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Why would it be different for a man?


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In our group we had one man getting the band the rest were women. I am told that the doc told him that men would only need one fill most likely to get their desired restriction and that a woman would need up to three. Well we all were at the same level, except for the man. The first day off liquids phase and we were able to eat real food; he had restriction to the point that it was as if he already had at least 3 fills. So why is it different for a man? If you have insight it would be greatly appreciated.

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I saw the You Tube Video in which Dr. Ortiz mentioned this and for some reason he never explained the "why." It is a awkward moment that borders on slightly offensive in a gender-centric egotistic way (IMHO).

If anyone has any idea as to the "why" please share your thoughts.

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You know I was wondering if they put the band in with a fill for the guys but not for the girls. I thought a stomach was a stomach.

That is a really good question considering that there are quite a few doctors who do provide an initial fill during the surgery anyway. Yah, I was told that all stomachs are about the size of an American football and the doctor did not say anything about gender being a factor.

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In our group we had one man getting the band the rest were women. I am told that the doc told him that men would only need one fill most likely to get their desired restriction and that a woman would need up to three. Well we all were at the same level, except for the man. The first day off liquids phase and we were able to eat real food; he had restriction to the point that it was as if he already had at least 3 fills. So why is it different for a man? If you have insight it would be greatly appreciated.

OK, here's my experience, when I was banded, Dr. Ortiz had a choice of using the 4cc band or the 10cc band. It depened on how much fat was surrounding my stomach. It's the surgeons judgement call. Internally we all have fat attached to our stomach and its usually a thicker amount in men. In my case, Dr. Ortiz placed the smaller band around my stomach and I had restriction from the beginning. In fact, I had too much restriction, I was so tight that there was talk that I might have to have my lap band replaced with the larger 10cc band. But I managed somehow to live with the restriction and everything worked out. On my first fill 12 weeks after surgery, I only took .4cc's, today I only have 2.0cc's in my band. Every fill I had was never more than a half of a cc. After banding, the first fat you'll loose is the internal fat around your stomach. This is why after your first fill it's a short time later that you'll need another fill. As you loose the weight and the internal fat disappears, the band becomes looser and you loose that restriction. This is why most patients require 3 to 6 fills the first year, it's that internal fat that you can't see that is why you loose your restriction. Once most of that internal fat is gone, you stabilize with your fills and you hit the so called "sweet spot". As you know, here in the USA they use only the 15/17cc Inamed Advantage lap band. It's so big that it's like putting a "Hula Hoop" around your stomach. LOL. The restriction right after surgery very rarely ever happens with that big band. But, as you read about patients with this band, it takes a lot of saline and adjustments to get restriction and or to hit the sweet spot. All the bands do the same job, with a proper fill/adjustment they give you restriction, depending how much internal fat you have, each patient will require a differnet amount of saline to get that restriction. The statement about men only requiring one adjustment??? I don't know about that??? Hmmm,, That wasn't true in my case. I probably had the normal 4 to 6 the first year.

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Thanks Dolittle that would explain it. My next question would be then why wouldn’t the doc use the smaller on all women. Maybe he does bit if he isn't he should know that the Girlies in my group are feeling no restriction yet. We could eat the house and the garage if we wanted. I was just wishing that the band was going to provide restriction right away like it has for the man in our group. We were all disappointed actually to find that we were not feeling what he was.

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Thanks Dolittle that would explain it. My next question would be then why wouldn’t the doc use the smaller on all women. Maybe he does bit if he isn't he should know that the Girlies in my group are feeling no restriction yet. We could eat the house and the garage if we wanted. I was just wishing that the band was going to provide restriction right away like it has for the man in our group. We were all disappointed actually to find that we were not feeling what he was.

