Realize band

[TexasFire 84]

Ellisa, so glad to hear you are still at the exercise! I went this morning for a consultation and tour of the school I am considering. I really like it, so I may enroll and begin next month. I'm going to "sleep on it" for a couple days and make sure this is the right one for me. I think I would really enjoy being a personal trainer!

Isuza - Wow, in all the hubbub, I missed the fact that you are going to be banded! I thought you were simply offering insight as a professional-in-training! That's awesome! I wish you the absolute best of luck! I know it is the best thing I have ever done for myself and my family.

[MichelleInCA 22]

I got my Realize band implanted yesterday! Home from the hospital and so far, so very good. Not much pain at all. Did the x-ray imaging thing, and Fluid is flowing through just fine. My doc said the fact the band is not pre-shaped makes it easier to fit around the stomach loosely. And I can have my first fill as early as 4 weeks if I'm not feeling any restriction and heal up well. Happy camper, here!

[Ellisa 6]

Michelle,

Congratulations! You're off to your new life.

[NukeChik 1]

Congrats Michelle, if you have any questions let us know! Take care of yourself!!

[lsuza 0]

Being a med student with all the medical terms Im learning once in a while you forget and "i" here or an "e" there when spelling.

Im no troll or I wouldn't ned bariatiric surgery myself! I am not a proctor nor did I claim to be. I do have a clear understanding of how the proctor thing works. It's all about the $

[lsuza 0]

With the Allergan band you can put the first fill in when it's placed - it contours itself to any stomach with no restriction due to an even distribution of Fluid, unlike the Realize Band so you don't have to wait 4 weeks with an empty band in you. I hope your doctor told you that before he put the band in.

[TexasFire 84]

Yes, my doc tells all about the band being put in while empty and tha first fills occur 4 to 6 weeks after surgery. He explained all that in the seminar. It worked out great for me.

[Elisabethsew 50]

I know many of the people on this thread are not in the medical field. I am and have been for a long time. Please realize that it's VERY common for healthcare/pharmaceutical companies to offer incentives to MDs to use their products. These companies spend a fortune developing new products and drugs and ear mark huge advertising budgets to "sell" them.

As an example, the staff in the cardiology cath. lab never spend a penny on buying Breakfast or lunch. We average 70 cardiac caths a day so you can imagine how many people work in this area. Everyday (M-F) Breakfast and lunch is provided by one or more healthcare reps from a company seeking to get their product/drug in use/prescribed. We live in a capitalist society and this extends to the healthcare industry as well.

Who cares if the MD is getting paid to use a new, FDA approved band? I have a friend who gets $1,500.00 to give a 45 minutes slide presentation to other MDs on the benefits of Guardacil and he's paid by the pharmaceutical company. He rated as one of the 10 top OB/GYN MDs, has authored a book, tests MDs who are applying for Board Certification, etc. The fact that he lectures for money on a product he believes in does nothing to lessen his abilities as an MD.

Just a little offering on a different perspective...

[Ellisa 6]

Isuza,

I was informed that my band would be empty for 4 weeks. Thank heavens it was, I wouldn't have been able to eat a thing if it had been filled. The swelling following surgery and the band itself provided more than adequate restriction.

I believe you aren't a proctor or sales rep for LapBands. I believe you are exactly what you say, a busy med student planning to be banded soon. Just try to trust that those of us who chose (or whose surgeons chose for us) something other than the product you prefer are safe and happy, just as you will be. But bless your heart, if anything goes wrong with your (or anyone else's) AP band, I hope you won't go looking for some conspiracy from Allergan. Sometimes things happen regardless.

[Ellisa 6]

Just wanted to mention on the $$ point, I know of doctors who get "prizes" for writing a certain number of scripts for certain meds. (I don't know if this is still a practice, I should say I know it happened a few years back) but, they didn't prescribe them unless they believed they were useful. but another thing they get from these companies is samples which they would give to patients who couldn't afford them.

Isuza as you said before doctors are taking money from BOTH companies. So maybe that's why my husband's surgery was over $20,000 2 years ago and mine was $17,000 ish just 3 months ago. AND my doctor is charging $12,500 as of Jan. 1 of this year. He opened his own surgical center. So isn't that wonderful? The money from the band companies has allowed him to lower prices?

[luluc 6]

With the Allergan band you can put the first fill in when it's placed - it contours itself to any stomach with no restriction due to an even distribution of Fluid, unlike the Realize Band so you don't have to wait 4 weeks with an empty band in you. I hope your doctor told you that before he put the band in.

Let's not set expectations that aren't real. With 5cc's put in at surgery, and 7.9 in my 10cc band, after 5 months - NOW is when I have restriction. It did not occur instantly, and should not be eluded to an overnight success.

