Why are some weight loss surgery patients so clueless?

[VSGAnn2014 12,992]

I'm surprised at some of the questions I see here and on other WLS boards from new VSG patients, like ...

* I just had VSG surgery. What am I supposed to eat now?

* My surgeon says not to drink alcohol until X months out. Can I drink now anyway?

* When can I start eating ice cream?

* I'm four days out and just had chicken McNuggets. Have I damaged my sleeve?

* If you plan to drink heavily, first take a Percocet to calm your stomach.

I totally get that, even pre-op, this surgery can sometimes be overwhelming. But some patients' questions suggest that even though they've just undergone major surgery they haven't read their post-op instructions, understood their instructions, don't believe what could happen to them if they don't follow instructions, or maybe they just never received any instructions at all.

Weird!

[fezik23 240]

Yes! I find it frustrating too, and I wonder whether these folks are getting no guidance from their providers or they go into this blindly or are just not paying attention

[MichiganChic 3,262]

I try to just ignore it. I really hope if people want to know the answers to those questions that they research on here, get good answers that will help them, and that they heed any good advice given. I worry about the ones that ask those questions looking for an answer that will support their behavior, and they have no clue about the need to change, or really demonstrate a lack the desire to make the needed change for success. Of course, we have no way of knowing who will fall into which category, but I just skip most of those posts now to avoid the irritation.

But one thing that is baffling to me - where in the world did these people have surgery that they got NO post op instructions? Or did they actually get instructions that they ignored, or somehow think they should get the instructions from internet strangers who are not qualified to give advice, hoping to hear what they want?

[VSGAnn2014 12,992]

Just to clarify -- I'm NOT talking about things all new sleevers want to know, like tips for getting all your Water down, which Protein shakes taste best and where to buy them, what are some safe, early exercise regimens, what does "the new full" feel like, etc.

[labwalker 1,177]

A lot of those questions strongly suggest that either the providers are running surgery mills and providing little pre or post op support; or the patients are asking questions that should have been fielded at the doctor's office. After six visits with a NUT, consulting with the doctor, and other hoops I had to jump through, I pretty much knew exactly what I needed to do.

That is one reason I always suggest shopping for the best practice, not the best price!!! Support is important!

But, I think we should try to offer sound advice, so long as it isn't medically related and might contradict what their doctor would expect.

[tkauhi 90]

I have to say that I'm one who received NO instructions. I waited thinking I would be visited by a nut in the hospital but nothing. Before discharge I asked the surgeon about it and he said he didn't use them as it cut into his bottom line. I know what everyone is thinking and I've thought the same thoughts but I can say I was so desperate to have the surgery and he had good reviews that I just trusted him. I don't ask many if any questions on this forum for fear of being ridiculed but others who have had the guts to ask questions have helped me learn so much. I google a lot and have bought some books but you are right, there are some or maybe just me that had no nut instructions and no follow up (except for weigh ins) care. If I ask questions he will answer them otherwise he rushes me out the door. He had this same (RNY) surgery 9 years ago so I thought I was getting someone good and someone who understood what we go through. I messed up big time. I'm just on my own along with reading answers to questions asked on this forum, books and google...

[labwalker 1,177]

There is a big difference between folks who didn't receive guidance, and need advice from others who have shared the same journey because they have no where else to turn.

I think the first poster was upset about folks who were told what to do by their doctors (such as no alcohol for six months) and then come here asking for some sort of validation for doing exactly what their doctor told them not to do.

[MichiganChic 3,262]

@@tkauhi Wow! That's so absurd!! It really makes me mad that when there is such an abundance of information out there, and it's relatively inexpensive to provide, that health care professionals don't do it! Shame on them, not the patients. Even if it cuts into his bottom line, he is OBLIGATED. Also, he could just refer you and let you decide and pay for it. I went to a bariatric center of excellence, and they did a good job of instruction. However, my insurance (that paid for almost everything) didn't pay for one of the dietitian meetings they required, so I had to pay out of pocket for it. The docs office gave me a break, and only charged $30 for it. So, you should never feel bad for seeking information - that's way different than a question like "I had surgery last week, and I ate a hamburger - Did I do any damage?". I think those are the questions that get irritating after a while.