To my understanding and back when I got banded, I was told most women get the smaller band and the men get the larger. I've been told that women carry most of their fat on the outside and men have more internally. It's not a good thing to have restriction right after surgery. You want that band to heal and nest itself in that spot where the surgeon placed it. With the band healing and locking itself in the proper position, it decreases the complication rate in the future,, like band slippage. In my case I had to be very careful those first 3 months to make sure I healed and the band stayed in the proper position. As I lost weight and lost my internal fat, my restriction eased up and my first fill wasn't till the 12 week mark after surgery. Like I said, all I needed at the first fill was a little squirt and I had my restriction back. The trend now is for everyone to get the larger band, so you don't have the complication of having what I experienced. I think this is one of the reasons patients that get banded in the states get the huge Avantage band, the other reason is, and this is my opinion, its so you need more fills and have to go back, thus the insurance pays more over the long run. I've been to several post surgery support groups in my area and all the post-op patients complain that it takes them 6 months and numerous fills to have restriction. And its because their doctor just adjusts the band in small amounts of saline. More trips to the doctor for fills, more money in their pocket. But this is just my opinion. LOL

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DOLITTLE, IF YOU GET A CHANCE TO ASK THE GOOD DR THIS QUESTION, ADD THIS QUESTION IN ALSO:

CAN YOU PLEASE EXPLAIN HOW COME SO MANY HAVE TO GET UNFILLS WHEN CLOSE TO GOAL WEIGHT OR ON MAINTENANCE? IT SEEMS IT'D BE JUST THE OPPOSITE WITH YOUR BODY GETTING SMALLER, LOSING FAT, AND YOU'D THINK YOU'D NEED A HEAVIER FILL TO TIGHTEN THINGS UP, BUT....

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DOLITTLE, IF YOU GET A CHANCE TO ASK THE GOOD DR THIS QUESTION, ADD THIS QUESTION IN ALSO:

CAN YOU PLEASE EXPLAIN HOW COME SO MANY HAVE TO GET UNFILLS WHEN CLOSE TO GOAL WEIGHT OR ON MAINTENANCE? IT SEEMS IT'D BE JUST THE OPPOSITE WITH YOUR BODY GETTING SMALLER, LOSING FAT, AND YOU'D THINK YOU'D NEED A HEAVIER FILL TO TIGHTEN THINGS UP, BUT....

OK, I sent this question to Dr. Ortiz and we'll see what he has to say about this subject.

But,, I have an opinion and I think it's a good one. I think patients that get close to goal and end up having an unfill were too tight in the first place. As you get close to goal you start to try to eat normal,, like what you used to. A combination of a physicological and physical thing. Physiologically you think your close and don't have to work as hard, and you start eating more, but physically, your still banded and have the same restriction, you end up PBing more and irritating your stomach. With this constant yo-yo/PBing thing going on, you find yourself in trouble and end up having an unfill. But like I said,, this is my opinion.

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Okay enough with the speculation.

Dr. Ortiz,

Hypothetically, you have 2 patients, 1 male and 1 female. They Both have the same BMI and the SAME brand/size band. Why would the male patient only require 1 fill & the female patient require 3 fills to reach the same level of restriction?

Thank you for your candid reply.

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OK, I sent this question to Dr. Ortiz and we'll see what he has to say about this subject.

But,, I have an opinion and I think it's a good one. I think patients that get close to goal and end up having an unfill were too tight in the first place. As you get close to goal you start to try to eat normal,, like what you used to. A combination of a physicological and physical thing. Physiologically you think your close and don't have to work as hard, and you start eating more, but physically, your still banded and have the same restriction, you end up PBing more and irritating your stomach. With this constant yo-yo/PBing thing going on, you find yourself in trouble and end up having an unfill. But like I said,, this is my opinion.

NICE THEORY DOLITTLE BUT IMO THAT STILL DOESN’T MAKE SENSE AS MANY OF US HAVE LESS THEN OUR FIRST FILLS IN AND STILL HAVE MORE RESTRICTION THAN WHAT WE HAD AFTER OUR FIRST FILLS, HENCE GETTING MORE FILLS AFTER OUR FIRST FILLS

ANOTHER THEORY I HEARD, THAT SINCE LOSING WEIGHT AND SMALLER STOMACH, THE BAND HAS ACTUALLY SLIPPED DOWN A BIT OVER THE SMALLER STOMACH. (not slipping way down as in a slipped band) BUT IMO THAT DIDN’T HOLD MUCH WATER AS THEN EVERYONES BAND BECOME UNSTITCHED.

