Lap band erosion

[WASaBubbleButt 41]

Yeah I get what your saying..but come on..where is there any other surgery that doctors get away with that? Really it seems illegal.

Nope, not illegal in the least. A doctor is running a business like any other and he can pretty well run it as he chooses, and that is the way it should be. Too much of big brother isn't a great idea.

Banding is a big money maker, fills are not. Docs are in business to make a living. Fair is fair. I do wish they'd be a little more honest about it though. These docs that flat out refuse to provide care to patients that they didn't band, fine. At least be honest about it.. there isn't enough money in it to be worth while but don't hide behind liability issues. Banding is the only surgery I can think of that docs hide behind this. Money is a fair subject, so be honest. But it isn't liability according to the boards of medicine or medical malpractice insurance co's. That is something Inamed started and how it's gotten out of hand and docs use it to hide behind.

I'm sure there is a sense of frustration as well. Look at all the business US docs are losing to Mexico? That has to hurt the bottom line, you know it does. So be honest about it. But the deceit of Inamed has to come to an end. It has reached a point where US citizens cannot obtain even emergency care in the US as a CASH PAY PATIENT! Inamed is gonna pay for this one day and in a big way. Let's see if my psychic predictions pan out.

[DrWatkins 5]

I think the fact that J&J is in the picture now things will be changing. Historically Inamed pretty well got their own way since they didn't have any competition. Today they do, today they have J&J. It used to be that Inamed didn't give any deals on the band, something like buy 10 and get one free. Today they are reconsidering and thinking it might pay to give quantity discounts. That is only because of J&J IMHO.

I agree, insurance co's are doing a little better covering WLS but they still have a very long way to go. I have often wondered if the reason they don't like paying for WLS is because typically WLS is quite expensive and does not have a great deal of success. Look at the technique used 25 years ago for the sleeve procedure? What an ineffective horror. Look at the cost to follow a bypass patient. The labs, the complications, the strictures, everything. Then look at the number that eventually gain it all back again? What purpose did the surgery serve?

I can't help but to wonder if the band turns out to be effective 20 and 30 years from now, would insurance be pushing the procedure instead of making people jump through hoops to get it done? My own insurance covers banding but I went to Mexico anyway. Between the psych eval, nut eval, sleep studies, six month medically supervised diet, etc etc etc., I realized recently that had I used insurance vs. paying cash... by the time I would have been getting my first fill under insurance I was actually at goal by going to Mexico. The hoops they wanted me to jump through served them well, they didn't have to pay for my surgery because I was not willing to wait.

I agree with you here. I suspect that people stuck it to Medicare for so many years that Medicare finally put their foot down and now they are doing a 180 here. Of course, I'm reminded of the gal on OH that had a band placed under Medicare and for whatever reason she thought she would have to pay $20 towards her fills and she wasn't willing to do that. She wanted a revision to bypass so she didn't have to pay the $20 out of pocket. How many times can Medicare play these games?

Well, I live in AZ so my surgeon is only about three hours away from me. I can go there anytime I wish and it's not a big deal but that is not the case for many. There are quite a few people getting bypass vs. a band because they can't afford US rates for either a bypass or band and if they get a band they can't keep running to Mexico for fills. So they opt for bypass thinking there is no follow up care. Obviously, that isn't accurate.

I agree with you that it is ideal to have the support system in place but many who have surgery in the US don't have that. I drove three hours to Mexico for my surgery yet a person posting here who also lives in the Phoenix area drove 14 hours to Denver for her surgery last week. She's planning to go to Mexicali and see my surgeon for her follow up care because it's easier and cheaper. And if she were to have a complication or problem it is much easier to drive to Mexico vs. CO. So it really isn't just Mexican banded patients that experience the very issue you refer to, it is a good number of US banded folks as well. Look at the number of people posting here and on OH that drive hours and hours to see Dr. C for follow up care, same thing.

My doc is willing to do her follow up even though it really ends up costing him money but his explanation is that there are docs that do follow up for his patients, it's only fair to do follow up for other doc's patients. He charges $175 for fills on people he did not band. $100 goes to the Asst. surgeon for doing the fill, $75 goes to the hospital for radiology services, and my doc gets to pay for the supplies. But he's right, fair is fair. If US docs are going to follow up his patients he needs to return the favor.

Sure, these things do happen. Just as in any country there are good docs and bad ones. If you'll notice the link in my sig it is how to research Mexican doctors. While there are jerks in Mexico there are also quite a few very good docs. If someone can't afford US prices they either leave the country or go without surgery. I think that is a shame.

While complications certainly happen in Mexico they happen in the US as well. Look at all the infections happening lately. I have not seen a single post from anyone that went to Mexico and had surgery in the last few months that came home with an infection. But there are plenty that are coming home with infections in the US. Did you know that according to the CDC US hospitals have higher infections stats than Mexican hospitals. Now, this could be that they do fewer elective procedures or a few other reasons. But the point is that Mexico does have a lower infection stat than the US. I don't know what it is about infections lately but my goodness, people are posting a great deal lately about infections. It's spooky.

