Realize vs. Inamed

[Mellis 0]

Maybe I am just out of it--but since when did patients tell docs which tools to use? As a nurse who has worked in OR's--I don't recall that ever happening. My husband is a mechanic--people don't tell him which tool to use-they just want their car fixed. I didn't care which band my doc used(as long as it was a good product--don't put a rubber band on there!)--I wanted him to use the band that HE was most comfortable using and that in HIS experience had the best results.

[lee41 0]

I’ve been following the many posts about the merits of the Inamed vs. the Realize lap band. And, for a few days, I found it a bit disconcerting to have the Realize band trashed so vehemently by one poster. I thought, “Oh my goodness, do I have “a hunk of junk” in my belly!” How could that be? I certainly had taken my time in choosing the type of bariatric surgery that would be best for me, and I had been very diligent in finding a highly competent and experienced lap band surgeon. Because there is a learning curve that goes along with doctors honing their skills at implanting the band, I wanted a surgeon who had successfully completed a zillion lap bands. I wanted a surgeon who had excellent stats in regards to lap band complications. After an extensive search, I found a doctor who had completed over 1200 lap band procedures (not quite a zillion), had excellent lap band complication stats, was selected as a Proctor for both the Inamed and the Realize bands, and practiced in a Center of Excellence.

<!--[if !supportEmptyParas]--> <!--[endif]--><o:p></o:p>

Although I had seen both the Realize and the Inamed bands up close and personal, I, not being an engineer of medical technology, could not discern which band might function better. It didn’t make much sense for me to choose a band based upon which one was most esthetically pleasing to me. However, if the band were to be placed around my neck instead of my stomach (and thus be visible to those around me), I might have felt more inclined to offer my opinion as to which band should be used. No… instead I deferred to my doctor to make that decision. You know, the one whom I had so carefully chosen because of his competence and experience and amazing complication stats.

<!--[if !supportEmptyParas]--> <!--[endif]--><o:p></o:p>

I don’t really think that my doctor is going to risk his superb medical reputation, or put his excellent complication stats in jeopardy by putting ‘a hunk of junk’ in my belly. He uses the Inamed and the Realize band because he believes BOTH to be excellent bands.

Isn’t it great that we the consumers have two companies making quality bands. Because of the competition among band manufacturers, we are likely to see further improvements on lap band technology.

<!--[if !supportEmptyParas]--> <!--[endif]--><o:p></o:p>

Oh yes, yesterday I had my first fill at my doctor’s office (Dr. Trace Curry). It was so exciting to see my Realize band on the fluoroscope screen and see the barium slowly moving through the band. It was comforting to see my Realize band functioning perfectly.

[Ellisa 6]

I'm not in the healthcare field, but I've noticed that more often I'm being given options about my health care, sometimes if my doc feels strongly he'll/she'll make a it clear what his/her recommendation is. My GYN, PCP, and surgeon have all given me options recently as to health care and helped me weight the benefits of each choice.

When my father had cancer 4 years ago, he too was given options on everything from the type of treatment to the facility and even the option of not doing any treatment. His was a terminal cancer, so it was basically do you want to have 6 months to a year of feeling fairly good with no treatment. Or possibly a few more months and feel really crappy for most of it. He took the treatments, it weakened his immune sytem, he spent weeks in the hospital with pnumonia and died within 11 months. But we don't blame anyone. Might we have felt differently if those decisions were made by his doctor and then we found out he could have done something different?

My mechanic also gives me options. I don't tell him which tools to use, but I can decide if it's worth buying the most expensive part that'll last 5 years or one that should last 2, but I'm trading the car in 6 months anyway.

I would not be comfortable about having my doctors make decisions about my health without allowing me to weigh the consequences; do I want recommendations and advice about all the options he/she is aware of? Absolutely.

[MacMadame 81]

Maybe I am just out of it--but since when did patients tell docs which tools to use?

I think it has to be a partnership. The doctor is an expert in medical things, but we are an expert on ourselves. So both have to have input into any decision, IMO.

[WASaBubbleButt 41]

Maybe I am just out of it--but since when did patients tell docs which tools to use? As a nurse who has worked in OR's--I don't recall that ever happening. My husband is a mechanic--people don't tell him which tool to use-they just want their car fixed. I didn't care which band my doc used(as long as it was a good product--don't put a rubber band on there!)--I wanted him to use the band that HE was most comfortable using and that in HIS experience had the best results.

When it comes to bands most docs who offer both bands will give patients a choice and they should. Patients are far more involved in their own medical care than they were in the 50s and I think this is something to be encouraged.

There are differences in the band that patients need to be aware of and make their own choices. Patients are far more aware of what is available to them than they used to and I think it's great! I am thrilled that patients are more aware of the options available to them. Plastic surgery patients choose their breast implants, they choose the size, style, and brand. Same with penile implants, butt cheek implants, chin implants, cheekbone implants, etc. Banding patients choose their brand of bands, joint replacement folks have options and choices in their implanted devices, contact lens wearers pick their types, brands, and styles of contact lens, those who are fitted with diaphragms and IUDs choose brands and options.

