I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: NDXUFan on July 11, 2013, 10:38:02 PM
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I am curious, should donors be paid? In a nutshell, in a kidney transplant, donors assume the biggest risk of anyone in the transplant process. Yet, the donor is not compensated for taking that large risk. Morever, everyone else in the transplant chain is very well compensated, to say the least. Is it hypocrisy for the transplant industry to act as a financial commodity, while forbidding the donor who is taking a major risk to do the same?
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Sure it is. They feed the greed.
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No. Just because society wants us to pander to our most base instincts and reward everyone's greed doesn't mean we have to.
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NDXUFan, how do you define "the transplant industry"?
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Another thought. The majority of donors are not assuming any risk. They're already dead. MooseMom has a good question about who is the transplant industry. I think that well trained experienced doctors deserve a decent income. Most of them are not rich just better off than some of us. The good ones end up putting in a lot of hours for that income. The nurses are paid according to how that hospital pays nurses with their level of education and experience. Social workers and nutritionists are almost never well paid. The Gift of Life associations are non-profit with only a few employees.
Most living donors do it because they really want to. They don't expect compensation.
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While the organizations which coordinate the cadaver organ donation, also known as Organ Procurement Organizations (OPO) are usually not-for-profit, public charities, their leadership receives pretty good salaries.
In Los Angeles, it's OneLegacy.
Annual salaries:
Thomas Mone, CEO & EVP: $631,964.
Chowdary Garimella, COO & VP Operations: $487,087.
Davis Grafty, CFO & VP Finance: $290,498.
The organization has a fund balance (profit over time) of over $30,000,000.
Investment income: $363,682.
http://www.guidestar.org/FinDocuments/2011/953/138/2011-953138799-08aab7de-9.pdf
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I'm not sure where the hypocrisy is. The officers are being paid market value for their work. I can't tell how long it took to have that much of a fund balance. Do you want them to give some cash to everyone on dialysis in the greater Los Angeles area? There must be thousands of patients.
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I've heard Iran pays for kidney donation. It's a lot cheaper than paying for years of dialysis.
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Thanks for that info Zach, i had not seen it before.
NDXUFan - you may want to search a little here on the forum - paying for kidneys has been discussed quite a bit in other threads. :waving;
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I'm not sure where the hypocrisy is. The officers are being paid market value for their work. I can't tell how long it took to have that much of a fund balance. Do you want them to give some cash to everyone on dialysis in the greater Los Angeles area? There must be thousands of patients.
I don't think giving cash to dialysis patients is going to help increase the pool of donors - living or deceased. I'm not sure what point you were trying to make there. However, I see nothing wrong with compensating a donor for their time - like Australia's health system is now doing. I also don't see a problem with some of that UNOS money going to pay for deceased donor's funeral services. To me, that is not greed, but a fair compensation for a major gift/event. I would only support it if Medicare and/or private insurance covered that payment. I do not think it should be up to the individual organ transplant recipient.
KarenInWA
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The hipocrisy is claiming that paying donors would be "unfair" since not everyone could afford to pay a donor, however, the wallet biopsy is the most critical component of the workup process.
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There's a real easy solution to solve this problem. Donors should be compensated, especially when they have to take time off work to heal and the pain they go through, not to mention the risks of surgery. The ethical issue is only kidney patients that have money would have an unfair advantage. How you get around that is have our government pay donors. Set a flat fee for their kidney, say $50,000. Keep patients on a list and when a donor clears all the medical hurdles and donates his/her kidney they will receive the check. Everyone wins because that list is going to be a lot shorter and the government will save millions in the long run because dialysis is much more costly than kidney transplantation. Buying and selling organs privately will still be illegal. I mean if we can sell our plasma and blood then why can't a person sell his or her kidney?? Thousands of lives will be saved.
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While the organizations which coordinate the cadaver organ donation, also known as Organ Procurement Organizations (OPO) are usually not-for-profit, public charities, their leadership receives pretty good salaries.
In Los Angeles, it's OneLegacy.
Annual salaries:
Thomas Mone, CEO & EVP: $631,964.
Chowdary Garimella, COO & VP Operations: $487,087.
Davis Grafty, CFO & VP Finance: $290,498.
The organization has a fund balance (profit over time) of over $30,000,000.
Investment income: $363,682.
http://www.guidestar.org/FinDocuments/2011/953/138/2011-953138799-08aab7de-9.pdf
I'm not sure where the hypocrisy is. The officers are being paid market value for their work. I can't tell how long it took to have that much of a fund balance. Do you want them to give some cash to everyone on dialysis in the greater Los Angeles area? There must be thousands of patients.
Think of all the research related to organ transplant 30 million dollars can go in to?
How about a better public education program to increase donations?
And this is just one of 58 OPOs throughout the U.S. and its territories.
How much money are they hoarding?
I'm not sure this is a perfect example of "regulatory capture" but it is wrong in any case.
8)
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I don't think giving cash to dialysis patients is going to help increase the pool of donors - living or deceased.
Assuming you meant "paying cash to donors, living or dead", your statement denies the realities of supply and demand.
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Yes! Donors should be paid.
My :twocents; for the hundredth time.
:waving;
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There are really two separate questions that are getting mexed together:
1. Should donors be paid?
2. Should payment be "market based", allowing those who can pay preferential access to organs, or should we continue with a variety of "to each according to his need, from each according to his ability".
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First and foremost we need to start to provide lifelong coverage for immunosuppressive therapy after kidney transplant because it is a waste loosing a kidney after the 3 year cutoff date creating additional expense for medicare and is dangerous for the patient.
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I wonder just how many kidney patients would be able to pay for a new kidney. ESRD can ruin you financially.
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We need to start to provide lifelong coverage for immunosuppressive therapy after kidney transplant because it is a waste loosing a kidney after the 3 year cutoff date creating additional expense for medicare and is dangerous for the patient.
As you probably know, several congresspeople are working on that bill. I don't know where it stands at the moment, though.
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I wonder just how many kidney patients would be able to pay for a new kidney. ESRD can ruin you financially.
I still say have it be a line item on the bill that insurance and/or medicare pays. As for the amount, that needs to be negotiated, but once it's set, it's set. The same, across the board, no matter who/what is paying - as long as it's a 3rd party.
KarenInWA
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NDXUFan, how do you define "the transplant industry"?
Individuals in the medical field who derive a financial gain from transplants.
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I'm not sure where the hypocrisy is. The officers are being paid market value for their work. I can't tell how long it took to have that much of a fund balance. Do you want them to give some cash to everyone on dialysis in the greater Los Angeles area? There must be thousands of patients.
Market value means is what the market thinks they are worth to the group or organization.
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I'm not sure where the hypocrisy is. The officers are being paid market value for their work. I can't tell how long it took to have that much of a fund balance. Do you want them to give some cash to everyone on dialysis in the greater Los Angeles area? There must be thousands of patients.
I don't think giving cash to dialysis patients is going to help increase the pool of donors - living or deceased. I'm not sure what point you were trying to make there. However, I see nothing wrong with compensating a donor for their time - like Australia's health system is now doing. I also don't see a problem with some of that UNOS money going to pay for deceased donor's funeral services. To me, that is not greed, but a fair compensation for a major gift/event. I would only support it if Medicare and/or private insurance covered that payment. I do not think it should be up to the individual organ transplant recipient.
So, you are asserting that third party decision makers should be making decisions that will not effective their basic existence in life?
KarenInWA
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The hipocrisy is claiming that paying donors would be "unfair" since not everyone could afford to pay a donor, however, the wallet biopsy is the most critical component of the workup process.
Exactly.
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I'm not sure where the hypocrisy is. The officers are being paid market value for their work. I can't tell how long it took to have that much of a fund balance. Do you want them to give some cash to everyone on dialysis in the greater Los Angeles area? There must be thousands of patients.
I don't think giving cash to dialysis patients is going to help increase the pool of donors - living or deceased. I'm not sure what point you were trying to make there. However, I see nothing wrong with compensating a donor for their time - like Australia's health system is now doing. I also don't see a problem with some of that UNOS money going to pay for deceased donor's funeral services. To me, that is not greed, but a fair compensation for a major gift/event. I would only support it if Medicare and/or private insurance covered that payment. I do not think it should be up to the individual organ transplant recipient.
KarenInWA
So, what price will these "great" decision makers pay if they are wrong?
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If they are wrong about what?
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If they are wrong about what?
They are the ones who started this stupid policy to begin with, what does 100,000 people waiting for a kidney, tell you?
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That tells me nothing about them and a lot about people not willing to be donors. You still haven't said what they would be so wrong about that they should pay. There are millions of people who won't donate when they're dead and definitely won't when alive. That speaks to their values.
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That tells me nothing about them and a lot about people not willing to be donors. You still haven't said what they would be so wrong about that they should pay. There are millions of people who won't donate when they're dead and definitely won't when alive. That speaks to their values.
So, they should be willing to take an incredible amount of risk for no compensation, where else in the world does this happen? Honestly, I am not sure how many people really know about transplant donation, many have given me a clueless look.
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Altruistic donation would be at risk of a paid donor system. The new paired donations and donor chains has improved matching kidneys and most of these are started by an unrelated altruistic donor. The numbers of altruistic donors is on the rise.
The real issue with the high number of people on the organ wait list for kidney patients is the large number of patients who could have prevented ESRD by poor control of obesity which leads to HTN and diabetes and CKD all on its own. Addressing prevention is the best way to impact the number of renal transplants needed.
As far as effects on donors, there are absolute risks of renal donation with a small percentage who die from the procedure. Vendors in Pakistan and other nations demonstrate no long term economic benefit and at increased risk of physical debility.
http://organdonorincentives.org/wordpress/wp-content/uploads/2010/01/AST-Pakistan.pdf
This is at the heart of the ethical considerations using a paid organ system where the coercion of the financial gain could lead someone to place their on life at risk. In addition, the poor and disenfranchised would be the fodder for such a system which sets off an entirely different aspect of the ethical concerns when considering an organ market.
It is simply a bad idea ethically and practically, who is going to pay for these things? Exploitation of poor people who would consider selling a kidney is an ethical situation we should not venture.
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Altruistic donation would be at risk of a paid donor system. The new paired donations and donor chains has improved matching kidneys and most of these are started by an unrelated altruistic donor. The numbers of altruistic donors is on the rise.
The real issue with the high number of people on the organ wait list for kidney patients is the large number of patients who could have prevented ESRD by poor control of obesity which leads to HTN and diabetes and CKD all on its own. Addressing prevention is the best way to impact the number of renal transplants needed.
As far as effects on donors, there are absolute risks of renal donation with a small percentage who die from the procedure. Vendors in Pakistan and other nations demonstrate no long term economic benefit and at increased risk of physical debility.
http://organdonorincentives.org/wordpress/wp-content/uploads/2010/01/AST-Pakistan.pdf
This is at the heart of the ethical considerations using a paid organ system where the coercion of the financial gain could lead someone to place their on life at risk. In addition, the poor and disenfranchised would be the fodder for such a system which sets off an entirely different aspect of the ethical concerns when considering an organ market.
It is simply a bad idea ethically and practically, who is going to pay for these things? Exploitation of poor people who would consider selling a kidney is an ethical situation we should not venture.
NDXUFan:
HemoDoc, we agree on many issues in the dialysis industry. However, the claim that obesity causes diabetes has simply not been proven. To blame dialysis patients for that issue is intellectually false and intellectually lazy. Every Academic Nephrologist has told me that the cause of type II diabetes is simply unknown. If you are interested, I am willing to give your their names and institutions, privately. Distinguished Professor of Nephrology Jerome Kassirer and Former Head Editor of the New England Journal of Medicine has stated in public that, "Losing weight does not improve your health." Who is going to pay for these things, who is currently paying for dialysis at $100,000 per year to our pal, Kent Thiry and the Billing King, Davita? Who is being forced to give a kidney, as you know, fraud is punishable by law. I worked in the welfare building in a major metro area and when people run out of arguments, they cite the poor. This argument has been used for years and years. Is it ethical to give someone a kidney transplant or force them to be tortured by Thiry and Davita the Billing King? Unlike most of you, I have worked with the poor for many years, I think that argument is total bunk or bullhockey. If you want to talk about group in need of ethics, Thiry, Davita, and Fresenius need to be in the front of the line. Ethics is a matter of subjective opinion and in that area, Davita and Fresenius are receiving an "F." You think we could not afford kidney transplants compared to what we are paying your buddies at the Billing King, you have to be joking? So, I am curious, who appointed you as the decision maker of costs and benefits for someone else? We already have a system like that now, how is that working for you and the other patients? The donor has the most to lose, why cannot they not be compensated for that risk? You were compensated for the risk, time, effort, and med school, it took to become a physician. I am curious, why should you have been compensated for those factors and the kidney donor should not be? I have to laugh like crazy about people who are making out like corporate executives who state that donors should not be paid. Many of these individuals need to be told to mind their own business and practice what they preach, which the majority of the time, they consistently fail to do.
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Many people will not sign a donor card feel that they will not get the best effort at saving their lives.
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Altruistic donation would be at risk of a paid donor system. The new paired donations and donor chains has improved matching kidneys and most of these are started by an unrelated altruistic donor. The numbers of altruistic donors is on the rise.
The real issue with the high number of people on the organ wait list for kidney patients is the large number of patients who could have prevented ESRD by poor control of obesity which leads to HTN and diabetes and CKD all on its own. Addressing prevention is the best way to impact the number of renal transplants needed.
As far as effects on donors, there are absolute risks of renal donation with a small percentage who die from the procedure. Vendors in Pakistan and other nations demonstrate no long term economic benefit and at increased risk of physical debility.
http://organdonorincentives.org/wordpress/wp-content/uploads/2010/01/AST-Pakistan.pdf
This is at the heart of the ethical considerations using a paid organ system where the coercion of the financial gain could lead someone to place their on life at risk. In addition, the poor and disenfranchised would be the fodder for such a system which sets off an entirely different aspect of the ethical concerns when considering an organ market.
It is simply a bad idea ethically and practically, who is going to pay for these things? Exploitation of poor people who would consider selling a kidney is an ethical situation we should not venture.
NDXUFan:
HemoDoc, we agree on many issues in the dialysis industry. However, the claim that obesity causes diabetes has simply not been proven. To blame dialysis patients for that issue is intellectually false and intellectually lazy. Every Academic Nephrologist has told me that the cause of type II diabetes is simply unknown. If you are interested, I am willing to give your their names and institutions, privately. Distinguished Professor of Nephrology Jerome Kassirer and Former Head Editor of the New England Journal of Medicine has stated in public that, "Losing weight does not improve your health." Who is going to pay for these things, who is currently paying for dialysis at $100,000 per year to our pal, Kent Thiry and the Billing King, Davita? Who is being forced to give a kidney, as you know, fraud is punishable by law. I worked in the welfare building in a major metro area and when people run out of arguments, they cite the poor. This argument has been used for years and years. Is it ethical to give someone a kidney transplant or force them to be tortured by Thiry and Davita the Billing King? Unlike most of you, I have worked with the poor for many years, I think that argument is total bunk or bullhockey. If you want to talk about group in need of ethics, Thiry, Davita, and Fresenius need to be in the front of the line. Ethics is a matter of subjective opinion and in that area, Davita and Fresenius are receiving an "F." You think we could not afford kidney transplants compared to what we are paying your buddies at the Billing King, you have to be joking? So, I am curious, who appointed you as the decision maker of costs and benefits for someone else? We already have a system like that now, how is that working for you and the other patients? The donor has the most to lose, why cannot they not be compensated for that risk? You were compensated for the risk, time, effort, and med school, it took to become a physician. I am curious, why should you have been compensated for those factors and the kidney donor should not be? I have to laugh like crazy about people who are making out like corporate executives who state that donors should not be paid. Many of these individuals need to be told to mind their own business and practice what they preach, which the majority of the time, they consistently fail to do.
Actually, I am quite familiar with Jerome, he was my ex-sister in laws Mentor at Harvard. My ex-wife often had dinner with Jerome. Nevertheless, there is a definite correlation between obesity and Type II diabetes. Not sure where you got your information, but that is not in dispute. You state it has not been "proven." Well shucks, that applies to about 2/3rds of medicine. So thanks for calling me a liar and lazy, but no thanks.
Jerome's contention is that calling obesity a disease fuels the billion dollar industry dealing in pharmaceuticals and such. He has a point with that, but understanding the mechanism of insulin resistance, metabolic syndrome and diabetes, yes there is an absolute correlation with obesity.
