes and charges less, under $20, to drive him downtown.
It probably helps that Mr. Gerstell, a retired electrical engineer, handles new technology with aplomb.
Donna Nettleton has encountered a different reaction at the Oasis Institute in Shiloh, Ill., where she volunteers to teach older people about digital devices.
Her students take happily to Facebook, but “Uber and Lyft are scarier because they involve money,” she explained. Older adults, warned continually about scams and identity theft, fear that misusing an app could empty their bank accounts.
“It’s challenging to build the confidence they need to actually use these things that could make life easier for them,” Ms. Nettleton said. So far, she’s been unable to convert any of her advisees — including her 80-year-old mother — into riders.
More than half of adults over 65 own smartphones, the Pew Research Center has reported. Yet among adults 50 and older, only about a quarter used ride-hailing services in 2018 (a leap, however, from 7 percent in 2015). By comparison, half of those aged 18 to 29 had used them.
Thanks to Gordon G for finding this. Hard to believe an airport is a place to hang out, study or even have weddings, but this video makes me want to visit!
From Crosscut: Nuclear power has stalled in the United States. The country’s 97 commercial reactors provide 20 percent of its power, but only one reactor has gone online since 1998 — in Tennessee in 2016. Two more reactors — behind schedule and way over budget — are due to become operational in the early 2020s in Georgia, but two other reactors under construction in the South died a few years ago when the company behind them filed for bankruptcy. And nuclear power is struggling financially to compete with cheaper power produced by natural gas, causing several reactors to close in recent years.
Recently, however, there have been murmurs of a new nuclear age. Many environmental groups remain opposed to nuclear energy. But as the realities of climate change — and the fast-growing demand for energy worldwide — become more apparent, a handful of environmental activists and politicians are mentioning nuclear power alongside other carbon-free options.
“Given the urgency and the scale of the challenge, we have to keep all low- and zero-carbon technologies on the table,” Gov. Jay Inslee told New York magazine in a profile of his presidential campaign, which centers on climate change..
This is where TerraPower steps in. Founded 11 years ago by Bill Gates, the Bellevue company has been pursuing more perfect nuclear power, as it works to create a new type of reactor that requires refueling just once every 20 to 60 years. (Continued)
From Aeon: Endemic to the mountain forests of New Guinea, the King of Saxony bird-of-paradise (Pteridophora alberti) is best-known for the flamboyant, mate-attracting efforts of its males. The bird’s courtship displays – which often double as a means of keeping competitors at a comfortable distance – make use of bright yellow breast feathers, wildly waving head plumes and peppy dance manoeuvres capped off with an exceptionally outsized, almost otherworldly bit of squawking. This video from the Cornell Lab of Ornithology provides a rare glimpse into the world of this idiosyncratic little bird, which has proven notoriously difficult to photograph in its rugged natural habitat.
When dialysis was invented in the 1960’s Congress decided that it would be too expensive for insurance companies, so they decided to cover the care of chronic renal disease for any age – basically the government became a single payer for this one disease! But other chronic diseases have not fared so well. There are favored classes of people with basically free care – the Military and the VA Hospital System. Native American clinics and hospital are also federally funded. Even under Medicare there is “original” or “advantage.” Medicaid is our “safety system” which is chronically underfunded. This article from the University of Pennsylvania argues that the best current approach is to improve Obama care. What are your thoughts in the current “ethical mess?”
It is a patchwork that covers some people and some diseases but not others. We can improve it by bolstering Obamacare.
By Amy Gutmann and Jonathan D. Moreno. Ms. Gutmann is the president of the University of Pennsylvania, where Mr. Moreno is a professor of bioethics. Published in the NYT.
The recent Democratic primary debates in Detroit made at least one thing clear: The party exclusively responsible for passing the Affordable Care Act is now waging political warfare over whether to reform it or eliminate it. Senator Bernie Sanders was loud but not lonely in advocating “Medicare for all,” which would supplant the A.C.A. with a single-payer system and virtually abolish private employer-based health insurance. His predictable answer to who will fund its high price is apparently the 1 percent who need to pay their fair share.
But there is another 1 percent, and they are not the privileged ones you’re thinking of. They are the roughly 1 percent of Medicare patients who have end-stage renal disease and cost the system $34 billion every year. No matter how rich or poor, young or old, Medicare kidney patients are guaranteed treatment mostly paid for by American taxpayers. (continued)
Some geniuses go through life without recognition. C.S. Peirce is an example of an incredible mind that is now being discovered in relatively buried archives at Harvard.
Posted inEducation, Essays|Comments Off on The smartest person you may have never heard of.
Dr. Rick Rapport, UW Harborview Neurosurgeon, has written the story of Medic One (Seattle’s Medic One: How We Don’t Die). How fortunate we are to have Dr. Leonard Cobb here at Skyline and to now have this history documented. Nick Licata review the book in the Seattle Times. Click here for that article.
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