August 26: First Consult with Dr B

Oct 13, 2006

It was a long day yesterday - my appointment was supposed to be at 2:30 but he was "running late". It was 4:30 by the time I got in to see him. However, when I did get in, he took his time and answered all my questions. I was with him for about 45 minutes. At one point, I asked him if he felt like it was an interview -- he smiled and said "Kind of"

Here's some of the answers to my questions:

1) how long after you see Dr B can you expect to have your surgery?

After this initial meeting, there is a group session (4-5 others who will be getting the surgery) that you attend where this is a dietician, his nurse and someone who has gone through the surgery. It's an information type session and you do a test at the end to ensure you understand what this is all about and it's repercussions. After that, it would be about 3 months for the lap band or 6 months for the gastric bypass. It's a longer wait for the bypass as he only does 1 surgery / week and has to wait for intensive care time as you are there after surgery. So, if I got in this fall for an information session (he couldn't really say when it would be as he doesn't look after that part), it could be as soon as after Christmas. What a nice birthday present to myself eh?


2) what type of pre-counselling / information is given?

See above for that information session. I also have a pamphlet on the banding process and the nurses are available for email questions at any time.

3) do you have to attend support groups in advance? (I am hoping yes)

No, the support groups that his office runs are for post-operative patients (4 times / year).

4) where are the support groups and / or message boards for support after the surgery

He does not recommend any weight loss support boards and only his support group. This is because they want you to follow their program and not get swayed by others. There is another group in Fredericton as well that are his patients.

5) how long does the surgery take? how long are you in hospital? how long out of work?

For the surgery I am interested in, the lap band, the surgery is only 40 minutes long (average) and you go home the same day. Out of work for 2 weeks. The gastric bypass is longer (couple of hours) and you spend time in intensive care, then 3-5 days in hospital

6) what do you eat after surgery - in the weeks following and guidelines for after

Almost entirely liquids / purees for the first 5-6 weeks. Then they have a diet outlined in their booklet which is approx 900-1100 calories/ day I believe. You can't drink while you are eating with the one I want. The premise is that if you drink, it will wash the food through the opening to the stomach and you will continue to be able to eat. This way, you eat the food and it "piles up" around the band and takes longer to digest.

7) do you get full fast and that's how it works?

Basically, yes.

8) can you still eat "junk" or will you be physically ill?

Yes you can eat junk and with this surgery, no you would not necessarily get physically ill. If you eat junk (high calories), you're not going to lose the weight or lose as quickly.

9) are there negative things to know ahead of time? how many people in NB have died? how many have had the surgery?

The negative stuff is outlined in his booklet but the lap band is 20 times safer. The negative things he talked about were that the band could slip, which may involve a resurgery or there could be a problem with the band. 3/60 patients that he has done this way have had to have it removed. No one has died from the lapband - 2 have died from the gastric bypass (out of 150+) but he felt that they would have died within a few years anyway. They were both over 55 years of age so he no longer does this surgery for people over 55. He's done 60 lap bands and over 150 gastric bypass.

10) what are some of the reasons why people gain back the weight?

Not following the program, not exercising, not doing their follow-up appointments, making high calorie choices like milkshakes and gatorade.

11) what is the benefit of the lap band vs roux-en-y?

Less invasive, 20 times safer, done larascopically, no cutting, quicker recovery time. Slower weight loss but in 5 years, the same net effect.

12) $4500 for the lap band right? do fills cost as well? how often? does he do both? have people had success with both?

Yes $4500 and they take credit cards. Fills do not cost - usually need 3-4 fills in a lifetime. First fill is 6-8 weeks after surgery once the swelling has gone down. One patient has had 15 fills but she comes to him to loosen when she wants to go on vacation and "have fun" and tighten again when she gets back. Man oh man! That's ballsy eh?

Yes he does both surgeries and yes people have an 85% success rate with both. Most people are at goal within 1 year but they define success as being at goal within 5 years and keeping the weight off.

13) how many surgeries does he do a week?

1 bypass and as many lap bands as he can fit in.

14) of the 2 surgeries, which would he recommend?

Definitely the lap band, although he knows the price is restrictive. Unfortunately, Blue Cross and Medicare don't cover it. They don't cover any type of "prosthesis" (sp) like glass eyes or breast implants for example and that falls into this category. He hopes this will change when they realize the benefit to a person's health.

15) how often are fills done? do you have to make appts far in advance?

3-4 times in a lifetime usually and yes you do have to make appt in advance.

He was trained at McGill University in Quebec and for the lap band by a Mexican doctor (best in the world he says) who has done over 3000 lap band surgeries.

He said that yes, any of us can lose the weight but when we stop the "dieting" it will all come back. Morbid obesity is a disease - this is not our "fault". I felt much better after talking to him.

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