Changing Bariatric Practice POST Surgery?

[RavenClaw779 2]

Considering moving my aftercare to another bariatric practice - if they'll have me.

Could use some feedback - as in am I crazy to consider doing this?

Here's the deal: I had gastric banding in early March and lost 27lbs in prep for the procedure. In the two weeks following the surgery I lost 12lbs. Since then, I've had four fills giving me 4.8cc in an 11cc band. My weight has not changed give or take 2lbs - so I'm 238-240 - regardless of activity level and apparently, what I consume.

I'm hungry within 2 hours of eating and can eat pretty much anything, but since my surgeon's practice states "No in-between meal snacks" I really try to hold the line which means there are quite a few meetings in which my loud, literally howling stomach is the source of discomfort for me and an amusing distraction for others. Couple this with the fact that I'm a Type II Diabetic who controls her blood glucose with a small amount of medication, diet and exercise. By the time I do breakdown and eat the forbidden "snack" rather than waiting for the next meal, I'm often sweating, hands shaking due to my blood sugar having dropped too low. Thus there's a chance I'll eat too quickly - we know what happens then or I eat the wrong, but safe items like ice cream or candy that melts quickly, and raises my glucose so I feel normal.

Beyond the obvious problem of not making progress with my band is that I'm not getting through to my Bariatric Practice.

1) I haven't seen my surgeon since the operation - he doesn't "have time" as he's busy with new patients.

2) I see a PA for my fills. She's almost always overbooked and frazzled. When she complimented me on losing 25 lbs between fill #1 & #2 without even looking at me and I said, "Excuse me? I haven't but a pound or two!" She had to check the chart - "Oops! My bad - I read it wrong!"

3) I keep telling her (see above) and the reaction is basically, "Uh-huh...well, let's get this fill in". After fill #3 she told me I had 5.5cc in the band; last week she advises me it's only at 4.8cc?!

4) No labs have been ordered, the saline hasn't been removed to check the band is holding what it should, no fluoroscopy - and no concern that I'm getting nowhere

- just "see you in four weeks!"

Last week's trip in for my big 0.6cc fill was the same experience as fills 1-3. I arrive on time and wait for over an hour and a half - and it's an hour drive each way, so I've had to take at least a half-day off from work. While I wait in the over-crowded waiting room, wishing I'd brought something, anything to eat, I watch the single PA juggle fills and consults for pre-surgical patients, have a melt-down because the surgeon has asked her to squeeze in another post-op having problems. Meanwhile the bariatric nurse is ranting at another pre-op patient about his "failure to lose weight" on Medifast, when in trots a pizza delivery guy with two large pies for the staff...right through the waiting room of starving bariatric patients. When it's all said and done, I leave with a raging headache, a long drive and the need to find a convience store for OJ - not a "clear liquid" but better than having a hypoglycemic incident on that hour drive home.

Thoughts? Comments?

[Mimilou2004 13]

I considered changing practices but in the end chickened out. It doesn't sound like you are getting the support you need and deserve. Is the other practice really any better? If it is and they will meet your needs, I think you would be justified in changing over. Let us know what you decide.

Mimi

[Phranp 46]

Considering moving my aftercare to another bariatric practice - if they'll have me.

Could use some feedback - as in am I crazy to consider doing this?

Here's the deal: I had gastric banding in early March and lost 27lbs in prep for the procedure. In the two weeks following the surgery I lost 12lbs. Since then, I've had four fills giving me 4.8cc in an 11cc band. My weight has not changed give or take 2lbs - so I'm 238-240 - regardless of activity level and apparently, what I consume.

I'm hungry within 2 hours of eating and can eat pretty much anything, but since my surgeon's practice states "No in-between meal snacks" I really try to hold the line which means there are quite a few meetings in which my loud, literally howling stomach is the source of discomfort for me and an amusing distraction for others. Couple this with the fact that I'm a Type II Diabetic who controls her blood glucose with a small amount of medication, diet and exercise. By the time I do breakdown and eat the forbidden "snack" rather than waiting for the next meal, I'm often sweating, hands shaking due to my blood sugar having dropped too low. Thus there's a chance I'll eat too quickly - we know what happens then or I eat the wrong, but safe items like ice cream or candy that melts quickly, and raises my glucose so I feel normal.

Beyond the obvious problem of not making progress with my band is that I'm not getting through to my Bariatric Practice.

1) I haven't seen my surgeon since the operation - he doesn't "have time" as he's busy with new patients.

