Surgical center vs. traditional hospital

Just wondering how many people have utilized a surgical center vs. a traditional hospital. The vast difference is that most surgical centers will place the band without a psychological evaluation and meetings with nutritionists and so forth. Before I was actually banded I went to multiple seminars and meetings with different doctors. I'm just curious ithat if the people that were "just banded" feel they are receiving the tools that they need to succeed.And, if the people that went to the hospitals feel that everything they are/went through is worth it. It seems that it was the generalization at the seminars that without the team of doctors either a person would fail or at the least have difficulties.

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Banded 31 Mar 08
267 highest
249 current
165 goal (I think, I just want to be a size 12 again!)

I researched the band for a year or so.

My insurance didn't require psych eval. I understood how the band worked and am doing just fine.

The doc put in 3 cc in a ten cc band at the time of surgery and I have restriction and am losing weight just fine.

I'm often surprised at the people asking the same questions over and over and wonder how much they researched since they obviously have internet access.

Also, I've dealt most of my life with my difficulties with food. Alarmingly it seems some folks aren't prepared for the emotional struggle. (i.e. people actually crying cause they can't eat solid food)

I didn't require that psychological support, but I'm thinking that some might have an easier trip if they did have.

Obesity is a very complex issue and some are just not properly prepared, imo.

Having said all that, I think that many do seem to find their way.

Peace.

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Every little step takes me farther. Every small right decision takes me down the road I want to be on. And if there are small detours on my way, those same small steps will take me thru them.

I'm not banded yet and I will be self-pay. If I have my surgery at the hospital it is 17,500 and if I have it at the surgery center it is 14,000. My surgeon still requires a psych eval, a nutrition/exercise class, an addiction class, a body image class and then a pre-op surgery nutrition class. I think it's really great that he requires this and I understand why he requires it. But I've been dealing with my eating issues most of my life too, with therapy, support groups, programs, retreats, self-help books, books about nutrtion and addiction, diets, etc. My therapist could probably fill out the MPPI test for me. Because of my years dealing with my eating issues, I don't expect to learn much from all of these classes or the psych eval. I've already been to the nutrition/exercise class and I didn't learn anything I didn't already know. But like I said, I think it's a really good idea that my surgeon requires this, because there are alot of people who don't know this stuff.

Even though I know all of this stuff and that the changes I'm going to have to make after being banded are going to be hard, I will probably still cry sometimes when I can't eat like I want to. Just because I understand something intellectually, doesn't mean that dealing with the emotional side of it is easy. When something happens that upsets me, I turn to food and stuff all of my feelings down and numb myself. When I can't do that any more I'm going to have to deal with all of those feelings. I rarely feel any of my feelings now because I eat so much, so when I'm not able to numb myself with food, my feelings may be very intense sometimes, until I get used to it.

Not everyone will have the same reaction that I do to not being able to eat, and who knows, maybe I won't either. I won't know until I go through it.

PS

Well spoken,and since you are expecting the emotional issues, perhaps they won't catch you so unawares.

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Every little step takes me farther. Every small right decision takes me down the road I want to be on. And if there are small detours on my way, those same small steps will take me thru them.

The difference for my surgeon using the surgical center or using the hospital is if you need to stay overnight to be monitored for stuff like apnea, high blood pressure, etc. If you don't have any other complications to look for, using the surgical center saves you about $3k, but you still have to do all the same pre-op requirements (psych test/eval, pre-op testing,etc.) It's not a way to bypass all the pre-op steps at all.

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I don't think that the requirements like seminars, psych evals, multiple consults, etc necessarily have anything to do with whether your surgery is in a surgical center vs. hospital. It's what your insurance and/or the specific surgeon (or his practice) requires. I researched the band for more than two years; I did not feel the need to attend seminars. Because I was self-pay, my doctor did not require them. But I can see how they may be helpful for some.

I was banded in a surgical center (which is located inside a hospital) and was in and out in about 4-5 hours. I was treated well by everyone there and had a good experience. As far as I know, my doc does not do the surgery in a hospital unless you have complications or special conditions that necessitate it. He did require a consult with a nutritionist. A consult with a psychologist was not required, but he works with one and that was made available to me (not included in my flat fee, though). I already knew that I had emotional eating issues so I began working with a therapist prior to being banded.

