Yesterday was my second follow-up visit. I was embarrassed when the nurse weighed me, and I saw that I had gained a pound. (I had anticipated there would be no change.)

As soon as she left the room, I was overcome with emotion because I felt like such a failure and tears welled up in my eyes. I had the first appointment of the day and was early, so I fully expected to have time to regain my composure before my surgeon arrived. However, he arrived early and walked in during my emotional moment. I am normally do not display my emotions, so I was even more embarrassed that I did not have it together when he and his understudy (I referred to him as this because I don't know his title...he is already a doctor and is learning from my surgeon) walked in.

Though he is a man of few words, he was very understanding (but not comfortable) as I explained through my tears that I was frustrated with myself because I was working so hard (walking 10 miles daily and following my "rules") yet I knew I was eating way too much. I told him the only reason I hadn't taken my diet pills was because I knew he would not be pleased. He said "diet pills are an ineffective treatment for obesity over the long-term, and research has shown the band is an effective treatment." He then asked me several questions and said I needed a fill.

I got 1 1/2 cc's. I felt the prick of the needle but nothing else.

I asked if I had perhaps stretched my pouch because I was eating too much. He said it was "very unlikely."

I also asked again about how many fills he thought I would need, and this time, he said 6-8 over the two year period. I didn't ask why the number had increased to possibly 8.

I asked why I had become full at the beginning of the 4th week when I first ate regular food, yet I hadn't experienced that since. He said the swelling tightened my band.

I then asked what happens if he puts in the maximum amount of fill over the next two years, and I'm still physically hungry. He said that will not happen. He said if he puts in the maiximum amount I wouldn't even be able to physically drink liquids. He said he doesn't want to make patients too tight because if they are, they won't be able to eat the type of foods he wants them to because they will be physically unable to. He said then if they don't tell him them are having difficulty, they end up eating the wrong kinds of food, which compromises their weight loss.

He said my port is easy to locate so the next time he would have me see his nurse practitioner (NP). Does anyone else see an NP for their fills?

I am quite nervous about seeing the NP. Although she is very confident, she gave me incorrect information three times in the past when I asked simple procedural questions before my surgery. (Maybe she is new, but in my profession, if I don't know the answer to a question, I state that and say I will seek an answer then report back; I expect the same from other professionals.)

Then also, on the day of my surgery, I was experiencing severe nausea in the parking lot after I left the hospital. (I had planned to stay overnight but there was a mix-up in Recovery and I was dismissed) Questions were to be directed to her, so I called her and left a detailed message, explaining the situation and asking for anti-nausea medicine for the drive home.

By the time she called back, we had started home and my nausea had worsened. I explained how sick I was, and she asked me if I had "insisted" on going home; I told her no and explained they had said in Recovery that I was doing well and that the surgeon had said there was no need for me to stay. She told me I would have to "tough it out" then. I told her I had a long drive home, thinking she might have forgotten this, and asked again if there was any way I could get some medicine, explaining I was afraid I would throw up and cause my band to slip; she said no.

On the drive home, I had become even more nauseated. We stopped at a pharmacy to get my pain pill prescription filled, thinking that might help me sleep and hoping the anit-nausea medicine could be called in to that destination. I hadn't yet received a call back from the NP at this time, so my husband called the hospital. He ended up talking with the doctor who had assisted my surgeon. He was the doctor who was training at the time with my surgeon and he had written the pain pill prescription. After my husband explained the situation, the doctor called in the medicine I needed.

I know all of that doesn't mean she can't do a fill properly, but for these reasons, I am concerned. (She was also not nice to two of the women in my small group pre-surgery session.) I am thinking about calling the surgeon's office Monday and tell them that I am more comfortable seeing him again. However, if I do, I may be told I have to see her (I understand my surgeon wants to save his time for the more difficult fills), and what if she learns from the office staff that I called asking to change my appointment with her? (She sees patients on the same day that my surgeon does, so changing the day wouldn't help.) I know I should be open-minded and give her a chance, but it's hard for me to be comfortable with the thought of seeing her, based on my past experiences. Any ideas?

testing before I post because previous ones did not work

Cool, my posts seem to be working now.

I'm sorry to hear about the problems you have had with the NP. I think it is important for the surgeon and staff to know how you have been treated. You are the patient, which makes you a consumer of their "product". It is important for us to be comfortable with those providing our medical care. There are some instances where we don't have much of a say in our providers such as emergency procedures but in our case as bandsters we should "help" our surgeons learn to provide better "service" to their patients.

I see a PA instead of the surgeon. The PA was there when I had surgery although I was already out by the time he arrived in the OR so I didn't meet him until a few weeks ago. My first post op appointment was with the surgeon. Although I like my surgeon, his PA seems more comfortable working with patients in an office setting. I would think that surgeons who have PA's or NP's on staff have them to help provide a more personal touch than the surgeon may be able to provide. (My sister is a PA in an emergency department so maybe my view is a little different from others on this.)

Cool, my posts seem to be working now.

 

I had a problem earlier as well.

 

I'm sorry to hear about the problems you have had with the NP. I think it is important for the surgeon and staff to know how you have been treated.

 

I looked at my appointment card today and noticed the NP's name on the card was not the same as the one I had seen before. I went to the bariatric surgery website, and the NP that I was uncomfortable with is no longer listed as a staff member. I know no other details, but I am very relieved.

 

I see a PA instead of the surgeon. The PA was there when I had surgery although I was already out by the time he arrived in the OR so I didn't meet him until a few weeks ago. My first post op appointment was with the surgeon. Although I like my surgeon, his PA seems more comfortable working with patients in an office setting. I would think that surgeons who have PA's or NP's on staff have them to help provide a more personal touch than the surgeon may be able to provide. (My sister is a PA in an emergency department so maybe my view is a little different from others on this.)

 

I see a PA for my general medical needs. She is absolutely awesome! Hopefully, I will feel the same way about my surgeon's NP.

 

Thanks for sharing!

I'm glad to hear that the "mean" NP is no longer there!

Usually, seeing a NP allows for more time to have questions answered, and have less of a rushed type of appointment. If you don't want to see a NP, you can insist on seeing the MD when making the appointment. It may mean that you might not get the day or time of appointment you want, but usually, fills don't make the MD's much money, so they keep their appointment slots open for patients and appointments that will bring them higher revenue to their practice. Most NP's are paid a salary, and don't have to worry about how many patients they see or how complex the patient is in order to make money, the MD's, most of them, do. But it is your right and if your MD's office is part of a larger health care group, there should be a patients rights poster or pamphlet which explains your rights as a patient. Don't be afraid to complain, but don't be mean either, just state your case to the office manager, director, or administrator. That way they will know what is going on in their practice and can do something about it. Bottom line, if you don't want to see a NP, you shouldn't have to, but it can be a good experience.