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Fitness level affects the outcome of weight loss surgery
Patients with morbid obesity who have a low level of fitness have a poorer outcome after weight loss surgery. For people with morbid obesity, weight loss surgery - which shrinks the stomach - can be life-saving. But it is not without complications. And now a team at William Beaumont Hospital reveals that patients with a low level of fitness tend to do worse after this kind of surgery. They looked at a group of 109 patients, three quarters of whom were women, and divided them into groups according to their level of morbid obesity and fitness. Those with the highest level of obesity and lowest fitness had a seven times higher risk of complications compared with those whose were less obese and had a higher level of fitness. Their surgery took longer, their post-operative recovery times were greater, and complications like unstable angina, renal failure and deep vein thrombosis were more common. The researchers say that it is important that doctors measure a patient's fitness when they present for weight loss surgery. Improving fitness and losing some weight prior to surgery could improve the outcome. |
Raising fitness levels is the No 1 priority for the Black Ferns going into next year's women's rugby World Cup in Canada but they need money to achieve it.
A fitness disparity was apparent in last night's 24-15 second-test victory over closest rivals England at Waikato Stadium and coach Jed Rowlands later confirmed addressing that was top of his list heading to Edmonton next August.
He hopes to have a build-up budget approved by the New Zealand Rugby Union to help achieve it.
The New Zealand forwards were down to a walk in the last 10 minutes as a fitter England team came back at them and the home team were unable to add to their 24-8 half-time lead in front of an appreciative crowd of about 2000 in perfect conditions.
Rowlands admitted his players had not reached the fitness levels he wanted from them with England having the jump on them in that area at present. Better fitness would be needed to defend the World Cup.
"(England) have some advantages in that they pour a lot of money into the game. They are going to meet once a week fairly soon and some of them are semi-professional, so they are able to put that extra effort into fitness.
"Some of our girls are getting better and it is just an attitude change that we are working on."
The Black Ferns received as much financial backing from the NZRU as any other of our national teams, other than the All Blacks, and Rowlands hoped an extra injection for World Cup year would be approved.
"It is important. We are the reigning champs and I'm sure they'll help us as much as they can."
Against an England team sporting 11 changes to their starting XV from that beaten 33-8 in the first test in Auckland four days earlier, the Black Ferns never had the start they wanted last night. They found themselves down 8-3 after 12 minutes after a try to fiery England flanker Maggie Alphonsi set up by a fine swerving run from right wing Danielle Waterman.
But the home side scored three converted tries in the second quarter, with centre Hannah Myers, elusive fullback Amiria Marsh and block-busting Otago wing Piki Solomon crossing the line.
England stiffened up their defence after analysing their first-test effort and were able to shut down a New Zealand backline attack that seemed for chunks of the game to lose confidence. Advertisement Advertisement
Rowlands sees England as their biggest hurdle at the World Cup and is pleased his team was able to beat them 2-0, while still coming out with plenty to work on in terms of fitness, skill levels and decision making.
Next year he plans to take a squad of 40 players and work hard on those aspects, pick his 26-strong World Cup from NPC and trial form and is hoping to secure a July build-up test.
England's cricketers arrived in Islamabad three hours before dawn yesterday, but their dedication to winning the three-Test series against Pakistan saw them in the hotel gym before breakfast. Hard work with an emphasis on fitness is what brought success here five years ago and the formula is being re-applied.
"It's going to be a tough challenge but we'll be working very, very, hard," England captain Michael Vaughan said before an afternoon pool session rounded off the day. "You've got to be fit to play competitive cricket out here as Tests often go five days."
The gym culture is pretty well ingrained now and players, especially bowlers, often spend extra time building up their core strength. It is all a far cry from the 1980s when Surrey bowler Nick Taylor was asked by bowling coach Geoff Arnold why he was building up his body with weights rather than the legs which got him to the crease. "Oh, I'm not doing it for cricket," Taylor replied. "I'm doing it to look good on the beach."
If fitness provides the basis for coping with the challenge of this tour, actually succeeding requires players to adapt to alien conditions, a mysterious process that sees some players thrive and others flounder. With a tour of India scheduled for March, England need to crack the secrets now if world domination is to follow.
"Winning the Ashes after such a long time was fantastic, but there's more required to get that number one spot," saidd Vaughan. "To be regarded as best team in the world you have to be successful on the subcontinent. Beating Australia was a big bridge to cross but coming to Pakistan is the next big challenge and it's come at a good time."
As against Australia, England's biggest challenge will be to take 20 wickets in a Test, this time on pitches that could be a bland shade of turgid. It has not been done often in Pakistan; in 21 Tests between the sides since 1961 there have been 17 draws, with two wins apiece.
Like the home side, England will be hoping pace and reverse swing will break the back of the batting. It certainly did against the Aussies, but then Simon Jones, unavailable here due to recent surgery on a bony spur on his right ankle, was a revelation with the older ball. He will be missed but opportunity knocks for James Anderson and Durham's Liam Plunkett, both possible short-term replacements.
Pakistan potentially have an edge in the spin department, with Danish Kaneria and Mushtaq Ahmed. Both are proven match-winners, though Vaughan, perhaps forgetting just how little county cricket England players play, felt that they lacked the mystery of a Muttiah Muralitharan due to their time at Essex and Sussex respectively. Vaughan does feel he has the best player on either side in Andrew Flintoff, however, and is most grateful.
"Freddie is the best all-rounder in the world and to have his bowling, batting, fielding and overall presence in the team is great for a captain," Vaughan said. "Mind you, there will be a stage when he doesn't fire as well as he as done in the last six months. For him to maintain that level of performance for every series will take some doing."
But this England team are far from being a one-man-heavy outfit as when Ian Botham was in his pomp. Their brand of attacking cricket (the equivalent of 15-man rugby), matched by Australia during the summer, has rekindled interest in Test cricket all around the world. As one Pakistani journalist confided, England had saved the five-day game from extinction.
"Apart from some outstanding individual players, our strength has been our character," Vaughan said. "That has enabled us to bounce back from the odd defeat and the odd bad day very well. It's also allowed us to change games on days four and five favourably enough to win them."
Net practice is in Rawalpindi today and England will see a bit more of their surroundings, though with security so tight sightseeing jaunts may be out of the question.
"We hope to see bit more of Pakistan than cricket grounds, hotels and airports," said Vaughan, "but the tiring nature of the cricket means you do tend to go back to the hotel, eat, and go to bed.
"We're playing in a golf day to raise funds for the earthquake victims, and
we'll try to get out, especially if there are some nice courses to play on."
Radio controlled helicopters parts catalog