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What are two things that fascinate you about this chapter?

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What is 1 thing from this chapter that confuses you?

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Benefits: Using these hybrids, Colossal’s long-term goal is to convert swaths of today’s mossy tundra into the grassy steppes they once were during the Pleistocene epoch, the period of multiple ice ages that ended 11,700 years ago. Some scientists hypothesize that at large scales, this reversal could reduce future climate change by slowing the thaw of Arctic permafrost.

Risks: They might overpopulate as they have no natural predators. Due to their large size, they have to eat more, meaning that other animals may not have enough food to eat, causing them to die also. It is also unethical as they may not have a good quality of life due to current climate conditions

yi en : there may be mutations and they become weird ass monsters.

Group's Opinion:

Abigail: This is stupid, they are relying on too many hypotheses. They are putting the cart before the horse.

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Harvard geneticist George Church has co-founded a new company with an audacious goal: engineer an elephant that resembles the extinct woolly mammoth. The company, named Colossal, aims to use woolly mammoth DNA to make a hybridized Asian elephant that could thrive in Arctic climates.

Using these hybrids, Colossal's long-term goal is to convert swaths of today's mossy tundra into the grassy steppes they once were during the Pleistocene epoch, the period of multiple ice ages that ended 11,700 years ago. Some scientists hypothesize that at large scales, this reversal could reduce future climate change by slowing the thaw of Arctic permafrost. Along the way, Colossal hopes to create new-and lucrative-biotechnologies, including tools that would supplement traditional conservation approaches.

"We're de-extincting genes, not species," Church says. "The goal is really a cold-resistant elephant that is fully interbreedable with the endangered Asian elephant."

The idea of using biotechnology to help endangered species, or even extinct ones, is not new. In 2009 researchers successfully cloned a subspecies of ibex that had died out in 2000, though the clone lived for only a few minutes. In April, the San Diego Zoo and California-based nonprofit Revive & Restore announced they had cloned an endangered black-footed ferret, with the goal of adding genetic diversity back into captive-breeding programs.

And for years, Church's plans to "resurrect" a mammoth using the extinct titan's sequenced DNA made headlines around the world.

"Most of the science had been solved; they just needed that funding and focus," says Colossal co-founder Ben Lamm, a serial entrepreneur who most recently founded the AI company Hypergiant. "It's kind of exciting-after two years of working on this-to start to tell people what we're doing."

Don't expect pseudo-mammoths to arrive anytime soon. Colossal's plans rely on several technologies that are unproven in elephants. Even on the company's most aggressive timeline, Church says that Colossal's first hybrid calf is six years away. A self-sustaining herd could take decades to establish.

But even at this early stage, Colossal's mission raises profound questions about what it means for a species to be extinct-and how biotechnology can and should be used to address today's extinction crisis. With Colossal's arrival, the conversation is no longer abstract, says Tori Herridge, a mammoth biologist at the Natural History Museum in London. "My initial reaction was one of like, Shit's getting real," she says.

Welcome to Pleistocene Park

Church's dreams of engineering a hybrid mammoth first deepened after an interview he did with the New York Times in 2008 about efforts to sequence the woolly mammoth genome.

At first, the idea was more of a grand intellectual puzzle. But in the years that followed, Church started to collaborate with Stewart Brand and Ryan Phelan, the founders of the California-based Revive & Restore. Brand and Phelan aim to use biotechnology to help shore up threatened species and to bring back extinct ones. ( Find out more about the science-and ethical debate-around bringing back extinct creatures.)

"De-extinction and the idea of what we call genetic rescue is really a story about hope and being able to repair some of the damage that humans have caused over the centuries," says Phelan. "It's not nostalgia-it's really about increasing biodiversity."

Brand and Phelan invited Church to the world's first conferences on "de-extinction," held in 2012 and 2013 at the Washington, D.C., headquarters of the National Geographic Society. (National Geographic Partners, which produced this article, is a joint venture between The Walt Disney Company and the nonprofit National Geographic Society.)

At these meetings, Church met Sergey Zimov, a Russian ecologist and director of the Northeast Science Station in Cherskiy, in the Republic of Sakha. Since the 1980s, Zimov has studied Siberian permafrost and has sounded the alarm on the vast amounts of methane and carbon dioxide that could seep into the atmosphere as it thaws. ( Find out more about climate change's threats to Arctic permafrost.)