As far as your considerations of my ethical constraints, just because you disagree with my position does not make intellectually dishonest and lazy. Get a grip man.
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There is strong correlation between weight gain /obesity and type 2 diabetes. I have treated diabetics for 25 years and was trained in a residency with diabetes as the main disease we saw. The research is clear and real life patients back it up. The trend toward higher weight now in society and increase in diabetes incidence is strongly correlated.
Insulin resistance ocurrs often with obesity because fat cells are an organ themselves and they secrete hormones that cause insulin resistance . More and larger fat cells leads to insulin resistance. That is not a drug industry lie. I have many issues with the pharm industry but this isnt one of them.
Lets all play nice here also. Getting personal isnt going to help anyone.
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I'd say this is relevant: Popular Science (the magazine) is shutting off their comment section online (http://www.popsci.com/science/article/2013-09/why-were-shutting-our-comments). As the article says a "politically motivated, decades-long war on expertise has eroded the popular consensus on a wide variety of scientifically validated topics. Everything, from evolution to the origins of climate change, is mistakenly up for grabs again." Now too even the impact of obesity on diabetes is something anonymous internet commentators call into question.
Trolling the internet is all very amusing but trolling debases the the community, it corrodes understanding. Trolling isn't harmless.
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Altruistic donation would be at risk of a paid donor system. The new paired donations and donor chains has improved matching kidneys and most of these are started by an unrelated altruistic donor. The numbers of altruistic donors is on the rise.
The real issue with the high number of people on the organ wait list for kidney patients is the large number of patients who could have prevented ESRD by poor control of obesity which leads to HTN and diabetes and CKD all on its own. Addressing prevention is the best way to impact the number of renal transplants needed.
As far as effects on donors, there are absolute risks of renal donation with a small percentage who die from the procedure. Vendors in Pakistan and other nations demonstrate no long term economic benefit and at increased risk of physical debility.
http://organdonorincentives.org/wordpress/wp-content/uploads/2010/01/AST-Pakistan.pdf
This is at the heart of the ethical considerations using a paid organ system where the coercion of the financial gain could lead someone to place their on life at risk. In addition, the poor and disenfranchised would be the fodder for such a system which sets off an entirely different aspect of the ethical concerns when considering an organ market.
It is simply a bad idea ethically and practically, who is going to pay for these things? Exploitation of poor people who would consider selling a kidney is an ethical situation we should not venture.
NDXUFan:
HemoDoc, we agree on many issues in the dialysis industry. However, the claim that obesity causes diabetes has simply not been proven. To blame dialysis patients for that issue is intellectually false and intellectually lazy. Every Academic Nephrologist has told me that the cause of type II diabetes is simply unknown. If you are interested, I am willing to give your their names and institutions, privately. Distinguished Professor of Nephrology Jerome Kassirer and Former Head Editor of the New England Journal of Medicine has stated in public that, "Losing weight does not improve your health." Who is going to pay for these things, who is currently paying for dialysis at $100,000 per year to our pal, Kent Thiry and the Billing King, Davita? Who is being forced to give a kidney, as you know, fraud is punishable by law. I worked in the welfare building in a major metro area and when people run out of arguments, they cite the poor. This argument has been used for years and years. Is it ethical to give someone a kidney transplant or force them to be tortured by Thiry and Davita the Billing King? Unlike most of you, I have worked with the poor for many years, I think that argument is total bunk or bullhockey. If you want to talk about group in need of ethics, Thiry, Davita, and Fresenius need to be in the front of the line. Ethics is a matter of subjective opinion and in that area, Davita and Fresenius are receiving an "F." You think we could not afford kidney transplants compared to what we are paying your buddies at the Billing King, you have to be joking? So, I am curious, who appointed you as the decision maker of costs and benefits for someone else? We already have a system like that now, how is that working for you and the other patients? The donor has the most to lose, why cannot they not be compensated for that risk? You were compensated for the risk, time, effort, and med school, it took to become a physician. I am curious, why should you have been compensated for those factors and the kidney donor should not be? I have to laugh like crazy about people who are making out like corporate executives who state that donors should not be paid. Many of these individuals need to be told to mind their own business and practice what they preach, which the majority of the time, they consistently fail to do.
Actually, I am quite familiar with Jerome, he was my ex-sister in laws Mentor at Harvard. My ex-wife often had dinner with Jerome. Nevertheless, there is a definite correlation between obesity and Type II diabetes. Not sure where you got your information, but that is not in dispute. You state it has not been "proven." Well shucks, that applies to about 2/3rds of medicine. So thanks for calling me a liar and lazy, but no thanks.
Jerome's contention is that calling obesity a disease fuels the billion dollar industry dealing in pharmaceuticals and such. He has a point with that, but understanding the mechanism of insulin resistance, metabolic syndrome and diabetes, yes there is an absolute correlation with obesity.
As far as your considerations of my ethical constraints, just because you disagree with my position does not make intellectually dishonest and lazy. Get a grip man.
The IU Nephrologist of over 30 years of experience told me that they did not know what was the cause of diabetes, along with the University of Cincinnati Nephrologist of 50 years experience. My primary care physician and endocrinologist had Dr. Kassirer in Medical school. The IU Nephrologist said that many in Nephrology are lazy and unwilling to research alternatives to In-Center dialysis. I quote, "If In-Center dialysis works for them, they are too lazy to research anything else." Please explain to me why they are so many that work in dialysis who are grossly overweight and are not diabetics? Many academic endocrinologists have publicly stated that most diabetic cases are people over 50, because their system simply quits making insulin, not their weight. Professor Emertius of Organic Chemistry Joel Kauffman(14 drug patents and 100 peer reveiwed publications) stated that "The BMI index has never been scientifically proven." I had a number of hard science people look at the claim that "400,000 people die from obesity." They stated that the study was mathematically incorrect and the IU Nephrologist said the study was a bunch of "Nonsense."
I would contend that one of the reasons that people become diabetics is a lack of sleep over a time span of years. I did not have any health issues of any kind until I worked the night shift for 20 years, except when I was born with pneumonia. IU has stated that, "controlling blood sugar levels without the correct amount of sleep is almost impossible." In addition, my body fat was very, very low and I could bench press 450 pounds and I was able to pass a very stressful police physical, how can that be? I would love to see you try to tackle Jerome "The Bus" Bettis, 5'11" 260, top 5 rusher in NFL history. That is a task not even I would attempt, I am not crazy. Here is Bettis running over Brian Urlacher of the Chicago Bears: http://www.youtube.com/watch?v=Fa1TSaKmG2o How many thin people do you think that could beat Bettis running down the football field, not very many. The IU Nephrologist said that many years ago, he figured out that people were not all the same. It would be a great thing if most of medicine would realize that basic fact as well. Yes, I realize that stereotyping is a much easier way..... New Jersey Governor Chris Christie has great blood work. Yet, physicians who have never, ever examined him, claim he is going to "drop dead" at any moment. What is the basis for that claim?
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There is strong correlation between weight gain /obesity and type 2 diabetes. I have treated diabetics for 25 years and was trained in a residency with diabetes as the main disease we saw. The research is clear and real life patients back it up. The trend toward higher weight now in society and increase in diabetes incidence is strongly correlated.
Insulin resistance ocurrs often with obesity because fat cells are an organ themselves and they secrete hormones that cause insulin resistance . More and larger fat cells leads to insulin resistance. That is not a drug industry lie. I have many issues with the pharm industry but this isnt one of them.
Lets all play nice here also. Getting personal isnt going to help anyone.
Ok, then, why are Academic Nephrologists with many years of experience telling me that they do not know what causes Type II diabetes? The Mayo and The Cleveland Clinic have stated that they did not know what causes diabetes.
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I'd say this is relevant: Popular Science (the magazine) is shutting off their comment section online (http://www.popsci.com/science/article/2013-09/why-were-shutting-our-comments). As the article says a "politically motivated, decades-long war on expertise has eroded the popular consensus on a wide variety of scientifically validated topics. Everything, from evolution to the origins of climate change, is mistakenly up for grabs again." Now too even the impact of obesity on diabetes is something anonymous internet commentators call into question.
Trolling the internet is all very amusing but trolling debases the the community, it corrodes understanding. Trolling isn't harmless.
Many MIT scientists do not agree with your contention about climate change. You cannot deny that the drug industry has made billions in profits off of the cholesterol theory, while too many people are complaining of side effects of statins. In other words, people who disagree with the status quo, should be "shut up." Modern insulin medications are great and outstanding for the most part..... The day will come when someone will disagree with your beliefs or opinions, and they will want to silence you. My family left Nazi Germany in 1933..... Just because I disagree with your opinons, I am not a "troll." Many push ideas and theories because they receive research funding or MONEY. Bill, I thought you were opposed to that sort of thing? My view is that individuals do not have the right to force their beliefs on other people, it is just that simple. Michelle Obama preaches a certain style of eating, while she stuffs fast food in her face, ice cream, and God knows what else, can we say hypocrisy? In other words, the rules are for thee, but, not for me. Remember this?
Amendment I
Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the government for a redress of grievances.
Do these rights apply to some people or every American citizen?
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"My view is that individuals do not have the right to force their beliefs on other people, it is just that simple".
Hmm, seems to me that is exactly what you are trying to do, and furthermore, not respecting the opinions of others. Just a question. Why are you so defensive about the link between obesity and diabetes?
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There is strong correlation between weight gain /obesity and type 2 diabetes. I have treated diabetics for 25 years and was trained in a residency with diabetes as the main disease we saw. The research is clear and real life patients back it up. The trend toward higher weight now in society and increase in diabetes incidence is strongly correlated.
Insulin resistance ocurrs often with obesity because fat cells are an organ themselves and they secrete hormones that cause insulin resistance . More and larger fat cells leads to insulin resistance. That is not a drug industry lie. I have many issues with the pharm industry but this isnt one of them.
Lets all play nice here also. Getting personal isnt going to help anyone.
Ok, then, why are Academic Nephrologists with many years of experience telling me that they do not know what causes Type II diabetes? The Mayo and The Cleveland Clinic have stated that they did not know what causes diabetes.
[/quo
I realized the problem here. You are thinking in absolutes. This thing or that thing are THE cause of an illness.. That is a common error people make. medicine doesn't really work that way. Most problems are a complex combination of factors with genetics being the most important.
Yes I would agree we don't know exactly what CAUSES diabetes .But we do know that some of the factors are genetics, diet and weight. It is almost a combination of these and possibly other factors.
Just because weight alone doesn't cause diabetes , doesn't mean it isn't related strongly.
You can always point to people who beat the odds. Just look at how SOME smokers can live to be 100 . That dosesnt prove smoking doesn't kill. Its just that some people defy the odds. Its all odds and percentages , but rarely absolute.
I am smart enough to know we don't have all the answers. We just have educated guesses. medicine is an ART, NOT a SCIENCE. Remember that. Your science people sometimes forget that.
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One other point on weight gain and diabetes. There is a growing body of STRONG evidence that weight loss or bariatric surgery is a complete CURE for many diabetics. I have several patients of my own that this worked for.. they were very obese and on many oral daibetes meds with poor control. Then after the surgery and weight loss , no more meds at all and no glucose problems. This is another indicator that weight is related in some manner. Again it is not the ONLY cause but one strong factor.
I am not a proponent of surgery in general as i was trained as a surgeon and am now very much anti many surgeries and no longer perform anything except minor office procedures. I have seen many sugeries go bad including my wife having a paralyzed stomach from a failed Fundiplication for GERD. She lives on a feeding tube now for food and water. of course this makes her dialysis easier as she has a "perfect"diet'.
So I am not advocating bariatric surgery, only using it as an example of a cure for diabetes based on weight loss.
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"My view is that individuals do not have the right to force their beliefs on other people, it is just that simple".
Hmm, seems to me that is exactly what you are trying to do, and furthermore, not respecting the opinions of others. Just a question. Why are you so defensive about the link between obesity and diabetes?
I am not, just stating facts that certain individuals do not want to hear or rocks their world view. They can think whatever they want, I could care less.
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One other point on weight gain and diabetes. There is a growing body of STRONG evidence that weight loss or bariatric surgery is a complete CURE for many diabetics. I have several patients of my own that this worked for.. they were very obese and on many oral daibetes meds with poor control. Then after the surgery and weight loss , no more meds at all and no glucose problems. This is another indicator that weight is related in some manner. Again it is not the ONLY cause but one strong factor.
I am not a proponent of surgery in general as i was trained as a surgeon and am now very much anti many surgeries and no longer perform anything except minor office procedures. I have seen many sugeries go bad including my wife having a paralyzed stomach from a failed Fundiplication for GERD. She lives on a feeding tube now for food and water. of course this makes her dialysis easier as she has a "perfect"diet'.
So I am not advocating bariatric surgery, only using it as an example of a cure for diabetes based on weight loss.
Many in the medical profession love to stereotype individuals. They have run all kinds of tests on me and each time, they strike out. When they strike out, they are truly pissed off. The reason that weight loss surgery is pushed so hard, is that it is a major money and profit maker for the hospitals(Wall Street Journal)
COMPARISON OF RISK AND BENEFIT
by Paul Ernsberger, Ph.D.-Northwestern Case Western Reserve University
"Well, the gold standard in medicine is the controlled clinical trial. We don't go subjecting 100,000 people to a surgical procedure without doing a controlled clinical trial or dozens of clinical trials, and then looking at the results. Do you know how many clinical trials have been published on weight-loss surgery or gastric bypass? Zero. None of them have compared it to clinical conservative treatment and found it to be superior for life expectancy or for anything else other than, you know, risk factors. A number of trials have been started, and the final results have never been reported. We have to ask, you know, why haven't we seen the final results? I think it's because it's bad news. "
"The stomach is not simply passive sac for storing ingested food, but plays a complex role in the processing of nutrients. Surgical procedures which interfere with the normal operation of the stomach inevitably cause multiple problems. Unfortunately, no controlled trials have ever been run which include physical examination of the patients for possible side effects by independent doctors not associated with the surgeon. In a rare instance of independent examination of bariatric surgery patient, a team of neurologists examined 500 patients who had received either gastric bypass or gastroplasty and found neurological complications (nerve or brain damage) in 5% of them (Neurology 37:196-200, 1987). The patients were usually examined within a year after surgery, so the incidence of long-term neurological deterioration could be much higher than 5%. Possible damage to organs other than brain and nervous system has not been put under rigorous independent evaluation."
Paul Ernsberger, Ph.D.
Associate Professor of Medicine, Pharmacology and Neuroscience
Case Western Reserve School of Medicine
10900 Euclid Avenue
Cleveland, OH 44106-4982
pre@po.cwru.edu
http://gastricbypass.netfirms.com/ernsbergerarticle.htm
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Here is some proof. There has been research looking into Bariatric surgery as a cure for diabetes. NOTICE THERE WAS ALSO A GREAT IMPROVEMENT IN DIABETIC NEPHROPATHY SHOWN , WHICH SHOULD INTEREST ALL OF US HERE.
YOUR PH.D WAS QUOTED 11 YEARS AGO ( ON TV) ABOUT INFO FROM THE 1990S. THAT IS SO OUT OF DATE. MEDICINE CHANGES DRAMATICALLY IN 5 YEARS OR LESS. S
SO IF YOU ARE GOING TO QUOTE PEOPLE AS EXPERTS, DONT USE 10 TO 20 YEAR OLD DATA AND QUOTES.
ALSO, THE OPINION OF ONE PH.D. IS SIMPLY OPINION. THIS IS REAL DATA BY REPUTABLE RESEACHERS , NOT OPINION.
Gastric Bypass 'Cures' Diabetes in Almost a Third of Patients
Lisa Nainggolan
Sep 19, 2013
New Score Predicts Diabetes Remission Post Bariatric Surgery
Bariatric-Surgery Long-Term Metabolic Results
Gastric Bypass Puts Type 2 Diabetes Into Remission
=Publication of a new, albeit retrospective, study has shown that almost a third of obese patients with type 2 diabetes undergoing gastric bypass were effectively "cured" of their diabetes, being in complete remission as per the strictest definition possible that was maintained for 6 years after the surgery.
The researchers also found that patients undergoing such surgery significantly reduced their cardiovascular risk factors according to the Framingham Risk Score and that diabetic nephropathy either improved or was completely resolved; the latter is "remarkable," said the surgeon who led the study, Stacy A. Brethauer, MD, from the Cleveland Clinic, Ohio.
