Thursday, October 28, 2010

The good, the bad, and the ugly

The Good
I'm alive, I didn't kill anyone today, and I got a .5cc fill.

The Bad
On previous visits I was wearing a simple cotton skirt and a simple cotton t-shirt and stepped on the scale barefoot.  On this visit I was wearing long pants, suede boots (as they were my heaviest - I maybe, sort of weighed them), a short sleeved thin sweater and a heavy (again with the weighing) cardigan.  When I got there, I sort of put my big key ring in one of my pockets and my iphone in the other.  And then there were the sunglasses hanging off my sweater and the glasses I decided to wear (I usually only wear them when reading or in front of a spreadsheet at work).  Oh and there was the water I'd drunk so far that day and man oh man did I have to pee.

This morning at home I weighed 13.8lbs less than I weighed the last time I saw him.  This afternoon at the office I weighed 6lbs less than the last time.  I swear to God I was shocked that there was nearly an 8lb differential - but also secretly pleased as that put me at less than a lb per week in the 7 weeks since I'd been there.

The Ugly
So I'm in there with him and I'm telling him how I'm doing great on this restrictive diet I'm on, and how I'm following all his rules (I am a serious rule follower after all) but that I think I need a fill as I can definitely eat more than 1 cup of food, though I'm being really good about not doing that and I'm getting hungry in about 2 hours, maybe a little less after I eat.

Me:  For instance, I had 4oz of chicken salad just under 2 hours ago and my stomach just started growling.
Him:  Now, now now, a growling stomach is not a sign of hunger.  That's just air passing through your stomach.
Me: raised eyebrows (I can't do just one - which really annoys me) - uh.. it's not?  Cuz the rest of the world sort of thinks it is.
Him:  It can occasionally be that, but just stomach rumbling isn't a sign of hunger.
Me: Well of course not, but I can tell the difference in my own body.
Him: I'm not so sure you can. (well excuse the fuck out of me you pompous ass)
Me:  okay - I had 4oz of chicken salad just under 2 hours ago and I am feeling all the signs I attribute to hunger.

I believe he rolled his eyes at that point.

Him: let me show you the latest research (he leaves and comes back handing me a pamphlet from Realize with a section circled)  Read this.

"Research has shown that a more conservative
approach to adjustments in the first year
results in better long-term weight loss."

It has 2 sample patients with a month by month time line under both of them and on the conservative side the guy had 4cc in his 1st month and then an additional 1.75cc in month 4.

Me:  Okay, so the conservative patient had in month one what I have now.
Him: No, (shaking his head in a patronizing way as he takes it from me to show me how wrong I am).  You see..  Oh... wait.. um... (emphatically) Well he didn't get his first fill until 4 months and this is your 3rd fill.  All I'm saying is to go slow.

I manfully refrained from flipping him off at that point.

He continued on to tell me (I seriously pulled out a notebook and took notes) "The band is not designed to reduce hunger.  Its only purpose is to keep you from eating fast, not chewing your food well, and reducing your portion size."

I told him that I was only addressing the literature that I got from him.  The red, yellow, green thing.  That the yellow sign suggests you need a fill if you are getting hungry between meals or if you can eat more than a cup of food and well, since both of those things are true for me, I'm following what he's told me in the past and telling him what's going on with me.

I told him that while I'm not medical professional I have been doing a certain amount of research trying to more fully understand what I'm working with and it's a pretty consistent theme that having the band filled to some point which differs from person to person absolutely helps makes you feel satisfied longer after eating and how I was just trying to reconcile how all of the other information I'm getting from a variety of sources differs from what he says as I've chosen him to be my doctor.

I went on to tell him about the article that Fluffy directed me to on her blog called It's not about Restriction by Dr. Terry Simpson and how its main premise is "the purpose of the band is not restriction; the purpose of the band is to lose weight by suppressing the appetite"

His reaction; "That's complete baloney".  I did go on to explain that the article was designed to point out that those people with bands who are looking for restriction to mean that they are so tight it's hard to eat are missing the point - that they should be looking for it to help them stay satisfied longer. - That appeased him a little and while he wouldn't agree the band was designed in part to suppress appetite he did acknowledge that in some people there might be some help with that, but that in general appetite suppression is an entirely separate issue from the Band.

