Surgeon disappointed in weight loss / Bandsters a Dying Breed?

[A New Woman 1]

Okay, so I have two topics here to discuss and they kind of go hand in hand. First a little background on my story. I was banded on 3/12/09. I am 5'2" and started my journey at 233 lbs (BMI 42). This morning my scale (naked and on an empty stomach) said 178.00 so that gives me a weight loss of 55 lbs in a year. I am thrilled with my weight loss because I know that I would have surely gained in that year and I have not consistently lost over a years period like that without losing/gaining/losing/gaining.

I went for a one year visit with my surgeon on Monday 3/15. In preparation of my visit he wanted me to have an upper GI which I did. He wanted to check the placement of my band and the restriction. He was getting a little concerned about how tight my band was (9 cc's) before he would ever consider any more fills. Makes sense to me.

So I go for my appointment and I tell the nurse that basically my band is fickle. Some days I feel like I am exactly where I need to be and other days I feel like I could be just a little tighter as my portions sometimes are a little bigger than I'd like. Not an every day thing but happens on occasion. I was in no way begging for a fill.

So surgeon comes to the door and motions me out of the office (no hello BTW) to follow him. I follow him to a computer screen where he shows me the my upper GI and shows how well my band is doing, says hes happy with the placement, all looks good and that I have some good restriction. I'm still okay with that because I wasn't 100% convinced I needed adjusted. I really just wanted to talk it out and find out where I should be, but I think he automatically was on the defensive that I was going to insist on a fill. As we are walking back to the room he says to me "you smoke?" To which I reply "No." He then says "well, I smell smoke, does someone in your house smoke? So I kind of shrug my shoulders because I'm confused by this and say, "Well, I don't smoke but yes, my husband is a smoker." I'm confused though because I came from work to the appt. He then goes on to say "Well, the one thing I can smell is smoke and you smell like smoke." So I again say, "well, I've never been a smoker, in fact I lost my mother to COPD, and my sister and father to lung cancer. I'm not a smoker." Well the subject finally drops but what gets in my craw is that I can tell he still doesn't believe me. First thing that bothered me about the appt.

Then we move on to talking about my diet, what I've been eating, he tells me my choice for the afternoon lunch was horrible (3 chicken fingers and some mashed potatoes). Which, okay, I can agree with that. But I remind him of the other meals that were good choices. He then proceeds to remind me that "you would have done better with bypass but YOU wanted the band". So I tell him that I'm very happy with the band and I say "You know Dr. X, I've lost over 50 lbs (it was 52 at his office) in the last year, don't you think that's good. So he tells me that it's okay but not exceptional and how only 5% of his patients are bands now the rest bypass. The thing that really got me was that I could tell that I am a disappointment to my surgeon. I think he only views me as bringing his statistics down which makes me really upset because I think I should be applauded for what I have accomplished and not made to feel bad. He ended up giving me a .5 cc fill (which I told him I was surprised he was giving me that much) and he had me drink some Water (first time ever) before I left the office. I think he thinks I'm insistant on fills (only one visit was I ever insistent) because I don't come in and say I'm at my sweet spot. I never throw up, rarely feel stuck and at times still felt my portions were too large. But I guess because I wasn't telling him what he wanted to hear, I'm not successful and he's taking it personally or something. The whole experience was so negative I just don't know what to make of it. If your surgeon acted this way, how would you feel?

Second question, since he told me that he's only doing minimal bands now, and said the stats for the whole state of Michigan for bands were "lousy", are we becoming a dying breed to bypass?

[scottyd 0]

What a jack ass he was to make you feel this way. I would not let it get you down. Stand up for yourself the nest visit. You paid for it no one has the right to make you feel like that. NO ONE.

[patsal 1]

Sounds to me like he may be getting negative feedback form the insurance companies where bands are concerned, and he prefers to work with a "sure thing". The band is 70% us and 30% the tool we have to work with, where the bypass is the opposite. I am curious about what extra "stuff" you did. DId you do the paych eval and the nut? Were they "canned" to get the sign off or were they real? By that I mean, has your nutritionist gone over menus with you? Has s/he worked with you to figure out if you have foods that don't work well with you--like white refned carbs, etc.