It takes a certain road to take with your surgeon to get to the proper fill restriction. Having an advanced fill with the Allergan Band does not guarantee any level of success vs those w/out a surgical fill.

I knew I would be getting a fill during surgery - it's protocol w/my surgeon - and to advise of the amount upon recovery.

Reaching restriction is so personal - that one can not equate a non fill surgical procedure vs another and say one has an advantage. I was banded the same day as my husband, and he had 1/4 the fill I had - and reached restriction much earlier.

This journey is not the same for any 2 persons - regardless of their band type.

[WASaBubbleButt 41]

Just wanted to mention on the $$ point, I know of doctors who get "prizes" for writing a certain number of scripts for certain meds. (I don't know if this is still a practice, I should say I know it happened a few years back) but, they didn't prescribe them unless they believed they were useful. but another thing they get from these companies is samples which they would give to patients who couldn't afford them.

Isuza as you said before doctors are taking money from BOTH companies. So maybe that's why my husband's surgery was over $20,000 2 years ago and mine was $17,000 ish just 3 months ago. AND my doctor is charging $12,500 as of Jan. 1 of this year. He opened his own surgical center. So isn't that wonderful? The money from the band companies has allowed him to lower prices?

No, that doesn't really have anything to do with drug companies. That has to do with greed. When banding was first around (and one doc still attempts to charge this here in the Phoenix area) they were charging $30K for the band. Everyone was going to Mexico where it was farrrr more reasonable and the surgeons were vastly more experienced in banding and aftercare.

US docs have HAD to lower their prices or they have no business. Your doc charged $17K three months ago, my Mexican surgeon charged me $7800 15 months ago and that included a night in the hotel the evening before and two nights in a private hospital after surgery.

Why do you think there is so much drama between US surgeons and Mexican surgeons? The US surgeons blast them at every opportunity with huge and silly claims. They do that to keep the patients in the US, it's not working but they try.

Kirshenbaum is getting busier and busier and it's because he's a good surgeon with a fair price. Kirshenbaum has been charging $9950 and CO is expensive for cost of living. Your doc charges $17K. See what I mean?

Docs have no choice but to charge more reasonable prices for surgery.

Consider this, the band has always cost US docs the same, between $3500-$4K. Yet they were charging $30K for a 30 minute procedure. ??? Do you really think doing the absolute easiest surgical procedure in bariatrics deserves $30K for 30 minutes? Docs want to make $1K a minute, but it was due to doctors outside the US that forced them to be a little more reasonable. Not drug companies.

I swear, bariatrics has the most greedy of all doctors. The $1100 fills by Dr. Brad Wilcox (current) to the $1K/minute for the easiest procedure to do requiring the least skill in bariatrics. It's all about greed.

[Ellisa 6]

Wasa,

I agree there is the greed factor. And that all the money in this business is "up front" so there's no write-offs for unpaid bills.

But that being said, I also think it's only fair for me to mention that both my surgeon and Jewish Hospital were in network for Anthem. Because of that agreement my surgeon's portion was well under $2K (TWO-K, I didn't leave out a zero) for 1 hour (not $30K for 1/2 hr.). Maybe that's why he no longer is in network as of January and he can lower his prices overall. And due to a large hernia repair my overall bill was much higher than the basic $17K, and due to my distance of travel I had to spend the night at the hospital. In fact the hospital's portion alone was just over $21K. Anthem paid all of that (except my $560 deductible). BTW they paid the Anesthesia Associate nearly as much as the surgeon. My surgery took over an hour, due to the hernia repair.

I have to wonder if insurance companies would pay a more fair amount and people didn't consider any medical mistake a lottery opportunity, perhaps US doctors (and facilities) could lower their self pay prices even more. It also wouldn't hurt if the cost of living were the same here as in Mexico and if drug prices etc. were a low here as there. My sister and daughter who are nurses couldn't survive here if they were paid the wages that a nurse in Mexico is paid. My point is there are many many factors in the pricing. I have to wonder if the profit margin might (I'm saying MIGHT, I obviously have nothing to back this up) be the same or higher in Mexico if all is factored in.

I know that the $ amount still looks like a lot for an hour's work, but I think we all realize that the surgeon and anesthesiologist have to pay the cost of their office space, utilities, equipment, and staff salaries etc. It's not like we get a separate bill for the nurses, receptionist, scheduler, accountant, etc. And they aren't in surgery everyday.

I didn't go to Mexico because I have insurance and could find a good quality surgeon here. If that hadn't been the case, I wouldn't have objected to that possibility. I do believe there are excellent facilities and surgeons there.

But I can't agree that the price differences is all about greed of US medical professionals vs. Mexican medical professionals. If medical professionals in either country weren't in this for the money, they could find plenty of pro bono work among the poor/uninsured.