THANKS A BUNCH FOR ASKING, I'VE BEEN WONDERING ABOUT THIS FOR A GOOD YEAR

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we don't give fills at the time of surgery. I will ask Dr. O for a medical reason why the fewer fills, but from what I understand... part of it is I don't think that mens' stomach's thin out like women's do as they lose weight - that's part of the reason we need more fills.... as we lose weight our stomach itself thins out so we lose our restriction....

but even with the averages... some women only need one fill and some men may get 4 or 5 to get to their goal, there is no hard and fast rule for number of fills required to get to goal and stay there....

I will send a note to Dr. O and as soon as i get a response i'll post it :)

MERRY CHRISTMAS my band family! Have a safe and blessed day!

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NICE THEORY DOLITTLE BUT IMO THAT STILL DOESN’T MAKE SENSE AS MANY OF US HAVE LESS THEN OUR FIRST FILLS IN AND STILL HAVE MORE RESTRICTION THAN WHAT WE HAD AFTER OUR FIRST FILLS, HENCE GETTING MORE FILLS AFTER OUR FIRST FILLS

ANOTHER THEORY I HEARD, THAT SINCE LOSING WEIGHT AND SMALLER STOMACH, THE BAND HAS ACTUALLY SLIPPED DOWN A BIT OVER THE SMALLER STOMACH. (not slipping way down as in a slipped band) BUT IMO THAT DIDN’T HOLD MUCH WATER AS THEN EVERYONES BAND BECOME UNSTITCHED.

THANKS A BUNCH FOR ASKING, I'VE BEEN WONDERING ABOUT THIS FOR A GOOD YEAR

I really think it depends on how much fat you have internally clinging onto and around your stomach. As you loose weight and body fat, the first fat you'll loose is that fat hanging onto your stomach. That's why we need a fill so soon. I've never heard that men require less fills than females. I really think thats BS. Everyone is different, why Dr. Ortiz picks one size band versus another is why he's the surgeon and I'm not. There could be numerous reasons why I got a 4cc band versus another patient got a 10cc band. I was banded almost 3 years ago, band criteria has changed since I was banded. Maybe the 4cc band is no longer available, I don't know. Like I said, bigger bands are being used in the states, maybe it's for many reasons? One, to eliminate the restriction right after surgery. The other is that in the USA, your lap band surgeon can ding the insurance company a few more times before you achive restriction. Also, there's always the possibility the 4cc band is no longer the best choice to use and its being phased out? I can't speak for your surgeon. I can't say why a surgeon uses one band or another. Plus, things change over time, some to the good and some are questionable. Since I was banded using the bigger band might be the best thing for patients. Lap band surgeons and Inamed have learned alot since I was banded and maybe the 4cc band isn't the best choice anymore. I know that every clinic that specializes in banding, they want you, as a patient, to be successful. They all live on their reputation and want you to succeed. Patients that succeed tell their friends and others that the band works. I know in the area I live in, the surgeons slowly bring a patient to restriction when they could do it the first time they adjust a patients band via using a fluoroscope and a barium swallow. Why they do blind fills and spoon feed the saline to the patients band is my theory of milking the insurance company for more money. I guess we'll have to see what Dr. Ortiz has to say about this. But, I love this kind of debate, this is why this forum and many others are on the web, to bring questions like this to the front and have a nice friendly debate,, OH I JUST LOVE THIS KIND OF DEBATE!!!

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Hey gang!

My daughter, 15 now but 13 when banded, has lost 50lbs and has only had one fill--her original first fill at OCC at the 8 week mark. Just asked her, and she never gets anything "stuck". My "2-cent" theory: she is young enough that she hasn't had the opportunity to screw up her metabolism with a hundred fad diets. She doesn't have to trick her body with high-protein foods or low-carb alternatives to anything. I think that she lost enough of the internal weight, that her lapband is loose enough to comfortably eat all types of foods. I, on the other hand, had my lapband placed at the same time as she did, on a much older stomach (haha) and diet-weary metabolism. I have had 4 fills to date, have lost 65lbs, and still have foods that I won't touch for fear of an "episode".

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As you know, here in the USA they use only the 15/17cc Inamed Advantage lap band. It's so big that it's like putting a "Hula Hoop" around your stomach. LOL.

