Who is a "good" candidate vs. a "bad" candidate for surgery?

[Skywalker 170]

I just want to hear some of everyone's thoughts on this. I'm a little discouraged tonight, because my private mental healthcare provider wouldn't write me a recommendation and said I lacked nutritional insight to have the surgery and keep off the weight afterwards. I know that the surgery will shrink your stomach size, and not do anything to one's metabolism or mind.

Without going into great detail--I've basically been on some type of diet and exercise since I was 14, and I'm 36 now. Sometimes it hasn't worked so well (the last couple years) and sometimes it's worked great (I won a trophy in basic military training for coming in first in a marathon and kept the weight off for 8 years). I have been on almost every diet from Weight Watchers to South Beach to juicing, but they're not working for me at this point to the extent that I am still hungry.

My goal for surgery is to be able to follow Weight Watchers and maintain dietary/exercise changes without being so hungry and feeling deprived. I want a meal of a small bowl of Cereal or a yogurt + apple to satisfy me without stomach growling. Is this the right frame of mind or is there something else I'm missing?

[NothingUpMySleeve 244]

Wtf does "lacks nutritional insight mean"? I mean, I guess I do see some people here talking about burgers and goodies at two days out, but if you've done south beach or Atkins, you probably get the gist of lean Proteins, etc.

Could he give you any more detail? To me, the bad candidate would be one who wanted to keep on living the same, but expecting a different result. A good candidate (I guess) would be someone willing and ready to live a healthy lifestyle, but needing a little extra help from the sleeve.

[moonlitestarbrite 902]

what does that mean, "nutritional insight?"

a bowl of Cereal or yogurt and an apple isnt going to give you the amount of Protein you need post op. but i would call back and ask for him to be more specific...

i have found there are a lot people around here who are still poorly educated about basic nutrition post op. maybe that is what he means? do you have an idea of what you would need to eat post op to get 60-80 grams of Protein per day?

[Skywalker 170]

@Nothingupmysleeve:

Honestly I don't know how this misunderstanding occurred. Either he doesn't want me to get the surgery for personal reasons, or he didn't listen to me, or he doesn't think I'm telling the truth. I normally get along well with this guy, but he wrote the following things in the psych letter that aren't favorable to approval:

“She showed up to the interview drinking a Starbucks non fat iced mocha with cream”

(I do this occasionally, and this was one of those days. And it wasn't cream, it was light whipped cream, but whatever)

“She drinks iced tea and sees nothing wrong with this”

(I told him I drink unsweetened iced tea as much as possible, it helps me hydrate and get my Water intake. I don't know why he missed the unsweetened part)

“This provider is concerned she may not have sufficient understanding of good nutrition and meal planning to help her maintain a lower weight after surgery”

“…..this will be a very difficult adjustment for her”

“….she has only recently made some changes necessary for success after the surgery”

(Not sure why he put down these things. I have told him that I've been on some kind of diet and exercise for many years, the most recently being Weight Watchers from 2012 to now; I studied nutrition, bought special foods and logged everything. I lost 30 lbs. with great struggle but due to hunger and busy schedule gained it all back. The way he writes it's like I've never tried anything.)

[Skywalker 170]

"i have found there are a lot people around here who are still poorly educated about basic nutrition post op. maybe that is what he means? do you have an idea of what you would need to eat post op to get 60-80 grams of Protein per day?"

I did hear that, and I've been trying to learn as much about the surgery as possible to be successful. I will literally follow any plan my Dr. wants me to. I understand the higher Protein is important for wound healing; the first time I heard this was actually after I had my C-Section, and the protein/wound healing connection was solidified during my medical training (I'm a CNA). I have a couple cases of the Premier Protein Drink stored in the garage right now to have pre and post op.

Edit: I think each of those Premier Protein drinks is about 30 grams of protein per drink, I'll have to check again and correlate it with the nutrition requirements.

Edited June 17, 2014 by Skywalker

[Unhappysleever 39]

do you have an idea of what you would need to eat post op to get 60-80 grams of Protein per day?

@@moonlitestarbrite i am 5 mths post op and still don't know what I need to get to 60-80 grams per day - I haven't been back to the nut since 2nd month, she was never very helpful.

Any suggestions would be most appreciated - however don't do Protein shakes!!!!

[Skywalker 170]

Excuse me (to everyone)--When people say "the nut" to what are they referring? I used to think it was the lap band but the sleevers use this term too, so I'm confused.

[quuquui 30]

You sound like me. We understand that this is a tool and that we will always be working on our head hunger, our sugar addiction or emotional eating. We understand that the sleeve is a tool, not a cure. In my opinion, I think you need to find another healthcare provider and start from scratch.

[moonlitestarbrite 902]

Excuse me (to everyone)--When people say "the nut" to what are they referring? I used to think it was the lap band but the sleevers use this term too, so I'm confused.

nutritionist. dietitian. the person doing your nutritional counseling.

[moonlitestarbrite 902]

do you have an idea of what you would need to eat post op to get 60-80 grams of Protein per day?

