Lack of knowledge about Lap-Band

[Arthemise 1]

It amazes me how many health-care professionals know hardly anything about the Lap-Band. I had to educate my PCP about it, and then I had to tell the pharmacist about how we weren't supposed to swallow pills whole. She asked me if the Lap-Band was reversible -- uh, not really, unless you have another surgery.

Is it just my podunk town?

[Marine mom 3]

docs usually only know about the stuff they use every day. There isn't anyway that they can keep up with every specialty, and no reason a pharmacist should.

[Arthemise 1]

I would think that at least some preliminary knowledge about Lap-Band would be given to PCPs. I can see where they wouldn't know the details, but they should at least know how it works. A lot of people are getting the band nowadays. The first step, at least for me, was talking to me PCP about it.

As for pharmacists, they very definitely need to know what medication a Lap-Band patient should be given. Just as they need to know about drug interactions, they need to know what will cause people problems (pain, vomiting, etc.). High dosages of NSAID could cause severe problems over time, and they should know that.

[BetsyB 9]

Pharmacists need to know about how drugs work, how they interact with one another, and whether they might induce an allergic response in patients who've identified drug allergies. They cannot possibly be expected to know the restrictions associated with every disease process and surgery that walks through the drugstore door.

Determining whether the size of your stoma requires a liquid med or a pill splitter is the prescribing physician's purview (and if not a bariatric surgeon, that physician might require education from you). The pharmacist's role is to dispense prescriptions safely using different benchmarks.

If you want the people who provide care to you to know about your band and your restrictions, it's your responsibility to tell them. Most are very receptive.

Sometimes, patients are the best teachers. No one says you need to become the Ambassador of All Things Band-Related. But extend a little grace to the vast population of people for whom banding has really not even registered on the radar. They make up most of the world.

[Marine mom 3]

Lol, grace is one of my favorite words.

[Arthemise 1]

Sorry, I just don't agree, and I guess I'm in the minority on that. In my opinion, the pharmacist should have at least a little knowledge about the Lap-Band. I was not rude to the pharmacist and was willing to share my knowledge about it, but I'm not a medical professional; she is. I know it's my responsibility to take care of myself because no one can know my entire situation. But would you expect a pharmacist to know what medicines someone with a pacemaker should and shouldn't take? I would.

[Marine mom 3]

medications that cause pain and vomiting would be an issue without the band. As for nsaids, they can cause a problem for anyone longterm. I had to give them up a long time ago. These are issues that anyone with stomach problems would be dealing with, rather than lapband issues.

Meds that affect heart rate, etc., are in a different class than the potential issues for lapbanders. apples to orange comparison.

my pharmacist has no clue i was banded. it isn't a medication issue. it is not his business nor his problem.

[Arthemise 1]

Great, thanks for telling me I have unreasonable expectations of the people I pay to take care of my health. I'm out of here.

[Katy517 1]

It strikes me as odd that your opening post is all about your concern for lack of knowledge about banding and yet a few responses that disagree with your premise and you're ready to leave arguably the best source of lap band information on the web.

I'm all about personal responsibility and feel that I can only hold myself responsible for what I don't know. I am fortunate to have a PCP who is familiar with the lap band procedure and that has been of tremendous value to me. He's the same doc though who didn't know what an Oophorectomy was when taking my medical history for the first time. My excellent lap band surgeon on the other hand is really pretty weak in the area of lap band nutrition and I've had to educate myself in those areas that my common sense tells me he's incorrect in his recommendations.

Personal responsibility for our own health and a thick skin when it comes to criticism are necessary not only when we're obese and contemplating this life-changing surgery, but also while that change is ongoing.

Good luck to you on your journey to good health.

Great, thanks for telling me I have unreasonable expectations of the people I pay to take care of my health. I'm out of here.

[Marine mom 3]

Great, thanks for telling me I have unreasonable expectations of the people I pay to take care of my health. I'm out of here.