It's not nostalgia-it's really about increasing biodiversity.

Zimov also has an idea for how to keep that carbon in the ground. Since 1996, Zimov and his son, Nikita, have worked on Pleistocene Park, a fenced-off parcel of tundra near Cherskiy. The Zimovs have introduced elk, bison, reindeer, Bactrian camels, and other large herbivores there to test the creatures' effects on the landscape.

Tens of thousands of years ago during the Pleistocene, much of Europe, Asia, and North America was covered in highly productive grassy steppes that were densely populated by diverse herbivores. By 10,000 years ago, many of these herbivores-including mammoths-had gone extinct across much of the world, probably in part because of human activity such as hunting. As these animals died out, the grasslands they maintained through grazing gave way to shrubs, trees, and mosses, yielding the tundra and taiga we see today.

Mammoths, the Zimovs suspect, were essential to maintaining the ancient Arctic's highly productive grasslands. The massive creatures knocked down trees, stirred up earth, and fertilized the soil with their dung, helping the grasslands thrive. Their heavy foot falls also punched through layers of snow and ice, letting the Arctic chill more deeply penetrate the permafrost.

"Consider the ecosystem kind of as a body," says Nikita Zimov. "The mammoth is the right fist."

Though Pleistocene Park doesn't have that fist yet, the enclosure's current herbivores may already be shaping its soils. In a study published last year, the Zimovs found that during winter, the compacted soils within Pleistocene Park can get more than 10 degrees Fahrenheit colder than the soils outside the park.

The park's vision of bringing back ancient grasslands is "an exciting hypothesis," says University of Maine paleoecologist Jacquelyn Gill, based on the effects that today's elephants have on their habitats. However, she cautions that researchers still don't know the full details of how woolly mammoths' ecosystems functioned, which complicates efforts to remake them today.

"To use that as a justification for a project like this-that has large ecological, social, ethical, [and] bioethical considerations-very much feels like putting the cart before the horse," she says.

Sparing no expense

Still, the Zimovs' project spurred Church and the conservationists at Revive & Restore to more seriously pursue research on mammoth DNA and elephant cells.

Until now, the Church lab's work on elephants and mammoths has been a part-time, volunteer effort among his regularly changing staff. As a result, none of this work has yet been published in the scientific literature, to the consternation of outside experts. Church says his lab is now on track to submit two studies for publication in the next several months.

Church's lab had also been conducting its elephant research on a shoestring budget of roughly $10,000 a year, drawing on a $100,000 donation from investor Peter Thiel and support from Revive & Restore.

By contrast, Colossal has $15 million at its disposal, fundraised from a group of investors including Silicon Valley venture capital firms and prominent life coach Tony Robbins. Colossal's funding will support the Church lab's ongoing research on elephant cells, as well as the company's own lab, which will be run by Eriona Hysolli, a former postdoctoral researcher in Church's lab who is now the company's head of biological sciences.

Beth Shapiro, a paleogeneticist at the University of California, Santa Cruz, says that Colossal's funding model may be transformative for geneticists who work on species conservation. "It's a totally new source of money-a huge source, potentially-that's being invested directly into things that we all care about," she says.

To help guide its efforts, the company has recruited scientific advisers, including two with a background in elephants or mammoths: University of Potsdam geneticist Michael Hofreiter, who studies mammoths and other Pleistocene animals, and Oxford zoologist Fritz Vollrath, who studies the behavior of spiders and modern elephants.

The company's advisers also include two prominent bioethicists who study genome editing: R. Alta Charo of the University of Wisconsin at Madison, and S. Matthew Liao of New York University. (Stanford University chemical engineer Joseph DeSimone, a member of Colossal's scientific advisory board, is also a member of the National Geographic Society's board of trustees.)

Life scientists find a way

Colossal's ultimate goal is to swap enough key genes into the Asian elephant genome to make a "proxy" species that's adapted to the Arctic cold, as mammoths once were.

The last common ancestors of woolly mammoths and Asian elephants lived six million years ago, Herridge says, and the two species still share more than 99.9 percent of their DNA. But the elephant genome stretches about three billion base pairs long. That means there's more than a million individual differences between the Asian elephant and woolly mammoth genomes that scientists must sift through.