Of the patients, "27% had complete remission maintained for 5 years, and that is the operational definition of a 'cure' by [American Diabetes Association] ADA standards. Hopefully this will help people understand that the effects we see after these procedures are durable. Even in the patients who had some of their diabetes come back, the disease came back milder; we have changed the trajectory," he told Medscape Medical News
Dr. Brethauer first reported the results of the study at the American Surgical Association meeting in Indianapolis in April, and they have been published online today in the Annals of Surgery. His colleague, Philip Schauer, MD, also from the Cleveland Clinic, presented the findings at the Prediabetes and the Metabolic Syndrome 2013 Congress in Vienna, Austria around the same time.
At the time of the presentation at the surgery meeting, the study generated many comments and questions, which are included, together with Dr. Brethauer's responses, in the article.
One noted that this study adds to the findings of STAMPEDE, a randomized controlled trial also carried out at the Cleveland Clinic: "Today's paper adds even more proof. Not only does it work, but it works 5 years later. It is not totally new. We reported good results at 10 years. The Swedish colleagues reported at 20 years. But your paper was far more elegant and far more detailed," observed Walter J. Pories, MD, from East Carolina University, Greenville, North Carolina. Why, then, he wonders, are there still "cries for more evidence, more evidence?"
Dr. Brethauer replies that the surgical community must continue "to provide data to support the concept that this is a surgically treated disease. It is a major paradigm shift for our endocrinology colleagues to accept. And I think it is going to require time and a new generation of endocrinologists before they fully embrace this."
Talking of Cure is "Controversial and Provocative"
Dr. Brethauer explained to Medscape Medical News that while his study is not unique in reporting longer-term outcomes, it is one of the few to have used the strictest definition of remission, as per ADA criteria, "that a patient has to have HbA1c of 6% or less, normal fasting blood glucose [<100 mg/dL], and be completely off diabetes medications for one year."
In their study, the Cleveland Clinic researchers went back and examined the clinical outcomes of 217 patients with type 2 diabetes who underwent bariatric surgery between 2004 and 2007 and had at least 5 years of follow-up. The majority of patients (n = 162) underwent Roux-en-Y gastric bypass (RYGB), with the remainder undergoing gastric banding (n = 32) or sleeve gastrectomy (n = 23).
At a median follow-up of 6 years (range, 5–9 years), a mean excess weight loss of 55% was associated with mean reductions in HbA1c from 7.5% to 6.5% (P < .001) and fasting blood glucose (FBG) from 155.9 mg/dL to 114.8 mg/dL (P < .001).
Long-term complete remission, as per the ADA criteria, occurred in 24% of patients, and partial remission (HbA1c 6%–6.4%, FBG of 100–125 mg/dL for 1 year in the absence of antidiabetic medications) was observed in 26% of patients. In addition, a further 34% of patients improved their long-term diabetes control compared with presurgery status. There were 16% of patients who remained unchanged.
When only the RYGB patients were considered, 31% of patients achieved complete remission; 27% of bypass patients continuously sustained this for more than 5 years, the ADA definition of a "cure," the researchers note, although Dr. Brethauer observed that the use of this term with respect to type 2 diabetes "is still quite controversial and somewhat provocative."
Realistic Expectations; Diabetes Recurs but Legacy Effect
Dr. Brethauer and colleagues go on to say that it's now obvious that the remission rates first seen in short
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Here is the intro to another journal article. It again points out weight gain and diabetes.
Introduction
The prevalence of obesity and the associated health consequences, including type 2 diabetes mellitus (T2DM), continues to rise.[1] The typical progression of T2DM is one of deteriorating β-cell function that requires an increasing amount of oral medical therapy and finally insulin treatment to achieve adequate glycemic control.[2] Ultimately, there is pancreatic β-cell failure.[3] Calorie restriction and subsequent weight loss have been shown to be effective treatment modalities of T2DM.[4] Caloric restriction can improve hyperglycemia through regulation of hepatic glucose production.[5] In addition to cumulative weight loss, the rapidity with which the weight loss is achieved also exerts an effect on glycemic control.[6] Unfortunately, most individuals are unable to maintain a reduced body weight through diet alone.[7] In contrast, weight loss achieved by bariatric surgery has been shown to result in a lesser degree of recidivism than nonsurgical treatments and is associated with marked improvement of glycemic control.[8]
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This is at the heart of the ethical considerations using a paid organ system where the coercion of the financial gain could lead someone to place their on life at risk.
The same could be said of coal mining, police work, fire fighting or working as a convenience store clerk - all cases of placing one's life at risk for financial gain.
And there is the job of "royal organ donor" (yes, really) in at least one country where a peasant is type matched to the king and given a great life - in return for agreeing to donate ANY organ should the king need it.
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I guess I just don't see compensating a live donor (be it kidney, liver, or bone marrow) for lost wages and time when not every donor will get their lost wages covered by work or short-term-disability. Up in BC Canada, I'm told by someone who received a kidney from a live donor that the hospital compensated his donor for lost wages. It only makes sense to me that this be done. In my personal case, my donor was retired and married, so she did not need to worry about losing income. But in reality, this does not happen that often, since not many retired folk are healthy enough for donation. Also, Australia is starting to compensate live donors on a trial basis. It will be interesting to see how that turns out.
KarenInWA
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This is at the heart of the ethical considerations using a paid organ system where the coercion of the financial gain could lead someone to place their on life at risk.
The same could be said of coal mining, police work, fire fighting or working as a convenience store clerk - all cases of placing one's life at risk for financial gain.
And there is the job of "royal organ donor" (yes, really) in at least one country where a peasant is type matched to the king and given a great life - in return for agreeing to donate ANY organ should the king need it.
Hello Simon,
could you please tell me more about the "job" of the "royal organ donor" ? Where and when does/did it take place ?
Thanks from Kristina
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Many people will not sign a donor card feel that they will not get the best effort at saving their lives.
Many humanitarian Christians in England (and on the Continent) are not prepared any longer to sign donor cards ...
... because they feel the donor-card-system wishes to exploit their humanitarian Christian good mindedness...
... many healthy humanitarian Christians (with a normal body weight and a healthy life style who look after themselves)
also feel that they were born with two kidneys in the first place and it was meant by nature to stay this way...
... and it was meant by nature that they need both kidneys to function properly for the rest of their lives...
... many are not willing anymore to give away one of their kidneys
to assist an obese life style of some other people who seem to be unable
to care for their own body...and/or their own life... and as a result end up on a kidney transplant list
as a direct result of their own (often obese) life style...
which results in self-inflicted kidney failure... and many other health problems...
... many people also wonder why mainly humanitarian Christians are being targeted
to give away one of their kidneys ... whilst no other people seem to be targeted for a kidney donation....
and many people are wondering why that should be so ?
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where is your information source for this observation, Kristina? what do you mean by humanitariun? I would have thought that it would be very humanitarian to gibe a kidney to a fellow human being?
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One of the sources of the information comes from a phone-in-discussion
...instigated by a London Radio Station ... and inspired by the story of a UK Christian family
who had donated the kidneys of their diseased son in good trust to a needy person on the British Kidney Transplant Waiting list...
...and this family found out later that one of the donated kidneys was transplanted by NHS nephrologists for money
to a Middle Eastern business man who was flown in to receive his kidney transplant
in a London NHS hospital ... but this Middle Eastern business man was not even registered
on the UK kidney transplant waiting list...
... As you can imagine, emotions ran very high during this phone-in-discussion...
and this discussion made many listeners re-think...
... Many wondered about the integrity of the UK kidney transplant waiting list...
and it was mentioned that these days “The Christians” are not being thrown to the lions any longer ...
... but instead they seem to be exploited to supply “spare body parts” whenever needed...
... I listened to this discussion with great interest...
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The original post deals with living donation, not cadaver, and the issues raised are irrelevant to deceased donation.
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Not only that, but not all ESRD patients are overweight and/or caused their kidneys to fail....
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:Kristina, out of curiosity, how did these people find this information out? Was there a follow up, where people said that they did not wish to donate any longer?
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Not only that, but not all ESRD patients are overweight and/or caused their kidneys to fail....
... that may be true but Radio and many other news, including newspapers
inform people in the UK that NHS health services face a crisis
because so many obese people (including children) experience ESRF due to self-inflicted kidney failure...
... I wonder: do other countries experience similar problems?
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This is at the heart of the ethical considerations using a paid organ system where the coercion of the financial gain could lead someone to place their on life at risk.
The same could be said of coal mining, police work, fire fighting or working as a convenience store clerk - all cases of placing one's life at risk for financial gain.
And there is the job of "royal organ donor" (yes, really) in at least one country where a peasant is type matched to the king and given a great life - in return for agreeing to donate ANY organ should the king need it.
Hello Simon,
could you please tell me more about the "job" of the "royal organ donor" ? Where and when does/did it take place ?
Thanks from Kristina
-
Many people will not sign a donor card feel that they will not get the best effort at saving their lives.
Many humanitarian Christians in England (and on the Continent) are not prepared any longer to sign donor cards ...
... because they feel the donor-card-system wishes to exploit their humanitarian Christian good mindedness...
... many healthy humanitarian Christians (with a normal body weight and a healthy life style who look after themselves)
also feel that they were born with two kidneys in the first place and it was meant by nature to stay this way...
... and it was meant by nature that they need both kidneys to function properly for the rest of their lives...
... many are not willing anymore to give away one of their kidneys
to assist an obese life style of some other people who seem to be unable
to care for their own body...and/or their own life... and as a result end up on a kidney transplant list
as a direct result of their own (often obese) life style...
which results in self-inflicted kidney failure... and many other health problems...
... many people also wonder why mainly humanitarian Christians are being targeted
to give away one of their kidneys ... whilst no other people seem to be targeted for a kidney donation....
and many people are wondering why that should be so ?
Kristina, obesity, kidney failure, and diabetes have not been scientifically proven. In fact, most of the grossly overweight people in a dialysis clinic are the people working at the clinic, not the patients.
The situation has not changed since 1998 when, in their New Year’s Day editorial, “An illfated New Year’s resolution,” Marcia Angell, MD, and Jerome P. Kassirer, MD, editors of the New England Journal of Medicine, warned of the dismal record and questionable value of weight loss interventions:
“Until we have better data about the risks of being overweight and the benefits and risks of trying to lose weight, we should remember that the cure for obesity may be worse than the condition.”(29)
Weight loss surgery can work, but cannot be considered safe. This is an elective surgery that can turn deadly or leave previously-healthy patients incapacitated for life.(18)
Bariatric surgery carries a higher mortality risk than often claimed, especially for older patients, according to a study that analyzed risks for 16,155 Medicare patients who underwent this surgery between 1997 and 2002.
While many surgeons count only deaths on the operating table, or within a few days, and report a death rate of under 1 percent, this study found mortality risk of nearly 5 percent within the first year. Older patients had higher risk – nearly half of patients age 75 and over died within the year.(19)
A recent study in Pennsylvania found a high suicide rate as well as similarly higher death rates for older patients.(20)
In addition, morbidity risk includes severe infection, leaks, blood clots, malnutrition, brain disorder, memory loss and confusion, inability to coordinate movement, vision impairment and a long list of other complications, along with repeated hospitalizations.
Many patients regain all the weight lost.(21)
Liposuction is another popular body-shaping surgery that is not risk-free. It can result in death, severe injury or disfigurement.(22)
“The inability of the volunteers to maintain their diets must give us pause,” wrote Dr. Martijn Katan in a recent Feb. 2009 editorial in the New England Journal of Medicine. He was reviewing a careful two-year diet program reported in the same issue.(25)
It’s an old story: Participants had lost weight for 6 months, then regained and were still gaining more weight at the end of the two-year trial. Nevertheless, a positive spin by the authors claimed “clinically meaningful weight loss.”
In addition, many in the medical industry are taking money from the weight loss industry.
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Mark Kern, Professor of Exercise and Nutritional Sciences at San Diego State University, has pointed out that many of Lustig’s arguments are not scientifically supported, including his demonizing of fructose: only if 95 percent of our calorie intake were to come from fructose would we expect it to affect our metabolism in the ways Lustig describes. According to Kern, Lustig doesn’t even get the biochemistry right: fructose does not often (much less always, as Lustig has it) metabolize to fat.
Case Western Reserve University professor Paul Ernsberger explains the implications of the ADA's 1997 redefinition:
"Is the overall incidence of diabetes rising? It is difficult to say. This is because the standards for diagnosing diabetes have changed radically over the last 30 years. We have gone from measuring glucose in the urine to carrying out an elaborate procedure known as the oral glucose tolerance test and finally to relying solely on fasting blood glucose. The level defining diabetes was dropped from 140 to 126 mg/dL in the 1990s. Loosening the diagnostic standards greatly increased the number of people classified as diabetic. Also, screening for diabetes has been stepped up, and now most people over age 45 are supposed to be checked every 3 years. In contrast, the average fasting blood glucose level in the adult population is about 85 mg/dL, and this value has not changed in decades. If there truly were an epidemic of diabetes, the average blood glucose level would rise, just as the average body weight has risen."
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Mark Kern, Professor of Exercise and Nutritional Sciences at San Diego State University, has pointed out that many of Lustig’s arguments are not scientifically supported, including his demonizing of fructose: only if 95 percent of our calorie intake were to come from fructose would we expect it to affect our metabolism in the ways Lustig describes. According to Kern, Lustig doesn’t even get the biochemistry right: fructose does not often (much less always, as Lustig has it) metabolize to fat.
Case Western Reserve University professor Paul Ernsberger explains the implications of the ADA's 1997 redefinition:
"Is the overall incidence of diabetes rising? It is difficult to say. This is because the standards for diagnosing diabetes have changed radically over the last 30 years. We have gone from measuring glucose in the urine to carrying out an elaborate procedure known as the oral glucose tolerance test and finally to relying solely on fasting blood glucose. The level defining diabetes was dropped from 140 to 126 mg/dL in the 1990s. Loosening the diagnostic standards greatly increased the number of people classified as diabetic. Also, screening for diabetes has been stepped up, and now most people over age 45 are supposed to be checked every 3 years. In contrast, the average fasting blood glucose level in the adult population is about 85 mg/dL, and this value has not changed in decades. If there truly were an epidemic of diabetes, the average blood glucose level would rise, just as the average body weight has risen."
126 is absolutely an abnormal blood glucose value. You fail to acknowledge the epidemic of "adult onset" diabetes seen in kids today. Fructose is an issue in that it is a cause of inflammation as well as contributing to obesity.
http://www.nytimes.com/2012/05/07/opinion/no-longer-just-adult-onset.html?_r=0
The reason for changing from a diagnosis of diabetes at 140 to 126 was the knowledge that much of the damage for diabetes happens in many patients BEFORE they even know that they have diabetes. In addition, we now have preventive measures to slow the progression to diabetes in the "pre-diabetic" patients who are also growing in number. Sorry, I can't agree whatsoever with your contentions.
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Mark Kern, Professor of Exercise and Nutritional Sciences at San Diego State University, has pointed out that many of Lustig’s arguments are not scientifically supported, including his demonizing of fructose: only if 95 percent of our calorie intake were to come from fructose would we expect it to affect our metabolism in the ways Lustig describes. According to Kern, Lustig doesn’t even get the biochemistry right: fructose does not often (much less always, as Lustig has it) metabolize to fat.
Case Western Reserve University professor Paul Ernsberger explains the implications of the ADA's 1997 redefinition:
"Is the overall incidence of diabetes rising? It is difficult to say. This is because the standards for diagnosing diabetes have changed radically over the last 30 years. We have gone from measuring glucose in the urine to carrying out an elaborate procedure known as the oral glucose tolerance test and finally to relying solely on fasting blood glucose. The level defining diabetes was dropped from 140 to 126 mg/dL in the 1990s. Loosening the diagnostic standards greatly increased the number of people classified as diabetic. Also, screening for diabetes has been stepped up, and now most people over age 45 are supposed to be checked every 3 years. In contrast, the average fasting blood glucose level in the adult population is about 85 mg/dL, and this value has not changed in decades. If there truly were an epidemic of diabetes, the average blood glucose level would rise, just as the average body weight has risen."
126 is absolutely an abnormal blood glucose value. You fail to acknowledge the epidemic of "adult onset" diabetes seen in kids today. Fructose is an issue in that it is a cause of inflammation as well as contributing to obesity.
http://www.nytimes.com/2012/05/07/opinion/no-longer-just-adult-onset.html?_r=0
The reason for changing from a diagnosis of diabetes at 140 to 126 was the knowledge that much of the damage for diabetes happens in many patients BEFORE they even know that they have diabetes. In addition, we now have preventive measures to slow the progression to diabetes in the "pre-diabetic" patients who are also growing in number. Sorry, I can't agree whatsoever with your contentions.
