TEMPE SUPPORT GROUP

 So I am putting together our Support Group Program ---Ive put together other programs under other doctor's names and in other states LOLOL - but for this since we are a Surgery Center and not a specific doctor's office I get to ask for some ideas and suggestions....

What do you like? Dislike? about groups you go to... What would you like to do? See?  Talk about?  
I'd like to offer a daytime meeting like at 9:00 am - what would interest in that be?
We are a LAP-BAND Center so the focus would be on LAP-BAND issues and lifestyle but really? for long terms success I eat the way band patients eat to keep the weight off and being a 9 yr post RNY patient I can offer a lot of support there too.... 

Id love to hear from you!!! 

I kind of like the idea of a doctor that is able to do all the procedures.  Doctors that do just banding are typically considered a band mill and that's not so great.

In looking at your website your doctors only do banding.  What about the other options?  Banding provides the lowest and slowest weight loss and carries a LOT of complications and failures.  Even you didn't choose banding.

Me?  I dislike band mills, I dislike pushing one surgery type when there are four of them out there.

I just love your rebuttals, they are very insightful, thank you.

Darcie

 Nice to see you on the boards. are you still doing Life coarch  stuff ?? 

So what Dr is doing the bands ? is that Dr Orris & Debarros on Souhtern near McClintock ???    

A lady I work with at the bank is looking for a lap band Dr to do fills  - Any Idea's on price ?  


P.S.  support groups that allow pts from all practice's  are well received  on this side of town.  

The fundamentals of weight loss are the same with all operations. Darcie knows these fundamentals as well as anyone-- she is a great cook- has written a cookbook- and I have had the pleasure of her cooking.
She knows how to lose weight, she knows how to keep that weight off - and she can teach other people how to do that.

I have done all weight loss operations- have published about all weight loss operations, and look at the data on an ongoing basis.  It is a mistake to say one operation has more issues than another- they are all operations. If you do not abuse a lap-band-  there is minimal chance of having issues with it. But that is not the important point. Bottom line with all weight loss operations-- at five years out- those who make lifestyle changes will keep their weight off-- those who don't- won't (all data, all operations).

What Darcie is offering is a support group on the east side, with the benefit of her experience. There is no financial benefit of this for the outpatient surgery center - this is a good chance to learn about how a successful person did it. She has taught countless patients - and those who wish to benefit from this- I recommend they attend.

I am going to recommend my east side patients go to this support group.

Dr Simpson! I am Rosalinda Celaya, and have seen you for the last 5 1/2 years while trying to get the Lapband. I wanted to tell you that I am now banded.11/13/09..although bummed that i couldn't finish out the journey w/ you, my insurance insisted that i used a UHC center of excellence, surgeon Robin Blackstone, who is equally as enthusiastic and encouraging as you are! I am so thankful for all the education and support you and your office staff provided me throughout those years...I've had a fast and realitively painless recovery! I am looking forward to meeting my goals! I have your books and intend to follow them and be successful!!! Thanks again for everything!

~~If you do not abuse a lap-band-  there is minimal chance of having issues with it.~~

WHAT?  Surely you can't say that in real time with a straight face???  The long term risks and complications with a band are huge in number and revision surgery is BIG business for surgeons who do all the procedures.

I was the star lap band patient, I did everything exactly right.  I also had the best of the best surgeons.  Bands suck!  One day you can't swallow your own spit and the very next day you can eat anything and everything.  Everything affects restriction, weather, stress, TOM, food temp, everything.  With a sleeve weight loss is better and faster than banding, long term risks and complications are much fewer than banding, there is no value in bands.  None.  It is a temporary way to lose a small portion of excess weight.

BTW, I don't blame doctors for not doing aftercare on bands they did not place although in AZ we have a LOT of doctors that will do aftercare on patients they did not operate on.  I fully understand the money is in the surgery and you guys are making a living.  I just wish doctors like you would stop lying about the financial reality here by claiming your medical malpractice will not cover you.  That's a load and quite easy to prove.

BTW, on your website you point out all the risks of bypass and DS, any reason you don't outline the complications of banding?  I mean, you are a band doctor so it's not like you are not aware of slips, erosion, band intolerance, stoma spasms, port infections, port flips, esophageal dilation, pouch dilation, etc. etc. etc.

You have to admit, your website is very deceptive and misleading.  If one didn't know what they were doing they might actually believe the only way to survive WLS is to have a band and we all know that isn't true.

 Dr. Simpson,

I know you've done a lot of bands and I've only had one...but my experience is NOT what you have described.  Esophageal dysmotility about a year into an otherwise successful band experience is not abusing the band.  It is the band abusing the body. I was fortunate that I had that lousy piece of garbage removed in time for reversal of the damage.  Not all of the 25% of banding patients who end up having to have their bands removed are as fortunate as I.

While I see that YOU say you have experience with the DS, I have never found a DS patient who claims you as his or her surgeon.  Why is that?  And you list "revisions" on your advertising page here, but not revisions to the DS.  So where are these DS patients?  And why do NONE of the DS sites who gather names of successful DS surgeons list you as someone who has done a sufficient number of procedures that he might be considered "qualified?"