This is not correct. I (a female) have a 10cc band. A friend of mine (a male) has a 4 cc band. We were both banded in the states by the exact same doctor within 10 months of each other. All of the other patients I have spoken with at our monthly meeting have either a 4cc or 10cc band. I believe there are some other options out there now, but I don't believe they are the "only" options.

and this is my opinion, its so you need more fills and have to go back, thus the insurance pays more over the long run. I've been to several post surgery support groups in my area and all the post-op patients complain that it takes them 6 months and numerous fills to have restriction. And its because their doctor just adjusts the band in small amounts of saline. More trips to the doctor for fills, more money in their pocket. But this is just my opinion. LOL

Yes, this is your opinion and I do not feel that it is correct or fair. I was a cash patient and my fills for the first year were 100% included in the price of my surgery. I had an office visit every month for the first year whether I received a fill or not just to make sure things were going well. Even patients whose insurance paid receive their first year of follow up care for free. It is kind of like when I had my knee surgery, I had three post-op visits at no charge because they were included as a part of the surgery cost. I have nothing against the doctor's in Mexico, but I am guessing that most anyone that went to a doctor in Mexico would have gone to an American doctor if insurance would have covered the procedure and you would have only had to pay $2,000 for the surgery as another friend did because their insurance covered it.

We have a doctor in this area that gives more aggressive fills than mine. When one of his employees came to work for my doctor what they discovered was that my doctor has a lot less patients that need emergency unfills (often in the middle of the night) within a few days of having a fill. The goal of my doctor is to help the patient learn to work with their band and make good food choices, not just cinch them down and see how fast they can lose as this is not healthy, nor is it a contest. We get too hung up on the idea that we need to lose the weight quickly and then we get our panties in a wad when we feel that we are not losing fast enough. As far as I was concerned, the fact that I was losing or staying the same and not gaining meant that I was headed in the right direction, regardless of how fast or slow it was occurring.

The other is that in the USA, your lap band surgeon can ding the insurance company a few more times before you achive restriction. Good grief, no wonder so many in the world have negative opinions of Americans, even Americans have negative opinions of their fellow Americans.

What I have discovered is that in the end, my cash payments in the states vs. the cash payments of patients who go to Mexico ended up being a difference of about $3,000 when hotels, airline tickets, companion fees, fill trips, etc. are all taken into account. For me, that $3,000 bought me peace of mind knowing that my doctor was a phone call and/or 20 minutes away. I also find comfort in knowing that the place that did my surgery was also going to be the place that would do my fills. Those monthly visits gave me confidence each month that I was on the right track whether I received a fill or not, the barium swallow proved that nothing was wrong with my band, and I never had to wonder if I did or did not need a fill, nor did I have to save up for trip to get a fill.

I have nothing against lap band doctor's in Mexico, I think they do a great service as do many lap band doctor's in the US and Canada. We are going to find good and bad in any country if we take the time to look. There is no way one doctor could do absolutely everyone's lap band surgery and fills which is why we have choices in doctor's and choices in whether or not we are going to speak ill of other's in a "just my opinion" sort of way. I am not saying that you should choose a US doctor over a doctor in Mexico, everyone needs to do what is best for them, I am just asking for common courtesy and respect for all doctor's trying to help us change our lifestyle and live healthier, longer lives.

With that being said, Happy New Year to everyone!

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As you know, here in the USA they use only the 15/17cc Inamed Advantage lap band. It's so big that it's like putting a "Hula Hoop" around your stomach. LOL.

This is not correct. I (a female) have a 10cc band. A friend of mine (a male) has a 4 cc band. We were both banded in the states by the exact same doctor within 10 months of each other. All of the other patients I have spoken with at our monthly meeting have either a 4cc or 10cc band. I believe there are some other options out there now, but I don't believe they are the "only" options.

and this is my opinion, its so you need more fills and have to go back, thus the insurance pays more over the long run. I've been to several post surgery support groups in my area and all the post-op patients complain that it takes them 6 months and numerous fills to have restriction. And its because their doctor just adjusts the band in small amounts of saline. More trips to the doctor for fills, more money in their pocket. But this is just my opinion. LOL

Yes, this is your opinion and I do not feel that it is correct or fair. I was a cash patient and my fills for the first year were 100% included in the price of my surgery. I had an office visit every month for the first year whether I received a fill or not just to make sure things were going well. Even patients whose insurance paid receive their first year of follow up care for free. It is kind of like when I had my knee surgery, I had three post-op visits at no charge because they were included as a part of the surgery cost. I have nothing against the doctor's in Mexico, but I am guessing that most anyone that went to a doctor in Mexico would have gone to an American doctor if insurance would have covered the procedure and you would have only had to pay $2,000 for the surgery as another friend did because their insurance covered it.