2) I see a PA for my fills. She's almost always overbooked and frazzled. When she complimented me on losing 25 lbs between fill #1 & #2 without even looking at me and I said, "Excuse me? I haven't but a pound or two!" She had to check the chart - "Oops! My bad - I read it wrong!"

3) I keep telling her (see above) and the reaction is basically, "Uh-huh...well, let's get this fill in". After fill #3 she told me I had 5.5cc in the band; last week she advises me it's only at 4.8cc?!

4) No labs have been ordered, the saline hasn't been removed to check the band is holding what it should, no fluoroscopy - and no concern that I'm getting nowhere

- just "see you in four weeks!"

Last week's trip in for my big 0.6cc fill was the same experience as fills 1-3. I arrive on time and wait for over an hour and a half - and it's an hour drive each way, so I've had to take at least a half-day off from work. While I wait in the over-crowded waiting room, wishing I'd brought something, anything to eat, I watch the single PA juggle fills and consults for pre-surgical patients, have a melt-down because the surgeon has asked her to squeeze in another post-op having problems. Meanwhile the bariatric nurse is ranting at another pre-op patient about his "failure to lose weight" on Medifast, when in trots a pizza delivery guy with two large pies for the staff...right through the waiting room of starving bariatric patients. When it's all said and done, I leave with a raging headache, a long drive and the need to find a convience store for OJ - not a "clear liquid" but better than having a hypoglycemic incident on that hour drive home.

Thoughts? Comments?

Yep, if I were you I would probably change practices.

But, I do have this to say about you trying to follow this docs orders not to snack: ARE YOU CRAZY????!!! You are a diabetic, low blood sugar is as bad as high blood sugar. Don't listen to crazy people (your doc office) telling you to do things that will harm you (don't snack -- even if you are crashing from low blood sugar!). I'm sorry, but that is insane! Also, have you considered that when you eat too few calories your body goes into starvation mode? C'mon, give yourself credit, you know your body better than anyone else and particularly better than a doc office that can't tell you from 50 other patients. I am a diabetic too ... but I haven't been on medication for almost a year now. Had my surgery, lost some weight (my ticker is not accurate, I no longer have a scale -- for months now) and poof! no more diabeties! I still check my blood sugar and the numbers are always good. About six months ago I wasn't getting enough calories and I was crashing a little but that was simple enough to fix. Take care of yourself -- you are the ONLY one that will, believe me. Your doc is obviously in this for the money only. Do all the reading you need to do and then make your move. Also, there have been posts here about people having difficulty changing practices so you should check it out here first. There's a lot of help here - read, read, read and ... ask if other posters have used your practice, they may be able to tell you something about changing or not changing. Use this resource, it's great.

Take care of yourself! Eat good healthy Snacks to keep your blood sugar up. All the best to you on your journey.

Fran

[Dawn5115 0]

uh.....wow. I really hope that isn't normal practice. DO keep us updated. I'm only 6 days out.... but I was unable to get a liquid pain med.for some reason. I had no post-op x-ray (I'm self-pay, and I thought these things were expected and inluded?) And the surgery center was to call and check on me the following day... they called three days later. And now my post-op appointment is 3 weeks after surgery... not at one week and again at two weeks like I thought.

[RavenClaw779 2]

Dawn - I don't know that the service standards vary by practice based on whether you self-pay or not. My post op was three weeks out and with a nurse, not the surgeon. They did a portable X-ray when I was in recovery - I just barely remember that. I did get an Rx for liquid pain med(awful tasting) but by day 3 I no longer needed any pain meds inc. Tylenol. Don't let my experience sour you; give it time before worrying.

Fran & Mimi - Ladies you're both spot on!

One thing I do think my practice and many others do consider is what insurance carrier you have. I'm w/BCBS and everything from the approval process to all claim payments was smooth. I've met my deductible, and my out-of-pocket and coinsurance so what they'll get paid for their $150 fill is what ever BCBS negotiated rate is. They won't be able to bill me for anything...but if they drag the fills out as long as possible, so that I have to keep coming in repeatedly and into 2011, they be able to bill me up to $400 for more fills to inch me toward the "green zone".

I am rather surprised that no one in the practice has grasped the fact that my scale isn't moving - or maybe they have, so they can D-R-A-G out the fills a wee bit at a time.

I did speak with another local practice today. They said I need to fax them all my paperwork and they'd review it and consider accepting me. Wonder if they'd like my SAT scores too? College transcripts? Resume? Credit Report? Finger Prints:w00t:!

[KimmyTx 0]

You've gotta advocate for yourself. If you don't, who will? Your doctor isn't giving you the treatment you require so he deserves to lose your business.

[jingleboob 5]

Where in Upstate NY are you?