So far, Lamm and Hysolli say that the Colossal team is targeting a minimum of 60 mammoth genes, including genes involved in the animal's fat deposits, its blood's ability to hold onto oxygen at low temperatures, and its trademark shaggy coat.

Inserting the relevant mammoth genes into Asian elephant DNA would require making many genetic edits at once, a problem that Church's lab has chipped away at in other species. His team used the powerful gene-editing technique CRISPR-Cas9 to edit the pig genome at dozens of different places at once, with the goal of making pigs whose organs can be safely transplanted into humans. ( Learn more about the revolutionary potential of CRISPR-Cas9.)

At least one of these candidate mammoth genes has been tested in transgenic lab mice. But individual genes can have many potential effects across the whole genome, and a gene's ultimate effect on an organism's traits comes down to when, where, and how much that gene is expressed within the body. This sort of regulation partially depends on stretches of DNA that aren't well understood in extinct mammoths.

Church says that Colossal's researchers should be able to screen for many potential issues early in a hybrid embryo's development. That said, he acknowledges that some engineered traits-such as the animal's ears, which need to be small to prevent frostbite-couldn't be checked until late stages of development.

But the single biggest source of uncertainty for Colossal is how it will develop its embryos. Asian elephants are endangered, so to avoid the use of surrogates, the company says that it will develop an artificial elephant womb.

Past experiments with lambs and mice have shown that artificial wombs can support premature fetuses for up to four weeks, or support five-day-old embryos for up to six days. But so far, Church says that no artificial womb has been used through any mammal's full gestation period.

To meet its goals, Colossal would need to pull off this world first with modern elephants. Their gestation lasts nearly two years and yields calves that weigh more than 200 pounds at birth.

Colossal also needs a self-sustaining supply of Asian elephant cells. In particular, Church says, the company must develop a line of induced pluripotent stem cells, which have been biochemically nudged into a primordial state that lets them transform into many possible cell types, such as eggs. These kinds of stem cells have been created for other endangered mammals, including the northern white rhino -but not yet for elephants.

Stopping to think if they should

Any experiment that involves animals comes with ethical challenges. If Colossal does successfully create a healthy hybrid calf, that only further raises the stakes. Elephants are long-lived, highly intelligent creatures that maintain complex, multigenerational matriarchal societies.

Research into ancient mammoths suggests they shared many of these social traits. So how would the very first mammoth-elephant hybrid be properly cared for and socialized? And how would a future herd of these hybrids learn to survive in the Arctic-and effectively reboot mammoth culture from scratch?

"It's not just about having them exist, but making sure that once they do exist that they can thrive and live a flourishing life," says Liao, the New York University bioethicist on Colossal's scientific advisory board. "Otherwise, you're being cruel to these animals."

Colossal and the Zimovs have a friendly, unofficial agreement that Pleistocene Park could host some of the company's future mammoths. For now, that experiment is confined to 7.7 square miles (20 square kilometers) of land, with eventual plans to fill out an area spanning 55.6 square miles (144 square kilometers).

But today's migratory elephants can cover very long distances, and so did woolly mammoths. One recent study of a 17,000-year-old woolly mammoth tusk found that the young male walked tens of thousands of miles over its 28-year lifespan, crisscrossing much of modern-day Alaska. If Colossal's full vision were ever to be realized, it would require rewilding millions of square miles of Arctic tundra to affect the global climate.

The scale of these proposed changes would create thorny problems around land use, the effects on existing Arctic wildlife, and global governance. And what effects would there be on the approximately 180,000 Inuit in Russia, Canada, the United States, and Greenland-the peoples most directly at risk in a stressed, rapidly changing Arctic?

"Quite frankly, I get quite dubious when settler scientists want to remake the world in a particular image," says Daniel Heath Justice, an Indigenous studies scholar and animal cultural historian at Vancouver's University of British Columbia. He notes that biotechnology can be a useful tool for conservation, but he adds that work along these lines, such as Colossal's research, "cannot only be led by non-Indigenous interests."

In a statement, Colossal said that "there will be no impact on the Indigenous tribes that currently live in the area" and that its "highest priority is its commitment to conservation and the preservation of all species, including humans."

If Colossal can deliver on that priority, the company's supporters argue, living species will reap the benefit, even if an elephant-mammoth hybrid never arrives. With Colossal's funding, the Church lab is working on a way to synthesize elephant endotheliotropic herpesvirus. This virus infects and kills many young Asian elephants, but it can't be grown reliably in the lab. Culturing it would be a crucial first step toward making treatments and vaccines.

