Anticlimactic first consult

[Tootles1975 59]

So I met with my surgeon for the first consult this week (Dr. Dieter Pohl in northern Rhode Island) and found the visit surprisingly anticlimactic! Heh. I guess because I'd done so much reading here and at other forums online since the initial seminar, there wasn't much he could tell me that I didn't already know!

I was a bit surprised by how fast it all could happen (4-6 weeks after I get through all my appts). He didn't mention anything about supervised weight loss requirements (I just have to see a nutritionist twice, along with all the other standard appointments). He does prescribe a two-week liquid pre-op diet, but didn't want me to lose any particular set amount before surgery, nor did he really pinpoint a goal he'd like me to reach afterward.

It's funny how different everyone's experience is, but I left feeling like it should be harder somehow!

[AshleePage 65]

Here's a video I made about questions to ask your surgeon! Hope it helps!

Congratulations on your decision to better your health & best of luck on your journey!

[superbariatricbabe 180]

omg same here Tootles! I was expecting... well I don't know what i was expecting, but something more 'doctory' than a conversation. I had my first consult earlier this week, and it was basically a chit chat... We just talked about goals, he agreed that the bypass was the right choice for me, and cautioned that it's not just a quick fix. He doesn't even want me to do a pre-op diet - he said it's only for patients over 350lbs. I weigh 310 right now (gained 8 lbs when i quit smoking last month!) But I kind of want to do it anyway if it will make the surgery safer. (I am f***** terrified of complications and surgery itself.)

But in the next 8 weeks, I need to get a physical, some blood work, cleared by therapist, and then see a dietitian twice. Easy peasy lemon squeezey.

What is your pre-op diet regimen?

[Tootles1975 59]

omg same here Tootles! I was expecting... well I don't know what i was expecting, but something more 'doctory' than a conversation. I had my first consult earlier this week, and it was basically a chit chat... We just talked about goals, he agreed that the bypass was the right choice for me, and cautioned that it's not just a quick fix. He doesn't even want me to do a pre-op diet - he said it's only for patients over 350lbs. I weigh 310 right now (gained 8 lbs when i quit smoking last month!) But I kind of want to do it anyway if it will make the surgery safer. (I am f***** terrified of complications and surgery itself.)

But in the next 8 weeks, I need to get a physical, some blood work, cleared by therapist, and then see a dietitian twice. Easy peasy lemon squeezey.

What is your pre-op diet regimen?

Right?! I think I went in expecting him to have more rules and regulations for me. I had a lot of questions so maybe I covered a lot of that with my inquiries. But I don't know. His office also gives out a huge 60-page booklet at the information seminar you go to before you make the first appointment and that is very very explanatory of all that's involved. Maybe that's the shorthand so that the actual first visit can be really quick!

I started dieting myself on June 2. Restricting carbs to 50-70 g a day (or less when I can manage) and calories to 1200-1500. So far I've lost about 15 pounds and it's been working out well. I stopped drinking diet soda entirely or anything with carbonation, and most of my Snacks are Protein (lunchmeat, cheese, small amounts of peperoni), nuts, or sugar-free popsicles and Jello. I also really try to get at least 64-80 oz of Water a day. I've been surprised at how easy it's been so far. (I've lost weight on Weight Watchers and doing low carb before but I never restricted calories so much at the same time.) I think being so focused on knowing this is all to benefit me before surgery is really helpful. I'd like to lose about 30 more lbs (or even more) before surgery.

My official pre-op diet will be a liquid diet for two weeks before surgery, consisting of:

-3 Protein shakes of at least 15 grams a day (100-150 calories each) [i think the office sells a specific brand themselves, which...bothers me a little as it seems a bit convenient for them to profit. I may try to purchase my own. ]

-1 light dinner of 3 oz lean meat, poultry or fish with vegetables or a frozen low cal dinner (lean cuisine, smart choice, etc.)

-at least 64 oz Water per day

-1 Multivitamin with Iron daily (again they charge $25 per month for their own vitamins) or you an do 2 flintstones complete and extra Calcium of 1000 mg Calcium (viactive or caltrate or others, 2-3 per day)

Doctor also suggested starting Biotin before surgery to help with hair loss, but I'm torn on that as I already have a lot of pesky facial hair (I'm Italian) that I don't want to increase too!)

Your requirements are less than mine. In addition to two nutrionist visits, I have to do an upper endoscopy, gallbladder ultrasound, sleep apnea test and psych consult, plus get a letter from my PCP.

Edited June 29, 2014 by Tootles1975

[oweemytoe 43]

Wow.. I have a 4 month process that I am about 1/2 way through. That has been filled with the initial informational meeting, first meeting with the surgeon, 2 meetings with the dietitian, 2 psychological evaluation visits, three 2 hour educational workshops, a final visit with the surgeon and a 1.5 hour to 2 hour informational meeting (with my support person) with the nurse practitioner. In between all these visits I have had to have a chest xray, an EKG, blood work, medical clearance by a pulmonologist and then of course keep my PCP up to date with everything that has been going on. I actually am glad it has taken the amount of time that it has, as I wouldn't want to feel rushed. I am surprised to hear that your surgeon is requiring you to buy shakes from them, as my dietitian and my surgical binder lists what we need and encourages you to comparison shop.