I don't think I've ever been under the delusion that medical professionals take care of me because they love me. It's their career, they do it for the money. Just like I do my job for the money. That's not a crime or a bad thing.

Ah the blizzard of '08, it's over but still can't get out yet today! The county I live in will actually fine us for driving unless it's an emergency. Going crazy... isn't that an emergency? LOL

[WASaBubbleButt 41]

Wasa,

I agree there is the greed factor. And that all the money in this business is "up front" so there's no write-offs for unpaid bills.

But that being said, I also think it's only fair for me to mention that both my surgeon and Jewish Hospital were in network for Anthem. Because of that agreement my surgeon's portion was well under $2K (TWO-K, I didn't leave out a zero) for 1 hour (not $30K for 1/2 hr.). Maybe that's why he no longer is in network as of January and he can lower his prices overall. And due to a large hernia repair my overall bill was much higher than the basic $17K, and due to my distance of travel I had to spend the night at the hospital. In fact the hospital's portion alone was just over $21K. Anthem paid all of that (except my $560 deductible). BTW they paid the Anesthesia Associate nearly as much as the surgeon. My surgery took over an hour, due to the hernia repair.

I have to wonder if insurance companies would pay a more fair amount and people didn't consider any medical mistake a lottery opportunity, perhaps US doctors (and facilities) could lower their self pay prices even more. It also wouldn't hurt if the cost of living were the same here as in Mexico and if drug prices etc. were a low here as there. My sister and daughter who are nurses couldn't survive here if they were paid the wages that a nurse in Mexico is paid. My point is there are many many factors in the pricing. I have to wonder if the profit margin might (I'm saying MIGHT, I obviously have nothing to back this up) be the same or higher in Mexico if all is factored in.

I know that the $ amount still looks like a lot for an hour's work, but I think we all realize that the surgeon and anesthesiologist have to pay the cost of their office space, utilities, equipment, and staff salaries etc. It's not like we get a separate bill for the nurses, receptionist, scheduler, accountant, etc. And they aren't in surgery everyday.

I didn't go to Mexico because I have insurance and could find a good quality surgeon here. If that hadn't been the case, I wouldn't have objected to that possibility. I do believe there are excellent facilities and surgeons there.

But I can't agree that the price differences is all about greed of US medical professionals vs. Mexican medical professionals. If medical professionals in either country weren't in this for the money, they could find plenty of pro bono work among the poor/uninsured.

I don't think I've ever been under the delusion that medical professionals take care of me because they love me. It's their career, they do it for the money. Just like I do my job for the money. That's not a crime or a bad thing.

Ah the blizzard of '08, it's over but still can't get out yet today! The county I live in will actually fine us for driving unless it's an emergency. Going crazy... isn't that an emergency? LOL

What insurance pays vs. what private pay folks pay are two very different issues. Private pay is better, hands down. No insurance issues to deal with, less overhead, cash in hand. Insurance co's negotiate fees on reasonable prices paid for that geographical location.

Hernia repairs... that's one stitch. One single stitch. Most docs in the US charge extra for that single stitch but in Mexico they do not. It's all part of banding. I had a hiatal hernia, didn't know it, and he told me about it after he fixed it.

Mexico wages... true. The average nurse makes $500/month and the average doctor in Mexico makes $1K/month. But those are averages. Along the border averages no longer count. Sure, it's cheaper but not as much as most would think. The private hospital I was at is one of the more expensive hospitals in Mexico. Along the border it is not as cheap as you would think. The nicer the town the more expensive it will be. Tijuana is going to have a lower cost of living than Mexicali for example, but the fees are the same regardless to patients (for the better docs, the trashy ones charge $6K+ for people shopping by price vs. skill).

Clearly, the doc has overhead. That isn't my point. Cost of living is increasing yet the cost of banding is decreasing. In 2001 docs were charging $30K for banding because they COULD get it. They can't get that today so they have to lower their fees to something more reasonable.

Look at it this way, they had less overhead for banding in the beginning because virtually no insurance company covered it. Most were cash pay. There is less overhead with cash pay. Some were getting $30K for a lousy band. Today they have more overhead because insurance is starting to cover banding more now than ever. Yet they are charging half what they used to and still making money! Good money at that! It's greed.

I'm not saying bariatric surgeons should not make a buck. They don't go to work daily for their health, it's a living. They should make an income. That's not my issue. My issue is the greed involved. $30K for banding because they could get it. They did not lower prices because band makers are reimbursing them the difference, they are lowering prices or they wouldn't have any business. Bariatrics is the only speciality in medicine where greed is still okay. Docs can claim their medical malpractice insurance does not cover doing fills for those banded out of the country but since when does medical malpractice say if you were born in Mexico you can't get medical care here? Hello??? A little common sense goes a long way but these docs don't think about the obvious, they often times assume we are all stupid and will believe anything they say.