"...the prevalence of diabetes … did not appear to increase substantially during the 1990s."
-CDC's Morbidity and Mortality Weekly Report, 2003
Diabetes "epidemic" amounts to 0.4% increase
Adjusted percentage of adults aged >= 20 with fasting blood glucose levels above 126 mg/dL
NHANES III (1988-1994) NHANES (1999-2000)
8.2 8.6
"Type 2 diabetes is still a rare condition [in children]."
-Centers for Disease Control and Prevention, 2005
While I would not disagree that most of the damage happens before the individual knows that they are a diabetic, I would submit the lowering of the fasting score is because the drug companies want to make more money from giving diabetic drugs...... Indiana University has stated that many times, blood sugar is not well controlled if the individual is not getting the proper amount of sleep. Yes, I know it is true, because that was the issue with my blood sugar, now it is a 5.4 A1C score. My blood sugar was a disaster(Labs proved it) when I did not get the right amount of sleep. As a kid, I was thin and I played sports year around, football, basketball, track, and baseball. I rarely, if ever ate carbs or Ice Cream, ever. I might have been lucky to eat candy once per month. Even when I weighed 265, my body fat levels were normal and I bench pressed 450. My height is 6'3." I walked 3 miles every day of the week. There is a donut shop right near my house, I have been there once in seven years. My old nephrologist who played college football said my bench press was "awesome." Instead of obsessing about what I ate, which I have never been a big sugar eater, please explain to me why I became a diabetic? By the way, when I was 265, I was wrestling heavyweight, and if you know anything about conditioning in wrestling, that will not need any further explanation. No sugar or very little and no ice cream, can you explain that to me? No sugary drinks or any of that crap..... How do you pass a police physical if you are out of shape, please explain that one? I was drinking sugar free many years before it was popular. Actually, my very favorite drink is ice cold water and has been since I was a child.
If the weight and diabetes theory is true, many who work in dialysis better be worried, because the very vast majority of them are grossly overweight. I get sick and tired of being lectured by people who are grossly overweight, abuse alcohol, smoke, and abuse their body every single day, while telling me how to live and I did none of those things. One of your friends in medicine told me that I was "overweight." Spoke to a nurse who was a major college athlete and she said "that is a load of total crap." It might be a good idea for our friends to practice what they preach, however, I will not waste anytime waiting. If it is so great, why are they not setting the example???
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Many people will not sign a donor card feel that they will not get the best effort at saving their lives.
Many humanitarian Christians in England (and on the Continent) are not prepared any longer to sign donor cards ...
... because they feel the donor-card-system wishes to exploit their humanitarian Christian good mindedness...
... many healthy humanitarian Christians (with a normal body weight and a healthy life style who look after themselves)
also feel that they were born with two kidneys in the first place and it was meant by nature to stay this way...
... and it was meant by nature that they need both kidneys to function properly for the rest of their lives...
... many are not willing anymore to give away one of their kidneys
to assist an obese life style of some other people who seem to be unable
to care for their own body...and/or their own life... and as a result end up on a kidney transplant list
as a direct result of their own (often obese) life style...
which results in self-inflicted kidney failure... and many other health problems...
... many people also wonder why mainly humanitarian Christians are being targeted
to give away one of their kidneys ... whilst no other people seem to be targeted for a kidney donation....
and many people are wondering why that should be so ?
Kristina, obesity, kidney failure, and diabetes have not been scientifically proven. In fact, most of the grossly overweight people in a dialysis clinic are the people working at the clinic, not the patients.
The situation has not changed since 1998 when, in their New Year’s Day editorial, “An illfated New Year’s resolution,” Marcia Angell, MD, and Jerome P. Kassirer, MD, editors of the New England Journal of Medicine, warned of the dismal record and questionable value of weight loss interventions:
“Until we have better data about the risks of being overweight and the benefits and risks of trying to lose weight, we should remember that the cure for obesity may be worse than the condition.”(29)
Weight loss surgery can work, but cannot be considered safe. This is an elective surgery that can turn deadly or leave previously-healthy patients incapacitated for life.(18)
Bariatric surgery carries a higher mortality risk than often claimed, especially for older patients, according to a study that analyzed risks for 16,155 Medicare patients who underwent this surgery between 1997 and 2002.
While many surgeons count only deaths on the operating table, or within a few days, and report a death rate of under 1 percent, this study found mortality risk of nearly 5 percent within the first year. Older patients had higher risk – nearly half of patients age 75 and over died within the year.(19)
A recent study in Pennsylvania found a high suicide rate as well as similarly higher death rates for older patients.(20)
In addition, morbidity risk includes severe infection, leaks, blood clots, malnutrition, brain disorder, memory loss and confusion, inability to coordinate movement, vision impairment and a long list of other complications, along with repeated hospitalizations.
Many patients regain all the weight lost.(21)
Liposuction is another popular body-shaping surgery that is not risk-free. It can result in death, severe injury or disfigurement.(22)
“The inability of the volunteers to maintain their diets must give us pause,” wrote Dr. Martijn Katan in a recent Feb. 2009 editorial in the New England Journal of Medicine. He was reviewing a careful two-year diet program reported in the same issue.(25)
It’s an old story: Participants had lost weight for 6 months, then regained and were still gaining more weight at the end of the two-year trial. Nevertheless, a positive spin by the authors claimed “clinically meaningful weight loss.”
In addition, many in the medical industry are taking money from the weight loss industry.
Hello, NDXFan,
I agree with you wholeheartedly... I also find it very odd that obese & overweight people seem to be victimized
as (the latest) scape-goats to hide financial problems many health services face these days ...
It is also strange that governments still promote (directly or indirectly) fast food & ready-made food at a time
when it has become obvious that many ingredients in such food contribute to health problems ...
One of my neighbours has made me aware of the serious problems overweight and/or obese people face
when they receive no real constructive medical help to address their problem...
because they HAVE to eat every day in order to stay alive and it seems very difficult for many
to avoid eating fast food and “ready-made food” – whilst they receive no no medical help to address their problem...
... my neighbour does not even know where to turn to receive medical help for her problem...
...my neighbours sad story also made me realize that I am certainly not the only one, who –
suffering from a rare disease (SLE/MCTD) – is being victimized by a very unhealthy health system...
because after I was diagnosed with pre-dialysis ESRF in August 2006 I was given no NHS medical help to avoid dialysis -
and I was left traumatized and left alone to face my failing kidney function alone ...
... but I was lucky to find assistance & help to refine my (already vegetarian) diet through the Internet...
and - with the help of my refined diet - I was very lucky to avoid dialysis ever since...
... I also feel very lucky because I found constructive special diet-assistance to avoid dialysis in my ESRF - courtesy of the Internet...
... whereas my neighbour has had no luck at all to address her eating-disorder ... not even through the Internet...
... I also realized how difficult it can be for diabetes patients in ESRF when IHD-member boxman experienced medical complications ...
(P.S. does anyone know how boxman is doing ?)
Best wishes from Kristina.
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All I will say is that I have actually treated over 1000 diabetics in my 25 years of practice. I agree with Hemodoc. The disease does so much damage, often before it is diagnosed. It is not some drug company conspiracy to make money. The damage to the nervous system and circulatory system is horrendous. The eyes , kidneys and feet are often damaged.
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All I will say is that I have actually treated over 1000 diabetics in my 25 years of practice. I agree with Hemodoc. The disease does so much damage, often before it is diagnosed. It is not some drug company conspiracy to make money. The damage to the nervous system and circulatory system is horrendous. The eyes , kidneys and feet are often damaged.
Absolutely true. Diabetes in many ways is a disease of the blood vessels which causes blindness by affecting the retinal vessels, heart attacks, strokes, peripheral artery disease, peripheral neuropathy and several other manifestations of diabetes including of course renal disease. I had very few adult onset diabetic patients who were not obese and manifest the constellation of findings described in the metabolic syndrome. If Jerome wishes to believe that obesity has nothing to do with diabetes, good for him. Expert opinions by themselves are not evidence for or against any medical theory. THe evidence to date supports the correlation between obesity and diabetes.
BTW, what does this have to do with transplant. Talk about a thread hijack.
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Kristina, I'm not sure it is entirely correct to claim that governments promote fast-food. To be fair, it is true that companies that produce these products lobby hard, but it is government that pushes fast food restaurants to prominently display nutritional information about the food they sell. At least consumers can't claim that they don't know what they're eating. I don't think anyone in the US nor in the UK thinks that Big Macs and fries with a 32oz soda is a source of good nutrition!
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It is true that governments and government MP's do not openly promote the fast food industry...
but I do remember vividly reading about different companies where MP's had "a share"
as board-members and/or "advisers" and my hair was standing up !!!
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This is at the heart of the ethical considerations using a paid organ system where the coercion of the financial gain could lead someone to place their on life at risk.
The same could be said of coal mining, police work, fire fighting or working as a convenience store clerk - all cases of placing one's life at risk for financial gain.
And there is the job of "royal organ donor" (yes, really) in at least one country where a peasant is type matched to the king and given a great life - in return for agreeing to donate ANY organ should the king need it.
Hello Simon,
could you please tell me more about the "job" of the "royal organ donor" ? Where and when does/did it take place ?
Thanks from Kristina
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All I will say is that I have actually treated over 1000 diabetics in my 25 years of practice. I agree with Hemodoc. The disease does so much damage, often before it is diagnosed. It is not some drug company conspiracy to make money. The damage to the nervous system and circulatory system is horrendous. The eyes , kidneys and feet are often damaged.
NDXUFan:
I thought of each and every one of you, today, at the primary care/endocrinologist's office. As I was leaving, I saw a physician who was grossly overweight. Does not look like he practices what he preaches, must not work in any field of dialysis, LOL! I had to admit, I thought of you and HemoDoc. Anyone who tells you that a blood sugar score of 104 is high, is an individual who is looney tunes. No, not a big fan of conspiracy theories, which I think are crazy. I think the drug companies want to make money and this is a way to line their coffers, in addition to weight loss companies.......
The notion that 65 percent of Americans are overweight or obese derives in part from a 1998 decision to redefine "overweight," which cast more than 35 million Americans into that category. This decision was made by a National Institutes of Health obesity panel chaired by Xavier Pi-Sunyer, one of the most influential obesity researchers in the country.
Over the years, Pi-Sunyer has received support from virtually every leading weight-loss company, including Novartis, Sanofi-Aventis, Ortho-McNeil, Wyeth-Ayerst, Knoll, Weight Watchers, and Roche. He has served on the advisory boards of Wyeth-Ayerst, Knoll, Abbott, Johnson & Johnson, and McNeil Nutritionals. He once headed up the Weight Watchers Foundation and is currently a board member of that organization. Pi-Sunyer gave the "obesity overview" presentation on behalf of Knoll, maker of the weight-loss drug Meridia, at a 1996 FDA advisory panel hearing on the drug. He has also been paid to sign his name to ghost-written journal articles used to promote the dangerous weight-loss combination known as "fen-phen."
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All I will say is that I have actually treated over 1000 diabetics in my 25 years of practice. I agree with Hemodoc. The disease does so much damage, often before it is diagnosed. It is not some drug company conspiracy to make money. The damage to the nervous system and circulatory system is horrendous. The eyes , kidneys and feet are often damaged.
NDXUFan:
I thought of each and every one of you, today, at the primary care/endocrinologist's office. As I was leaving, I saw a physician who was grossly overweight. Does not look like he practices what he preaches, must not work in any field of dialysis, LOL! I had to admit, I thought of you and HemoDoc. Anyone who tells you that a blood sugar score of 104 is high, is an individual who is looney tunes. No, not a big fan of conspiracy theories, which I think are crazy. I think the drug companies want to make money and this is a way to line their coffers, in addition to weight loss companies.......
The notion that 65 percent of Americans are overweight or obese derives in part from a 1998 decision to redefine "overweight," which cast more than 35 million Americans into that category. This decision was made by a National Institutes of Health obesity panel chaired by Xavier Pi-Sunyer, one of the most influential obesity researchers in the country.
Over the years, Pi-Sunyer has received support from virtually every leading weight-loss company, including Novartis, Sanofi-Aventis, Ortho-McNeil, Wyeth-Ayerst, Knoll, Weight Watchers, and Roche. He has served on the advisory boards of Wyeth-Ayerst, Knoll, Abbott, Johnson & Johnson, and McNeil Nutritionals. He once headed up the Weight Watchers Foundation and is currently a board member of that organization. Pi-Sunyer gave the "obesity overview" presentation on behalf of Knoll, maker of the weight-loss drug Meridia, at a 1996 FDA advisory panel hearing on the drug. He has also been paid to sign his name to ghost-written journal articles used to promote the dangerous weight-loss combination known as "fen-phen."
???????????
Well, if you are calling me and obsidianom looney toons, at least I am in good company.
You fail to understand that diabetes is not yes or no at any certain level, it is instead an insidious slow onset. My mother in law had a blood glucose fasting a couple of years ago about 104. I warned her to lose weight and exercise. She didn't. Today, a short time later, she has full blown diabetes. Sorry, if I am looney toons, how did I predict that outcome?
No sense arguing further especially on a thread about transplant about weight correlations with diabetes. Really, nothing more to say except, I am in good company with obsidianom. Thank you.
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Many people will not sign a donor card feel that they will not get the best effort at saving their lives.
Many humanitarian Christians in England (and on the Continent) are not prepared any longer to sign donor cards ...
... because they feel the donor-card-system wishes to exploit their humanitarian Christian good mindedness...
... many healthy humanitarian Christians (with a normal body weight and a healthy life style who look after themselves)
also feel that they were born with two kidneys in the first place and it was meant by nature to stay this way...
... and it was meant by nature that they need both kidneys to function properly for the rest of their lives...
... many are not willing anymore to give away one of their kidneys
to assist an obese life style of some other people who seem to be unable
to care for their own body...and/or their own life... and as a result end up on a kidney transplant list
as a direct result of their own (often obese) life style...
which results in self-inflicted kidney failure... and many other health problems...
... many people also wonder why mainly humanitarian Christians are being targeted
to give away one of their kidneys ... whilst no other people seem to be targeted for a kidney donation....
and many people are wondering why that should be so ?
Kristina, obesity, kidney failure, and diabetes have not been scientifically proven. In fact, most of the grossly overweight people in a dialysis clinic are the people working at the clinic, not the patients.
The situation has not changed since 1998 when, in their New Year’s Day editorial, “An illfated New Year’s resolution,” Marcia Angell, MD, and Jerome P. Kassirer, MD, editors of the New England Journal of Medicine, warned of the dismal record and questionable value of weight loss interventions:
“Until we have better data about the risks of being overweight and the benefits and risks of trying to lose weight, we should remember that the cure for obesity may be worse than the condition.”(29)
Weight loss surgery can work, but cannot be considered safe. This is an elective surgery that can turn deadly or leave previously-healthy patients incapacitated for life.(18)
Bariatric surgery carries a higher mortality risk than often claimed, especially for older patients, according to a study that analyzed risks for 16,155 Medicare patients who underwent this surgery between 1997 and 2002.
While many surgeons count only deaths on the operating table, or within a few days, and report a death rate of under 1 percent, this study found mortality risk of nearly 5 percent within the first year. Older patients had higher risk – nearly half of patients age 75 and over died within the year.(19)
A recent study in Pennsylvania found a high suicide rate as well as similarly higher death rates for older patients.(20)
In addition, morbidity risk includes severe infection, leaks, blood clots, malnutrition, brain disorder, memory loss and confusion, inability to coordinate movement, vision impairment and a long list of other complications, along with repeated hospitalizations.
Many patients regain all the weight lost.(21)
Liposuction is another popular body-shaping surgery that is not risk-free. It can result in death, severe injury or disfigurement.(22)
“The inability of the volunteers to maintain their diets must give us pause,” wrote Dr. Martijn Katan in a recent Feb. 2009 editorial in the New England Journal of Medicine. He was reviewing a careful two-year diet program reported in the same issue.(25)
It’s an old story: Participants had lost weight for 6 months, then regained and were still gaining more weight at the end of the two-year trial. Nevertheless, a positive spin by the authors claimed “clinically meaningful weight loss.”
