New device turns doctor into believer
By CHASE SQUIRES, Times Staff Writer
DADE CITY -- While many make half-hearted -- or even sincere but ill-fated -- New Year's resolutions to lose weight, Dr. Lee Grossbard is serious.
Grossbard was so intrigued last year by a new surgical technique to help patients lose weight that he rushed to learn how to perform the procedure, then he underwent it himself.
"It's given me a different attitude," he said. "A different lifestyle."
The surgery, using a device called a LAP-BAND, allows doctors to install a restrictive band around part of a patient's stomach, limiting the amount of food the patient can eat comfortably.
According to the device's manufacturer, Grossbard, working with Dade City's Pasco Regional Medical Center, is the only doctor performing the procedure in the Tampa Bay area and surrounding counties.
Grossbard said after mastering the technique and becoming certified, he knew it was right for him. After struggling with weight for years, Grossbard underwent the procedure at a friend's clinic in Mexico in October. In 10 weeks he lost 50 pounds and said he is on his way to his goal of losing more than 100. His 48-inch waist is down to 39 inches.
"I'm going through suits like you wouldn't believe. This suit is a month old, and I'm swimming in it," Grossbard said. "As I get thinner and thinner, I feel better and better."
Grossbard's breakthrough came from Inamed, a California company that won federal approval in 2001 for it's LAP-BAND procedure. An adjustable, removable device wraps around the stomach and can be adjusted from outside the body. As the band is slowly tightened, patients require less food to feel full. In theory, the less food in, the more weight off.
Grossbard, 50, said he understands his overweight patients. Their struggles are his struggles. The call of the midnight snack was irresistible, the frustration with diet plans ever-present.
Years of work with laparoscopic surgery -- surgeries performed with a minimal number of incisions and incorporating tiny cameras inside the body -- gave Grossbard the background in techniques used in LAP-BAND technology.
Inamed brochures describe the procedure as vastly different from the gastric bypass surgery employed by television weather forecaster Al Roker. Instead of cutting the stomach and rerouting food past the intestines, LAP-BAND surgery wraps a rigid strap around the upper part of the stomach.
Another type of stomach surgery staples off a section of the stomach.
Unlike those surgeries, patients wear the LAP-BAND for life, but if there are difficulties, it can be adjusted or removed.
Grossbard said he was impressed by the reduced risk and the less invasive method of installing the device, and while he said he was unwilling to allow anyone to physically cut his stomach, the LAP-BAND appealed to him.
Still, he said, no surgery is without risk, and patients must be committed to adhering to strict dietary guidelines.
The Food and Drug Administration includes six pages of warnings and cautions on its review of the LAP-BAND.
One warning: "placement of the LAP-BAND system is major surgery and death can occur." The FDA also warns during clinical trials, 89 percent of the test subjects reported some adverse reactions, the most common was vomiting at some point after the operation, according to FDA tests. Patients also reported problems from the band slipping out of place.
But the surgery is not nearly as invasive as bypass and stapling operations, Grossbard said. And for a severely obese person, the health risk of being overweight is usually far greater than the danger from the operation, he said.
Grossbard had his surgery on a Friday and was back at work on the following Monday.
But he also said he followed his doctor's instructions to the letter. Patients who won't follow instructions shouldn't get involved, he said.
"It's not for everyone," Grossbard said.
The FDA limits LAP-BAND procedures to patients who are severly overweight, usually 100 pounds or more. Grossbard, who is 5 feet 5, weighed 265 pounds.
Then patients must follow strict guidelines in the days after the surgery. Clear liquids are all that are allowed during the first few days.
Eventually, Grossbard said, patients are allowed to eat a variety of foods, but in small portions.
The doctor said he continues to go to excellent restaurants, but he is careful to limit his intake. The LAP-BAND helps, he said. He feels full after a very small amount of food.
Then there's the money.
The operation costs about $16,500, and insurance won't always pay. Sometimes home equity loans can be used, and the interest deducted, and there are tax benefits available to people who undergo medically necessary surgery. But there will be cost involved.
But in a way, that's good, Grossbard said.
"I want to see that buy-in," he said. "I want to see the commitment. If they think this is a magic bullet, that it will do all the work, I don't want that."
Grossbard said his weight loss is making him a believer.
"For the first time in years, I crossed my legs on an airplane -- in coach. Not my ankles, my legs," he said. "I've gone jogging, I hadn't jogged in 15 years. I've been playing tennis, I hadn't played tennis in 10 years. It's life changing.
"This is a religion to me," he said. "I just can't believe how good I feel."
To learn more
The makers of the LAP-BAND, Inamed, have an Internet site at www.inamed.com. An FDA site on the procedure is available at www.fda.gov/cdrh/pdf/p000008.html; And Pasco Regional Medical Center is online through the "hospitals" listing at parent company Health Management Associates Web site, www.hma-corp.com.
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