JR Stratton

Next to laparoscopic technology, gastric banding has been a great leap forward in bariatric surgery. Up until the early 1990s, gastric bypass was the most common procedure performed in the United States to treat morbid obesity. But the development of laparoscopic adjustable gastric banding system in 1993, and its FDA approval in June 2001, presented another surgical option in battling obesity. Gastric banding has appealed to a large population mainly because of a myriad of advantages it provides such as adjustability, reversibility and fewer risks of complications and side effects. Generally, adjustments enable the surgeons to alter the size of the stoma by changing the amount of saline in the band’s inner balloon via an access port, thereby changing the tightness of the band according to the patient’s needs and preferences. The band’s adjustability serves as a remarkable benefit, but it also demands that the patients receive regular follow-ups and professional coaching to ensure its long-term effectiveness. One of the most common problems many gastric banded patients face today is a lack of access to proper after-care programs. In some cases, patients travel away from their homes to have their surgery. And although, having these follow-up visits is almost as important as the procedure itself, most patients eventually stop the visits because of the inconvenience. As Dr. Ross Fox, a bariatric surgeon in Tacoma, Washington states, “We have to realize that the adjustable band is merely a tool, and it will not be effective, if it is not used properly.” Dr. Fox, who is one of the first surgeons in the U.S. to implant gastric bands, believes that currently the majority of band patients are not receiving the proper knowledge in how to use this tool effectively. “We have ‘orphan’ patients in our office regularly; they are patients with bands that we haven’t placed initially. They haven’t had any coaching or adjustments and therefore haven’t been able to lose any weight,” he said. As prominent bariatric surgeons with extensive experience in gastric banding surgery, Dr. Fox and his colleagues, Dr. Ariel Ortiz and Dr. Lee Grossbard had recognized the need for a comprehensive and accessible program that could help to educate gastric banded patients. So, when Iris Stratton, a friend and colleague, expressed her plan to establish a large number of Fill Centers throughout the United States, and asked them to join the organization as advisors and educators, they accepted her proposal wholeheartedly. For Iris Stratton, however, recognizing this vacuum and establishing Fill-Centers USA has been a natural development. A state-certified nutritionist and a state board-certified fitness instructor for over 30 years, Iris had always felt passionate about her work and strived to help her clients with their weight issues. But when her daughter’s struggle with weight escalated to the point of mental and physical anguish, Iris was compelled to explore their surgical options more extensively. “It was devastating to see my young daughter lose interest in school, her friends and eventually in life,” she expressed. “I had already looked into the gastric banding surgery as a phenomenal tool for weight control and weight loss. So I found a prominent surgeon who performed the gastric banding operation on younger individuals.” In just a few months, Iris was overjoyed to see the remarkable change in Dusti’s weight and her morale. But she also began to recognize her constant need for professional support and guidance in addition to the required band adjustments. The surgeon that performed her surgery was not in their local area. “One of the most important requirements for an effective gastric band is having a quality after-care program for many years beyond surgery,” Iris said. “While most surgeons make every effort to provide wonderful after-care to their patients, there are situations where, for various causes, some patients do not receive the individualized aftercare they need for success”. Iris began to materialize her plan in 03’ by gathering a team of renowned bariatric surgeons and a dedicated staff to provide a nationwide comprehensive program to gastric banding patients. “By establishing Fill Centers around the country, we are slowly overcoming the geographic problem, but we are also raising the bar on a variety of after-care services including monthly re-contact, diet and nutrition, exercise, supplementation, emergency care and band adjustments. We even provide healthy recipes, and a list of restaurants and what to order to this particular population,” she said. During the recruiting process, the program directors choose qualified nurse practitioners, surgeons, and physicians, who attend an intensive training course and learn a standard protocol for band adjustment. Also, as part of their training, they are instructed on nutrition, diet, fitness as well as risks and complications that are associated with the gastric band. In order to ensure a standard quality of operation, the organization performs regular quality reviews to various individuals, who monitor the overall performance of the providers and assess their strengths and weaknesses. “As part of the medical advisory board for the company, we are in close contact with the providers both during their training and afterward, and are available should any needs arise,” said Dr. Grossbard, who is also a Lap Band patient. “We make sure that our providers follow a correct and effective protocol in every single patient to make certain that their band functions at the optimal level.” Fill-Centers USA has a central office in Northern Arizona that oversees the function of its centers. Each center, in turn, has a sophisticated database, which enables them to network with one another and share information. “Every time a patient is taken on by one of our providers, their information is entered into the company’s central database and is accessible by other centers, our surgeons, and our corporate office.” Iris said. As she explained, if their members begin to have problems while traveling, they can call the number on their card and will be scheduled with the Fill Center nearest them at no extra cost. Fill Centers offers different payment programs, which include a yearly payment program or a membership program where members pay $155 per fill, which includes a regular consultation. “Band adjustments currently run the range of $150 to $2000, so our prices are comparable and, in most cases, lower than what patients would pay elsewhere,” Iris said. “Experience has shown that when patients commit themselves to having regular visits for reassessment, encouragement and additional coaching, they will have higher chances of long-term success. So, we encourage our patients to participate in our membership program.” Iris’ vision is being realized by Fill Centers impressive growth. “Helping gastric band patients across the nation on their journey to develop good habits around this amazing tool and achieve long-term weight loss has been my driving force. We are making every effort to having 50 plus Centers by the end of 08’”.