In addition, many in the medical industry are taking money from the weight loss industry.
Hello, NDXFan,
I agree with you wholeheartedly... I also find it very odd that obese & overweight people seem to be victimized
as (the latest) scape-goats to hide financial problems many health services face these days ...
It is also strange that governments still promote (directly or indirectly) fast food & ready-made food at a time
when it has become obvious that many ingredients in such food contribute to health problems ...
One of my neighbours has made me aware of the serious problems overweight and/or obese people face
when they receive no real constructive medical help to address their problem...
because they HAVE to eat every day in order to stay alive and it seems very difficult for many
to avoid eating fast food and “ready-made food” – whilst they receive no no medical help to address their problem...
... my neighbour does not even know where to turn to receive medical help for her problem...
...my neighbours sad story also made me realize that I am certainly not the only one, who –
suffering from a rare disease (SLE/MCTD) – is being victimized by a very unhealthy health system...
because after I was diagnosed with pre-dialysis ESRF in August 2006 I was given no NHS medical help to avoid dialysis -
and I was left traumatized and left alone to face my failing kidney function alone ...
... but I was lucky to find assistance & help to refine my (already vegetarian) diet through the Internet...
and - with the help of my refined diet - I was very lucky to avoid dialysis ever since...
... I also feel very lucky because I found constructive special diet-assistance to avoid dialysis in my ESRF - courtesy of the Internet...
... whereas my neighbour has had no luck at all to address her eating-disorder ... not even through the Internet...
... I also realized how difficult it can be for diabetes patients in ESRF when IHD-member boxman experienced medical complications ...
(P.S. does anyone know how boxman is doing ?)
Best wishes from Kristina.
NDXUFan;
The claims about fast food are simply bunk..... Have talked with a number of chemists who disagree with this claim...... By the way, when I ate mostly fast food, my cholesterol tanked to 40, how can we explain that fact? I am not talking about sugar drinks, but food.
Uffe Ravnskov, Professor of Nephrology and Professor of Clinical Chemistry:
What is particularly shocking is that the effect of the low-fat diet on clinical events was never tested before it was recommended to the public. To get a drug into clinical practice demands that it has been shown to be harmless or at least without serious side effects, first in various laboratory animals, then in healthy voluntary test subjects, and finally its therapeutic value must have been proven in a number of clinical trials. But dietary advices are given to millions of people based on speculation only.
Sound familiar?
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All I will say is that I have actually treated over 1000 diabetics in my 25 years of practice. I agree with Hemodoc. The disease does so much damage, often before it is diagnosed. It is not some drug company conspiracy to make money. The damage to the nervous system and circulatory system is horrendous. The eyes , kidneys and feet are often damaged.
NDXUFan:
I thought of each and every one of you, today, at the primary care/endocrinologist's office. As I was leaving, I saw a physician who was grossly overweight. Does not look like he practices what he preaches, must not work in any field of dialysis, LOL! I had to admit, I thought of you and HemoDoc. Anyone who tells you that a blood sugar score of 104 is high, is an individual who is looney tunes. No, not a big fan of conspiracy theories, which I think are crazy. I think the drug companies want to make money and this is a way to line their coffers, in addition to weight loss companies.......
The notion that 65 percent of Americans are overweight or obese derives in part from a 1998 decision to redefine "overweight," which cast more than 35 million Americans into that category. This decision was made by a National Institutes of Health obesity panel chaired by Xavier Pi-Sunyer, one of the most influential obesity researchers in the country.
Over the years, Pi-Sunyer has received support from virtually every leading weight-loss company, including Novartis, Sanofi-Aventis, Ortho-McNeil, Wyeth-Ayerst, Knoll, Weight Watchers, and Roche. He has served on the advisory boards of Wyeth-Ayerst, Knoll, Abbott, Johnson & Johnson, and McNeil Nutritionals. He once headed up the Weight Watchers Foundation and is currently a board member of that organization. Pi-Sunyer gave the "obesity overview" presentation on behalf of Knoll, maker of the weight-loss drug Meridia, at a 1996 FDA advisory panel hearing on the drug. He has also been paid to sign his name to ghost-written journal articles used to promote the dangerous weight-loss combination known as "fen-phen."
???????????
Well, if you are calling me and obsidianom looney toons, at least I am in good company.
You fail to understand that diabetes is not yes or no at any certain level, it is instead an insidious slow onset. My mother in law had a blood glucose fasting a couple of years ago about 104. I warned her to lose weight and exercise. She didn't. Today, a short time later, she has full blown diabetes. Sorry, if I am looney toons, how did I predict that outcome?
No sense arguing further especially on a thread about transplant about weight correlations with diabetes. Really, nothing more to say except, I am in good company with obsidianom. Thank you.
NDXUFan:
You are also leaving out the fact that she is probably over 50 years old and at that point is when most people become diabetics because the system quits making insulin(George Washington University Hospital-Endocrinology)
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NDXUFan:
You are also leaving out the fact that she is probably over 50 years old and at that point is when most people become diabetics because the system quits making insulin(George Washington University Hospital-Endocrinology)
Not to cut to the jugular, but you appear to be completely unaware that type II, "adult onset" diabetes is associated with an EXCESS insulin production with insulin resistance. Once again, what is your point my friend? Your facts are simply in error. You appear to be suggesting the type of finding with Type I diabetes which is actually an autoimmune disease wiping out insulin production in the pancreas. Type II diabetes is quite different than Type I and has NOTHING to do with reduced insulin levels until VERY late in the process. Sorry, you are simply wrong about your assertions.
http://en.wikipedia.org/wiki/Insulin_resistance
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NDXUFan:
You are also leaving out the fact that she is probably over 50 years old and at that point is when most people become diabetics because the system quits making insulin(George Washington University Hospital-Endocrinology)
Not to cut to the jugular, but you appear to be completely unaware that type II, "adult onset" diabetes is associated with an EXCESS insulin production with insulin resistance. Once again, what is your point my friend? Your facts are simply in error. You appear to be suggesting the type of finding with Type I diabetes which is actually an autoimmune disease wiping out insulin production in the pancreas. Type II diabetes is quite different than Type I and has NOTHING to do with reduced insulin levels until VERY late in the process. Sorry, you are simply wrong about your assertions.
http://en.wikipedia.org/wiki/Insulin_resistance
I concur with Hemo doc. Type 1 and type 2 are quite different.
I have never heard of any study showing 50 year olds reduce insulin production.
I had a patient in my offfice the other day with a glucose over 500 ( the meter read HI, which doesnt mean hello. It means WAKE UP OR DIE.
He was grossly obese and not taking his insulin. He refuses to check his sugar at home and is frustrating his wife who is a nurse. This guy is a walking time bomb. Yet like a lot of people doesnt want to deal with the issue and now is in great danger. He claims he cant get his sugar down. In reality he needs to lose 100 pounds and take his diabetes seriously. He doesnt get it that his weight is a major factor . Meds alone probably wont get him under control. So he just does nothing as he doesnt want to face that fact.
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NDXUFan:
You are also leaving out the fact that she is probably over 50 years old and at that point is when most people become diabetics because the system quits making insulin(George Washington University Hospital-Endocrinology)
Not to cut to the jugular, but you appear to be completely unaware that type II, "adult onset" diabetes is associated with an EXCESS insulin production with insulin resistance. Once again, what is your point my friend? Your facts are simply in error. You appear to be suggesting the type of finding with Type I diabetes which is actually an autoimmune disease wiping out insulin production in the pancreas. Type II diabetes is quite different than Type I and has NOTHING to do with reduced insulin levels until VERY late in the process. Sorry, you are simply wrong about your assertions.
http://en.wikipedia.org/wiki/Insulin_resistance
I am curious, if the cause of type II diabetes is so well known, why are the top academic Nephrologists telling me that they do not know what causes Type II diabetes?
http://medicine.iu.edu/nephrology/faculty-and-staff-directory/michael-a-kraus-md/
Clinical Interests:
•Home Dialysis
•Peritoneal Dialysis
•Dialysis Access Problems
•Continuous Renal Replacement Therapy (CRRT)
•Acute Renal Failure
•Chronic Kidney Disease
•Hypertension
•Glomerulonephritis
http://intmed.uc.edu/contact/directory/profile.aspx?epersonID=gallajh
Professor Emeritus of Nephrology, John Galla-University of Cincinnati. Dr. Galla is extensively published.
Cincinnati Children's Hospital which is ranked #3 in the United States, "The cause of Type II diabetes is unknown."
Our diabetes and endocrinology program was rated No. 6 in the country in the 2013-14 list of Best Children’s Hospitals published by U.S. News & World Report
http://www.cincinnatichildrens.org/service/d/diabetes/default/
http://health.usnews.com/best-hospitals/pediatric-rankings/diabetes-and-endocrinology
Honestly, never had any health problems until listening to your profession and their obsessive low fat diets. The old food standard was filled with bread and pasta, which is very, very bad for diabetics and blood sugar control. Never really was a big carb eater or sugary drinks, rather have peanuts than a candy bar. I am curious, I have a friend who is the same height as I am and same weight, is the picture of health, how could this be??? My body fat was tested at the University of Cincinnati and was told that it was "excellent." Care to explain? Now, that I am off of that stupid night shift, getting enough sleep and going back to my old ways of eating, my last A1C was 5.4 and the blood sugar score after that was 83, care to explain that one?
Professor Emeritus of Organic Chemistry Joel Kauffman, 14 drug patents, 100 peer reviewed publications:
Richard K. Bernstein, was diagnosed with IDDM at the age of 12 in 1946. Following the advice of the American Heart Association (AHA) and the American Diabetes Association (ADbA) to eat a high-carb (40%, then 60% carb) diet, his condition worsened and most of the complications of IDDM began to appear. He found that he could not normalize his blood sugars with any insulin regimen, and that exercise in his condition did not help. By doing a literature search himself in 1965, he realized the potential benefits of normal blood sugars.
By using himself as the test animal he found that about 30 g/day of slow-acting carbohydrate (essentially fiber with no simple sugars or high GI starches at all) was necessary to normalize his blood glucose levels, the rest of his diet being fat and protein. He obtained an MD degree at about age 45 partly to have his observations published in medical journals, because the papers were rejected when he did not have the MD degree.
He has continued the diet for 35 years so far, which includes on many days, 3 eggs for breakfast and no fruit. His total cholesterol dropped from 300 mg/dL to 179, of which LDL-C = 63 and HDL-C = 116 (that is not a misprint). His triglycerides dropped from 250 to 45. His lipoprotein(a) level, a marker of inflammation, became undetectable. In 1983 he began his own medical practice for diabetics. At the time of writing he is age 72 and he still works 12-14 hour days in his medical practice on diabetics.
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Dear NDXUFan,
I believe you are conflating the issues of proof and association. There is no doubt that exercise status and obesity are correlated with Type II diabetes. You are correct in stating that we do not yet "KNOW" the cause of diabetes. You are incorrect in your diatribe against the correlation between obesity and exercise status with adult onset diabetes. It is the insulin resistance state more specifically that we do not understand.
We also have very little understanding about obesity and the physiologic effects of obesity on the rest of the body. An interesting discovery in the last few years is some of the endocrine aberrations of obesity such as finding the protein Leptin, which regulates satiety and other factors. The physiology associated with obesity, lack of exercise are often studied under the terms of the "metabolic" syndrome which involves an insulin resistance state. Yes, these are complex factors. Yes, it is not readily understood at this time what is the precise cause of Type II diabetes, but we are not completely in the dark on the associations, how to treat it effectively and better yet, how to prevent it in many patients.
-
NDXUFan:
You are also leaving out the fact that she is probably over 50 years old and at that point is when most people become diabetics because the system quits making insulin(George Washington University Hospital-Endocrinology)
Not to cut to the jugular, but you appear to be completely unaware that type II, "adult onset" diabetes is associated with an EXCESS insulin production with insulin resistance. Once again, what is your point my friend? Your facts are simply in error. You appear to be suggesting the type of finding with Type I diabetes which is actually an autoimmune disease wiping out insulin production in the pancreas. Type II diabetes is quite different than Type I and has NOTHING to do with reduced insulin levels until VERY late in the process. Sorry, you are simply wrong about your assertions.
http://en.wikipedia.org/wiki/Insulin_resistance
I am curious, if the cause of type II diabetes is so well known, why are the top academic Nephrologists telling me that they do not know what causes Type II diabetes?
http://medicine.iu.edu/nephrology/faculty-and-staff-directory/michael-a-kraus-md/
Clinical Interests:
•Home Dialysis
•Peritoneal Dialysis
•Dialysis Access Problems
•Continuous Renal Replacement Therapy (CRRT)
•Acute Renal Failure
•Chronic Kidney Disease
•Hypertension
•Glomerulonephritis
http://intmed.uc.edu/contact/directory/profile.aspx?epersonID=gallajh
Professor Emeritus of Nephrology, John Galla-University of Cincinnati. Dr. Galla is extensively published.
Cincinnati Children's Hospital which is ranked #3 in the United States, "The cause of Type II diabetes is unknown."
Our diabetes and endocrinology program was rated No. 6 in the country in the 2013-14 list of Best Children’s Hospitals published by U.S. News & World Report
http://www.cincinnatichildrens.org/service/d/diabetes/default/
http://health.usnews.com/best-hospitals/pediatric-rankings/diabetes-and-endocrinology
Honestly, never had any health problems until listening to your profession and their obsessive low fat diets. The old food standard was filled with bread and pasta, which is very, very bad for diabetics and blood sugar control. Never really was a big carb eater or sugary drinks, rather have peanuts than a candy bar. I am curious, I have a friend who is the same height as I am and same weight, is the picture of health, how could this be??? My body fat was tested at the University of Cincinnati and was told that it was "excellent." Care to explain? Now, that I am off of that stupid night shift, getting enough sleep and going back to my old ways of eating, my last A1C was 5.4 and the blood sugar score after that was 83, care to explain that one?
Professor Emeritus of Organic Chemistry Joel Kauffman, 14 drug patents, 100 peer reviewed publications:
Richard K. Bernstein, was diagnosed with IDDM at the age of 12 in 1946. Following the advice of the American Heart Association (AHA) and the American Diabetes Association (ADbA) to eat a high-carb (40%, then 60% carb) diet, his condition worsened and most of the complications of IDDM began to appear. He found that he could not normalize his blood sugars with any insulin regimen, and that exercise in his condition did not help. By doing a literature search himself in 1965, he realized the potential benefits of normal blood sugars.
By using himself as the test animal he found that about 30 g/day of slow-acting carbohydrate (essentially fiber with no simple sugars or high GI starches at all) was necessary to normalize his blood glucose levels, the rest of his diet being fat and protein. He obtained an MD degree at about age 45 partly to have his observations published in medical journals, because the papers were rejected when he did not have the MD degree.
He has continued the diet for 35 years so far, which includes on many days, 3 eggs for breakfast and no fruit. His total cholesterol dropped from 300 mg/dL to 179, of which LDL-C = 63 and HDL-C = 116 (that is not a misprint). His triglycerides dropped from 250 to 45. His lipoprotein(a) level, a marker of inflammation, became undetectable. In 1983 he began his own medical practice for diabetics. At the time of writing he is age 72 and he still works 12-14 hour days in his medical practice on diabetics.
Using individual cases to "prove" anyhting in medicine is ridiculous. I can point to the 100 year old who smokes. Does that prove smoking is safe? I can point to the 40 year old athlete who works out daily, and then suffers a major heart attack. Does that prove exercise is dangerous? On and on I can go with individuals who defy the odds and in your thinking , "prove " certain facts.
Medicine is an ART, not a pure science. There are so many variables that we still dont even know exist. Genetics alone has such an effect on each person and we are just cracking the surface on that . WE can only look at studies of MANY patients to get data to direct our treatment and recommendattions. Some studies will contradict others.
In the end we can only draw our conclusions on the best available data form MANY studies of MANY patients. Anecdotal stories of individual patients are meaningless.
We may not know the exact "cause " of diabetes but we do know which factors TEND to increase the likelihood of developing it. Again genetics plays a HUGE role. That is why we check family history so carefully in patients. The other factors COMBINED with genetics tend to lead toward developing it. Some of the factors that clearly pop up over and over are diet, weight, exercise, lifestyle etc. Each factor may not "cause" diabetes itself , but added to genetics can push a patient into the disorder.
I can honestly say I almost NEVER have seen a thin adult onset type 2 diabetic in my 25 years of practice. It can happen , but is rare.