@@moonlitestarbrite i am 5 mths post op and still don't know what I need to get to 60-80 grams per day - I haven't been back to the nut since 2nd month, she was never very helpful.

Any suggestions would be most appreciated - however don't do Protein shakes!!!!

no wonder you are unhappy! did you not get sheets after your surgery? here are the sheets from my center. there is a thread somewhere with links to lots of post op plans.

http://www.urmc.rochester.edu/highland/departments-centers/bariatrics/bariatric-diets.aspx

good luck... any time you want you can google "bariatric post op diet" or "protein foods."

[moonlitestarbrite 902]

@Nothingupmysleeve:

Honestly I don't know how this misunderstanding occurred. Either he doesn't want me to get the surgery for personal reasons, or he didn't listen to me, or he doesn't think I'm telling the truth. I normally get along well with this guy, but he wrote the following things in the psych letter that aren't favorable to approval:

“She showed up to the interview drinking a Starbucks non fat iced mocha with cream”

(I do this occasionally, and this was one of those days. And it wasn't cream, it was light whipped cream, but whatever)

“She drinks iced tea and sees nothing wrong with this”

(I told him I drink unsweetened iced tea as much as possible, it helps me hydrate and get my Water intake. I don't know why he missed the unsweetened part)

“This provider is concerned she may not have sufficient understanding of good nutrition and meal planning to help her maintain a lower weight after surgery”

“…..this will be a very difficult adjustment for her”

“….she has only recently made some changes necessary for success after the surgery”

(Not sure why he put down these things. I have told him that I've been on some kind of diet and exercise for many years, the most recently being Weight Watchers from 2012 to now; I studied nutrition, bought special foods and logged everything. I lost 30 lbs. with great struggle but due to hunger and busy schedule gained it all back. The way he writes it's like I've never tried anything.)

uh. i would go see whomever your surgeon's office uses for psych evals. this guy either doesnt know what he's looking for or he's just biased against wls. my psych never even mentioned actual food consumed. its the nuts job to evaluate my diet, not the psych. (hint, drink only Water at your psych eval and nut appt)

[Shells_Almost_There 357]

As mentioned, please consider going to a psych person that is recommended by your surgeon's office. My surgeon has 6 nearby psych people who specialize in the eval of people getting ready for WLS and they are open to continue seeing patients before and after surgery. it's nice to have that choice! The guy I went to had a recumbent bike work station and has had RnY himself - I really liked him.

Sorry that this happened, but I hope that you can take some additional steps and be back on your way to surgery! Good luck!

[bikrchk 1,313]

do you have an idea of what you would need to eat post op to get 60-80 grams of Protein per day?

@@moonlitestarbrite i am 5 mths post op and still don't know what I need to get to 60-80 grams per day - I haven't been back to the nut since 2nd month, she was never very helpful.

Any suggestions would be most appreciated - however don't do Protein shakes!!!!

I get concerned when I hear someone say "I don't do protein shakes". It makes it sound like you've decided you're not up to following the post op prescription to get the required amount of protein. The protein, the supplements, the Portion Control, the exercise, is what we signed up for when we let someone cut us open so we could get healthy. We all need to pay attention to our after care. FOREVER. *End Rant* That said, there are lots of alternatives to "protein shakes" that can get you to your goal. For me, that's 74g per my Bariatric surgeon's instructions. I throw a scoop of chocolate Protein powder in my coffee every morning. Makes it taste like a latte and gives me 24g of protein. Isopure makes a clear, pre-bottled drink that tastes kind of like a Jolly Rancher. They have 42g of protein. The body can only absorb 25-30g at a time, so pace yourself with the super-high protein options. There's protein pudding, protein brownies and protein shooters. There are a variety of Protein Bars, Quest is one of the best nutritionally with 20g of protein and only 3 sugars. Another fav of mine is PowerCrunch with 14g and 5 sugars. That one tastes like a wafer cookie! If you refuse to do "protein supplements" at all, it CAN be gotten strictly from food, but personally, I couldn't live like that. I like variety. And vegetables. And occasionally carbs. And I would have room for none of it if I didn't use protein supplements in addition to a high protein diet. Have a look at http://theworldaccordingtoeggface.blogspot.com/. She's a long term success WLS patient and advocate and has a million recipes and ways to boost your protein intake that you may not have considered. Best of luck to you!

Edited June 17, 2014 by bikrchk

[Skywalker 170]

bikrchk--On the note of nutrition, has anyone found (post op especially) V-8 drinks helpful? Noticing that I don't tend to get a lot of vegetables normally, I have tried to drink one or two of these a day (and have my daughter do the same) to get some valuable nutrients. I would think, being liquid, that these might also be easily consumed post surgery.

[Skywalker 170]

bikrchk--I haven't had the sleeve nutritional classes yet, but when you mentioned the Protein intake, how does your doctor(s) advise you to balance that? We have Protein Powder in my house, and my daughter in particular loves it, but her PCP said no more than one a day or it's hard on her kidneys. I assume the same will be true for me for the long term post op diet....was just wondering if they tell people to fall within a certain Protein range post op for the rest of their life (not too much and not too little)