[Tootles1975 59]

Wow.. I have a 4 month process that I am about 1/2 way through. That has been filled with the initial informational meeting, first meeting with the surgeon, 2 meetings with the dietitian, 2 psychological evaluation visits, three 2 hour educational workshops, a final visit with the surgeon and a 1.5 hour to 2 hour informational meeting (with my support person) with the nurse practitioner. In between all these visits I have had to have a chest xray, an EKG, blood work, medical clearance by a pulmonologist and then of course keep my PCP up to date with everything that has been going on. I actually am glad it has taken the amount of time that it has, as I wouldn't want to feel rushed. I am surprised to hear that your surgeon is requiring you to buy shakes from them, as my dietitian and my surgical binder lists what we need and encourages you to comparison shop.

Maybe I'll find out about more as I get further through it. But, yes, sounds like it'll probably take 3-4 months for me as well.

I'm not sure if it's required to buy shakes from them, but it's recommended. I probably won't though and will go my own way with the tips from the people at this forum. I haven't received a binder yet, unless the 60-page booklet they gave out at the info seminar doubles as the "binder."

[oweemytoe 43]

I'm sure your 60 page informational booklet is the same as my binder, the place I am having the surgery through just stuck it in a binder with different sections so that when you go to the different appointments, especially the pre operative educational classes, you can add stuff in. Each practice just does it differently..

[Ginger Snaps 1,323]

My process from first consult to surgery was 86 days. I had all the pre-op tests (cardio, pulm, psych, NUT) but had no pre-surgery diet restrictions or anything like that. Only Clear liquids day before surgery. My doc said he doesn't like to put people on pre-op unless they are very obese because he feels the pre-op diet can weaken you and he wants his patients healthy and strong.

Of course it all depends on the surgeon and it's always best to go with the one who knows you best.

[Mommabird 367]

I go for my first consult on July 11th, but I don't get to see the surgeon. I have a scheduled hour with the nurse practitioner. From what I have read on their site, it will mostly going over my medical history and determining what tests I'll need to have done. I talked to the surgeon after the seminar and found out about a lot of the basic tests: a screening colonoscopy,a mammogram and pap smear within the last year. All done. I don't know if he'll want an endoscopy, but I had an "Ultrasonic Endoscopy" in Dec. Hopefully that will tell him anything he needs to know. I know I have to have a bariatric psych evaluation.and possibly a sleep study. I do have a weight loss requirement (per my insurance) that I've already started. After my consult, I have to go to a "Lifestyle Change" class. The info on that says to bring your "Gastric Bypass Patient Manual" so I guess I'll be getting one of those on Friday. The surgeon told me after the seminar, that with my history of fatty liver and pancreas, that I'll have to do a 3-4 week pre-op diet. He didn't tell me what that would be. Gee, I can't wait for that one ;- ). I'm just glad that things are finally starting to move forward. I'd really like to have my surgery before the end of the year.

[Wayne Hunt 59]

The entire process to me was surprisingly drama-free. The 6-month insurance-mandated waiting period was the hardest part, and biggest waste of time where I was required to do the 6 separate "training classes". Each of those cost me money out of pocket and amounted to FAR less information than I ever got in the average Weight Watchers meeting.

The fact that you're diving in and learning on your own is a fantastic thing. "The more you know"... "Knowledge is power", and any other cliches that might be appropriate and all that...

If you're forced to go through a similar waiting period, don't freak out, and don't waver. That's what the insurance companies are hoping you'll do, and (I propose) why they do it in the first place.

13 weeks out, I've adopted a saying that I seem to be applying a lot to my own journey (and offering to others as a sign of support.... It's very fitting, and very appropriate to the great things coming your way... It is simply this;

"Welcome to the Best of your life"

Wayne

[Tootles1975 59]

Appreciate everyone's feedback. It really is such a different process from person to person! I have scheduled all of my requirements for this month except the endoscopy which I'm waiting to hear back from the office on for scheduling, and the nutritionist who couldn't see me till August 1. So I could conceivably be done with all my appointments by mid-August maybe. My insurance (BCBS of Mass) doesn't have any six-month weight loss or lifestyle class or other waiting period requirements. Then if approval goes fine, it's usually 4-6 weeks after that for a surgery date. It'll hit right in the middle of my wedding anniversary and birthday, I bet.

Usually I am a terrible procrastinator at setting up doctor visits, and I kind of surprised myself in getting it all organized so quickly. I'm taking it as a good sign that I'm really committed and looking forward to this (despite my occasional doubtful moments). I imagine it's the first in many ways I'll begin to surprise myself through this journey.