"The only realistic, reasonable line of argument for these kinds of technologies," says Shapiro, the UC Santa Cruz geneticist, "is to help species that are alive thrive in a rapidly changing human environment."

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Mammoth-elephant hybrids could be created within the decade. Should they be?

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Harvard geneticist George Church has co-founded a new company with an audacious goal: engineer an elephant that resembles the extinct woolly mammoth. The company, named Colossal, aims to use woolly mammoth DNA to make a hybridized Asian elephant that could thrive in Arctic climates.

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Benefits:

Improved nutritional content

Increased crop yields

Reduced use of pesticides

Improved environmental sustainability

Risks:

Health risks: allergic reactions, toxicity, other health problems

There is limited evidence of health risks which makes it unclear if GM crops are suitable for human consumption.

There is a lack of long-term studies which means that the potential health risks of consuming GM foods over the course of a lifetime are unknown

Assessing health risks are complex.

Environmental risks: GM crops may pose a threat to non-target species, unintended impacts on soil health and other aspects of the environment.

Economic risks: GM crops may be expensive to produce, which results in higher prices that may not be affordable to some groups of people.

Group's Opinion: GM crops can be useful but we think that more research should be done to better understand the benefits and risks of GM crops.

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The Benefits and Risks of Genetically Modified Foods - A Comprehensive Guide - Data Max

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Understand the science behind GM foods and learn about the potential health benefits and risks. Get a balanced and informed perspective with this detailed guide.

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Benefits:

-Cost-effectiveness: GM fruit vaccines can be produced at a significantly lower cost compared to traditional vaccines. It is estimated that the production cost of the GM hepatitis B vaccine would be less than one penny per dose.

-Accessibility: The low cost of GM fruit vaccines makes them more accessible to people in developing countries who may not be able to afford traditional vaccines. This can help in reaching a larger population and reducing the burden of diseases like hepatitis B.

-Stability: Traditional vaccines often require refrigeration to maintain their effectiveness. However, GM fruit vaccines have shown to remain stable even in processed or dried forms, making them easier to store and transport, especially in areas with limited access to refrigeration facilities

-Potential for disease eradication: The development of GM fruit vaccines opens up possibilities for eradicating certain diseases altogether. The success of vaccines in eliminating diseases like smallpox and the progress made with polio vaccination gives hope that hepatitis B could also be eradicated using this technology.

Risks: No risk everyone happy

1. Consistency of dosage from fruit to fruit, plant to plant, lot to lot, and generation to generation is not similar.

2. Stability of vaccine in fruit is not known.

3. Evaluation of dosage requirement is tedious.

4. Selection of best plant is difficult.

5. Certain foods like potatoes are generally not eaten raw and cooking the food might weaken the medicine present in it.

6. Not convenient for infants as they might spit it, eat a part or eat it all, and throw it up later. Concentrating the vaccine into a teaspoon of baby food may be more practical than administering it in a whole fruit.

7. There is always possibility of sideeffects due to the interaction between the vaccine and the vehicle.

8. People could ingest too much of the vaccine, which could be toxic, or too little, which could lead to disease outbreaks among populations believed to be immune.

9. A concern with oral vaccines is the degradation of protein components in the stomach due to low pH and gastric enzymes. However, the degradation can be compensated by repeating the exposure of the antigen until immunological tolerance is accomplished (Mason et al. 2002).

10. Potential risk of spreading the disease by edible vaccine delivery is a concern of many. Potential contamination of the oral delivery system is a possible danger.

Group's Opinion: Great plan 10/10, but using bacterial ecoli to use as vaccine is more effective

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Tomatoes and bananas genetically modified to contain hepatitis B vaccine could rid the world of the virus, a leading American scientist said in London yesterday.

The virus, which causes high fever and attacks the liver, is a precursor of liver cancer, the biggest single cause of cancer deaths. This new development will save hundreds of thousands of lives a year, said Charles Arntzen, the scientist who developed the technology.

The breakthrough in producing a cheap, stable vaccine by genetically modifying plants became biology's holy grail in the 1990s, and is seen by the US bio-tech industry as its vindication and public relations saviour. Plant vaccines will be a billion-dollar business, said Professor Arntzen, who leads a team of the world's top plant scientists at Cornell University in New York state.