I'd MUCH rather patients be involved in their own medical care and be an active participant vs. being told what to do and how to do it. Doctors often times choose drugs and devices based on cost and how much they like the reps. I don't want my band chosen because my doc likes the rep, I want the band that is best for me and I want to be a part of that discussion.

Consider this, Inamed used to be more proactive in weeding out the bad docs and not selling them bands. That would leave patients going to that doctor with limited choices in bands and not because the doc didn't like the brand of band but because they were so horrible they couldn't buy them. Inamed wouldn't sell them. THAT is how the bad docs used to pick band brands. Nope, not me... I want to know everything about the band and I might agree or disagree with the type or style being put in me.

There are significant port issues with J&J vs. Inamed and I think patients have a right to know what those port issues (namely placement) are and decide if that is what they want.

I'd have to respectfully disagree with your stance on this one. I'm thrilled patients are more active in their medical care than they were 60 years ago. They are getting better quality care and able to make choices about their own care and that's a great thing! I wish they had more options available to them.

If we were talking about actual tools such as the reference to your mechanic husband I'd be more inclined to agree. But if there are two mufflers available and one is a cheap crappy version and one is a more quality version, I would hope his customers know there is such thing as quality difference in various car parts. They aren't telling him which wrench to use to install the muffler (are wrenches used for mufflers??), they are dictating the quality of muffler they choose to use. Big difference.

[irideaqh 0]

There are significant port issues with J&J vs. Inamed and I think patients have a right to know what those port issues (namely placement) are and decide if that is what they want.

Do you mind explaining what the port placement issues are?

Thanks.

[Ellisa 6]

I don't know what Wasa was refering to, perhaps something altogether different.

But at Dr. Curry's office we were shown and handled both bands. The port on the Realize band was anchored in a different manner. It has a self anchoring device. The LapBand is sewn in place. It was explained that the Realize band takes a little less time to place and is placed a little differently. I'm trying to remember, but I'm thinking it's anchored more deeply into the muscle. Also last fall, when I was in the pre-banding process, the Realize port was a little bit flatter than the LapBand port. I don't know if that has changed or not.

Since I know someone personally who had her port "flip" before her first fill and had the sewn LapBand, I thought hmmm, maybe this other way is better.

Some people in my group didn't like the thought of the self anchoring and wanted one that was sewn. But from what I gather, ports sometimes flip regardless of the brand. And my DH has the LapBand and his port is just fine after 2 years. Dr. Curry likes both bands and offers both.

And frankly, I would not care which one I have as long as it works properly. But some people do feel strongly one way or the other and I suppose that's why we have competition in the industry. And that's a good thing in IMHO.

[Angie4b1g 1]

My doctor asked me if I had a preference or if I wanted him to put the one that 'fit in there best'.

Obviously I went with choice B.

I don't care if I have the one that is new or trendy or what. I want the one that works best for MY body.

[lsuza 0]

If the port flipped its because the surgeon didn't stitch it in properly - The Realize Band port leave a bigger scar, has no tactile response for the adjuster an has to be placed flat and evenly since needles hold it in place, not stiches. Re-operation rates increased 15% once the Velocity Port Applicator was introduced in the clinical trials.

[Ellisa 6]

My scar is smaller than my husband's. As you pointed out on the other thread Isuza, it's about surgical technique.

[WASaBubbleButt 41]

Do you mind explaining what the port placement issues are?

Thanks.

I don't like the port placement. Well, I'm just going to edit, copy, and paste something I *just* sent in a PM:

With Inamed the surgeon stitches the port into place exactly where he wants it. W/J&J it comes with a device that looks like a glue gun. They put the port on the bottom of the glue gun and place it where they want it. Then they pull a trigger and the port has staple like things on the bottom of it that reach out, grab a hunk of tissue, and hang on. No sutures. With the Inamed port they stitch it into the fascia which is connective tissue above a muscle and below a fat pad. With the J&J the staple things grab hold of whatever it can hang onto.

Before the J&J band was FDA approved J&J could not discuss it but they did refer me to a J&J rep in Germany that could discuss it. (FDA rules) He said that when they were making plans to change the band after it was purchased from Sweden they were asking doctors for suggestions on how to improve it. Doctors wanted less OR time and it's faster to use the glue gun device than it is to stitch it into place. So that is one of the changes that was made.

There are no "needles" that are on the port (Isuza), they look like staples that haven't been used yet. They go around the bottom of the port. When the device works during surgery the open staples come out, attach to tissue, curve under, and hang on like fingers around a pole. This is where it comes to personal preference, my personal preference is that I want my surgeon taking the time to suture my port into place. There is no way to suture a J&J port, there are no holes to run sutures through. With the Inamed port it has holes like the petals on a daisy for sutures to run.

If you'll look at my posts for some time I was kinda pro J&J but after seeing the port placement and the duck bill (a thing that sticks out on the band) I'm back to being pro Inamed.

