Support and Motivation from your Clinic. I know that this journey can be difficult at times. There are so many reasons that people choose to have lapband surgery and just as many reasons why some are successful and others less so. Many people are fortunate to get support and motivation from family and friends. Other people have chosen not to share their decision to have surgery with anyone and therefore have no one but themselves to offer up encouragement. This is where a good clinic can shine. I know at our clinic there is nothing we want more than for our patients to succeed. Sometimes the things we say (“you need a little fluid removed not added”) may not be what the person wants to hear, but it is always said for the right reasons. We wish we had a crystal ball that could tell us when a patient was struggling. As I’ve said before the most dreaded words I can hear are: “I was too embarrassed to call” (that and “you look great.. for someone your age”). A good clinic will be there for you to help you through the plateaus and the times where you may wonder if you have done the ‘right thing’ (you have)…but you have to contact them.
Access to Support Staff in a Timely Manner. When you are struggling with hunger and the scale hasn’t moved in a week or two most likely you want an adjustment and you want it NOW. Understandable to say the least however not always feasible. Your clinic should always however do their best to get you in for a visit within a timely manner. I would say that a ‘timely manner’ would be within 2 weeks of a phone call or email requesting a visit. Like any medical office, clinics are busy and ‘next day’ appointments are not often possible unless there have been cancellations. At our clinic we do on average 20-25 adjustments/day and also have to fit in people who require a defill. Our appointments can take anywhere from 15 minutes to 40 minutes. If someone is having a problem we are not about to look at the clock and chirp ‘times up!’. We also have a cancellation list which is great for people who can pop in at the last-minute. If you know that you are starting to notice an increase in hunger put the call in asap so that you can schedule an appointment and avoid backsliding due to hunger. We don’t like to schedule adjustments any closer than 4-6 weeks apart as it has been proven that it can take a while for the effects of the adjustment to ‘kick in’. This time also allows patients to adjust their eating to their last adjustment and prevents them from getting over-filled. Quite often patients will cancel an appointment because at the last minute their fill has ‘kicked in’ and their hunger is well controlled.
Prompt and Appropriate Management of any Band-Related Issues. Your clinic needs to shine in this area. If you are having an issue that you may feel is in ANY way related to your band you must let them know. These could include such things as: any signs of infection, abdominal pain/discomfort, pain at your port site, difficulty swallowing, heartburn, reflux of fluid up your throat at night, frequent regurgitation of food/fluid, night-time cough. If you suspect you are having issues that are band-related let your clinic know. (Now this is meant to be an un-biased blog…but I feel I must give credit where credit is due. Our surgeons are remarkable and if there is ANY suspicion that a person is having a band related problem it is dealt with thoroughly and promptly. Every clinic should do this for their patients health and safety).
Personalized Care. A persons lapband is as unique as they are. Yes the implanted device is either a large band or a small band, but how that band and a patient work together is specific to them. In the ‘old days’ we all followed an adjustment algorithm in which we added or subtracted a set amount of fluid. This we quickly found led to bands that were either too tight or too loose. It is important that your clinics staff talk with you and discusses in detail HOW you are eating, WHAT you are eating, HOW QUICKLY you are able to eat a small meal, and any DIFFICULTIES you may be having. Sometimes our patients get frustrated because they want a ‘big fill’ only to leave the room with as little as 0.1cc added to their band. This is because all aspects of a persons hunger, eating behaviours and habits have been taken into consideration. It is far better to err on the side of caution and have the person return for another small fill, than to make them too tight and introduce such issues as heartburn, reflux and maladaptive eating.
This brings me to the thrilling conclusion of ‘Great Expectations…from your Clinic Part II’!! (Hopefully you did not start this too late in the evening because you will NEVER sleep now!) I hope it has been informative and I hope your clinic is meeting your expectations. If they are not, call them up, email, make an appointment to go in or chat on the phone about what you feel is not being met and figure out how to get it fixed. The comittment for success rests both with you and your clinic.