DS Pioneer Gives Up On DS - For Lapband???

You speak wise words, Jupiter.  Your experience will serve the RNY's well.  I've read some VERY stupid people posts, too.  It's like the first thing they can't wait to do is test their limits.  Keep working to talk some sense into those people before they sabotage themselves big time.

Well, I'm certainly testing my limits -- bit it's NOT in the way of seeing how many supplements I can get away with not taking. 

It seems as if there is a probably a huge financial component to this as well, as Lori mentioned. Since Dr. Simpson seems to be working directly with Allergan, I am sure there is *modest* compensation involved. I mean, afterall, being a company who makes a surgical device.. wouldn't you just be jumping for joy if an accomplished surgeon associated himself with you, your company, and your product? This seems to be the case here. Before I knew about DS, I had BRIEFLY been interested in banding.. now the people who don't know better would be highly influenced to have a nice surgeon telling them that banding was the way to go, wouldn't they? Allergan is fully aware of this.. and lining their pockets. 

I would be willing to bet "modest" is not an accurate description!

I get no compensation from Allergan -- none.  I have been given a dinner or two -- but I would rather be at home than a dinner with corporate types.  So I have no association with Allergan -- I am sure they would like me to be, but I think if someone comes up with a better band -- then I will use that one. I did go to their Total Care Forum -- since it involves being someone who takes care of every part of the patient -- which I strongly believe in. I don't think there were many surgeons who did more DS than I did -- I love the operation.  But as with any operation --  you have to take care of yourself-- which is why I wrote the book "Weight Loss Surgery: A lighter look at a heavy subject." And, by the way -- we get less for the band than we ever did for the DS -- .  The issue isn't money -- it is we can never predict which patients will take care of themselves and which will not.  They all promise -- then they disappear.  Anyway - -enough of this -- to be clear -- I am not now, nor have I ever received any compensation from Allergan -- not how I roll

As long as you give people the true rundown of all operations, I'm good with it. My main beef with surgeons who don't do the DS is that they tend to give out false/misleading information or none at all about a surgery which *can* be a good option.

But you're right - compliance is crucial to a good outcome. It's one of the reasons I rather like having the DS be the red-headed stepchild of the DS world. Making people work harder to find it weeds out people who might not work hard to keep it going.

As long as you're up to answering some questions, I have a few for you:

why do you choose to offer the band as your primary surgery rather than the VSG? If you've done the DS, you already know how to do it. At least the VSG *can* be converted to a DS if the patient needs it, and there's no fear of slipping, erosion, breakage or need for fills. It also offers the benefit of removing one source of ghrelin.

Any idea why only 0.1% of your DS patients chose to follow-up? That seems incredibly low. Is that after a certain amount of time? 1 year? 2 years? etc Or they never even came back for a 10 day or 3 month followup?

--BT

Most patients come back faithfully in their first year.  The fall off is after the second year. We have done a number of  lap VSG and placed bands over them later.  Slips and erosions are very rare.  Fills are a great time to discuss what the patient is doing -- we use it for education.

So, anyone that doesn't want to listen to me and always consider me RIGHT (HAHA), remember that I said:

"Simpson doesn't want the responsibility of non-compliant DSers on his watch.  Same reason we don't want converts that are easily distracted by the smokescreen of stupidity looking into the DS.  The DS is NOT a toy and not for those incapable of understanding the serious nature in which their anatomy has been altered by the procedure and the diligence that is required to stay healthy."

Dr. S has not done the DS or the RNY for several years now, long before allergan rolled out "total care" or whatever. In, fact, he has practiced total care on his patients and had spectacular results with the band as a result.

It's a shame that there are so many who aren't given proper startup instructions enough to keep themselves healthy.  I have a lot of faith in my surgeon as a surgeon, but I trust the knowledge out here about supplements.  She was to have me try another 3 months on 5000 iu of dry D and see how that goes.  I decided that 2yrs was long enough with low D and jumped right to 50,000 iu to see how that does for me.  I'm not about to play around with this stuff.   I know that we out here talk alot about our nutrition, but what of those who don't bother going to sites like this?  They think they feel fine and no reason for follow up until they feel horrible.  I can see where some docs get fed up at the patients only seeing them when they're over the edge health-wise.  I have little patience for them myself.