-
NDXUFan:
You are also leaving out the fact that she is probably over 50 years old and at that point is when most people become diabetics because the system quits making insulin(George Washington University Hospital-Endocrinology)
Not to cut to the jugular, but you appear to be completely unaware that type II, "adult onset" diabetes is associated with an EXCESS insulin production with insulin resistance. Once again, what is your point my friend? Your facts are simply in error. You appear to be suggesting the type of finding with Type I diabetes which is actually an autoimmune disease wiping out insulin production in the pancreas. Type II diabetes is quite different than Type I and has NOTHING to do with reduced insulin levels until VERY late in the process. Sorry, you are simply wrong about your assertions.
http://en.wikipedia.org/wiki/Insulin_resistance
I am curious, if the cause of type II diabetes is so well known, why are the top academic Nephrologists telling me that they do not know what causes Type II diabetes?
http://medicine.iu.edu/nephrology/faculty-and-staff-directory/michael-a-kraus-md/
Clinical Interests:
•Home Dialysis
•Peritoneal Dialysis
•Dialysis Access Problems
•Continuous Renal Replacement Therapy (CRRT)
•Acute Renal Failure
•Chronic Kidney Disease
•Hypertension
•Glomerulonephritis
http://intmed.uc.edu/contact/directory/profile.aspx?epersonID=gallajh
Professor Emeritus of Nephrology, John Galla-University of Cincinnati. Dr. Galla is extensively published.
Cincinnati Children's Hospital which is ranked #3 in the United States, "The cause of Type II diabetes is unknown."
Our diabetes and endocrinology program was rated No. 6 in the country in the 2013-14 list of Best Children’s Hospitals published by U.S. News & World Report
http://www.cincinnatichildrens.org/service/d/diabetes/default/
http://health.usnews.com/best-hospitals/pediatric-rankings/diabetes-and-endocrinology
Honestly, never had any health problems until listening to your profession and their obsessive low fat diets. The old food standard was filled with bread and pasta, which is very, very bad for diabetics and blood sugar control. Never really was a big carb eater or sugary drinks, rather have peanuts than a candy bar. I am curious, I have a friend who is the same height as I am and same weight, is the picture of health, how could this be??? My body fat was tested at the University of Cincinnati and was told that it was "excellent." Care to explain? Now, that I am off of that stupid night shift, getting enough sleep and going back to my old ways of eating, my last A1C was 5.4 and the blood sugar score after that was 83, care to explain that one?
Professor Emeritus of Organic Chemistry Joel Kauffman, 14 drug patents, 100 peer reviewed publications:
Richard K. Bernstein, was diagnosed with IDDM at the age of 12 in 1946. Following the advice of the American Heart Association (AHA) and the American Diabetes Association (ADbA) to eat a high-carb (40%, then 60% carb) diet, his condition worsened and most of the complications of IDDM began to appear. He found that he could not normalize his blood sugars with any insulin regimen, and that exercise in his condition did not help. By doing a literature search himself in 1965, he realized the potential benefits of normal blood sugars.
By using himself as the test animal he found that about 30 g/day of slow-acting carbohydrate (essentially fiber with no simple sugars or high GI starches at all) was necessary to normalize his blood glucose levels, the rest of his diet being fat and protein. He obtained an MD degree at about age 45 partly to have his observations published in medical journals, because the papers were rejected when he did not have the MD degree.
He has continued the diet for 35 years so far, which includes on many days, 3 eggs for breakfast and no fruit. His total cholesterol dropped from 300 mg/dL to 179, of which LDL-C = 63 and HDL-C = 116 (that is not a misprint). His triglycerides dropped from 250 to 45. His lipoprotein(a) level, a marker of inflammation, became undetectable. In 1983 he began his own medical practice for diabetics. At the time of writing he is age 72 and he still works 12-14 hour days in his medical practice on diabetics.
Using individual cases to "prove" anyhting in medicine is ridiculous. I can point to the 100 year old who smokes. Does that prove smoking is safe? I can point to the 40 year old athlete who works out daily, and then suffers a major heart attack. Does that prove exercise is dangerous? On and on I can go with individuals who defy the odds and in your thinking , "prove " certain facts.
Medicine is an ART, not a pure science. There are so many variables that we still dont even know exist. Genetics alone has such an effect on each person and we are just cracking the surface on that . WE can only look at studies of MANY patients to get data to direct our treatment and recommendattions. Some studies will contradict others.
In the end we can only draw our conclusions on the best available data form MANY studies of MANY patients. Anecdotal stories of individual patients are meaningless.
We may not know the exact "cause " of diabetes but we do know which factors TEND to increase the likelihood of developing it. Again genetics plays a HUGE role. That is why we check family history so carefully in patients. The other factors COMBINED with genetics tend to lead toward developing it. Some of the factors that clearly pop up over and over are diet, weight, exercise, lifestyle etc. Each factor may not "cause" diabetes itself , but added to genetics can push a patient into the disorder.
I can honestly say I almost NEVER have seen a thin adult onset type 2 diabetic in my 25 years of practice. It can happen , but is rare.
NDXUFan:
Yes, now we are getting to some agreement, many studies of many patients. This is why when some in the medical profession try to use one person as a lecture to everyone else, I have to laugh..... Some of my family have had diabetes and that caused some physicians to obsess to me. Yet, they did not bother to listen that these individuals were 85-90 years old when they became diabetics. When I was given the label of diabetic, I was walking at a bare minimum of 3 miles per day and many days, 5 miles per day. I worked out four days per week...... Honestly, I think the cause was that I was not getting enough sleep from working so much overtime, 750 hours in 5 months. Before this and the night shift, I never had any health issues of any kind, just the fever a few times per year....... I would agree, genetics plays a huge role, no disagreement. How would you feel if the medical profession tried to blame you for having cancer? Honestly, I think it is a genetic issue. What we have to look at in the numbers is a term called absolute risk. In speaking to many chemists and physics people, they would tell you that the term relative risk is mathematically misleading.
Stats Department-George Mason University:
An important feature of relative risk is that it tells you nothing about the actual risk. This can be very important for evaluating how significant a relative increase might be. A small increase in risk in a large population can result in many deaths. For example, brain tumors are diagnosed in about 6 per 100,000 persons per year, whereas malignant breast cancer is diagnosed in about 134 per 100,000 people. A 10 percent increase (relative risk of 1.1) in brain tumors means .10 x 6 = .6 new cases per 100,000 people. On the other hand, a 10 percent increase in breast cancer affects 134 per 100,000 people. If the population of the United States is 300 million (which is 3,000 times 100,000), the small increase in brain tumors would result in .6 x 3,000 = 1,800 new cases. In contrast, the same increase of rate in breast cancer would result in 134 x 3,000 = 402,000 new cases, more than 200 times as many.
http://www.stats.org/in_depth/faq/absolute_v_relative.htm
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NDXUFan...what is the point you are trying to make? You start with one topic about transplant and now you are talking about diabetes. Are you trying to tell people not to trust doctors because some other doctor has a study to dispute the original claim? You have 2 doctors trying to give you there expertise on the subject but all you want to do is argue to point out how wrong they are by pulling out some study that ONE person wrote. I think there is a reason why general census agrees with hemodoc and obis. Probably because all studys and research they have done tend to point to what they are saying.
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NDXUFan...what is the point you are trying to make? You start with one topic about transplant and now you are talking about diabetes. Are you trying to tell people not to trust doctors because some other doctor has a study to dispute the original claim? You have 2 doctors trying to give you there expertise on the subject but all you want to do is argue to point out how wrong they are by pulling out some study that ONE person wrote. I think there is a reason why general census agrees with hemodoc and obis. Probably because all studys and research they have done tend to point to what they are saying.
I know more than a few very qualified experts who disagree, think as you please. Most doctors do not know how to read stats, as pointed out to me by chemists and physicists, Ph.D's. Relative Risk as a stat is worthless, what we need to look at is Absolute risk. These are the same people who claimed for years that overweight people have all kinds of cardiovascular issues. Yet, in research done by the Mayo Clinic, in the December 2006 Lancet, it was found that that viewpoint was incorrect. Claims that 400,000 people are dying from obesity is just total nonsense and guess what? When I asked specialists at Indiana and Ohio State, they agreed, the claim was bogus. In addition, I took that claim to the chemists and physicists, they said that the math was wrong and sloppy...... There are many things that are trumpeted by the press and others that are simply wrong. Another example, is wages between professional men and professional women. It has been claimed that men make more than women, this is false and incorrect. To compare wages, you must have individuals in the same field, education level, work experience, etc. When we do this, we find that professional women make more than professional men(Stanford Department of Economics). Another reason is that HemoDoc's good friend, Dr. Kassirer, pointed out that 7 out of the 9 "experts" on the 2004 Cholesterol panel were taking thousands of dollars per year from the drug companies. Why do you think it is that the drug companies are spending billions per year on dining physicians, because it pays, not because they are nice people. The first goal of a corporation is to make money or profits. As the dialysis industy has done the bare minimum to set up dialysis patients to fail, 12 hours per week, is clearly not cutting the mustard. Yet, the patient is blamed for failing when the first liability rests with Davita and Fresenius, along with government run health care. The Government has done a lousy job with dialysis and the majority of the population is clueless to the crappy medical care that is coming their way.
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NDXUFan...what is the point you are trying to make? You start with one topic about transplant and now you are talking about diabetes. Are you trying to tell people not to trust doctors because some other doctor has a study to dispute the original claim? You have 2 doctors trying to give you there expertise on the subject but all you want to do is argue to point out how wrong they are by pulling out some study that ONE person wrote. I think there is a reason why general census agrees with hemodoc and obis. Probably because all studys and research they have done tend to point to what they are saying.
I know more than a few very qualified experts who disagree, think as you please. Most doctors do not know how to read stats, as pointed out to me by chemists and physicists, Ph.D's. Relative Risk as a stat is worthless, what we need to look at is Absolute risk. These are the same people who claimed for years that overweight people have all kinds of cardiovascular issues. Yet, in research done by the Mayo Clinic, in the December 2006 Lancet, it was found that that viewpoint was incorrect. Claims that 400,000 people are dying from obesity is just total nonsense and guess what? When I asked specialists at Indiana and Ohio State, they agreed, the claim was bogus. In addition, I took that claim to the chemists and physicists, they said that the math was wrong and sloppy...... There are many things that are trumpeted by the press and others that are simply wrong. Another example, is wages between professional men and professional women. It has been claimed that men make more than women, this is false and incorrect. To compare wages, you must have individuals in the same field, education level, work experience, etc. When we do this, we find that professional women make more than professional men(Stanford Department of Economics). Another reason is that HemoDoc's good friend, Dr. Kassirer, pointed out that 7 out of the 9 "experts" on the 2004 Cholesterol panel were taking thousands of dollars per year from the drug companies. Why do you think it is that the drug companies are spending billions per year on dining physicians, because it pays, not because they are nice people. The first goal of a corporation is to make money or profits. As the dialysis industy has done the bare minimum to set up dialysis patients to fail, 12 hours per week, is clearly not cutting the mustard. Yet, the patient is blamed for failing when the first liability rests with Davita and Fresenius, along with government run health care. The Government has done a lousy job with dialysis and the majority of the population is clueless to the crappy medical care that is coming their way.
???
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NDXUFan...what is the point you are trying to make? You start with one topic about transplant and now you are talking about diabetes. Are you trying to tell people not to trust doctors because some other doctor has a study to dispute the original claim? You have 2 doctors trying to give you there expertise on the subject but all you want to do is argue to point out how wrong they are by pulling out some study that ONE person wrote. I think there is a reason why general census agrees with hemodoc and obis. Probably because all studys and research they have done tend to point to what they are saying.
I know more than a few very qualified experts who disagree, think as you please. Most doctors do not know how to read stats, as pointed out to me by chemists and physicists, Ph.D's. Relative Risk as a stat is worthless, what we need to look at is Absolute risk. These are the same people who claimed for years that overweight people have all kinds of cardiovascular issues. Yet, in research done by the Mayo Clinic, in the December 2006 Lancet, it was found that that viewpoint was incorrect. Claims that 400,000 people are dying from obesity is just total nonsense and guess what? When I asked specialists at Indiana and Ohio State, they agreed, the claim was bogus. In addition, I took that claim to the chemists and physicists, they said that the math was wrong and sloppy...... There are many things that are trumpeted by the press and others that are simply wrong. Another example, is wages between professional men and professional women. It has been claimed that men make more than women, this is false and incorrect. To compare wages, you must have individuals in the same field, education level, work experience, etc. When we do this, we find that professional women make more than professional men(Stanford Department of Economics). Another reason is that HemoDoc's good friend, Dr. Kassirer, pointed out that 7 out of the 9 "experts" on the 2004 Cholesterol panel were taking thousands of dollars per year from the drug companies. Why do you think it is that the drug companies are spending billions per year on dining physicians, because it pays, not because they are nice people. The first goal of a corporation is to make money or profits. As the dialysis industy has done the bare minimum to set up dialysis patients to fail, 12 hours per week, is clearly not cutting the mustard. Yet, the patient is blamed for failing when the first liability rests with Davita and Fresenius, along with government run health care. The Government has done a lousy job with dialysis and the majority of the population is clueless to the crappy medical care that is coming their way.
???
My point is that many things and stats are not being read correctly. Another example of the latest obsession, Uffe Ravnskov, M.D. Nephrology and Ph.D. Chemistry:
According to conventional wisdom it is wise to lower your cholesterol if it is too high. The main reason for this advice is the observation that people with a high cholesterol more often get a heart attack than people with a normal or a low cholesterol. The observation is correct, but it does not mean that the high cholesterol is the cause of the heart attack (see section 1). If it were, lowering of the high cholesterol by any means should prevent it, but it doesn´t (except with the new group of cholesterol-lowering drugs, the statins; see below).
Before the introduction of the new cholesterol lowering drugs, the statins, more than 40 trials have been performed to test if cholesterol-lowering can prevent a heart attack. In some of the trials the number of fatal heart attacks were lowered a little, in other trials the number of fatal heart attacks increased. Overviews of the trials have shown that when all results were taken together, just as many died in the treatment groups (e.g. those whose cholesterol was lowered) as in the untreated control group (78,79). The following table gives the accumulated results. None of the differences were statistically significant. Nor were they by more sophisticated analyses.
http://www.ravnskov.nu/myth5.htm
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Stephanie Seneff, Ph.D. Engineering, MIT:
There is actually only a weak correlation between high cholesterol and heart disease. Many people with high cholesterol never get heart disease, and, conversely, many people with heart disease have low cholesterol levels. And the ever-so-popular statin drugs lead to many disturbing side effects that should convince the informed reader that they can't possibly be good for you [5] (Statin Side Effects)
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Stephanie Seneff, Ph.D. Engineering, MIT:
There is actually only a weak correlation between high cholesterol and heart disease. Many people with high cholesterol never get heart disease, and, conversely, many people with heart disease have low cholesterol levels. And the ever-so-popular statin drugs lead to many disturbing side effects that should convince the informed reader that they can't possibly be good for you [5] (Statin Side Effects)
I will simply say that statins have in fact lowered the number of fatalities from heart disease over the past many years. Now I agree it is not simply the lowering of the total cholesterol that is the reason. There are many other reasons including the significant anti inflammatory effects they induce that reduces the damage to the vascular system. There is also the far more important effect on the balance between HDLs and LDLs and and other effects on the balance of the lipoproteins and lipids. Simply talking about lowering total cholesterol is a simplistic and inaccurate approach to the issue.
Statins have in fact been one of the great life savers in modern medicine . We still dont have the complete picture as to why but the effects are clear , they save lives.
The drug companies are my least favorite corporations . They are guilty of much damage and bilking the public out of much money. They are one of the biggest reasons health care is so expensive and insurance premiums rise so fast. BUT, dont mix up the bad behavior with the drugs themselves. While some drugs are clearly horrible, statins in general are a big advance in life saving and general health. Yes they can have side effects , but the good far outreaches the bad.
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So is what u are telling me is that over weight people should not worry about getting heart problem or diabetes NDXUFan? I just want to make sure before I go to a buffet for lunch. No offense but my wife is also a pediatric doctor and thinks you are way off in your assumption, but it is your opinions so I will respect them.
But just one more time I will ask you the question NDXUFan.....
Are you trying to say that over weight people should not worry about getting heart problems or diabetes NDXUFan?