As someone who has struggled with my weight nearly all of my life and gained/lost/gained back more time after time I think you should be proud of your loss so far. While it is not the 2 pounds per week that is stated it is still a good loss. I would suggest that you see a nutritonist since your dr. seemed to be venting but not productive in his suggestions. If you encounter the same attitude the next time you go, I would ask for his suggestions or find myself a new practice.

[Phranp 46]

Sounds like your doc is a real prince! I'm sure his thinking is just warped. Not everyone is looking to lose 150 lbs in one year. I have lost about 45 lbs in nine months and I am fine with it. I would not object to myself or anyone else losing more faster, but I like the idea of letting my mind catch up to what is happening with my body. I have had this relationship with food for many, many, MANY years and it's more than a notion to change my way of thinking at my age. I am doing so much better now and prefer the band over bypass. I know a number of people that had bypass and they have gained quite a bit of their weight back. I like the idea of being in partnership with my band. I do my job and the band does its job and all is well. I am down 8 sizes and I am thrilled!

I hope your doc was just having a bad day and that he apologizes for his boorish behavior the next time you see him.

All the best to you!

[ElfiePoo 109]

Sorry but your doctor sounds like a horse's ass. 50 pounds lost is 50 pounds less than you weighed last year and most likely far less than you would've weighed a year later without the band. His little GI cannot tell him whether you have 'good' restriction. Only you can. Give two people the same 12cc band and give them both 8cc and I guarantee one will most likely not have enough and the other one may be too tight.

If my surgeon acted this way, I'd most likely first confront him about it first and let him know I was less than pleased with his attitude and, unless he has a good explanation, I'd be looking for a new doctor.

.

[A New Woman 1]

Sounds to me like he may be getting negative feedback form the insurance companies where bands are concerned, and he prefers to work with a "sure thing". The band is 70% us and 30% the tool we have to work with, where the bypass is the opposite. I am curious about what extra "stuff" you did. DId you do the paych eval and the nut? Were they "canned" to get the sign off or were they real? By that I mean, has your nutritionist gone over menus with you? Has s/he worked with you to figure out if you have foods that don't work well with you--like white refned carbs, etc.

As someone who has struggled with my weight nearly all of my life and gained/lost/gained back more time after time I think you should be proud of your loss so far. While it is not the 2 pounds per week that is stated it is still a good loss. I would suggest that you see a nutritonist since your dr. seemed to be venting but not productive in his suggestions. If you encounter the same attitude the next time you go, I would ask for his suggestions or find myself a new practice.

Yes, I did the psych eval and saw a nut before and in the beginning after being banded. I am not 100% on my food choices. Sometimes I'm excellent; sometimes not. But I am well aware of the choices I make when I eat and am accountable to my choices. I do exercise regularly too. I do zumba, kickboxing, walk at least 2 miles and do my Wii. I have made so many positive lifestyle changes over the last year and I 100% follow the band rules about eating/drinking, etc. What I think is odd with his attitude was initially I was told it would probably take me about a year and a half to reach my goal. They actually considered me "skinny" compared to other patients since I "only" had to lose 100 lbs. so I was told it might not be as fast for me. My bariatric nurse often says "it's a marathon, not a sprint." So why in the world would my surgeon make me feel like I'm a failure? I truly think it's all about his "stats" and I'm bringing down his success rate. He told me to come back in 6 months and I tried to get some positive encouragement out of him when I was leaving and I said "well, maybe by then we can start talking about a tummy tuck" and he basically said in a derisive voice, "well you have to lose another 50 lbs." as if it wasn't even a goal to shoot for in the next 6 months. It was just plain weird. I was the last patient of th day, I think. I think he was in a "mood" and I got all his frustrations.

