Well,

I think our decision for the Lap Band procedure (self paying patients) as opposed to the Gastric Bypass procedure (OHIP covered) is now made.

We investigated both surgeries fully and without bias. We have friends who have used the Gastric Bypass and others who have done the Lap Band. Both have excellent stories of success over the long term and both have stories of difficulties.

Overall, the desire to have the cost-free version was strong but the 3-10 year wait list was wholly undesirable. In fact, I would say that if we were a full 100 pounds heavier than we are right now, my husband and I might have actually qualified for emergency surgery and a US destination hospital. Our co-morbidities are relatively non-existant so its off to the bank for us.

Anyway, Lap Band is the absolute winner now. Our Consultation is tonight and we expect that all will go swimmingly and our banding will take place in the next 30 days or so no matter where we choose to get the procedure done.

As for Canadians out there considering leaving home to get banded... I think you should re-consider whether you are self-pay or insured.

We did the math and here is how we saw things...

Cheapest is undoubtedly Tijuana, at least the procedure portion. Many of the clinics flooding the internet are from Tijuana, Mexico (usually just refer to themselves as a suburb of San Diego). You can really save thousands of dollars there if you are only considering the banding. Prices range from 5000 USD to 11000 USD and the market there is dominated by a handful of practitioners, some from the US and Canada. Problems we considered are as follows with absolutely no evidence, not even anecdotal, just our own 'WHAT IF' brainstorming.

- Hospitals and clinics have unknown standards

- Dr's claims to huge surgical numbers are unverifiable

- On returning home, complications may result in the removal of your expensive band by Canadian doctors using non-laproscopic methods.

- Free follow-ups require traveling to Mexico

- No liquid diets noted prior to surgery... does this not put the liver at risk?

- Unless you speak Spanish, are you sure you are safe?

The United States is the Most Available option for Canadians. There are many practioners all over the country and lots of financing companies willing to help you pay for the procedure. Consider the following...

- The US Dollar (at time of writing) is at a 20% premium to our Canadian Dollar which means that you will pay 20% more for everything from travel to lodgings for a few weeks in the host city to the procedure to medications purchased before returning home.

- The consultation we had in a good hospital in a good market gave us the cost of the procedure at 16000 USD but they did not provide any free follow-ups after the first year or fills ever. That means that should you decide to return for fills or adjustments you will again pay our in USD.

- Even if you decide to get it there and use the clinics up here to fill and follow-up... expect to keep paying and paying.

- Should you experience an emergency complication... you may again lose your band the hard way.

Finally, Canadian clinics... In our opinion are the Best Choice. For the following reasons and more...

- Your dollar is at par... hello!!! its our dollar and their dollar... doesn't change from day to day

- Since you will use a clinic close to you... the follow-ups and fills are probably free.

- Your band clinic will be contacted for emergency complications and I should hope that your banding doc would have something to say about the band's removal before it happens.

- If you have complications that only require a visit within 24-48 hours to your clinic... you can get there!

- Your costs outside of the procedure and some medications may only be a night in a local hotel once in a while depending on the distance you are from the clinic.

Well, I hope this information isn't too contradictory to anyone else's considerations. It is for these reasons and more that we will choose a clinic within a few hours drive from home in Ontario.

Any comments?????

Hi: Riding the fence here, I think this debate is a wonderful debate. Hopefully, people doing research will latch on and read all the opinions. Getting to all the pros and cons, this link has been one of the best and I hope others join in.

I personally am not engaging in any debate, although of course others are free to carry on if they feel it is useful.

I've already expressed my opinion about the original post, my reasons for my opinion, and provided some suggestions as to where to get information relevant to some of the things being said on this thread.

Access to health care is an important issue, and I would suggest checking out the ethical guidelines for the Canadian Medical Association and the College of Physicians and Surgeons in your province. These guidelines address the ethical obligation of a physician to treat a patient in life-threatening circumstances. I think it is a good idea to be informed of these, in any circumstance, banded or not.

Not to shy away from the discussion, but my purpose in responding to this thread was to express my honest feelings about the original post, which I felt needed to be heard, as well as my reasons for those feelings. It is pointless to drag on a debate, since it would just be a repetition of the same, and there are still going to be differences of opinion anyway.

I agree it is a good idea to be informed... and when I had my post plastic surgery issue and I talked to my PS about the treatment and the base statements that were made to me about going home and getting care from the surgeon who did the work. And it was along the lines of if they had seen me and taken care of the post surgical issues they then become medically responsible for seeing me on an ongoing basis and if the complications escalated they would be responsible for repairing those complication and it was something they had no desire to get involved with. So they treated the symptom and got me out of there. Fortunately my complication was an abscess that burst and then healed on its own but I got the idea they wouldn't touch me unless it was life or death and even then it would be a debate could I get to my surgeon.

Since I went to the emerg I had no inclincation of seeing a PS I knew I would see a general emerg doc. That emerg doc sent me to the infectious diseases unit who in turn talked to a PS who was described what had happened to me but who I never saw and who never personal evaluated my issue. And if I ended up in emerg during my extensive travels (I am on the road 300 days a year) I would never expect to see a band surgeon to help me and to that end I am prepared with a CD and a thorough understanding of my band and how it works and where my port etc are.

Heather