band assist

I am a Physician Assistant with over 12 years of experience in internal medicine and gastric band management . I am a certified provider in band management and have done thousands of fills. I believe in the band because I have seen, first hand, how well it works.....if the patient has been taught how to use it!!! Too often, the patient is rushed in and out of the office for a fill and the provider doesn't address what the patient is doing right or wrong. The weight log does not tell the whole story, far from it. Unfortunately, most providers put far too much "weight" in the weight log. For instance, the patient comes in for a 2 week follow up and has lost 3 lbs, great right? Not quite, If the provider doesn't ask the appropriate questions he/she may not know that the patient is too tight and vomiting daily, surprisingly, many patients won't offer this info up to the provider because they are losing weight. The provider MUST spend time withe the patient to determine if the band is too tight or is the patient making mistakes that cause vomiting. This vomiting is risky for band patients because it may cause a slip or erode the mucosa of the esophogus as well as many other potential problems. Believe it or not, there are plenty of "band bulemics" out there and most aren't identified because the provider doesn't spend enough time with the patient. On the flip side, some patients come in with a weight gain, yet their band is very tight. This is actually a common dilema and again if the provider doesn't ask the right questions, the patient will end up getting a fill when in reality, they need a small defill. Most patients want their band as tight as possible because that equates to more weight loss, right? When the band is too tight, the patient knows that most foods will cause vomiting. Ironically, its the food that they shouldn't eat, that they end up eating, thus weight gain. In this patient, with a small defill, the vomiting will resolve and their weight will drop. I am available to answer any questions this community has via this forum or email at jvmed@me.com.