Successful experiments show that the vaccine worked, he added, and will cost less than one penny a dose to make. A single gene transferred into a tomato or banana plant is reproduced as a protein thousands of times inside the fruit. When eaten it passes into the intestine and then into the blood stream producing antibodies against hepatitis B - working the same way as a traditionally injected but much more expensive vaccine.

A single dried banana chip or tomato paste sandwiched in a wafer contains enough protein to act as a vaccine dose. Traditional vaccines have to be refrigerated and cost £10 for a successful course, making them too expensive for developing countries where hepatitis B kills many people directly and causes the death of many more through subsequent cancer.

Prof Arntzen, who is director of the Boyce Thompson institute for plant research at Cornell, has been visiting his opposite numbers at Britain's top plant research laboratory, the John Innis institute attached to Norwich University.

Talking to scientists at the US embassy in London, he said it was the most exciting area of biological science and that 40 new vaccines being worked on worldwide opened the possibility of eradicating some diseases altogether.

His institute was founded by a high-ranking Salvation Army officer in the 1920s to expand human understanding of plants and to enhance their benefits to humankind. It was for this altruistic reason that its scientists had tried to produce cheap vaccines from plants that would benefit millions of people in the developing world who could not afford western medicine.

"We have rid the world of smallpox through vaccination, we are close with polio. Now I believe we can do it with hepatitis B too," Prof Arntzen said.

His experimenting began in the 1990s with e-coli antibodies being genetically introduced into potatoes and fed to mice. A small quantity of uncooked potato was enough to produce antibodies in mice. Three clinical trials on human volunteers produced the same results but it did not work in cooked potatoes because the antibodies producing proteins were too unstable.

However, when the technology was used for hepatitis B using tomatoes, the proteins remained stable, allowing the vaccine to work even in processed or dried tomatoes. Thirty original plants, producing 15lb of tomatoes a week, were enough to produce thousands of doses of effective vaccine at one cent per four doses.

The vaccine has been held back because the US department of agriculture and the food and drug administration had no licensing mechanism for plant vaccines. "They are working on it and hope to have something up and running in two years," said Prof Arntzen.

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Vaccine in GM fruit could wipe out hepatitis B

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Tomatoes and bananas genetically modified to contain hepatitis B vaccine could rid the world of the virus, a leading American scientist said in London yesterday.

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Benefits:

potentially produce higher crop yields

reduce the use of pesticides

improved food quality

can feed more people in developing countries

crops can be engineered to withstand weather fluctuations and extremes, hence providing products even during poor weather conditions

it is also engineered to have a high content of a specific nutrient.

Risks:

trigger allergy in humans

other organisms may be harmed, deteriorating the ecosystem

emergence of new diseases

Group's Opinion: Although it has different advantages, it is not necessary because original products can be sufficient, while they do not have such environmental disadvantages.

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By: Ian Murnaghan BSc (hons), MSc - Updated: 5 Feb 2024 | *Discuss

With all of the controversy around genetically modified (GM) foods, sorting through huge volumes of information can seem like a daunting task. Many members of the public are asking questions about GM foods and they are also raising concerns about the effects these foods may have on their health or the environment. There are different advantages and disadvantages of GM foods, although to what extent they can help or harm humans and the environment is a debatable aspect of this technology.

Benefits Of GM Foods

A proposed benefit of GM foods is that they can potentially produce higher crop yields, which could help by feeding more people in developing countries. They are also cited as more economical, despite the initial higher cost of the seeds. The rationale is that they reduce the need for pesticides and herbicides as well as reducing the manpower needed to successfully grow the crops, which should translate into improved financial gains.

Improved food quality is another benefit associated with GM foods. A tomato, for instance, can be engineered to stay fresher for longer, thereby extending its shelf life in the supermarket.

Yet another benefit that is believed to occur from GM technology is that crops can be engineered to withstand weather fluctuations and extremes. This means that they can provide sufficient yields and quality despite a severe, poor weather season.

Another benefit is that GM foods can be engineered to have a high content of a specific nutrient that is lacking in the diet of a local population group. The vitamin A rich 'golden rice' is one example of a GM food that has been engineered to have high levels of a nutrient.