You know...if you want to bad-mouth a surgery you don't have a positive reputation performing on your OWN website (as you are doing now), go for it....but when you do it here where we are supposed to be exchanging facts, not advertising talking points, I think you might expect to be called out for those claims.

BTW, I am about the most non-compliant patient you will ever encounter--well, I'm all over my supplements but I'm all over chocolate as well--and I'm a few days short of four years out and I've just finished three months on the couch due to a sacroiliac joint injury and I'm STILL at 76% of excess weight lost.

So why don't you try to stick to what you consider the good points about the band--if your imagination is that good--without promulgating false data about the surgery you don't do.  

THAT would be "doing no harm."

Sue

I am so utterly disappointed in you Dr. Simpson.

You used to be a whole-hearted DS supporter.  Then you sold out to the lapband business model.

You told me that it was because your DSers were non-compliant.  Odd that YOU had this problem to that extent, when other practices (including foreign practices) don't.  I assert your pre-op education, followup and post-op support programs were deficient, or you were too lazy or unwilling to provide them.  You couldn't be bothered with helping people get and maintain what you at one time swore was "a better operation in terms of efficacy for weight loss [compared to RNY]."  Which you stated "has no long-term sequella specific to it." (Quotes from the letter he wrote for me to support my appeal for the DS in 2003.)

Now, you solely support a procedure
* For which you are likely being given kickbacks and/or other income which are not disclosed to the patients, from the manufacturer of the medical device you install
* Which requires the patient to repeatedly return to your office to maintain -- and for which you can CHARGE office visits, as opposed to the less remunerative support that DS surgeons provide their patients.
* Which you can slap on after other failed procedures with hollow promises of how this is a vialbe "revision"

Your assertiions about the safety and efficacy of the band are NOT supported by the literature.  In fact, there are increasingly insistent calls to REMOVE the band from the market.  See for example, this recent paper:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2698858/?tool=pu bmed
(Patient Saf Surg. 2009; 3: 10.)
Conclusion The placement of a gastric band appears to be a disservice to many morbidly obese patients and therefore, in the current culture of evidence based medicine, the prevalent use of laparoscopic gastric banding can no longer be justified.


Since you are apparently incapable of providing or unwilling to provide adequate pre-op educational or post-op support sufficient to be in the business of performing the DS procedure, I am glad you've gotten out of that business.  But your current business model is based on a flawed procedure and device, and your website contains what may of us believe is (putting it in the best light possible) intellectually dishonest information.  This is not merely advertising "puffery" -- this negatively impacts people's LIVES.

SHAME ON YOU.

It is interesting how you accuse me of not supplying patient follow up on one hand and then accuse me of seeing patients too much for the band in another- a logical fallacy. If a patient comes in for a post operative visit - whether it be for a DS or a lap band - you consider it business if we charge for one but not the other?

Then you cite a single paper - but not the multiple papers that are out there -- and use that as the sole basis for an argument- a paper that comes from a single source? Yet the whole of papers out there show that the lap-band is safer by a factor of ten- in all aspects?

Then you say I am likely getting kickbacks-- for which you accuse me of, but have no basis for?  And yet you fail to note or discuss the many staples that are used are also "medical devices" and something for which device companies are paid.  So if Ethicon or Covidian take a DS surgeon to dinner that is not bad, but if they take me to dinner that is bad? Did you know that the staple manufacturers get more for a DS than they do when they sell a band?  But because you think one is better it is ok - and not ther other?

Then you say an office visit is less renumerative for one than the other-- although they are coded out the same? So if patients use office visits to learn, to change lifestyle, to have good results because it takes time to learn about any procedure and what it does-- if they do it for one that is ok, but not the other?

Then when a procedure fails - and someone revises it to another - you say that is wrong- but you refuse or simply ignore other data? It is ok to revise from one procedure to another as long as you think it is good?

Thank you for the assumption that surgeons do one procedure for money and the other for love - when you don't know reimbursement rates, motives- but because you like the procedure you had it must be good.

Your arguments are not based on the whole of the data - and your conclusions are based on a flawed belief that if data/surgeons do not believe in your belief they are wrong.

This is not religion- this is medicine- this is surgey.

If you think it is better to reoperate on someone for multiple hernias from the malnutrition of a DS, or bowel obstructions, or leaks than it is to operate on someone to reposition the band- or to take a band out -- you are simply wrong.  You can be an evangelist for a procedure- but if you want to cite a small bit of literature and dismiss those of us who take the entire body of literature- admit it.

Here are the facts:

In all large studies across all literature-- the band is safer than other procedures.

The band does require education - as all procedures do- it does requre follow up visits-- as all procedures do-- and the band is adjustable - others are not without major intervention.

There is no trading malabsorption for obesity with the band.

Bad things can happen with any surgical procedure- and if you think a website is what I would use for informed consent then you are so wrong.

Glad you like your procedure- but to say it is better than a lap band is like saying a horse is better than a car because you don't need gasoline.

The band is not flawed, anymore than any weight loss operations are flawed. Patients have a problem of obesity- and this is the tool I seek to use. In our data-- outcomes (weight loss over three years or more) are equal -morbidity and mortality is less- and patient satisfaction is higher with the band than with DS.