I know exactly what you are talking about. There was a Mexican doc (I believe he was in Monterrey) and he was actually making his own band. He referred to it as the "Mexican" band. He and his asst surgeon placed about 650 of these bands and a whopping 50% eroded. One would THINK that after removing the first 100 bands to erosion they would have a bit of a clue but nope, it took 650 bands and over 300 erosions before they quit using that band and began using Inamed. That surgeon was murdered and the bands are no longer being made or placed but sure, it happened.

That's why patients need to research regardless of where they are having surgery. I don't care if it is the US, Mexico, India, or anywhere else. They have to do their research. It is surgeons like that, that give all Mexican docs a bad name. Yet if the same level of horror happens in the US people don't claim all medical care in the US is risky. There are posts right here regarding liver lacerations, stomach lacerations, infection, and everything else including death and these folks had surgery in the US. We tend to forgive those docs because they are US docs. But Mexican docs are a different story.

As for nurses taking the narcotics, that happens every single day in the US. I used to work for a hospital and part of my job was to catch these nurses. It was much easier than many think but due to the Pyxis system it made it almost simple to catch them. If you look at the board actions for nurses or docs in AZ, the greater majority of the board actions involve drug and alcohol abuse (Arizona Medical Board - Protecting the Public's Health). Nurses take patient's meds all the time. Orders might be to give 6mg IV morphine. Maybe the patient gets 3mg and the nurse keeps 3mg. Happens all the time. There was one nurse that was so used to popping drugs she didn't even think twice about it and one day I was at the Pyxis and she was at the other, about 2' away from me. She entered the patients name and info, removed a Vicodin, and popped it in her mouth right in front of me.

I have no doubt US docs have had to remove bands that were placed wrong, infected, etc. But Mexican docs do the same. My doc operated on a botched bypass patient. Patient had bypass in the US and the surgeon essentially butchered her. She couldn't find anyone to fix it. Either they didn't have the skill to undo the damage (according to the family her case was very tricky and quite complicated) or they didn't want to mess with their stats. Regardless, she couldn't get it taken care of in the US. She resorted going to Mexico and having the problems repaired there. So sure, there are some really bad docs in Mexico and they pretty well butcher their patients. But that is not the norm just like it isn't the norm in the US.

I am familiar with Laminar flow hoods and when I worked at mayo we had the same set up as you describe in OR. With all the precautions we take in the US we really shouldn't have any hospital caused infections such as MRSA but again, our stats are higher than Mexico for infection. And nursing homes? Holy crap, MRSA spreads faster than the staff can keep up with. It's usually lazy behavior on the part of the staff.

All in all I think the US and Mexico have very similar issues in many ways. Infections, bad doctors, lazy nurses who steal narcotics, botched surgeries, the works. That is why I push research, again... see my sig link. We are less forgiving of Mexican docs vs. US docs. What would really be ideal is to make the band more affordable to everyone, more accessible to people, and much fewer hoops to jump through to satisfy the insurance co's.

Thank you. One person here often times says we should all meet in real time and discuss these kinds of issues over a bit of wine or imported beer. It would be kind of fun to get everyone on the boards together for some good discussion. One point I would like to clarify... in rereading this post I am writing it appears that I am anti-US and pro-Mexico. That is not my intent at all. My first choice for people is to stay in the US for surgery. But there are many people that simply can't afford US prices so they either leave the country or go without. That isn't right.

Out of fear that we're going to get kicked off the boards for using up all the bandwith, I'll be brief!

If a surgeon's office number appears at the end of a TV ad this suggests that they are using the ad and paying for the placement.

For years, in the Inamed/Allergan committee meetings, a common complaint was that many patients were leaving the country to buy surgery only (no aftercare) and then returning to their local community to care for the complications. This gives the band a bad name in the local community and the problem isn't the band so much as it is with complications from out-of-the-country surgery and no aftercare. Surgeons complained that they promoted the notion that you could buy the surgery without the aftercare. We thought they ignored those comments.

Urgent unfills are a problem. I've driven a few hours before to unfill a band in the back of my car. I've made house calls, boat calls (patient at a marina), truck calls (in Wal-Mart parking lot), met people in the mountains and many other interesting trips to unfill bands. Like most of my band surgeon buddies I keep a tackle box in my car with all the stuff in it and use it often. The other day I flew to Columbus to unfill a band (have my pilot's license). They had awesome leather recliners in the pilot's lounge of the small airport that worked perfectly for band adjustments. As more and more surgeons offer the procedure, access to fills will improve over time. Currently, it's a problem.

It would be fun to have a lapbandtalk.com meeting. Should we march around the White House or what?

[DrWatkins 5]

I'm wondering Dr. Watson, do you do fills for patients that have their bands placed by other surgeons? I have also have had issues with finding a fill doctor and think it's ridiculous that doctor's get away with turning patients down. It's like saying..sorry your knee replacement was done by such and such doctor..I can't look at it even though I'm qualified to do so.

