Today is our 21th Wedding Anniversary.  I think we are going to see the movie Puss N Boots and then, I dunno.  Not much money to spend but that's ok.  I hope your day goes well.

Hi all,

It's going to be a cool wet day today.  Yesterday I got a massage and went to the mall.  It was good to get out.  Today is a couple of errands and that's it.  Since the weather is so nasty, I hopefully will hit the books.  Is that thunder?? Hmmmm, maybe just a noisy truck.  Have a great day all!!

The last part of your post made me smile. Thanks for the reminder of something to really be thankful for this year on Halloween.

Hi all,

Good news.  I got an extension on my course to April of 2012!  I am so glad. Now I have plenty of time to get things done. Today is paying more bills.  Color my hair.  Maybe a massage but may reschedule that.  My poor hubby messed up his back again.  So he is struggling with that.  Well, that's about it for me.

Duke has a robust program which is an American Society of Metabolic and Bariatric Surgery (ASMBS) designated Center of Excellence (COE). This designation is bestowed upon practices and surgeons that meet or exceed rigorously defined guidelines.

The ASMBS Center of Excellence criteria include the following:

• Hospitals must perform at least 125 bariatric surgeries per year. Surgicenters must perform at least 100 bariatric surgeries per year.
• Bariatric surgeons at these Centers of Excellence must have performed at least 125 bariatric surgeries during their career and must continue to perform 50 surgeries per year.
• Centers of Excellence must be staffed by a multidisciplinary bariatric team including surgeons, nurses and other consultants.
• All centers must pass a rigorous onsite inspection.
• All centers must report their long-term outcomes to the Bariatric Outcomes Longitudinal Database (BOLD). The information gathered in this database is used to analyze the safety and benefits of bariatric surgery.
• All centers must be re-evaluated with an onsite inspection every three years.

This is important because it means that you are engaging a program that is experienced and is providing you with well rounded resources to help give you the best chance for success. Duke has two programs. One in Durham and the other in Raleigh.  Duke Durham - I had my surgery in Durham. At that time, it was the only site that Duke had. It is the larger program. I really like and respect the medical team. I felt and still feel absolutely safe having my medical care through them and felt safe recommending my husband have his through them as well. I had my surgery over 4 years ago, so some things and personnel have changed, some are the same. We had some issues with the administrative, front office. We were able to manage the issues by working hard to maintain a dialogue with them and keep detailed records of who we spoke with, what the conversation was about, as well as asking about what to expect in terms of time lines, what happens next, etc... We both had Hillary Blackwell as the RNP that worked with us. She is absolutely phenomenal! She listens and takes time to answer questions. I couldn't ask for more. My surgeon was Dr. Eric DeMaria. He is no longer with the program. My husband's surgeon was Dr. Dana Portenier and we both really like him. He is approachable and knowledgeable; he is very good about talking with you to address any concerns and answer questions. I have not worked with any of the other surgeons at the Duke Durham facility. I like both of the psychologists with the program and feel confident that they are there to ensure that we had the tools necessary to maximize the opportunity from a psychological perspective. The registered dietitian that we worked with pre and post op is no longer with the program and I don't really know the RD's that work with the Durham program anymore. I attended all of the follow-up sessions that were prescribed, finding some more helpful than others. I also attended most of the support group meetings for the first 18 months or so. Each month has a different topic of discussion and with most of their support groups, following the topic of discussion, there would be a 10 to 15 minute open discussion/peer to peer meet and greet. After the first year, I realized that if it was October the topic was X, November the topic was Y, and so on... I was actually seeing the same slides and hearing the same information. Most of the information was geared to the preop patient or patients that were new postop. I didn't feel that I was getting much information that related to maintenance, so I didn't go as often. (Disclaimer... I also host my own peer to peer support groups, so when I wasn't getting new information, I didn't continue going.) Duke Raleigh - Duke opened a bariatric facility in Raleigh which happens to also be very close to my home. I decided to go to their support group meeting. I really like the format of their support group meeting, but also really like their overall program. It seems more intimate and patient centric. Their Bariatric Coordinator is FABULOUS and really provides one on one support to the patients. I have met and really like Dr. Jin Yoo, as well as Erica, the RNP that works with the program. Again, warm, caring, takes time to answer questions, I have really felt heard by Erica. I have met both of the RDs that work with the patients at Duke Raleigh, as well as the psychologist. While I have not 'worked' with them, I have met them at several of the support group meetings. They are warm, open, answer questions and seem good a problem solving. The support group meetings at the Duke Raleigh facility are run differently. They start with a topic/discussion which varies from one month to another that lasts about 30 minutes, then they welcome Q&A as well as peer to peer discussion. Often, many of the topics that they have had seem to have relevance across patient populations... i.e., it doesn't matter as much whether you are preop, losing weight or in maintenance. While I have not personally gone through the preop workup with this program, I have a large support group that has patients from programs all over the triangle and beyond. I tend to get feedback about many of the programs. I am not aware of the same kind of front office issues with this program, but it is a much smaller program.

I guess, the long and the short of my perspective, is that Duke has a strong, robust program. You can get 'lost in the crowd'... especially with the Durham program which is much bigger, but if you advocate for yourself as you go through the preop process, finding out what the process is, timelines, what to expect, who the point of contact is, etc... I think that can minimize or make manageable the administrative issues. Regarding the care you get, I believe it is very good. While you may 'like' the personality of one Dr over another, or prefer a particular Dr because they perform a particular surgery you want to have done, I absolutely believe that all of the members of the Duke Bariatric programs in Durham and Raleigh are top notch.

I hope I helped... if you have more questions, please let me know.

Regards,