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NDXUfan, I have noticed almost all the articles and people you quote are at least 7 to 10 years in the past. In medicine today, things change so rapidly that often in 2 to 3 years we look at things differently . Anything that predates 2010 now has to be looked at carefully and with great caution as to whether it is still true. That is not to say everything pre 2010 is wrong, but like an old car it needs to be inspected carefully to see if it is still viable. Some of the stuff you have quoted is over 10 to 15 years old and that is really out there .
The articles you quoted above ran from 1999 to 2006 . Lancet was 2006 , and the others were all older. If you are going to argue a point, try getting more up to date info . I generally look at research in the last 3 years for my information to base my arguments and treatment paradigms. Older stuff that is still viable will still be written about recently as it is tested and retested so it gains credance.
By the way, I have 2 brothers who are MDs and they are both epidemiologists . One is at CDC and the other at the state level. So I have had plenty of practice arguing medical facts and looking at research.
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NDXUFan...what is the point you are trying to make? You start with one topic about transplant and now you are talking about diabetes. Are you trying to tell people not to trust doctors because some other doctor has a study to dispute the original claim? You have 2 doctors trying to give you there expertise on the subject but all you want to do is argue to point out how wrong they are by pulling out some study that ONE person wrote. I think there is a reason why general census agrees with hemodoc and obis. Probably because all studys and research they have done tend to point to what they are saying.
I know more than a few very qualified experts who disagree, think as you please. Most doctors do not know how to read stats, as pointed out to me by chemists and physicists, Ph.D's. Relative Risk as a stat is worthless, what we need to look at is Absolute risk. These are the same people who claimed for years that overweight people have all kinds of cardiovascular issues. Yet, in research done by the Mayo Clinic, in the December 2006 Lancet, it was found that that viewpoint was incorrect. Claims that 400,000 people are dying from obesity is just total nonsense and guess what? When I asked specialists at Indiana and Ohio State, they agreed, the claim was bogus. In addition, I took that claim to the chemists and physicists, they said that the math was wrong and sloppy...... There are many things that are trumpeted by the press and others that are simply wrong. Another example, is wages between professional men and professional women. It has been claimed that men make more than women, this is false and incorrect. To compare wages, you must have individuals in the same field, education level, work experience, etc. When we do this, we find that professional women make more than professional men(Stanford Department of Economics). Another reason is that HemoDoc's good friend, Dr. Kassirer, pointed out that 7 out of the 9 "experts" on the 2004 Cholesterol panel were taking thousands of dollars per year from the drug companies. Why do you think it is that the drug companies are spending billions per year on dining physicians, because it pays, not because they are nice people. The first goal of a corporation is to make money or profits. As the dialysis industy has done the bare minimum to set up dialysis patients to fail, 12 hours per week, is clearly not cutting the mustard. Yet, the patient is blamed for failing when the first liability rests with Davita and Fresenius, along with government run health care. The Government has done a lousy job with dialysis and the majority of the population is clueless to the crappy medical care that is coming their way.
???
My point is that many things and stats are not being read correctly. Another example of the latest obsession, Uffe Ravnskov, M.D. Nephrology and Ph.D. Chemistry:
According to conventional wisdom it is wise to lower your cholesterol if it is too high. The main reason for this advice is the observation that people with a high cholesterol more often get a heart attack than people with a normal or a low cholesterol. The observation is correct, but it does not mean that the high cholesterol is the cause of the heart attack (see section 1). If it were, lowering of the high cholesterol by any means should prevent it, but it doesn´t (except with the new group of cholesterol-lowering drugs, the statins; see below).
Before the introduction of the new cholesterol lowering drugs, the statins, more than 40 trials have been performed to test if cholesterol-lowering can prevent a heart attack. In some of the trials the number of fatal heart attacks were lowered a little, in other trials the number of fatal heart attacks increased. Overviews of the trials have shown that when all results were taken together, just as many died in the treatment groups (e.g. those whose cholesterol was lowered) as in the untreated control group (78,79). The following table gives the accumulated results. None of the differences were statistically significant. Nor were they by more sophisticated analyses.
http://www.ravnskov.nu/myth5.htm
I will forgo looking up your links, but what you are trying to talk about is the issue of primary prevention of heart attacks across a general population. Secondary prevention trials offer the greatest evidence of statin benefit in a population proven at risk.
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So is what u are telling me is that over weight people should not worry about getting heart problem or diabetes NDXUFan? I just want to make sure before I go to a buffet for lunch. No offense but my wife is also a pediatric doctor and thinks you are way off in your assumption, but it is your opinions so I will respect them.
But just one more time I will ask you the question NDXUFan.....
Are you trying to say that over weight people should not worry about getting heart problems or diabetes NDXUFan?
NDXUFan:
My point is that many in the hard science/medical community disagree with those viewpoints. I really think it comes down to genetics, not lifestyle. I have just read and have experienced evidence that is contradictory. Most of my family is in the hard sciences and they think there is not enough evidence for those viewpoints.
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NDXUfan, I have noticed almost all the articles and people you quote are at least 7 to 10 years in the past. In medicine today, things change so rapidly that often in 2 to 3 years we look at things differently . Anything that predates 2010 now has to be looked at carefully and with great caution as to whether it is still true. That is not to say everything pre 2010 is wrong, but like an old car it needs to be inspected carefully to see if it is still viable. Some of the stuff you have quoted is over 10 to 15 years old and that is really out there .
The articles you quoted above ran from 1999 to 2006 . Lancet was 2006 , and the others were all older. If you are going to argue a point, try getting more up to date info . I generally look at research in the last 3 years for my information to base my arguments and treatment paradigms. Older stuff that is still viable will still be written about recently as it is tested and retested so it gains credance.
By the way, I have 2 brothers who are MDs and they are both epidemiologists . One is at CDC and the other at the state level. So I have had plenty of practice arguing medical facts and looking at research.
ND:
My brother is a Ph.D. in Physics and Materials Science(Northwestern), Dad is a retired chemist, Cousin is a Ph.D. in Chemistry(EPA), Dad's friend is a Ph.D. in Physical Chemistry, and his daughter is a Ph.D. in Biology. Each one has stated to me that there is not enough evidence for the cholesterol theory or HemoDoc's cause of global warming. My cousin who worked for the EPA stated to prove global warming, you would need evidence for at least 500 years or more.... I am not arguing that you or your experts are stupid, my point is that my experts are just as good.
Here is Joel Kauffman's background:
Joel M. Kauffman PhD
Professor Emeritus
Education
PhD (Massachusetts Institute of Technology)
Research Interests
One of my principal research areas of interest is in medicinal chemistry, where the focus is on the design and synthesis of potential new drugs with antiinflammatory and antimicrobial properties.
A second research area of interest is the synthesis of new molecules with defined fluorescent properties. Applications include laser dyes, scintillation fluors, waveshifters, and eye protection. These fluorescent molecules, in addition to having high quantum yields and good chemical stability, must be resistant to the exciting light, and in the case of scintillators used to detect radiation from nuclear process, must be resistant to free radical production.
Synopsis
Dr. Kauffman holds a PhD from the Massachusetts Institute of Technology. His research interests include the synthesis of new drugs, fluorescent laser dyes, fluorescent stains for microscopy, and exposing fraud in mainstream medicine.
ND:
We agree on many issues in dialysis, mainly that many in dialysis are extremely arrogant and hypocritical...... It still blows me away that a group who would assert their right to act like a business, would deny that same right to someone else, the same right that they assert for themselves, so hypocritical. Who died and promoted them as guardians of kidney transplants? The shortage of kidneys is due to the policies that they themselves promote. I hope someday they experience the results of their policies, they will be getting what they richly deserve.
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New MAJOR study on statins for lipid control , tolerance , and health effects.
They definatly lower LDLs and decrease mortality.
C (61% vs 44%, p<0.05).
Statin therapy may have had a survival benefit, the authors say. All-cause mortality at eight years trended toward a decrease for patients on daily and intermittent statin dosing compared with those who discontinued their medication (p=0.08).
A strategy of intermittent statin dosing can be an effective therapeutic option in some patients and may result in reduction in LDL-C and achievement of LDL-C goals, the authors conclude.
"This study is the largest to date to review different treatment regimens for patients with documented statin intolerance. Beyond confirming the results of previous small studies, it gives details on many interesting clinical characteristics of the statin intolerance population," said co-author Dr. Warner Mampuya of Centre Hospitalier Universitaire de Sherbrooke in Quebec, Canada, in an email to Reuters Health.
"Statins have well-documented benefits, and their discontinuation has been associated with increased risk for cardiovascular events. This study promotes the use of statins, which are important tools in lessening the burden of cardiovascular disease," he said.
:clap;
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New MAJOR study on statins for lipid control , tolerance , and health effects.
They definatly lower LDLs and decrease mortality.
C (61% vs 44%, p<0.05).
Statin therapy may have had a survival benefit, the authors say. All-cause mortality at eight years trended toward a decrease for patients on daily and intermittent statin dosing compared with those who discontinued their medication (p=0.08).
A strategy of intermittent statin dosing can be an effective therapeutic option in some patients and may result in reduction in LDL-C and achievement of LDL-C goals, the authors conclude.
"This study is the largest to date to review different treatment regimens for patients with documented statin intolerance. Beyond confirming the results of previous small studies, it gives details on many interesting clinical characteristics of the statin intolerance population," said co-author Dr. Warner Mampuya of Centre Hospitalier Universitaire de Sherbrooke in Quebec, Canada, in an email to Reuters Health.
"Statins have well-documented benefits, and their discontinuation has been associated with increased risk for cardiovascular events. This study promotes the use of statins, which are important tools in lessening the burden of cardiovascular disease," he said.
:clap;
ND:
I am curious, who sponsored the study, the drug company? I know of many people including myself that had memory issues while taking statins, I am not trying to be obnoxious, just honest. I looked up the physician on Google and I did not find anything. If you would, if you can, send a copy of the study so that one of my hard math people can read it. I will try to send it to Joel Kauffman. What is the absolute risk in this study?
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Here is the info. This was not a drug company study.!!!!!!!
■Researchers retrospectively examined medical records from the Cleveland Clinic Preventive Cardiology Section for their study data. Patients with a history of statin intolerance who were treated for at least 6 months between 1995 and 2010 were eligible for participation.
They actually looked at people who had side effects from statins . Over 1600 patients. This was a retrospective study of clinic records.
ntermittent Statin Dosing for Patients With Statin Intolerance CME/CE
Intermittent Statin Dosing for Patients With Statin Intolerance CME/CE
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Here is the info. This was not a drug company study.!!!!!!!
■Researchers retrospectively examined medical records from the Cleveland Clinic Preventive Cardiology Section for their study data. Patients with a history of statin intolerance who were treated for at least 6 months between 1995 and 2010 were eligible for participation.
They actually looked at people who had side effects from statins . Over 1600 patients. This was a retrospective study of clinic records.
ntermittent Statin Dosing for Patients With Statin Intolerance CME/CE
Intermittent Statin Dosing for Patients With Statin Intolerance CME/CE
Just asking :)
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Here is the info. This was not a drug company study.!!!!!!!
■Researchers retrospectively examined medical records from the Cleveland Clinic Preventive Cardiology Section for their study data. Patients with a history of statin intolerance who were treated for at least 6 months between 1995 and 2010 were eligible for participation.
They actually looked at people who had side effects from statins . Over 1600 patients. This was a retrospective study of clinic records.
ntermittent Statin Dosing for Patients With Statin Intolerance CME/CE
Intermittent Statin Dosing for Patients With Statin Intolerance CME/CE
I am curious, would you be willing to take statins?
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Here is the info. This was not a drug company study.!!!!!!!
■Researchers retrospectively examined medical records from the Cleveland Clinic Preventive Cardiology Section for their study data. Patients with a history of statin intolerance who were treated for at least 6 months between 1995 and 2010 were eligible for participation.
They actually looked at people who had side effects from statins . Over 1600 patients. This was a retrospective study of clinic records.
ntermittent Statin Dosing for Patients With Statin Intolerance CME/CE
Intermittent Statin Dosing for Patients With Statin Intolerance CME/CE
I am curious, would you be willing to take statins?
YES!!!. I have my wife on atorvastatin. Her cholesterol was over 330 and is now 180. Her father died of an MI at 49 . So it runs in her family. My own cholesterol is TOO LOW. That is not good either. It was 90 but I have gotten it up to 120. My wife is the most important person in my life and I trust atorvastatin (lipitor) for her. She has been on cholesterol lowering agents for 35 years . She has a strong heart at least when checked a few months ago .She has outlived her father by 17 years already. When he died in 1962 there were no statins. I thank statins for keeping her going.
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Here is the info. This was not a drug company study.!!!!!!!
■Researchers retrospectively examined medical records from the Cleveland Clinic Preventive Cardiology Section for their study data. Patients with a history of statin intolerance who were treated for at least 6 months between 1995 and 2010 were eligible for participation.
They actually looked at people who had side effects from statins . Over 1600 patients. This was a retrospective study of clinic records.
ntermittent Statin Dosing for Patients With Statin Intolerance CME/CE
Intermittent Statin Dosing for Patients With Statin Intolerance CME/CE
I am curious, would you be willing to take statins?
YES!!!. I have my wife on atorvastatin. Her cholesterol was over 330 and is now 180. Her father died of an MI at 49 . So it runs in her family. My own cholesterol is TOO LOW. That is not good either. It was 90 but I have gotten it up to 120. My wife is the most important person in my life and I trust atorvastatin (lipitor) for her. She has been on cholesterol lowering agents for 35 years . She has a strong heart at least when checked a few months ago .She has outlived her father by 26 years already. When he died in 1962 there were no statins. I thank statins for keeping her going.
Statins have a very strong history of safe use. Both my wife and I are on statins as well. No problems.
I am very suspicious of a lot of research going on today that has a significant financial incentive involved, both for using a product and for NOT using a product. The secondary prevention and regression trials are quite well done over many, many years. If you look at epidemiology studies, Japanese in Japan have a very LOW rate of heart disease, but that changes when they come to the US and modify their diet.
Yes, heart disease is multifactoral and I believe Cholesterol is one of those factors. No it isn't the entire story, however, in my own anecdotal experience, the majority of my patients who had heart attacks had issues with cholesterol and other aspects of the metabolic syndrome. And yes, exercise and weight loss is an important aspect of prevention and treatment.
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My Acupuncturist says the statin drugs come from a common root and the drug companies are becoming $$$ rich but add other things that can be dangerous. He just takes the root and I didn't pay any attention to the name.
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Statin development
In 1971, Akira Endo, a Japanese biochemist working for the pharmaceutical company Sankyo, began the search for a cholesterol-lowering drug. Research had already shown cholesterol is mostly manufactured by the body in the liver, using the enzyme HMG-CoA reductase.[7] Endo and his team reasoned that certain microorganisms may produce inhibitors of the enzyme to defend themselves against other organisms, as mevalonate is a precursor of many substances required by organisms for the maintenance of their cell walls (ergosterol) or cytoskeleton (isoprenoids).[59] The first agent they identified was mevastatin (ML-236B), a molecule produced by the fungus Penicillium citrinum.
A British group isolated the same compound from Penicillium brevicompactum, named it compactin, and published their report in 1976.[60] The British group mentions antifungal properties, with no mention of HMG-CoA reductase inhibition.
Some types of statins are naturally occurring, and can be found in such foods as oyster mushrooms and red yeast rice. Randomized controlled trials found them to be effective, but the quality of the trials was lo
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Back in 1992 when I was diagnosed with fsgs, no one spoke to me about the link between CKD and high blood lipids.
Fast forward to 2003 when I moved back to the US and had a check up for insurance purposes. I was shocked to see that my cholesterol was 550 and triglycerides 2100! My PCP said he'd never seen such numbers in a non-diabetic patient, and he immediately referred me to a nephrologist. I was really upset because I'd always watched my diet and I enjoy exercise and do so regularly. My PCP told me that I could "eat nothing but cardboard for the rest of my life" and still have high blood lipids simply because of my renal disease.
I was put on statins and Zetia, one of the statins being Crestor. I learned I was allergic to it, so I was put on pravastatin, one of the older statins that was not supposed to be as effective but had fewer side effect. Almost immediately my cholesterol was lowered to within normal range, and my triglycerides came down to about 250 which was still high but it was a lot better than 2100!
I don't have a lot of fancy shmancy studies to back me up, but I can't believe that NOT treating CKD-induced high lipid levels is a smart thing to do. I've tolerated the drugs very well, and I am thankful that they are available.