My doc is accessible any time of the day or night by phone, and I have also emailed the bariatric coordinator in his office with questions. So I was not "just banded" and I feel supported. I have had no problems and am doing well. So far, so good.

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Dr. Gerald Kirshenbaum (surgery) ~ 2/14/08
Dr. William Johnson (fills & aftercare)

Pre-surgery weight 302 lbs (BMI 43.3)
Pre-pregnancy weight 183 lbs (BMI 26.3)

The center I am going to is located within the hospital.. and is a 'Center of Excellence' so the only banding they do is in their outpatient ward inside the hospital. You have the option to stay the night if you wish and move to the inpatient side. The price of mine is the same whether you spend the night or not. The total is 23900.

I had to do a phsyc eval and nutrition appts with follow ups for the nutritionist and the surgeon within 2 weeks of surgery.

I just got home from my surgery today. I went to a surgical center. I had to spend the night. They also required a pysch evaluation as well as a host of of pre admission testing and a cardiac clearance. They have excellent nutrional counceling. They have classes every month to follow up about co dependency and other food issues. I went to a Barix Clinic. I don't know how much it cost because I was fortunate enogh to have my insurance pay for everything. Any time I have a question, I can pick up the phone and call them.

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Melody
Surgery 4/7/08
Dr Boe
Langhorne Pa
227/195

The center I used does most of their surgeries at their own surgery center. My insurance would not cover unless it was at the hospital, so the surgeon did mine there for me.

There's no difference in preop or postop requirements, info, support, etc. between patients at this particular center based on where they got their bands placed.

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-109 lbs
top 299/ surg 275 / now 190 / goal btwn 120-140
5"6'

My doctor has the option of performing the surgery at a surgical center or at a hospital. While I didn't have a choice because of my weight, I still would have chosen the hospital just due to the potential problems I could have faced due to my health. I'm a bit of a worry-wort so I felt better knowing that if something went wrong, I could get immediate emergency care.

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-MG

415/207.5/180
Start/Primary Goal/Secondary Goal

Banded 4.3.08 by Dr. Darrin Hansen in Sandy, UT

I was at NWWLS in Everett WA and they are AMAZING!

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Banded: 3/4/08
Location: Northwest Weight Loss Surgery in Everett, WA
Pre-Opp Weight: 229 Current Weight: 131

My blog/pic diary about my LAP-BAND® & weight loss journey!
http://lisetheloser.com/

I work in a hospital and my insurance only covered the procedure if I had it done at the hospital. I still had to see a psychologist (only once), had to see a nutritionist for 3 months, had to see a physical therapist once a week for 3 months, had to work out at the physical therapist's gym 3 times a week for 3 months, had to see my surgeon and my pcp once a month for 3 months. If I missed any one of those, I had to start all over. I feel like I was pretty much prepared for the surgery, but I was surprised at my emotional lability for the first week or so following the surgery (mostly related to food). I think it was a combination of the anesthesia, the pain (although it was very minor and almost totally due to a hiatal hernia repair done at the same time) and the fear of eating anything that wasn't liquid for fear of it getting stuck.

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Lucyb
Banded 1/21/08

Thread Starter

Thanks everyone for all of the responses. A little information on why I was asking in the first place: I was originally approved for a surgical center that is in another state, but I also found a surgeon located at a hospital that I liked just as well and was only one hour away. My insurance dragged their feet on approving me for the surgeon at the hospital. I got scared that my approval for the surgical center was going to run out (only had until 19 May), so I went ahead and went with them. The facility was awesome with a great caring staff, but I was just curious as to if I was missing out on anything by not having all of the prerequisites. I basically had my blood work done, got my heart checked out and I was banded a few days later. (That's the short version.) Everything is going very well for me and thankfully I have a wonderful support base on this fantastic journey. Best wishes to each of you and I hope that we will all use each other to learn from, lean on and support.

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Banded 31 Mar 08
267 highest
249 current
165 goal (I think, I just want to be a size 12 again!)