Duke Medical WLS Center in Durham, NC

[JudyBellyBand]

I have prayed about this for a long time and talked with other lap-band patients who had their procedure also at Duke. But I need to post for YOUR INFORMED CONSIDERATION that I would not recommend using Duke for Lap-band WLS. They are world class doctors and medical professionals. They absolutely are. The issue lies in their lack of an effective lap-band management, quality approach.

I realized going into their program that the medical staff, "eating disorder psychologist", and nutritionist were focused on their (99%) traditional one-year RNY patients and their needs. But what I did not know was just how critical the post-surgery lap-band program is. So what are they missing? It is a commitment and obligation to focus on post-op lap-band management process as a timely, pro-active program that is attentive and supportive to the patient …for now on.

Points to consider … (ten point scale with 10 being high)
My assessment & why: 18 out of 40 points
n Appointments (0 point) –
o It always takes 4 weeks to get either an in-office OR radiology based fill appointment.
o Waiting in the medical-room is typically 30 - 45 minutes
n Medical (5 points) - Medical staff attentive but reactive.
o It is typical you have to call them back after you “see how you are doing” and then get an appointment (see above). Even my dentist and veterinarian will calls after a simple visit and if there is a concern, they get you back in quickly not days and WEEKS later.
o I have had on-going issues with getting to an adequacy and sustaining “Inamed defined green zone” fill level. This plus the long wait for a follow-up appoint are a significant dissatisfying concern.
o Now that my band has leaked, I’m told because I am 30 months from surgery and still 30lbs from a normal BMI, that the band has done all it’s going to do and that I should consider leaving the non-functioning system in place and do the rest on my own. Does this sound like they understand the WLS patient who has a documented life-time of yoyo weight history and family history of multiple co-mortalities? I think not.
n Life-style Support (3 points) - At one point it looked like they were going to have a psychologist-lead support group, but it only lasted one meeting and that was about 18 months ago. . . every 6 month or a year would be nice.
n Nutritionist (10 points) - An outstanding nutritionist who has a process he consistently uses, it also very effective in giving you information tailored to what you’re missing. Offers his available by email, phone or schedule.

[Kathy]

This is an excellent thread, Judy. Good for you for posting a very fact-filled personal experience for those searching for a great Center for Banding. I can see why you are less than pleased. Thanks for this resource.

So, what will you do now?

[JudyBellyBand]

Kathy . . Thank-you so-o-o much for your thoughtful feedback. So, what will I do now? I am asking Duke to replace the band and get UHC's approval. Based on a call by the PA, it is my understanding that Duke WLS is getting approval for surgery.[1/31/07 NOTE: Even though they said they were, they we NOT as they were to busy until after the end of year. So it was fine for me to hang-out till it was conventant for them. I did get a call later saying that they might could do it in two weeks on Dec. 23rd ....but really] I do not yet know if Dr. DeMaria agrees to replace it or just remove it. If he agrees to replace my band, I will be fine. Then I will go ahead to have replacement surgery I hope the first of in January. However, if in our meeting (pending a scheduled date sometime now in December after the insurance approves the surgery), he does not agree to replace it, I will leave and go somewhere else. So really I am waiting to hear from Duke and to confirm the submission of approval for the "replacement". I just hope that they understand it’s not just to remove the failed band... But I will see when I meet with the doctor. This is my prayerful hearts desire and my anticipation for UHC to approve it.

In the short-term... I am talking with the Lord by praying a lot, dieting, and using a software tool (Diet & Exercise Assistant) that I found that tracks all ;o) the food I eat and the exercise (BTU burned) to tell me daily what I am doing to myself. It’s software that works on my desktop as well as my PDA. I’m also taking this OTC drug call ‘Venom’ that has a lot of caffeine and it’s helping… I think. I’m using them to give me CONTROL. Also, on Sunday I got a cold (stress related I feel) but the tools and getting sick means that I have loss 4 of the 10 lbs I gain last month. So I am feeling a little better about approaching Thanksgiving and Christmas by not gaining over my baseline that I was.