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Rerun, I always wonder about people who do that. How would he know how much of the root to take? And does he actually eat root or get some kind of pill for it? I never know if those kind of pills actually have in them what they say. I really wonder about people who drink those weird teas to get their supplements. They look so disgusting.
So many drugs are from plants, roots, funguses. I'd rather skip the "natural" route and take the pharmaceutical.
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Rerun, I always wonder about people who do that. How would he know how much of the root to take? And does he actually eat root or get some kind of pill for it? I never know if those kind of pills actually have in them what they say. I really wonder about people who drink those weird teas to get their supplements. They look so disgusting.
So many drugs are from plants, roots, funguses. I'd rather skip the "natural" route and take the pharmaceutical.
I don't know. He really knows a lot about Chinese Medicine and he got on that subject one day and he goes on and on and on so I must have tuned him out. Maybe it was red yeast rice and not a root? If you go to Mother's Cupboard or any of those natural supplement stores they have something for what ails you. He finally got rid of my wart on my finger that had been there for 2 years. Tee Tree oil, lemon oil and something else.....
I only take Olive Leaf (liquid) just a sip everyother day. I work with first graders and it is an anti-fungus antiviral supplement. Otherwise, I don't mess with supplements because they may build up and become toxic. Run it by your Nephrologist first.
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I take Natures Way standardized green tea capsules (2, 3 X day) giving me the equivalent of 9 cups of green tea. Add that to the one cup of normal green tea and I get a total of 10 cups/ day.
I have been doing this for about 4 years for the benefits of antioxidant properties and the ability to untangle amyloid placque buildup in the tissue of DRA (dialysis related amyloidosis) involved in creating carpal tunnel in long term dialysis patients.
There is also the benefit of lowering the bad cholesterol and reversing the damage of left ventricular hypertrophy in D patients
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Rerun, I always wonder about people who do that. How would he know how much of the root to take? And does he actually eat root or get some kind of pill for it? I never know if those kind of pills actually have in them what they say. I really wonder about people who drink those weird teas to get their supplements. They look so disgusting.
So many drugs are from plants, roots, funguses. I'd rather skip the "natural" route and take the pharmaceutical.
I don't know. He really knows a lot about Chinese Medicine and he got on that subject one day and he goes on and on and on so I must have tuned him out. Maybe it was red yeast rice and not a root? If you go to Mother's Cupboard or any of those natural supplement stores they have something for what ails you. He finally got rid of my wart on my finger that had been there for 2 years. Tee Tree oil, lemon oil and something else.....
I only take Olive Leaf (liquid) just a sip everyother day. I work with first graders and it is an anti-fungus antiviral supplement. Otherwise, I don't mess with supplements because they may build up and become toxic. Run it by your Nephrologist first.
Rerun is correct, the supplement industry is NOT regulated by the FDA so there is little effort to actually give people what they say is in their supplements. In addition, many "herbal" remedies can have severe toxic reactions. Better to avoid the supplements with rare exceptions.
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http://triblive.com/news/allegheny/4756502-74/organ-nonprofit-float#axzz2iOObgYXS
Taxpayers help pay for organ donor groups' parties, Rose Parade expenses
Saturday, October 19, 2013 10:30 p.m.
Executives at one nonprofit organ procurement organization charter a plane to travel fewer than 150 miles for a training session on leadership.
Another nonprofit pays out thousands of dollars a year for a Rose Bowl parade float, though auditors determine it's not a proper expense.
Yet another nonprofit honors its CEO with a $19,000 retirement party.
Each time, the organ procurement organizations bill part of the cost to taxpayers through Medicare.
If not for that, the public might never know how groups that make millions from recovering organs and tissues for transplantation sometimes operate behind the scenes. Federal law prohibits donors and their surviving families from receiving a penny.
Clearly, Medicare money cannot go for Rose Bowl tickets, lavish parties or golf tournaments, said Lloyd Jordan Jr., CEO of Carolina Donor Services in Greenville, N.C.
“For a cost to be allowable, it should be reasonable,” said Jordan, a certified public accountant and former Medicare auditor. “The provider should ... make sure that the cost doesn't exceed what a prudent and cost-conscious buyer would do.”
The Tribune-Review found multiple incidents of improper and undocumented spending by some of the nation's 58 organ procurement organizations. The newspaper reviewed 2011 federal tax filings and audits by the Department of Health and Human Services' Office of Inspector General since 2010.
“It's every taxpayers' dollar,” said Kent Holloway, president-elect of the Association of Organ Procurement Organizations, a national trade group. “The litmus test is to sort of look back in and say, ‘Would this feel right to me if I were looking in from the outside?' ”
The Trib found:
• The California Transplant Donor Network in Oakland, Calif., spent more than $167,000 that was improper or poorly documented as taxpayers' expenses, according to federal auditors. In 2007, the nonprofit threw a retirement party with 300 guests for former CEO Phyllis Weber. The organization billed $9,600, or about half of the cost, to taxpayers.
Weber's successor, CEO Cindy Siljestrom, said that seemed reasonable “based on the length of service and the role this executive played in founding this organization.”
Separately, the group spent $12,000 on banquet charges for a staff meeting in a Berkeley, Calif., hotel and $10,500 to sponsor a minor league baseball team. It paid $5,000 to sponsor a jazz show gala with gourmet food and exotic drinks.
Taxpayers shouldn't have paid for alcohol, Siljestrom said, and her group could have better documented expenses. But she defended spending on community outreach.
• When five board members of Life Connection of Ohio needed to get from their headquarters in suburban Toledo to Dayton, 146 miles away, the group paid $3,900 for a private plane and billed $2,100 to taxpayers.
The officials made the trip to meet with a lawyer about board responsibilities and training, spokeswoman Kara Steele told the Trib.
Having offices and board members in both cities makes “logistics for meetings challenging,” she said.
Life Connection employed family members of its executives, 2011 tax records show. The daughter of CEO Michael Phillips made $91,654, and the daughter-in-law of paid board Chairman Kenneth Kropp received $47,000 — slightly less than he did.
Life Connection does not allow nepotism, Steele said. One relative cannot directly supervise another, and anyone hired must be the best candidate for the position, she said. Phillips' daughter no longer works for the nonprofit.
• OneLegacy, the organ procurer in Los Angeles, spent more than $500,000 on unallowable or poorly documented items, a federal audit found.
Even after the inspector general faulted the nonprofit for spending money on Rose Bowl festivities, the group continued to submit a portion of its $75,000 per year float-sponsorship expenses to Medicare, CEO Thomas Mone said.
OneLegacy in 2006 spent $327,000 on the bowl game and parade, including float design and framework, football tickets, hotel rooms, limousines and flowers. Of that, $150,000 was improper, auditors said in a 2010 report, leading to a Medicare overpayment of $85,000.
Mone said the Rose Parade float generates TV, radio and newspaper stories worth more than $500,000, resulting in increased donations and donor registration rates.
After the audit, OneLegacy established a foundation so it could use private donations to pay for most of the float-related costs. Other procurers contribute to the float costs but use private money.
The Center for Organ Recovery & Education, the O'Hara-based organ procurer for Western Pennsylvania, most of West Virginia and a part of New York, paid about $5,000 to include an organ donor's face on the Rose Bowl float — but it used donations, CEO Susan Stuart said.
“We stand by our belief that the (float) is a highly effective donation education program and that it is an allowable cost,” Mone said.
The inspector general disagreed about the Rose Bowl costs, saying they exceeded what a “cost-conscious buyer would pay for public education.”
The Centers for Medicare & Medicaid Services refused to count subsequent sponsorships as an allowable expense for three years. The nonprofit has appealed.
• OneLegacy spent $32,000 on a three-day, beachfront retreat and $150,000 in credit card bills, including $8,400 at a New Orleans hotel. The nonprofit could not say where $26,000 went.
Mone recalled that the 2006 retreat was held at Montage, a five-star resort in Laguna Beach, Calif., where every room has an ocean view. It was “probably the only hotel large enough, in that southern part of our region,” he told the Trib, adding that OneLegacy claimed only allowable expenses as Medicare costs.
Auditors, however, said the nonprofit did not document the need for a retreat or demonstrate that the costs were reasonable.
“Conducting these retreats at locations that are conducive to uninterrupted education and discourse has helped to make these gatherings productive,” Mone said.
Mone said OneLegacy produced receipts for the credit card bills and the New Orleans tab paid to host officials from a dozen Southern California hospitals at a National Learning Congress.
Sponsorships for dinners and golf outings, he added, go through the foundation unless they are directly related to donor education.
Officials at the agency that oversees Medicare spending are tight-lipped about their oversight of organ procurement nonprofits. An agency spokesman initially declined to answer questions, then was unavailable because of the government shutdown.
Nonprofit administrators said the agency traditionally has paid little attention to them because they represent a small part of overall Medicare spending.
Organ donation can be a tough message to sell to the public, said Dr. Mark Fox, who serves on the ethics committee of the United Network for Organ Sharing, a national nonprofit that oversees organ allocation. A heavily watched event such as the Rose Parade, could generate awareness about donation and prompt people to become donors.
“Trying to find creative ways to bring message to an audience is challenging,” Fox said. “If you get three organ donors from watching the Rose Parade, that's a win all the way around. What on the surface might look like lavish spending could be creative genius.”
At the same time, the cost of losing donors because of spending missteps is high, said Stuart, CORE's CEO and president of the Association of Organ Procurement Organizations.
“If we lose the trust,” she said, “more people will die.”
Andrew Conte and Luis Fábregas are Trib Total Media staff writers. Reach Conte at 412-320-7835 or andrewconte@tribweb.com. Reach Fábregas at 412-320-7998 or lfabregas@tribweb.com.
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Sickening!
:puke;
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It appears that we are on the wrong side of the food chain,
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http://triblive.com/news/allegheny/4756502-74/organ-nonprofit-float#axzz2iOObgYXS
Taxpayers help pay for organ donor groups' parties, Rose Parade expenses
Saturday, October 19, 2013 10:30 p.m.
Executives at one nonprofit organ procurement organization charter a plane to travel fewer than 150 miles for a training session on leadership.
Another nonprofit pays out thousands of dollars a year for a Rose Bowl parade float, though auditors determine it's not a proper expense.
Yet another nonprofit honors its CEO with a $19,000 retirement party.
Each time, the organ procurement organizations bill part of the cost to taxpayers through Medicare.
If not for that, the public might never know how groups that make millions from recovering organs and tissues for transplantation sometimes operate behind the scenes. Federal law prohibits donors and their surviving families from receiving a penny.
Clearly, Medicare money cannot go for Rose Bowl tickets, lavish parties or golf tournaments, said Lloyd Jordan Jr., CEO of Carolina Donor Services in Greenville, N.C.
“For a cost to be allowable, it should be reasonable,” said Jordan, a certified public accountant and former Medicare auditor. “The provider should ... make sure that the cost doesn't exceed what a prudent and cost-conscious buyer would do.”
The Tribune-Review found multiple incidents of improper and undocumented spending by some of the nation's 58 organ procurement organizations. The newspaper reviewed 2011 federal tax filings and audits by the Department of Health and Human Services' Office of Inspector General since 2010.
“It's every taxpayers' dollar,” said Kent Holloway, president-elect of the Association of Organ Procurement Organizations, a national trade group. “The litmus test is to sort of look back in and say, ‘Would this feel right to me if I were looking in from the outside?' ”
The Trib found:
• The California Transplant Donor Network in Oakland, Calif., spent more than $167,000 that was improper or poorly documented as taxpayers' expenses, according to federal auditors. In 2007, the nonprofit threw a retirement party with 300 guests for former CEO Phyllis Weber. The organization billed $9,600, or about half of the cost, to taxpayers.
Weber's successor, CEO Cindy Siljestrom, said that seemed reasonable “based on the length of service and the role this executive played in founding this organization.”
Separately, the group spent $12,000 on banquet charges for a staff meeting in a Berkeley, Calif., hotel and $10,500 to sponsor a minor league baseball team. It paid $5,000 to sponsor a jazz show gala with gourmet food and exotic drinks.
Taxpayers shouldn't have paid for alcohol, Siljestrom said, and her group could have better documented expenses. But she defended spending on community outreach.
• When five board members of Life Connection of Ohio needed to get from their headquarters in suburban Toledo to Dayton, 146 miles away, the group paid $3,900 for a private plane and billed $2,100 to taxpayers.
The officials made the trip to meet with a lawyer about board responsibilities and training, spokeswoman Kara Steele told the Trib.
Having offices and board members in both cities makes “logistics for meetings challenging,” she said.
Life Connection employed family members of its executives, 2011 tax records show. The daughter of CEO Michael Phillips made $91,654, and the daughter-in-law of paid board Chairman Kenneth Kropp received $47,000 — slightly less than he did.
Life Connection does not allow nepotism, Steele said. One relative cannot directly supervise another, and anyone hired must be the best candidate for the position, she said. Phillips' daughter no longer works for the nonprofit.
• OneLegacy, the organ procurer in Los Angeles, spent more than $500,000 on unallowable or poorly documented items, a federal audit found.
Even after the inspector general faulted the nonprofit for spending money on Rose Bowl festivities, the group continued to submit a portion of its $75,000 per year float-sponsorship expenses to Medicare, CEO Thomas Mone said.
OneLegacy in 2006 spent $327,000 on the bowl game and parade, including float design and framework, football tickets, hotel rooms, limousines and flowers. Of that, $150,000 was improper, auditors said in a 2010 report, leading to a Medicare overpayment of $85,000.
Mone said the Rose Parade float generates TV, radio and newspaper stories worth more than $500,000, resulting in increased donations and donor registration rates.
After the audit, OneLegacy established a foundation so it could use private donations to pay for most of the float-related costs. Other procurers contribute to the float costs but use private money.
The Center for Organ Recovery & Education, the O'Hara-based organ procurer for Western Pennsylvania, most of West Virginia and a part of New York, paid about $5,000 to include an organ donor's face on the Rose Bowl float — but it used donations, CEO Susan Stuart said.
“We stand by our belief that the (float) is a highly effective donation education program and that it is an allowable cost,” Mone said.
The inspector general disagreed about the Rose Bowl costs, saying they exceeded what a “cost-conscious buyer would pay for public education.”
The Centers for Medicare & Medicaid Services refused to count subsequent sponsorships as an allowable expense for three years. The nonprofit has appealed.
• OneLegacy spent $32,000 on a three-day, beachfront retreat and $150,000 in credit card bills, including $8,400 at a New Orleans hotel. The nonprofit could not say where $26,000 went.
Mone recalled that the 2006 retreat was held at Montage, a five-star resort in Laguna Beach, Calif., where every room has an ocean view. It was “probably the only hotel large enough, in that southern part of our region,” he told the Trib, adding that OneLegacy claimed only allowable expenses as Medicare costs.
Auditors, however, said the nonprofit did not document the need for a retreat or demonstrate that the costs were reasonable.
“Conducting these retreats at locations that are conducive to uninterrupted education and discourse has helped to make these gatherings productive,” Mone said.
Mone said OneLegacy produced receipts for the credit card bills and the New Orleans tab paid to host officials from a dozen Southern California hospitals at a National Learning Congress.
Sponsorships for dinners and golf outings, he added, go through the foundation unless they are directly related to donor education.
Officials at the agency that oversees Medicare spending are tight-lipped about their oversight of organ procurement nonprofits. An agency spokesman initially declined to answer questions, then was unavailable because of the government shutdown.
Nonprofit administrators said the agency traditionally has paid little attention to them because they represent a small part of overall Medicare spending.
Organ donation can be a tough message to sell to the public, said Dr. Mark Fox, who serves on the ethics committee of the United Network for Organ Sharing, a national nonprofit that oversees organ allocation. A heavily watched event such as the Rose Parade, could generate awareness about donation and prompt people to become donors.
“Trying to find creative ways to bring message to an audience is challenging,” Fox said. “If you get three organ donors from watching the Rose Parade, that's a win all the way around. What on the surface might look like lavish spending could be creative genius.”
At the same time, the cost of losing donors because of spending missteps is high, said Stuart, CORE's CEO and president of the Association of Organ Procurement Organizations.
“If we lose the trust,” she said, “more people will die.”
Andrew Conte and Luis Fábregas are Trib Total Media staff writers. Reach Conte at 412-320-7835 or andrewconte@tribweb.com. Reach Fábregas at 412-320-7998 or lfabregas@tribweb.com.
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ND:
This from the very same people who claim donors should not be paid, what a joke, LOLOLOL!