At eight years old I was a normal little girl who just wanted to play with my friends. However, I was already gaining more weight than the other kids my age. As I grew older my mom began teaching me good eating habits and exercise plans, but I always found ways to cheat to get the food I wanted. That is when my fight with my weight began. In High School I became desperate and started doing hard drugs to lose weight. They would work while I was on them, but as soon as I would try to quit I would gain more than I had lost. Everyone around me was thin: my older sister, sisters-in-law, my mom, and all my friends. I envied them and wanted to look like them, so I ended up avoiding them. I tried everything to lose weight, but I would always end up cheating myself and going back to binging, which would make me even more depressed. When I got depressed, I would eat. When things went wrong, I would eat. In the meantime, I was gaining and gaining. So I started punishing myself for being so weak by cutting myself. I have permanent scars on my body as a harsh reminder of what I went through. In an attempt to help, my parents sent me to a wilderness program. For 42 days I ate healthy, stayed clean from drugs and didn’t feel the need to punish myself. We also hiked every day. It was good for me, and when I returned home, I weighed 121 pounds. In dealing with going back to school, the real world, and the same old temptations, I started eating a lot again. I was beginning to gain weight at a faster pace than ever, and within four months, I weighed 186 pounds. Kids at school started calling me horrible names like “Jenny Craig” or “piggy.” I would overhear my friends talking about how much weight I had gained, and it hurt. I started getting depressed about myself more every day I quit doing my hair or caring about my looks. I stopped hanging out with anyone. I hated life and everything in it. I refused to leave my house, and, towards the end, even my room. When I left my room, I would keep a blanket wrapped around me. I would constantly eat more and more because I was depressed and unhappy. I lost all self-respect. I became distant from my family. My mom tried everything she could to help me but all it would do is make me more angry at her. And so my life continued until my mom told me about the gastric banding procedure. She explained it would be a great tool to help me to lose my excess weight, but I would have to have surgery. She explained how a band would be placed around my stomach that would help me control what I could eat. I learned about the tube that leads to a port where they would adjust the tightness of the band. She explained all the facts but left the final decision up to me. After about two weeks and a lot of research on the surgery, I was willingly on my way to surgery. I was scared and unsure of how this would affect my life, but I knew it couldn’t be any worse than what it had been. My parents helped me work through details with my surgeon. Eventually, I was prepared for and underwent my surgery, which consisted of only five small incisions on my stomach. I remember waking up gagging because my body was not accustomed to what had been placed inside of me, and that was about the extent of my discomfort. After returning home, I was struggling with not knowing what to eat, how to eat, or any other details regarding my future life with the band. I also needed someone closer to my home to perform my adjustments. Realizing the void, my mom began research toward a system designed to help me and other banded patients like myself all over the nation with local aftercare. She and a group of concerned surgeons developed a Company called Fill Centers USA which offers banded patients local aftercare. Over the next couple of months I was taught to eat smaller portions. I slowly learned what I could and could not eat. It was a lot harder than I thought it would be, but with the help of my provider, I was losing weight and keeping it off, and that was good enough for me. My life was starting to change. I was getting complements on how I looked. I started taking pride in how I looked for the first time in a long time. My weight currently hovers between 130 and 140. It has been over four years since I got the band; it is not been a miracle cure for all of my problems in life, and no one should expect it to be. I have had my ups and downs. It has taken a lot of education and good support but I did it. I am happy and I now have a great life. I enjoy a wonderful job and have regained my self-respect. At five feet six inches I am average weight. In looking back, I believe I have been given a second chance at life because my parents cared enough to intervene and do what was the best thing for me. To sum it up: The band was the best thing that has ever happened to me. Because of it, even the hard times are not as difficult to get through. I have good health again, I have found how to be happy again, I’m close to my family again, but best of all I have learned to love myself. I was headed for self-destruction, and the band allowed me to change that. I still have to eat healthy and try not to cheat the band—and there are still those days I think I weigh too much and could lose more—but I’m learning to be happy with the way I look. I had wonderful family support and couldn’t have done it without Fill Centers. I love my band and how it has helped me get my life back. I don’t cry myself to sleep every night anymore—I can now think about other things and enjoy life. A message for parents of overweight teens from Dusti and her mother: Please don’t ignore warning signs. Your child doesn’t have to be obese for weight to make life a living hell. Chances are they will not talk about it with you because they are embarrassed and disgusted with themselves. They are cruel to you because they are angry at themselves. Rest assured they are suffering verbal abuse and other indignities at school and other social places because of their weight that they may not share with you. They will do anything it takes to lose that weight. All the wrong things are available to them at a very young age, and they are extremely vulnerable in their desperate state of mind. They will have access to everything from prescription drugs to the hardest of street drugs. Don’t fool yourself into thinking, “My child would never do that;” it is tempting to the best of kids when they are confused and desperate. They have no fear of what the fabricated methods of weight loss might do to their bodies or minds. They will discover much too easily the drugs will make the hurt go away if only for a short, dangerous period of time. Please don’t wait too long and let your child get to the point that Dusti had reached. First of all, you have to face the fact “My child needs help, NOW!” Don’t be afraid to step up and do what it takes to give your child hope. --Dusti’s Mom From a person that has been to the very bottom and was offered the help it took that saved my life: Don’t put it off, take action, if your child (or young adult) is overweight, then rest assured, he or she is suffering more than you might imagine. --Dusti