Sunday, August 30, 2009

Educating Primary Care Physicians about Lapband

As with all surgeries, lapband can result in complications. The band can slip, infection can occur, some people are so good at eating around the band (using slider food) that they gain weight back, or they never go in for their fills. Some Dr.s don't seem to give very good advice to their patients about sticking to higher density proteins and not turning them into slider food by adding things like gravy to them. Some actually recommend that people "prime the pump" with liquid before they eat. Some Dr.s take forever to give their patients a fill that actually acheives restriction.

Not all patients make sure they get the kind of support system they need to achieve success nor do their Dr.s The lapband is a tool not a cure. Other issues need to be dealt with simultaneously. If they're not, the band isn't as successful.

So some primary care physicians seem to only be aware of the failures and are unwilling to recommend their patients for the lapband. They also don't distinguish between gastric bypass which is much more drastic and has many more severe complications and the lapband. They confuse the statistics for the two.

I think a lot of these Dr.s really don't understand the nature of compulsive overeating. They keep thinking that if their patients just listened to them and followed the diets they hand them and had better nutritional education they'd lose the weight. But time and again, nutritional information and closely supervised diets don't help their patients.

Over the years some have prescribed drugs that haven't helped and have actually harmed overweight patients.

When I think of the money and time I spent on Weight Watchers, Nutrisystem, Tops, OA, Atkins, and some wierd combination of thyroid and speed one Dr. put me on, it makes me angry. I had a Dr. who didn't believe in the band. She thought I could do it myself. I knew I couldn't. I had to go to a new Dr. anyway because of insurance so I tested the next Dr. to see if he recommended the band. With two co-morbidities he took it seriously. He had Dr. friends who did lapband surgery with great success. So he went ahead and recommended me for the surgery which started the year long process of jumping through hoops to get the band.

I'm blessed that I had the persistance to get through that year and that I had a cooperative Dr. My insurance company also sent me to a top-of-the-line specialist. Some insurance companies won't cover the surgery at all. Although I have access to a nutritionist at my surgeon's office, I've found even greater support on lapbandtalk, especially on a thread called I'm here to help...This blog has also proved to be an invaluable ally in my recovery.

A lady at my church who is in much worse shape than me has not been able to get her primary care physician to recommend the lapband. Meanwhile, the meds she's on for her co-morbidities have made her gain even more weight.

People need to explore the risks, the failures, and the successes of lapband surgery before they make a decision. They need to know that its still hard work to lose the weight and keep it off. Their Dr.s should be helping them explore their options and get set up for success if the option for lapband is chosen.

I think the primary physicians need to get more educated, not only about lapband surgery, but about compulsive overeating itself. It is an eating disorder, an addiction, with genetic, biological, emotional, psychological, and spiritual componants that all need to be addressed. The band helps relieve the person of enough of the addiction aspect to let them work on the other aspects.

I had worked for years on all the other componants with counseling, 12-step meetings for food addiction, 12-step meetings for codependency issues, not to mention prayer and Bible reading and Bible study groups. I'd come to pretty good terms with my ADHD/ADD and still I could not succeed in losing and keeping off the weight.

I had a medical condition that needed a medical solution. I hope the woman in my church gets the help she needs. I hope the lapband, if she gets recommended, proves to be the tool she needs like it has for me. She's a precious soul and very much loved and appreciated in my church community. I want her to be around yet for a long time.