You don't pay a pharmacist to take care of your health. You pay a pharmacist to dispense meds and to understand their interactions.

As for your PCP, docs only know what they spend time with. I do not know everything about everything in my field. Do you? My doc is 12, but is a great guy who is willing to study if he doesn't know something, and I am happy to fill him in when things aren't as clear. That is why it is called a relationship.

lol, and my surgeon is clueless about nutrition, too. (unlike my pcp!)

[Tropicana 0]

It's amazing what patient's expect from their doctors.

[elcee 3,341]

and then I had to tell the pharmacist about how we weren't supposed to swallow pills whole.

According to who?

I swallow pills whole all the time and have never been told that I shouldn't. It all depends on the size of the pill, the shape, type of coating etc.

It's a case of knowing your body, your band and your limitations.

Therefore I don't see how you can expect your pharmacist to know this especially as it is not true.There is something called patient responsibility. The patient should inform the pharmacist of problems, contra indications etc. They can't be expected to know everything.

How many people including high profile stars have died because they omitted to tell their Dr/Pharmacist about all the other medications that they were taking?

And the lapband is reversible. It can be removed. yes it is generally only done if there is a problem but it can be done. that is the reason that it is many peoples WLS of choice!

[NurseShay 24]

I am in total agreement with elcee. Patient responsibility!

People pick their own pharmacys & they may or may not have a clue who you are. Medical history is not forwarded to them just a Rx to be filled. They may have no idea at all why your doc prescribed what you're taking. Medications serve different purposes unbeknownst to the laymen. You could be taking say sildenafil (revatio/viagra) for arterial hypertension not an erection. As a nurse when I took pharmacology one thing I remember was the main concept was learning drug catagories the side effects, interactions, dosage ranges & such. Your pharmacist may pick up on a dosage error or a negative interaction in what your PCP vs. An ER doc, that didn't know your full history (especially when you don't tell them!), may have overlooked. A medication order is only valid when written by the prescribing doctor stating the type & route (tab, liquid, patch, nasal spray, drops/ by mouth, subcutanous, buccal etc.) So the person who your issue should be with is the provider who wrote the order not the pharmacist. This is why its so important to tell your doctors EVERYTHING. They're not mind readers. If you've recently had a fill & are tight then you may need a liquid PO med. But many banders on a normal day can tolerate a tab pill. If you have issues with pills - break them in half or crush them & pour over some liquid (provided they are not extended release) but again if you discuss this with your doctor they can direct you as to what to do & prescribe exactly what you need. Not every medication comes in liquid form & not all can be crushed. In which case your doctor can change the drug altogether. Do not leave it up to your pharamacist! And by the way its rare you're even dealing with the actual pharmacist over a pharm technician & they may know a lot less than you're challenging them to be aware of. Its your responsibility to know & share with your providers all your medical history. Many banders do not wear medical braclets but in the event of an accident where you're unable to reveal such info & the ER doc's want to stick a NG tube without a scope down and meets resistance from your band they are not going to automatically think 'LAP-BAND®' over 'obstruction'. LAP-BAND® is only 9yrs old & isn't all that common in the US. Do your part... its your health after all! And by all means give correct info- ofcourse LAP-BAND® is reversible.

Best of luck next time & I'm sure your pharmacist will remember what you said so its even better for the next bander! Most fields of medicine require CEU's to keep a valid license to practice your field so you may have inspired him/her to take a class regarding new devices like lap band. No reason to be upset knowledge is power. =) ::thumbs up::

Edited May 3, 2010 by Sashay02

[Marine mom 3]

well said, Sashay!

[Manda87 3]

What does a PCP do when they cannot help you? They refer you to a specialist. For example, my PCP won't treat me for infertility, however my OB/GYN has more knowledge.

It's crazy how many people think doctors are Gods and they have magic in their fingers. I hate to state the obvious, but doctors are human too.