Reluctant doctors

[Alexandra 55]

Yesterday I had a conversation with the person at my doctor's office who schedules people for fills. What she told me got me wondering what other people's experiences have been.

My surgeon told me early on that we'd schedule fills when my weight loss dropped to less than 1-2 lbs a week for a period of three or four weeks. That's fine, that's exactly what I'd understood would be the yardstick. But yesterday I was told that their definition of "stalled" weight loss was more like 3 to 4 MONTHS without loss. Huh?

I managed to convince them that I was ready for my first fill, since the 17 - 19 lbs I've lost so far all came off in the first three weeks. I've been "stalled" for four weeks now and next week it will be five. And the facility that does fills only does them on one day a month. So if I didn't do it now I'd have to wait until "fill day" in November. I'd rather have several weeks to accustom myself to a new restriction level than several days, with the holidays coming and all.

In any event, the basic facts that: a) the band needs to be filled to work, and that each person feels a fill level differently, and c) it may be necessary to "sneak up" on the right level of restriction all seem to not be part of the equation. And I've heard the same comments from patients of many other doctors.

So why is that? What do you think is behind the common reluctance to schedule adjustments? I presume it's not the surgeon doing the adjusting, so what's the big deal? They don't balk if you want an office visit just to say hi, and that's almost as much trouble!

OK, vent over. I'm glad to be looking forward to my first fill, but frustrated to know that no matter what it will be months before I can have it tweaked if necessary. This journey may be longer than I'd planned.

[donali 57]

Alexandra, that is SO frustrating!!!

I have no idea why so many American docs seem to be so reluctant about fills. I mean, THAT'S THE WHOLE POINT!!!

If you were on a medication that wasn't working, they would change it. Same dif HERE.

I feel your pain. Hang in there, eventually you will get to your "sweet" spot. It's just unfortunate that they make it so hard to do.

Thinking about you!

[shellyj 5]

hey alexandra!

i cant believe your dr will only do fills once a month!! they take 5 minutes... my physicains assist does the fills. they do them whenever (at least 2 weeks apart) but they are booked usually 3-4 weeks in advance. i have had 2 fills and STILL able to eat about what i did before. i have 2.2 cc in my band.

i was reading a journal someone kept with the band (specifically till she reached 1/2 cup restriction) and she said EVEN when she ate ice cream she HAD to stop with a 1/2 cup!!! I CANT WAIT!!! oh i guess i have to. lol. i am glad you were able to talk your dr in to letting you have a fill.

[Alexandra 55]

(Shelly, I used my magic admin powers to delete your duplicate post.)

Part of the problem with my doctor's office is that they don't do them in the office. The fills are done in the radiology department at the hospital. I have no idea who precisely will be doing it, but I'm positive it won't be the surgeon.

Perhaps it comes down to the dearth of band patients around here. Doing all the adjustments on one day a month must work out for them some way. When I first called I wasn't even sure I'd be able to get in for the October date--I was worried it would be filled up already and I'd have to be making my appointment for November. But I was assured that never happens, and that it's always possible to be slotted in on short notice if necessary. I just think it's not going to be considered "necessary" unless there's been no results for what I think is too long.

You'd think they'd want to do whatever they could to help people succeed! Doling out adjustments like they're made of platinum is no way to do that. Their way just increases the risk of over-restriction, IMO.

[mrwindt 12]

Hi Alexandra

I really feel for you. If you're stalled all this time, they really should be doing a fill.

I had my first fill on Friday. I don't think I'm at that sweet spot yet, but it's better than it was. In my case - it is the surgeon who does the fill. And he will do it if you're not losing 2 pounds a week. Though he won't do the first fill for at least 6 weeks.

Keep pushing for a fill. It's so frustrating to be ready for one and not be able to get one.

Good luck.

Mary

[bjkgriffith 1]

Alexandra, I finally found a US doctor to fill my AMI band this weekand I really liked him. But, he told me that he believes in trying to lose the weight by controlling diet vs. filling often because he says that the fills lead to the erosion of the band. I don't know if that is true or not, but that was his reasoning. He usually gives his patients 0.5 cc in their lap band and was very reticent to put the 4.0 cc's in mine that Mexico said he should, so we went with 3.5 cc's. US doctors are too new to this. They are still a little gun shy.

Barb

[kellymoos 4]

My surgeon is the one who did the fill also. He is VERY much for getting the fills. At 4 weeks he was encouraging me to get a fill. He told me in 4 weeks to call him and he would do another one if I needed it. Weird how every Dr. is sooo different.

[soon2bskinny 0]

I had my surgery in Mexico but the doctors here in Dalton at Hamilton Surgical Weight Management will see me. My doctor wasn't at all reluctant about me having a fill. Seems I waited longer than most of his patients. He put 4cc in the first time and 3cc the second time (11cm band). I don't think I have found that sweet spot yet either but I am getting there. I believe here they encourage you to wait 6 weeks between fills but they leave it up to you if you feel like you need a fill. That is how the band is designed to work. Perhaps you should do some research and submit your findings about those related topics to your doctor. Or perhaps you should print some posts from here where we have discussed such things as restriction and "sweet spot". Maybe he is going too much by the book and not enough on personal experiences from his patients. Good luck with your first fill and I hope it works good considering you will have to wait so long for another.

[ldauph 8]

That is the same with my doc. he schedules fills every four weeks until you feel you don't need anymore.

[mkcarpen 0]

I am going today to get my first fill. My surgery date was 9/15/03. I have had not problems with my doctor. Good luck.

Kathy

[shellyj 5]

hey mkcarpen

i think we used the same dr., dr charles morton from southern hills. when you go for your fill or before you go you might want to schedule your 2nd fill from 2 weeks from your 1st fill. if you wait till after you have had the appt. the wait is about 3 weeks. i had to wait 3 weeks for 2nd and 3rd fill. i scheduled the fourth one today and if i AM feeling restriction i can always cancel the appt.

[Alexandra 55]

Well, it's great to hear that lots of doctors approach fills in the right way. Maybe when I know more about my doctor's office's reasons I'll feel less critical of their practices.

In any event , I'm 100% ready for the fill next Thursday morning. And wouldn't you know it...today I'm feeling more restriction from my empty band! Another mystery...

[soon2bskinny 0]

Alexandra,

My band is always that way. I never know from one day to the next how I much restriction I will feel. One day I can only do mush or liquid and then the next day I feel like I could eat a horse. I am usually very restricted in the morning and then by bed time I have to fight not to eat everything in the house. Good luck with your fill on Thursday.

[roxanne 0]

I am also very restricted in the morning and still a bit by noon but by supper time watch out I can eat alot. I wish it was the other way around open in the AM and restricted in PM as after work I can sit and eat where as during the day I'm working and food is not available. I have 1.25cc in my band maybe it's time for another fill. Roxanne

[Alexandra 55]

Hi Wendy!

I think that's a really good idea, calling the office. Ask to talk with Dawn, the nurse practitioner, because she's the one I saw at my last checkup. I didn't see the doctor at all! Dawn asked me a few questions about my restriction and what I'm eating, and made a couple of notes about how I'm "struggling" not to overeat. She said Maria does the actual scheduling and that she (Maria) would call me. It was on the phone with her that I had the conversation referenced above, so an actual appointment may not be necessary. If it is, maybe they can move your 11/20 appointment up a little so you can get in on the November fill date.

I did hear from another Bertha patient on the NJ Bandsters list that it was indeed Dr. Bertha himself who did the fill. That surprises me, but it's not a bad thing at all. Maybe I'll have a chance to chat with Dr. Abkin, finally!