Absorption of Extended Release Medicine

[DianaCox]

Not to burst your bubble or undermine your confidence, but ...

Bariatric Centers for Excellence, by and large, are a scam designed by a cabal between the insurance companies and surgery mills, in which they created a for-profit organization endorsed by the ASMBS to create "standards" that were heavily biased towards ONLY allowing large, high-throughput surgery mills to qualify, generally by requiring a minimum number of surgeries per year for the center and/or the surgeon, and thus steering insurance-covered patients to these bogus "Centers of Excellence" - self-serving monopolistic behavior in which the CoEs, due to the economies of scale, were required to give a steep discount to the insurance companies as well, in exchange for a monopoly over the insurance companies' patients.

The whole CoE concept for bariatric surgery was tossed by Medicare in 2013, after a comprehensive study showed they were not only worthless, but counterproductive: http://www.advisory.com/research/se...er-of-excellence-program-in-bariatric-surgery

I'm glad you think your practice is a good one, but I'm pretty sure there are plenty of patients of Inman's who have found it wanting in one or more respects. I'm also sure it's not the worst, however.

 

[Razbry]

GirlFriday....I considered myself fortunate to have had Dr. Douglass Hess (the American innovator of the DS) do my surgery, yet it did not save me from going down the tubes nutritionally, and ending up in the hospital for 5 days and then on PPN for 30 days. Hess was a great surgeon. However, the knowledge of nutritional needs were changing, and Hess retired. I had to take the led in finding my way back to health. I found it through vets of this and other boards. Only people who have walked the walk, can talk the talk.

 

[Razbry]

I know it has been implied by the conversation here about extended release medication, but maybe not said outright. There are many medication that are suspended in oil. Generally they are soft gel-like pills. Those types of pills are not a good fit for a DSer. I've researched every medication I've been prescribed for what constitutes its "base". You'd be surprised.

 

[Spiky Bugger]

I will consider myself wise to have chosen the Bariatric Center for Excellence that I did, then.
Our class was specifically for DS patients, and everything was centered around the needs for the DS patient. They didn't try to sell us anything, they even showed us the supplements from big box stores.

What Diana said.

Originally, the surgeons decided to create standards and called those who met the standards sonething like "Centers of Expertise." (maybe...memory fading, old age)

The insurance companies glommed onto the COE initials and suddenly, the truly experienced surgeons didn't qualify.

For example, once the Blue Cross COE program was begun, there was not one SINGLE solitary COE DS facility in the state of California, even though at that time California had at least five practicng, experienced DS surgeons. (In fact, that info was part of how I "convinced" BC to pay for my surgery.)

COE = SCAM concept, even though good surgeons may be in that group

 

[Munchkin]

Some do have issues with XR meds while others do not. And that can change again after the early post-op period is over.

Beware of any supplements sold by a surgeon's office. Always do your own due diligence and verify everything for yourself. Quite a few people have taken those BA products and learned the hard way they are not enough for DSers.