But you know, it's like chocolate. One likes Hershey's brand and another likes Dove brand. It's personal preference. They all work about the same way and as long as people lose weight safely that is all that really matters.

Isuza... port flips do not happen because the surgeon sutured the band incorrectly. When you lose weight you condense and your body accommodates the port differently. Sometimes it is a surgeon issue but not all the time. If someone flips two weeks out of surgery, my guess is it might be a surgeon issue. But if it flips after a 200# weight loss, I don't think it is fair to blame the surgeon.

The port placement scar is usually bigger for J&J than Inamed. The port glue gun device is bigger than the port so it takes a larger incision to fit the device into the body. But the difference is tiny, it's not a big deal. Some surgeons just make a bigger incision than they have to with the Inamed port. But if they only made the incision as big as absolutely necessary the Inamed port incision would be smaller. But again, it's a tiny difference, at best a half inch. Not enough to worry about. We have stretch marks bigger and thicker than the entire port incision so it's a non issue. Stretch marks are going to show 10x more than a port incision.

Angie... the bands all fit exactly right if surgical technique is done well. One thing I like about Inamed is that it does require the surgeon to determine which size is best for the patient. With my doc we pick the brand, he picks the size AFTER he gets in there and sees what size is necessary.

My bottom line is that I'm the patient, I'm paying the bill, I want to learn about all my options and I want a say in what is going in my body. I don't want my doc choosing based on money issues, which band he gets cheaper, which rep he likes, which company he wants to proctor for, etc. We should be aware of ALL our choices and we should be an active member of the decision making team when it comes to our own bodies.

Banding is a cut throat business. It is, check out all the patient coordinators posting here trying to drum up business and watch how they behave. Doctors do the same darn thing sometimes. We cannot depend on others to tell us what we want, which WLS we want, which doctor to use, which band we want. We have the responsibility to learn about all our options and choose with our doctors. It's all about educating yourself so YOU can make decisions about your own body with your doctor. There is no need to depend on others to make all your WLS choices for you. This is our last shot at weight loss, we owe it to ourselves to be well informed.

[Ellisa 6]

Wasa,

Right on!

My port incision is less than 1.5" and shrinking; it was a little longer right after my surgery. I suspect a lot has to do with how we are built as well as our surgeon's technique. I don't carry most of my weight in my stomach area. My husband did. His incision, two years out (LapBand) is larger than mine (Realize) 2 months out. I doubt it's because of our ports.

I don't think I've ever mentioned which band I have to people that I've spoken with who are considering getting banded. I'm not "con" either band; I guess I'm "Pro" both. I AM all about finding the best surgeon you can. I looked for one with a good reputation among his patients and peers who was highly skilled and experienced. In my case, I also wanted him/her to be in network for my insurance. I personally knew someone who had Dr. Curry for a surgeon before I checked him out.

I don't mind people "knocking" my band... but they better not "knock" my surgeon. :blushing: I get a little testy about that, because I did my research there!

In case anyone wants to know, I'm not on his payroll. I live more than 2 hours away so I'm not sending business his way because the folks I know who are considering banding prefer not to travel that far. But they have researched to find a reputable surgeon closer to home.

Wasa you explained the anchoring system far better than I could have. And perhaps this is surgical technique by the individual surgeon, but I understood that it was more "deeply/securely" attached. And I trust that mine was done properly. But I also trust that my husband's was sewn properly!

[Angie4b1g 1]

Angie... the bands all fit exactly right if surgical technique is done well. One thing I like about Inamed is that it does require the surgeon to determine which size is best for the patient. With my doc we pick the brand, he picks the size AFTER he gets in there and sees what size is necessary.

I don't disagree. I did my research and never found any compelling reason to pick one over the other, so I deferred the decision to the doctor. He actually suggested I get the Realize since I'm a web junkie, but ended up giving me the AP band.

Seems to be working, and I haven't died, so at this point I'm ok with his decision. :blushing:

[pearlygirl 1]

Totally off the subject here but for those with the Realize band - How many fills or what fill level did you reach before feeling a decent amount of restriction. I am leaning more toward this band but haven't decided for sure yet. My surgeon seems happy with both.

[MacMadame 81]

I think WasA is right about it being like chocolate. Because the way the Realize port is placed sounds better to me. :blushing:

I also prefer that the Realize band is one-size-fits-all because I've heard too many stories about people being given a too small band and having erosion or a too large band and not getting enough restriction or, worse, having slips. Then there are the ones whose band is the right size when it's put on but now that they've lost so much weight, it's too big and then slips.

The Realize band has a much bigger balloon for saline and so can be made to fit a wider variety of people. Of course, if it's too small for you, you need a different band, because one-size-fits-all is really one-size-fits-most.

I do agree about the buckle on the Realize band -- that's the only thing I don't like about it. It's really kind of honking big and I worry that if it moves around, it could lead to erosion. Though the data doesn't really show that. But I worry anyway. I'm a worry wart. :wub:

I think this shows how important it is to have choices and why one band isn't right for everyone.