Hello,

 

The summer is here-- and so is our summer schedule. Most of you, like us, are planning on getting out of town for a bit of time anyway. 
Support groups will be held the fourth Thursday of the month. There will be no support groups on the second Tuesday of the month until October.

NO SUPPORT GROUP TONIGHT!! We will have a seminar, however

 

Sincerely,

 

When you first came to us you signed a bunch of forms, one that we went over with your was called "considerations," of which you received a copy. In there we talked a lot about lifestyle changes and weight loss, but one of the most important parts of that was that if you had trouble you would come to our hospital and we would take care of you.

In fact, here is what it said, and you agreed to: 

It is best to go back to the surgeon that installed the band, or a hospital where the operation is performed, or be transferred there. You may have had a bad experience at the hospital where the band was placed, or may not wish to go to a hospital where the surgeon asks you to go.  Go there anyway. Remember, this is the surgery YOU asked for. If you go to a hospital where your surgeon does not go, you may receive improper care for your band, may lose the band, or may have increased costs, or complications that may be prevented by a surgeon familiar with the band.

 

Of course, every now and then we see tragic results of when this does not happen. At a recent lap band conference we discussed what happened to some of our patients who went to another hospital, where surgeons were either not as experienced with the band or not experienced with the band at all.

Patients have ended up in hospitals with open (not laparoscopic) operations -and had been in the hospital for many days, instead of just a few days - with large wounds. Patients lose their bands, when they may not need to lose them. Patients spend prolonged time on antibiotics. Some patients had injuries to the organs that were not expected.

Everyone likes to have surgery close to home - but we doctors only go to a few hospitals, and when it comes to something inside - it is best dealt with by us. We are fortunate to have the largest lap-band patient population in the valley, and great patients who are happy to come back. But, don't let the hospital, or covering doctors, or even my jokes put you off-- you are there to get something done.

A band can prolapse from eating too fast, eating too much, or getting too many things stuck. A band can erode into the stomach, requiring removal - and this happens after patients over-eat or eat too fast. While these things can all be prevented, once they happen we want to get you back to yourself as soon as possible. The best way is with an experienced team that can take care of you quickly and get you back on your road to recovery.  If you go to another hospital, with an less experienced team, or surgeons that are unfamiliar - chances are you will spend more time in the hospital, and have longer and more dangerous operations.

So, if you have any questions - let us know - email us, phone us, come to the hospital. Sometimes things are not manifest right away - but we will move quickly to get you on your way to good health and further weight loss.

A band slip is when the upper stomach pouch gets dilated forcing the band down the stomach, making it impossible to eat or drink anything.

When this happens we try to reverse the process by opening up the band (unfilling it) and putting the person on mushy foods (or sometimes just liquids) for a while to see if the stomach will go back. Sometimes it does, and sometimes it does not. Sometimes the only way to fix a band slip is to take a person back to the operating room and reposition the band. 

Slips can be avoided however. Here are a few simple tips to avoid ever having a band slip:

(a) Never eat fast -- if you eat too fast it will result in too much food in the upper pouch. This will stretch the pouch. The more the pouch stretches, the easier it stretches the next time. As the pouch stretches it gets so large it can cause heartburn, ad reflux - and if the upper pouch stretches too much - force the band down the stomach.

(b) Never eat more than the portion we tell you. If you chronically over eat you can stretch the pouch.  If you stretch the pouch you can cause the band to slip. This often happens when patients do not measure their food, but eat until they "feel full," or "feel restriction." We never use the word "restriction" in our practice- because that is not how the band works. The band does not stop you from eating too much food, the band will allow you to eat a lot of food, in fact. But if you measure your portions, and do not exceed them - the band will allow you to have your appetite suppressed for hours.

Early on that portion of food can be SMALLER than those little cups -- it is ok to eat less- IT IS NOT OK TO EAT MORE

(c) Eating things that are always getting stuck. The list of these is small: bread, pasta, rice, rubbery eggs, dry chicken. Small! Always seems like someone wants to eat dry chicken on vacation then call me! Avoid these foods, they are not worth it - do you like your band? Ok,avoid these foods.  There are others - if you eat too big a bite it can become stuck (eat slower). Dry meats can become stuck (learn how to cook them, or avoid them) and a few other things. So, be careful. And if you get a band fill - don't eat any of those for a week or two - and only eat them on a Monday so if there is a problem we can unfill you (not on a Friday)

What to do if you are worried: go to a liquid diet - make an appointment to see us for an unfill and then an upper GI. We will get you in quickly if you need an unfill.

 

We are sad to inform you that Bert died on June 3 after a brief illness.

Bert was a purebred mutt, and I found him down by Maricopa County hospital as a puppy in 1992. He was covered with fleas and ticks, and so I cleaned him up and took him home. He was a great little dog for many years.

On occasion Bert would join Diego, in coming to the office to see patients. He became a graceful little old man - but always wagged his tail, and enjoyed seeing patients.

Diego will miss Bert - but will be still happy to see you all. Thank you all for your condolences. I will miss Bert as long as I have a memory - great little friend, who just wanted to be close by, take some walks, and wag his tail.