Thanks again for asking.

[Kanda]

I was/am also a Duke Medical WLS Center patient. I almost 100% agree with Judy's non-recommendation. Let me give detail my experience. I had my surgery in 2004. Before my first fill, my port flipped. 2nd surgery in February 05, and before my first fill, my port flipped again. 3rd surgery in May 05 and finally that port is properly attached. I received too many fills to mention, each in small 1 cc increments, with no restriction. Each time, I would have to go to Duke to meet with the PA to say "I can eat anything", she would then "approve" me for a fill, which required another trip to Durham for the fill. So every fill would require two 2-hour trips to Durham, which caused me to miss half a day of work each time. I asked everyone there if they would please allow the fill to be done on the same day as the PA appointment, but that was too much to ask. I also agree with Judy about the length of time it takes to get an appointment. I called on November 8 to schedule an appointment, and was given the first available appointment on January 3rd.

One thing I will say is that the new director of the program Dr. Demaria seems to have a better understanding of band management that his predecessor. On my first appointment with him, he put in 8cc and I have lost 40 pounds. Now, considering I've had the band for over 2 years, I realize that is not much, but at least I've seen some benefit from the 3 surgeries I have endured.

Would I recommend Duke? No. I would recommend lap-band surgery, even though it has not been ideal for me, I still feel it can be an effective weight loss tool, I just feel that Duke does not have the same "care" for their lap band patients, their focus is much more on the RNY crowd.

Thanks Judy for your detailed review. It was good to hear from you again. Hope they get you back on track.

[starfish31160]

hey Judy and all my bandster friends. I think a lot about you guys and have wondered how everyone's doing. Judy, with your permission, I would like to call you and talk with you in length about what you have been going through. Oh my gosh, you have had trouble almost from day one. I have not had a fill since February and I'm like Kanda, Dr. DeMaria filled me with more than I have ever had. It made me really nervous if you remember the last time I wrote to you guys but it worked very well for a short while. I lost 10 lbs. and was ready to go gangbusters before summer and then, POOF, it seems like it was gone. And than I gained the 10 I had lost and 3 more. I have now on my own lost 8 of those extra pounds and was thinking that after the holidays, I would schedule another appointment but from looking at the posts here, I may need to call now. It has crossed my mind that I may have a leak because the first month or so after a fill are really good and then it's gone. How did they determine that you had a leak?
I will agree that Dr. DeMaria seems to have a better understanding of band life than the previous director but the previous director was always a PRO-RNY doctor - "It IS the gold standard of bariatric surgery." I'm sure you all heard him say that in the introductory meeting. I have lost 75 lbs which makes me the average bandster (losing 50% of myextra weight) but need to lose 75 more and have been discouraged by DWLC lack of post-surgery support.
I agree with Kanda wholeheartedly - I will always support the Lap band as a viable weight-loss tool but wish that more doctors would become band friendly so we can have more choices in choosing a care facility.

[JudyBellyBand]

WOW, oh Duke Friends . . . your stories here are so, so similar to mine. It's been too long since we all have talked. What a shame they just haven't seen the potential and opportunity in us lap-banders there cause it's a loss for us and them even though they don't seem to appreciate that fact. But maybe by posting our stories, we can make a difference to someone else in the future.

Kanda - I am so glad to hear from you. I have thought a lot about all you went through and it makes mine pale by comparison. Especially to have had so much happen to you in that critical 1st year. I also had a second surgery by Dr. M. My second one to fix the tubing sticking up more than .5 inch (do you remember how funny that looked ...and felt?) was at month 15 after the 1st. But your having loss 40lbs now IS wonderful and I am so glad you are staying on the down-ward track. I know you look wonderful and you are getting lots of exercise running now after the children. Thanks for filling us in here.