He suggested putting me on Fentermine. (I'm sure I'm spelling that incorrectly) if I'm truly getting hungry after 2 hours.  This is my lap band surgeon - suggesting to put me on drugs instead of giving me a fill to see if that works.  This is the 2nd visit in a row he's suggested putting me on drugs to deal with the fact that I get hungry within 2 hours of eating 4oz of chicken salad. 
I truly think he believes fat people are dumb.  I've had this impression to one degree or another since the first information session I went to and ultimately this is the problem.  I worked hard the whole time I was there to give off the impression that I was, in fact, dumb and needed his expert guidance to help poor pitiful little me and I think that's the only reason he gave me a fill.

While he was putting it in (that sound dirty which is gross given who I'm talking about) he said - see, you have to look at this, which I've got to say is kind of hard to see over my boobs, but I look and he's showing me how after he pushes in most of the cc he was planning on putting in and then lets go of the plunger thingy it slowly starts to push back out.  See!  Do you see that?  
Me: Uh, yeah.  
Him: Well that means your band is really tight, I'm only going to put in 1/2 cc.
Me: Okay.

Once it was in and I was up off the table (uh... dirty again) I said - so if being hungry after only a couple of hours is not a sign I need a fill, and being able to eat more than a cup of food isn't a sign - what is a sign?  

Him: If you are not losing weight. 

Me - I totally need to find a different practice.


Angela said...

This is just my opinion....but you TOTALLY need to find a new doctor. You deserve to have a doctor's office that acts as a partner in this whole process. I am sorry that he is making this so difficult for you.

Bonnie said...

What a tool!

Kristen said...

omg I can't imagine having to beg for a fill like you did, that is insane! Do yourself a favor and find a new practice ASAP! Sory you have to go through all of this.

Justawallflower said...

I agree, he is a complete tool, and obviously is not in the right profession! I hope you find someone that is more respectful!

Sandy Lee said...

I love how you played dumb. Can't believe we have to jump through hoops. My clinic just told me to let them know if 1 cup of food kept me for 4 hours without being hungry. I asked for a fill because I wasn't losing weight. Can I have your doc and you can have mine?

I sure hope this fill works for you (I only get 0.1cc fills and have only had 2 (and two unfills). Strange how some need lots and others need more.

I kept envisioning you standing on the scales with those padded body suits just to keep you weight up. Maybe you should look for a new doc. He doesn't seem to get the band. Just likes the shitload of money he makes doing surgery.

Maybe you should have asked him if he actually put a band in you :-)

Tina said...

OMFG--I am a researcher, know how to read statistics and data and have even read some of the research he spouted to you. in my very scientific opinion..your surgeon is a tool :)

He is spouting stuff without listening to you and that has all the signs of poor doctor all over it. During my last fill for example the nurse had to keep pressure on the needle plunger in order to keep the saline in because the pressure kept pushing it back out. With every fill the plunger has pushed back out a bit because a band is a hydrolic system with internal saline and air pressures. Sure there is some impact from band tightness but a little push back is NORMAL.

The band does curb your hunger absolutely it does. I have loosened up and am re-experiencing that hunger again. The literature on the band suggests that the band works in three areas--slowing you down, restricting the amount of food you can eat and..stimulating your vegas nerve so that you do not feel so much hunger while dieting.

RUN LIKE HELL and find a new doctor. This guy is the stupid one.

Sam said...

I have to agree, you need to find a new doctor to handle your fills.

Camille said...

You need a new surgeon. Find another bariatric surgeon in your area and explain the situation. The lap band is FDA approved as an appetite suppressant. I can't believe he wanted to prescribe dangerous pills instead of using the tool that he placed in you. Jackhole.

Jen said...

This made me SO angry. You *MUST* start looking for a new doc. ASAP.


Man. I'm so annoyed right now.

Hugs :)

Amanda said...

What a tool. Seriously. I agree with the others find a new doctor and soon. One that will listen to you. I am sure there are plenty of poeople who have taken that drug before but that is personally another reason I opted for the band...I do not want to take a possibly dangerous drug for a short time. I want to have this work for long term. Grrr. Tool

The Babbling Bandit said...

OMG! I can't believe your band surgeon suggested drugs instead of a fill. That is outrageous! I'm shocked and appalled that a registered doctor could be so ignorant about the medical tool he suppose to be helping his patients with. What about the patients he has that aren't as articulate as you? The ones that are hungry and need a fill but take the meds instead? It stinks of negligence to me.

As everyone else above said - time to find a new doc!


PS I love your writing style. I felt I was right there in the room with you!