They are miffed that people went to another surgeon for banding (the money maker) and wants fills (not a money maker) in the US. I don't blame them, they are in a business. My issue is not the docs not doing fills for folks they did not band. My issue is the honesty factor. Flat out admit that if they can't have the surgery business they don't want the fill business. It's fair, there is nothing wrong with their feeling that way. But damnit, quit treating us like we are a bunch of idiots that don't know better and have no common sense.

Terry Simpson started this line of crap on another forum just a couple of days ago and I confronted him about the medical malpractice issue and now he won't come back to the thread. Threaten some of these docs with honesty and call them on their BS and they run away with their tail between their legs. I asked for proof of his many claims and he never returned to the thread. ;o)

Brad Wilcox was posting here claiming he'd do fills on anyone regardless of where they were banded. He didn't mention he charges $1100 for fills! This was a PM conversation we had. He claimed he was unaware his office manager was charging this. Bahh... I'm not an idiot but he is greedy. ;o) He doesn't know his own fee structure that he set up? Com'on....

He said that his "office manager" didn't think it was fair that Mexican banded folks get a "cheap" surgery and then not have to pay up the way US banded folks do. What a load, he assumes it is his responsibility to charge people for having surgery in Mexico as some sort of punishment and then he reaps the rewards of punishing people? And again, he claims he didn't know he set his own fees up this way.

He can charge whatever he wants, if he gets takers on that one is a different story. But the point is honesty. Is honesty such a horror? And since I didn't build his swimming pool in my surgery I got a cheap surgery? I got a great surgery by someone far more experienced than he in a luxury hospital with two nights of hospitalization vs. shoving me out the door when I woke up.

These doctors are not thinking these issues through. Treating us like we are that stupid is not wise. Dishonesty is never wise. Assuming none of us have common sense is not wise. It's insulting and nothing more.

I don't expect US surgeons to fill Mexican banded patients. They are in this to make money and that is completely and totally fair. My issue is assuming since we didn't pay ridiculous prices for something that should not be that expensive we got a "cheap" surgery? I'm only asking for honesty, it's a money issue. US docs are miffed (and rightfully so) that they are losing money to the more experienced surgeons out of the country. But it wasn't cheap and it certainly was not inferior. It was a fair price for a quality surgery. As patients that is what we want and need. If they don't like it then they can do what Dr. K does in CO and charge fair prices for a quality surgery. How can some justify $17K for cash pays when Dr. K is charging $9950 for cash pay folks? Tell me greed isn't a factor, it is! CO has a very high cost of living.

Docs are business people like everyone else and they will charge what they can get. That's how business works. And patients are consumers in this case and we have to choose what is right for us.

In my case insurance would have covered banding. But it would have meant jumping through hoops, waiting it it out, and going to a surgeon I wasn't thrilled with. I have the money so I went to the surgeon I wanted, the one with the skill, experience, and background I was looking for and paid cash. It was my decision, my money, and I did what was right for me. Many US docs clearly don't like losing the business but you know what? It's like anything else, people go where they want for their own reasons. Grocery stores don't like customers going to their competition either. But that's how it works.

This is another reason for sleeves. No political crap, no BS, just get the sleeve and go on with your life. Minimal aftercare issues for the most part. I wish I would have done it. Not to say my band hasn't been a fantastic tool for me, it has. But I could have gone the rest of my life without knowing the politics of banding and been quite happy. ;o)

[Ellisa 6]

Wasa,

Well I see this is a deep area of concern for you.

My hernia repair was a lot more than one stitch. And of the $17,000 for self pays at the time, the lion's share went to the hospital. The surgeons can't help what the hospitals have to charge to stay in business.

As for greed factor, I'd say any "cosmetic" type surgeries have the greed factor. Should most of those surgeries cost the kind of money they do? At least if you go to Mexico for that you don't have to worry about after care for the rest of your life.

I agree if doctors are refusing to do fills for patients they didn't do surgery on, they should say that's the reason. I think most people would understand that they only have so many hours in the week and their patient load is increasing. Mine used to do that, but he has so many patients he's obligated to because he did our surgery, he simply can't any longer. Patients were getting testy because they couldn't get fills in a timely manner.

I'd love to see more fill clinics, but that makes me wonder, if the fill clinic isn't with my surgeon and something gets messed up...does the blame game begin?

Another reason that the sleeve would have just been simpler. But alas, my insurance doesn't cover it yet.

I'm glad though that you point out a very serious concern for folks going to Mexico. Right or wrong, greed or not; unless they can get back to Mexico for fills, it will be expensive if even available in an area close to home. Whatever was saved on the initial surgery could well be spent on travel and fills afterward. It's something I certainly would not have thought about had I needed to consider going to Mexico.