Banding Bulletin – July 2018

Banding Bulletin – July 2018

This Month’s FAQs:

Q:  What do we do with latex allergic patients?

A:  CRH offers non-latex bands for any patients reporting an allergy to latex.  These bands are BLUE, safe to use on your allergic patients and are provided at no cost.  We package our kits with the standard BLACK latex bands because they outperform the non-latex variety.  Latex bands afford better clinical results because they are stronger, hold better, and are much more difficult to accidentally dislodge than are the latex-free bands. Because of this, greater care should be taken when using the blue bands.   If you need additional non-latex bands, please let ME know and we’ll get some sent out to you!

Q:  How far ahead of time can I load the band on the ligator?

A:  We recommend loading the band onto the ligator fairly close to the time when it will be utilized.  Preloading will allow any band to stretch a bit, thus reducing its ability to contract and strangulate the banded tissue.  This loss of strength can be fairly dramatic, losing approximately 15% of the latex band’s strength within a couple of weeks.  The degradation is even more substantial when using latex-free bands.  This is why we do not preload the bands on the CRH O’Regan System!

Q:  Urinary symptoms are listed as a potential issue after banding – why is this?

A:  When following treatment protocols, the complication rate after using the CRH O’Regan System is roughly 1%.  The most frequently occurring issues are

• Post-banding pain – Almost totally avoided by keeping the patient in the office for approximately ten minutes after a banding, making certain they understand that they should feel absolutely NO pain or pinching, and then by adjusting the band if needed.
• Post-banding bleeding – Significant bleeds should be VERY uncommon, but if they occur, it would most likely be at the 10 day to 2 week timeframe, when the eschar covering the banded site separates or, less frequently, at 3 to 5 days when the banded tissue sloughs.  To minimize the risk of significant bleeding, make certain that the banded tissue has a narrow “neck” or “stalk”, which keeps the post-banding ulcer small, both minimizing its risk of bleeding as well as further reducing the risk of pain.
• Urinary urgency is uncommon and found most frequently in patients with BPH or in patients where the right anterior pile is banded.  The assumption is that this is largely caused by coexistent spasm, as it is typically helped by using topical antispasmodics such as nitroglycerin ointment.  Urinary retention is very rare; I am aware of only two instances of it and both patients had very severe BPH.  The risk of retention is greater when banding more than one hemorrhoid column at a session.

If you have any clinical questions, please contact ME and I’ll get right back to you with more information!

Additional training resources available!

We’ve received requests for an anal fissures information sheet for patients, over and above the information sheet for topical nitroglycerin ointment, and we’ve now posted it on our website HERE. We have a number of other clinical forms available as well and we encourage you to utilize these resources to educate your patients and to improve office efficiency!

We’d love to visit!  Please let ME know if you have a partner or an advanced practitioner that would like to be trained in the use of our technology, and we’ll get you on our calendar.  For those of you that have already been trained, let us head back in order to offer a “refresher” session to help you with your more difficult patients, or to work with your staff.  There is never a cost to you for this support, so please take advantage of it!

Annual Survey – Win a $500 Gift Card

It’s that time of year again! Your participation in our annual survey will enter you to win a $500 Amazon gift card. Your feedback helps us to better respond to the needs of our Partners, as well as to continue to refine our training and support programs.

Please follow the link in the email you received from me on Wednesday, July 11^th to access the survey. It will take approximately ten minutes to complete and you can save your progress between sessions until the survey closes on Wednesday, August 1^st.

Webinar

We will be holding our next round of webinars on Monday, July 30th to discuss some of the most frequently asked questions that we receive.

If this date does not work for you, or if you have any questions that I can address in the meantime, please feel free to contact ME.

CRH Anesthesia Management

CRH Anesthesia continues to expand in 2018. We are now servicing 39 endoscopy centers across the country and performing over 270,000 anesthesia procedures per year. Our partnerships are flexible so whether you are looking to start an in-house anesthesia program or would like to monetize an existing ancillary business please reach out to me or Carter Blanton for more information. You can also click this link to view a video explaining our anesthesia partnership models.

Carter Blanton
VP, Business Development
CRH Anesthesia
cblanton@crhanesthesia.com