We have a doctor in this area that gives more aggressive fills than mine. When one of his employees came to work for my doctor what they discovered was that my doctor has a lot less patients that need emergency unfills (often in the middle of the night) within a few days of having a fill. The goal of my doctor is to help the patient learn to work with their band and make good food choices, not just cinch them down and see how fast they can lose as this is not healthy, nor is it a contest. We get too hung up on the idea that we need to lose the weight quickly and then we get our panties in a wad when we feel that we are not losing fast enough. As far as I was concerned, the fact that I was losing or staying the same and not gaining meant that I was headed in the right direction, regardless of how fast or slow it was occurring.

The other is that in the USA, your lap band surgeon can ding the insurance company a few more times before you achive restriction. Good grief, no wonder so many in the world have negative opinions of Americans, even Americans have negative opinions of their fellow Americans.

What I have discovered is that in the end, my cash payments in the states vs. the cash payments of patients who go to Mexico ended up being a difference of about $3,000 when hotels, airline tickets, companion fees, fill trips, etc. are all taken into account. For me, that $3,000 bought me peace of mind knowing that my doctor was a phone call and/or 20 minutes away. I also find comfort in knowing that the place that did my surgery was also going to be the place that would do my fills. Those monthly visits gave me confidence each month that I was on the right track whether I received a fill or not, the barium swallow proved that nothing was wrong with my band, and I never had to wonder if I did or did not need a fill, nor did I have to save up for trip to get a fill.

I have nothing against lap band doctor's in Mexico, I think they do a great service as do many lap band doctor's in the US and Canada. We are going to find good and bad in any country if we take the time to look. There is no way one doctor could do absolutely everyone's lap band surgery and fills which is why we have choices in doctor's and choices in whether or not we are going to speak ill of other's in a "just my opinion" sort of way. I am not saying that you should choose a US doctor over a doctor in Mexico, everyone needs to do what is best for them, I am just asking for common courtesy and respect for all doctor's trying to help us change our lifestyle and live healthier, longer lives.

With that being said, Happy New Year to everyone!

I finally got to talk to a real person at Inamed/Allergan about lap bands. I learned a few things that I was misinformed about. The 14cc AP band isn't the only band used in the USA. The 4cc, 10cc and the 14cc AP bands are all available to surgeons in the USA. They told me that it's always up to your surgeon on which band is used. Weather he uses the 4cc, 10cc or the 14cc AP band is a judgement call by the surgeon. Also, I was told the larger AP band is rated at 14cc's, not the 15/17cc's I had been told before. I still have a couple more questions about fills that needed answered and I'm waiting to hear back from Inamed. As far as what bands are available in Mexico, I don't have the answer to that yet. I do know that the 14cc AP band isn't available in Mexico. I trying to get an answer to that question too. It seems that Allergan/Inameds marketing in the USA is seperate from the rest of the world. Why? I don't know answer to that either. I'm trying.

I know that in the area where I live, AGB surgeons use only the biggest band, Why? My opinion is still that of it takes more fills to reach restriction. I've been to to many support group meeting listening to post-op patients asking why after 6 months of fills they still don't have restriction. I've read the same stories at other boards. Why?

I can say that I'm really glad that 'Smiley' and her friend are really lucky to have a great surgeon and that they want their patients to succeed and this surgeon has a great post-op aftercare/fill program that takes care of their patients. I just wish that all clinics/surgeons would do the same. I know of a couple surgeons in the Chicago area that really go above and beyond to help their patients achieve success. In fact I go to one of them for my fills if I can't make it to the OCC. My local AGB clinics/surgeons won't even look at Mexican banded patient. Sorry, maybe I'm a little biased and POed about my local doctors and it showed through some of my posts. I'll try not to do that again.

I'm still trying to get some statistics about fills, like how many the first year, men versus women, etc.