We accept any banded patient for fills regardless of who did the surgery. We have a clinic in Oak Brook, IL if you want to call them. Dr. Duane Tull is the surgeon in Oak Brook and he has had the surgery himself. Neat guy. Their info is on our website, Synchrony Health :: Home.

hope that helps

brad

[NM Sunshine 1]

Wow I was raised in Chicago then moved to the burgs, not far from Oak Brook.

A question that is off the subject.....what does the good doctor and anyone feel about plastic surgery in Mexico, the kind where they get rid of hanging skin after weight lose???

[DrWatkins 5]

Wow I was raised in Chicago then moved to the burgs, not far from Oak Brook.

A question that is off the subject.....what does the good doctor and anyone feel about plastic surgery in Mexico, the kind where they get rid of hanging skin after weight lose???

I'm sure there are excellent plastic surgeons outside the United States that are less expensive. If it were my wife or family, I would have them get plastic surgery by any number of the awesome plastic surgeons I have worked with in the U.S.

[WASaBubbleButt 41]

I'm sure there are excellent plastic surgeons outside the United States that are less expensive. If it were my wife or family, I would have them get plastic surgery by any number of the awesome plastic surgeons I have worked with in the U.S.

I realize you are not a fan of Mexican medical care and in all fairness, I didn't used to be either. But I have to admit, I am very impressed with what I have seen so far and I have every intention in the world of having my plastics done in Mexico. Research needs to be done just as with any doc, but with the appropriate research the care can potentially be better.

What is done on an outpatient basis here in the US is done with a 2-3 day hospitalization in Mexico. I don't agree with how insurance co's are forcing the medical profession to kick people loose immediately after surgery and in the case of plastics, most patients are self pay anyway so why are we cutting corners? I can have a Tummy Tuck done by a good and responsible surgeon for half the price and 3x the hospital supervision in Mexico.

There are risks either way the patient goes. In the US the supervision is not what I believe it should be. In Mexico if something goes wrong it's unlikely any US citizen is going to win a lawsuit. People have to consider what matters to them.

[Dibaby 0]

We accept any banded patient for fills regardless of who did the surgery. We have a clinic in Oak Brook, IL if you want to call them. Dr. Duane Tull is the surgeon in Oak Brook and he has had the surgery himself. Neat guy. Their info is on our website, Synchrony Health :: Home.

hope that helps

brad

Wow thanks!! So much better than going downtown. I'm really fine with my fill just wanna get my band checked out make sure it's still okie dokie. It'll be 5 years for me in February and I haven't had a fluro in about a year.

Your stories are wonderful btw. Thanks for being so compassionate..you rock doc ::clap2:

[NM Sunshine 1]

DrWatkins

I'd love to have the names of a few of those USA docs.

WASA and the names of the MX docs.

If publicly naming them is a problem you could PM them to me.

I know it will be a while before I'm at the point that I will need the PS. I'm beginning my research and money saving.

[DrWatkins 5]

DrWatkins

I'd love to have the names of a few of those USA docs.

WASA and the names of the MX docs.

If publicly naming them is a problem you could PM them to me.

I know it will be a while before I'm at the point that I will need the PS. I'm beginning my research and money saving.

Let me know what part of the country you're in and I'll give you some names.

[NM Sunshine 1]

Let me know what part of the country you're in and I'll give you some names.

I'm in southwestern New Mexico. Silver City New Mexico. The closest cities are Las Cruces NM 100miles, El Paso Texas 140 m, Tucson AZ 200 m and Albuquerque NM 280 m.

[DrWatkins 5]

I'm in southwestern New Mexico. Silver City New Mexico. The closest cities are Las Cruces NM 100miles, El Paso Texas 140 m, Tucson AZ 200 m and Albuquerque NM 280 m.

Dr. Robin Blackstone in Scottsdale is a great band surgeon.

She's the closest one I know.

[NM Sunshine 1]

DrWatkins, your an :angel:. Thanks. Scotsdale isn't all that far (about 300 miles).

[Longhorn 1]

DrWatkins, your an :angel:. Thanks. Scotsdale isn't all that far (about 300 miles).

Just me butting in but didn't you ask for a plastic surgeon? And I think Dr. Watkins gave you the name of a band surgeon. Or should I keep my big nose out of it?

[BandZski 1]

Dr. W., I've really enjoyed your posts on this thread. They are very informative.

I've recently had to find a new fill doc, as my surgeon moved out of state. Luckily, I had a few to chose from. My surgeon was Dr. Zoe Deol in Troy, Mich. I believe that it's because of her excellent reputation that docs weren't leary at all about taking on her patients. I dedided to go to the Port Huron Lap Band Center which is farther away. They have a great reputation. And afterall, isn't that what's important.

Oh yeah, and I love my band! I like that all of my parts are still intact!

[NM Sunshine 1]

Just me butting in but didn't you ask for a plastic surgeon? And I think Dr. Watson gave you the name of a band surgeon. Or should I keep my big nose out of it?

I asked the Doc for band surgeon names in last post and names for Plastic Surgery in another post