Starfish31160 - just thinking of you makes me smile. And my word, 75lbs gone forever is WONDERFUL. I am emailing you now with my phone number and can't wait to talk. It's been what 18-20 months since we all talked! I did see Glory on Friday and she looks as beautiful outside as she always has inside. She really came to my aid on Friday. I so appreciate that support. You should see that woman.

I really want to thank each of you for taking the time to post and sharing your experience. I hope we can do more of this here.

[Kathy]

Yay! Duke Bandsters coming together! :wave:

[starfish31160]

Hey, we haven't had any activity here since we all met on Nov. 14. Have you guys moved somewhere else? I hope everyone had a great T'giving. I have been in the bed with the flu since Wed. until today so I don't remember much about the past 3 days. Judy, I will get around to calling you, I promise. I really do want to talk to you. I have not forgotten. What about the Duke forum. I can't find it online anymore. Is it gone or have they just gone to a very obscure location. I want to know what happened to Dr. McM. And one more question. I see on some of the North Carolina posts that people are referring to going to LBT. What is LBT?
Somebody holler back . . .!

[Lovemylpband]

www.lapbandtalk.com it is a site that most of us new about befor this one.

[Lovemylpband]

I go to Dr Voellinger in Charlotte. I had to have my band replaced in February due to a leak they think was from an oops when the band was put in. They are not 100% sure that that is what happened but I did have a leak in the band and the port.
Dr V. wants personal contact with his band patients. He feels that the way for us to succed is with his help. I love the man and highly recommned him and if something happened to my band again he would still be my Dr.

I'm sorry that you Duke girls are having such a hard time! Talking about it will help and researching options for you will also help. I'm 99% sure that Dr.V will take on patients who have had US bands for aftercare. If you want his # PM me and I'll be more than happy to give it to you.

Judy-I hope your trip and Thanksgiving was wonderful. Hope to talk to you soon.

[starfish31160]

Hi everyone. We haven't had any activity here since we all said hello on November 14. Have you guys gone somewhere else? Hope you all had a great T'giving. I've been in the bed with the flu since Wed so I have not had a holiday but I'm still thankful - for my beautiful daughters, for my friends, for my job, and for the privilege of being in ministry for my Lord.

Judy, I will call you. I have not forgotten. I really do want to talk with you.
And what about the Duke forum? Does it still exist? I can't find it online. I was trying to find out what happened to Dr. McM.
And one more question. I've noticed that some of you talk about going to "LBT." What is LBT and where do you go to get to it?
Talk it up folks. Give a holler back . . .

[JudyBellyBand]

Starfish31160 - I had that flu and it was horrible for more than 8 days. It was the longest I ever had. In fact it kept me from traveling as I had planned over Thanksgiving. I am having a time with the hunger. I miss my band. While I was sick I lost 5lbs but in the past week, I have regained 4lbs. Oh, I know I have to do better and I will . . .it's just crazy to do this to myself. Looking forward to talking to you soon.
Always, Judy

[Lovemylpband]

Sorry to hear that you didn't get to go away Judy. Glad your feeling better.

[JudyBellyBand]

Dear Dianne,
I contacted Dr. V's office yesterday and I am hoping he will take me. But I have to request info from Duke WLS Center to be transfered and that isn't easy doing this and paying the $150 fee BEFORE knowing that he will take me on as his patient and do the replacement lap-band surgery. If I do so (which is the direction I want to go), I burn the only bridge to Duke's WLS group and plus time/more delay.

But I went to the Alamance WLS support group meeting last night to hear and hopefully get a balanced oppenion from others who mostly go to Duke. 90% have had RNY surgery done or pending at Duke. All but one poor soul who is to have her RNY next week also at Duke WLS, are VERY unhappy about the lack of time or contact with a Doctor in hospital or office, the office personal's "attitude", their lack of time-management during scheduled appointments, and lack of meaningful services by the two staff psychologists. It was horrible to hear their stories about how disrespectful Duke WLS ctr has been (it did not use to be this way); one after another after another. The worst was from a young lady (about 28) who in September this year had 3 surgeries within 3 days by the same doctor who would do mine and is the head guy there now. She had a Lap-RNY, leaked 3 times, a dead spline from it, and was in the hospital for over 3 weeks because they could not stop the multiple leaks after initial RNY surgery. She was the most vocal about my not going back to Duke. . .