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I'm still trying to get some statistics about fills, like how many the first year, men versus women, etc.

DON'T FORGET THIS ALSO

CAN YOU PLEASE EXPLAIN HOW COME SO MANY HAVE TO GET UNFILLS WHEN CLOSE TO GOAL WEIGHT OR ON MAINTENANCE? IT SEEMS IT'D BE JUST THE OPPOSITE WITH YOUR BODY GETTING SMALLER, LOSING FAT, AND YOU'D THINK YOU'D NEED A HEAVIER FILL TO TIGHTEN THINGS UP, BUT....

THANKS FOR DOING ALL THIS WORK AND STAYING ON TOP OF IT DOLITTLE :)

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I finally got to talk to a real person at Inamed/Allergan about lap bands. I learned a few things that I was misinformed about. The 14cc AP band isn't the only band used in the USA. The 4cc, 10cc and the 14cc AP bands are all available to surgeons in the USA. They told me that it's always up to your surgeon on which band is used. Weather he uses the 4cc, 10cc or the 14cc AP band is a judgement call by the surgeon. Also, I was told the larger AP band is rated at 14cc's, not the 15/17cc's I had been told before. I still have a couple more questions about fills that needed answered and I'm waiting to hear back from Inamed. As far as what bands are available in Mexico, I don't have the answer to that yet. I do know that the 14cc AP band isn't available in Mexico. I trying to get an answer to that question too. It seems that Allergan/Inameds marketing in the USA is seperate from the rest of the world. Why? I don't know answer to that either. I'm trying.

I know that in the area where I live, AGB surgeons use only the biggest band, Why? My opinion is still that of it takes more fills to reach restriction. I've been to to many support group meeting listening to post-op patients asking why after 6 months of fills they still don't have restriction. I've read the same stories at other boards. Why?

I can say that I'm really glad that 'Smiley' and her friend are really lucky to have a great surgeon and that they want their patients to succeed and this surgeon has a great post-op aftercare/fill program that takes care of their patients. I just wish that all clinics/surgeons would do the same. I know of a couple surgeons in the Chicago area that really go above and beyond to help their patients achieve success. In fact I go to one of them for my fills if I can't make it to the OCC. My local AGB clinics/surgeons won't even look at Mexican banded patient. Sorry, maybe I'm a little biased and POed about my local doctors and it showed through some of my posts. I'll try not to do that again.

I'm still trying to get some statistics about fills, like how many the first year, men versus women, etc.

Thank You!

As for this comment, "My local AGB clinics/surgeons won't even look at Mexican banded patient." I am thinking that part of it may have to do with malpractice insurance. Unfortunately medicine today is too often governed by lawsuits or the possiblity of.

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Thank You!

As for this comment, "My local AGB clinics/surgeons won't even look at Mexican banded patient." I am thinking that part of it may have to do with malpractice insurance. Unfortunately medicine today is too often governed by lawsuits or the possiblity of.

I still think it's an American doctor/surgeons attitude when it comes to patients that have had medical procedures done outside of this country. I know of patients that were banded in Mexico and recieve aftercare here in the USA. I have lists of American doctors that will do fills and aftercare all over the USA. You've seen posts here at the forum from those patients that recommend doctors in their area. But then you'll see posts from patients that are asking forum members if they know of any doctors for aftercare in specfic areas of the country. I don't know what the malpractice insurance rules are for American doctors, but its pretty sad that in the area I live in, they won't offer or give any aftercare to a patient that was banded outside of this country. I know of at least a dozen patients in my area that went to the OCC and got banded, we all have to travel either back to the OCC or to the Chicago area (180 mile drive one way) to get aftercare. Is malpractice insurance different from one town in my state from another town in that same state? I'm guessing that it's not.

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In my opinion it is the surgeons preference as to whether or not they will take on the patient. When I was doing my calling around the area to each bariatic program, I found this to be true.

The first apt I had with my new surgeon here, she reviewed my chart and took a picture of my band for my file. The picture was to show that at the time of my 1st fill my band was in place and A-OK. Which it was and I knew it would be. The surgeon I choose told me up front the cost, packages and all that jazz.

I love the program I am in here in Omaha. I would recommend them to anyone!

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