शुगर और फैटी लिवर (Diabetes & Fatty Liver) में मैटाबोलिक सर्जरी (Metabolic Surgery) का क्या रोल है ?

 Doctor: When did you get Mini Gastric Bypass surgery done?

Patient: My surgery was done in August 2020. Patient: Ok. Doctor:At the time of surgery your Hba1c was 11.6 Patient:Yes! Doctor:How much is it now, when you got it checked last? Patient:It was 5.1 Doctor:Ok. Doctor:Are you taking any tablets for Diabetes? Patient:Nothing. Doctor:Were you taking tablets before surgery? Doctor:Have you met any doctor about this? Patient:No, I haven't consulted with any doctor, I just get my regular tests done. Doctor:Your triglycerides were 182mg/dL at the time of surgery. Patient:Yes! Doctor:Let's talk about other tests, your Hb is 12.9, other tests like calcium, proteins, everything is normal. Patient:Yes! Doctor:How much weight have you lost? Patient:I lost 42 Kg. Patient:Ok. Doctor:We are emphasizing diabetic patients in this talk. Doctor:Go to any Dialysis center in India and you will be surprised to see big lines of people for kidney transplants. Doctor:According to science, if your Hba1c stays higher than 9 for some years then there are chances of kidney damage. Doctor:Diabetes affects the fundus of the eye and you can get it checked with an eye examination. Doctor:What we have done with surgery that you lost 42 kg and your blood sugar levels are under control? Doctor:Have you ever had vomiting? Patient: Never. Doctor:Do you enjoy your meals? Doctor:Your Hba1c came down to 5.1 from 11.6 after surgery. Doctor:Your triglycerides are 78 now, which were more than 180 before surgery. Doctor:The other benefit which we can't see is, you got rid of Fatty liver. We would have known this if we had quantified your liver condition with fibro scan. Doctor:You must have heard from the young boy who was consulting with me before you, his Fibro scan report was 35 Kpa. Doctor:When we do surgery, we check the condition of the liver. Patient:Ok. Doctor:The surface of the normal Liver is smooth like glass. Patient:Ok. Doctor:Our Liver should be smooth like glass, if its surface is crude or coarse, that means it is going towards Liver cirrhosis. It is called NASH (Non alcoholic steatohepatitis). In persons who don't drink alcohol, their liver is damaged with fat and need Liver transplants. Doctor:Fatty Liver/NASH is the prime reason for Liver transplants these days. Doctor:Alcohol intake is the second reason for Liver Transplant. Patient:Ok. Doctor:With weight loss your liver becomes better, blood sugar levels are under control and the heart is better, which is like a gift. Doctor:But don't think, that you are free now. Patient:No. Doctor:Many people ask me will this surgery increase their lifespan? We don't know about the longevity of life. Doctor:Quality of life depends on us. Patient:Yes! Doctor:Because we are medically better now. Doctor:With 42 Kg weight loss, you must have lost some muscle mass. Doctor:But we don't want you to lose muscle or bone mass. Doctor:This is a controversial topic that with weight loss your bones will also become weak. Patient:Yes! Doctor:But your Vitamin D levels are quite same as before surgery, Calcium is also normal. Doctor:If we check bone density, that will be normal too. Doctor:But in some cases bone density increases and decreases. Doctor:Put your bones to work. Doctor:You need 1500mg calcium daily. Doctor:Eat 2 bowls of curd with 2 tablets of calcium. Doctor:If you are taking 1.5 liters of milk or milk products daily, then you don't need to take calcium tablets. Doctor:Because you need 1500mg calcium daily. Doctor:You are taking Iron tablet and continue taking multivitamin tablet. Doctor:Try to make food in cast iron utensils. Doctor:But keep an eye out. Doctor:Get your blood tests done once in six months. Doctor:It is important to go to the gym for muscle training. Doctor:Your surgery design is world class. Doctor:Because we do customized procedure according to the patient. Doctor:Because we know that you drink alcohol twice a week. Doctor:Can you eat parathas comfortably? Patient:Yes! Doctor:There are high incidence of nausea and vomiting in old surgery techniques. Doctor:This is called GI quality index. Doctor:This shows whether your tummy is happy or not. Doctor:This is the main point, if you don't feel happy then there is no benefit. Patient:I am very happy. Doctor:You should be happy with weight loss and should be monitored too. Patient:Ok. #metabolicsyndrome #weightlosstransformation #weightlossresults