Issues With GM Foods

A worrisome issue in GM foods is the ability of a food to trigger an allergy in humans. Some of the genes used in GM technology might be taken from a food that causes allergies in some people. Inserting that gene into another organism could cause the host organism to express that allergen as a trait. Alternately, a new allergen could be produced when genes are mixed across different species.

Another potential downside to GM technology is that other organisms in the ecosystem could be harmed, which would lead to a lower level of biodiversity. By removing one pest that harms the crop, you could be removing a food source for an animal. Also, GM crops could prove toxic to an organism in the environment, leading to reduced numbers or extinction of that organism.

Given that some GM foods are modified using bacteria and viruses, there is a fear that we will see the emergence of new diseases. The threat to human health is a worrisome aspect of GM technology and one that has received a great deal of debate.

Using The Fact Sheet To Make An Informed Choice

There are many other potential benefits and risks to GM foods, which you will likely learn about as you investigate the topic further and decide whether or not you want to support or avoid GM foods and related technology.

Reading a brief fact sheet is a good way to familiarise yourself with the purported benefits and issues related to GM foods. In this way, you can equip yourself with an overview of the knowledge needed to make an informed decision about GM foods and how they will affect your life.

What Next?

Find out more about GM foods by reading our articles about the Development and History of GM Foods and also find out the Types of Techniques Used to Genetically Modify Food.

You might also like...

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There are many proposed benefits and disadvantages of genetically modified (GM) foods. By learning about these different aspects, you can decide if you want to support or avoid GM foods.

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Crohn's disease affects the ileum in small intestine, reducing the absorption of the nutrients because of the swelling. He will feel lethargic because he does not have nutrients that are absorbed, and his body goes to starvation mode. He should take medicine. Eat frequently in small portions so that the nutrients can still be absorbed frequently in the jejunum. Eat a lot of carbodyhrates, so that he get a lot of energy

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Patient B requested for a full blood test after experiencing some symptoms, including sudden unexplained loss of weight, excessive sweating especially at night, constant feeling of fatigue and weakness and swollen lymph nodes.

A blood test was done and her results are shown.

What will you advise her in terms of
- possible reason for her symptoms
- possible ways to get better
- some do's and dont's

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Patient A has been complaining about breathlessness and general feeling of lethargy for the past few months. He was admitted to the hospital after he fainted during his school's cross-country run. A blood test was done and his results are shown.

What will you advise him in terms of
- possible reason for his symptoms
- possible ways to get better
- some do's and dont's

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Patient C was rushed to the A&E department after 4 days of consistent high fever that did not subside with medication. Doctors could not stop her bleeding and observed that she had lots of internal bleeding.

A blood test was done and her results are shown.

What will you advise her in terms of
- possible reason for her symptoms
- possible ways to get better
- some do's and dont's

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For the past few months, I experienced frequent vomiting and sharp pains on the top right corner of my abdomen. These symptoms tend to happen especially after eating my favourite food which is fried chicken.

I finally decided to see a specialist and was diagnosed with gallstones. The specialist advised me to undergo surgery to remove my gallbladder. I am worried and cannot make a decision because I have no idea what the gall bladder actually does for me. I wonder if I can still enjoy my favourite food and if I need to change my diet after this surgery?

---Soon Lee

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My mother was diagnosed with stomach cancer and recently had a surgery to remove half of her stomach.

She seems to be recovering well from the surgery but is struggling with her meals. She complains that she feels full after eating only a small meal and has also lost quite a lot of weight since her surgery. Can you please tell me why she is experiencing this and advise me on a suitable diet for her?

---Elyssa

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My son was recently diagnosed with Crohn's disease. The doctor said that the lower half of my son's small intestine is inflamed and cannot function normally because of this disorder.

I feel very distressed that my son is losing a lot of weight even though he has been taking his meals regularly. He also complains that he feels very tired easily. I need someone to explain to me why he is experiencing these symptoms.

---Bernice

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I was experiencing persistent cramps in my lower abdomen and found blood in my faeces. This made me worried because it is not normal and I went to a specialist for a check-up. He diagnosed me with colorectal cancer and advised me to go for a colostomy surgery to remove the cancerous growth. From what I understand, part of my large intestine will be removed and the remaining portion will be connected to a bag which will be placed outside of my body.

I will be undergoing this surgery next month and am getting very nervous. I wonder if I will need to change my lifestyle and diet after this surgery.

---Siva