[stargate713 0]

maybe business is slow for him and he's fishing to convert you to a bypass. I thought long and hard over this decision, and if it were not for the fact that the band is reversable in the event of a serious complication I would not be having surgery at all. Loosing 52 lbs is no small feat and you should be proud of yourself, and as you said you may have in all reality GAINED over past year without the band. I think the suggestion above to see the nutritionist is sound, just to see if you can improve in any areas, and the other thing would be that you didn't mention exercise. If you are not exercising you are missing a big part of the puzzle. Best of luck .....and keep up the good work!

[stargate713 0]

OMG! and I just looked at your pics on your profile.....you look fantastic! And so much more happy than in your before pic....no matter what the scale says you look like you lost more. (tell the surgeon to.....well you know...lol)

[bella71 0]

Having supportive doctors is crucial when you have a Lap Band. I felt so strongly about it that I switched primary doctors because I felt like my PCP was uninformed and definitely was not on board with my surgery. Doctors (like lawyers and accountants, etc.) are replaceable. If you feel tension between yourself and your surgeon, then by all means, change surgeons!

[michael watkins 0]

WOW!!!! i dont know what to say!! has he ever acted like that before? theres no excuse to treat you like that! he should be supportive to you and really caring! im sorry that you had to go through that. you should be proud of yourself for losing 50 pounds so far!!! thats great! maybe you can switch to a different doctor and transfer all of your records of the surgery. well you are doing great and keep up the good work!!

[coloradobanding 5]

I am totally and completely serioud when I say to find a different surgeon IMMEDIATELY!!!

This guy is in idiot in EVERY sense of the word!! My surgeon told me at my initial consult that 1lb a week is completely normal and anything above that is a bonus. By my Doctor's recommendation (he is a preferred bariatric facility too btw) you are EXACTLY where you should be!

Apart from either doctor's advice or any hint of "where you should be" you are a ROCK STAR!!! 50lbs is UNREAL!!! You should ONLY be congratulated and delight in your success, NOT having to deal with some overworked MORON who calls himself a doctor!!

One of the most important factors in this journey is encouragement, strenght and support. It sounds like you have the strength part (WAY TO GO) but the other elements are equally important. PLEASE get a new surgeon who actually KNOWS that he is talking about!! It sounds to me that this surgeon does so few lap-band procedures he doesn't know what he is saying and doing to his patients.

If it were me, let's just say he would NEVER talk that way to me again and he would have a few colorful adjectives to add to his vocabulary

[pickles123 0]

I think you should change doctors. The whole process is hard enough without a negative doctor thrown in.

Just my opinion though.

[BetsyB 9]

What an a-hole. Seriously.

What matters is that YOU are happy with your progress.

Is he not aware that the band is designed for losses of 1-2 pounds per week? That it's not geared for fast loss, but for lasting loss? (Many of us have more trouble with maintenance.)

It sounds as though he's become a Bypass Man. Many surgeons do have preferences.

They don't tend to wish to make their patients feel like crap for making the decision that's right for THEM, even if not what they'd choose.

I'd switch doctors.

(I am so thankful for my doctor---so, so, so thankful that he is supportive of individual choice. (And also thankful that he agreed with my decision from the outset.)

YOU deserve a doctor every bit as good as mine.

(Oh--and statistics can be skewed however the person with an agenda wants to skew them. You're doing great, and don't let him tell you otherwise.)

[SoccerMomma73 1,867]

I would tell him to kiss my big (but smaller than it used to be) white butt....seriously, I would be finding another surgeon. Lap band surgery is what you make of it. We could all eat around it (easily) if we wanted to. Fifty pounds in a year is completely and perfectly on track and is NOTHING to feel bad about. Take care of yourself and keep up the good work. I don't care if he was having a bad day, he has no right to take it out on you. You deserve someone who cares about you and has your best interest at heart.

[bigbirney 3]

What a douchebag. I would definitely switch Dr.s. I have been reading a great deal about weight loss and 1-2 pounds a week is great. The bypass is for people that want to lose weight without any effort. Keep your head up!