S-o-o as I write this, I am thinking and know that I am going to PRAY HARD that Dr. Voellinger will take me. I am sending the money and the forms today. PLEASE, if you see him, tell him WE (me, my husband,and hopfully you) are praying that Dr. Voellinger can take me.

Love in Christ always,
Judy

[Kathy]

Whoa Judy. That's just amazing. A good program gone wrong. What happened?!!!!! It's a wonder, really, that prgrams like that are still "serving" patients, if you call it that. I'm so sorry! I'll be praying that Dr V. will take you on and help you. It will be worth the drive. :)

[JudyBellyBand]

Dear Friends,
I have sent a ton of information to Dr. Voellinger and I am praying that he will take over my care. Please know that I am thankful for all the support and encouragement. It's so great to look hopeful and like it's not over for my getting another lap-band. Always, Judy

[Davenport67]

I am so scared. I have my first clinic appointment already scheduled at Duke WLS. I HAVE been wavering back and forth between Bypass and the Band. I just feel I can't be out of work for a month right now. I know that is not much of a reason. I am going to a Lap band seminar tomorrow night, you guys have given me alot of questions to ask them!! I am so glad that some one pointed me toward this board. I was researching on the other forum. :eek:

[ginabobina]

come see us in the NC area - you will pick up things about local docs and programs and everyone is very helpful! hop on in!

[JudyBellyBand]

10/22/07 UPDATE: I finally have my NEW lap-band.

It's funny that I feel so-o-o like a newbie and excited about my 5 day old new Lap-band AP-s. This is even though I had been fairly successful as a bander before having loss 77lbs and getting to BMI of 27. However, as a food-aholic I regained 40lbs in the last 12 months. . . it was a tuff year. A very tuff year dealing with my lap-band lost and FIGHTing with my old WLS center to do anything before 1 Jan 07 (when my policy changed to no longer pay for WLS surgeries) and UHC to pay again for my continuity of care ... I lost the fight and am self-paided for my new band. Oh well, the Lord owns it all. AND with Dr. David Voellinger (Charlotte, NC), I absolutely HAVE the VERY BEST surgeon in the Southeast. I checked it out...believe me.

I have done considerable research on many lap-band sites and have never known anyone to have this type of leak. I am the only one with a pinhole defect within the intertube to occur with a steady state of 9.1cc and 30 months out. Allergen had also said no this is uniquic; my old band is being sent to them for their analysis of the defect and hopefully they will help me pay for my new lap-band. But let me also say, I went a year without a band not knowing exactly where the leak was. This was even though it was initially determined as a 100% leak within the intertube with contrast fluoroscopy by the head or radiology at Duke University Medical. But they could not agree (doctors and Allergen) until they do a complete physical exam. So we'll see what Allergern hopefully can do for me. I feel sure they will because I know they are a responciable medical supply company who has a great focus and concern for the lap-band patients in general. Also, after all my research and my own personal success with my first band, I felt good enough to take the risk for a 2nd one. I knew I was safe, a new one would again be adjustable and it was not causing ANY physical (BUT HUGE MENTAL) issues just sitting there. I had an endoscope exam after 5 months after the leak and it proved that there was NO erosion and no slippage. IT was just 100% failure and not functioning.

But today is only 5 days post-op. I have No bruising even after a 2.5 hour OR experience to remove the old 42 month old EMBEDDED Vanguard lap-band and replace is with a complete new AP-s system. So YES, I have the BEST surgeon who did a GREAT job. AMEN, AMEN!!! So today I have already lost 16.5 pounds starting with the 2-week pre-op diet. I feel wonderful with no meds. And it is a great new day with much to look forward too... I'm celebrating :) for sure but not with food... Thank-you JESUS.