[VSGAnn2014 12,992]

@@labwalker said:

There is a big difference between folks who didn't receive guidance, and need advice from others who have shared the same journey because they have no where else to turn.

I think the first poster was upset about folks who were told what to do by their doctors (such as no alcohol for six months) and then come here asking for some sort of validation for doing exactly what their doctor told them not to do.

@@labwalker, it's a bit of both.

Yes, some people seem committed to recreating their pre-op lifestyle as soon as possible. I sense that some patients would never have been approved for surgery if they'd had to jump through any hoops at all.

But I've been puzzled that people would commit to this surgery -- no matter where or at what price -- and not be prepared either by their surgeons or, in lieu of that, self-education about what they can expect and how they will live.

As @@tkauhi has just confirmed, some surgeons simply don't educate their patients about post-operative behaviors even a little bit. Mind-boggling!

I have to wonder how those surgeons' patients' complication rates and long-term success rates compare (on the whole) to those of patients whose surgeons prepared them better for post-WLS life.

Edited August 3, 2014 by VSGAnn2014

[une nouvelle vie 327]

I just assume they're asking a question they don't know the answer to and want to see if anyone is willing to answer, it really doesn't bother me. In my job I deal with people of all levels of intelligence and so what seems crystal clear to some is going to be confusing and a gray area to others.

Since quite a large number of people who have weight loss surgery lose weight and gain it all back I think it's an opportunity for us to support each other and provide as much good information as we can with as little judgment as possible.

As to why they'd commit to such a big surgery without a lot of research and reflection? Myriad reasons, I would imagine. Again, I think we're all assuming everyone has above average intelligence and self awareness and a lot of people simply do not. They may be feeling so desperate to lose weight they don't consider consequences or how much work really goes into it. Maybe they know someone who breezed through WLS and think they can too. As many reasons and you have people who do it.

[moonlitestarbrite 902]

i will attest that there are many people out there who receive lots of medical instruction and still claim that have no idea what they should be doing. i can tell you that lots of people never even look at the discharge paperwork they are given. there are lots of reasons for this. my MIL is one example of a person who has so much anxiety all the time, she doesnt really hear what other people tell her. esp doctors or medical people. then we have my FIL and my mom who hear, but dont care and disregard what the doctors tell them....

there are people who arent able to read their instructions, people who dont process verbal instructions, people who think doctors are full of shit, people who think they know better than doctors. i have a friend who gets rid of every doctor that doesnt agree with her. then takes her meds, not as prescribed, but as she thinks she should take them. i'm like, why do have a doctor? just order your meds from mexico! (she's a book keeper not in the medical field)

there are some people who get little preparation, esp private pay people, but there is tons of info online, all you have to do is a little research, but some people need/want to be told what to do... and not take responsibility for themselves, ever. surgery isnt going to change that.

[mi75 1,235]

I find it terrible that there are docs out there who aren't concerned with the liabilities of not informing their patients. in the hospital patients are required to sign an 'informed consent' prior to surgery. it basically says that you are FULLY INFORMED of everything that is going on, your post op care plan, instructions, etc. it becomes a legal part of the patient chart...

i think that the reason so many people have questions that make some of us cringe is education. my nut AND surgeon were both amazed at everything that i knew about dumping, diet, portions, eating plans, infections, drains, etc. I AM a nurse by training, but just because i'm a nurse doesn't make me knowledgeable in all areas of medicine. i did a TON of research before i even started the process.

i downloaded every book i could find to my Nook. i spent HOURS on this site and asked all sorts of questions. i read many MANY threads on the pre-op boards and the post op boards. i felt like i went into it VERY educated and aware of what was happening.

as a result, there has not been ONE thing that has happened surrounding my surgery and after-care that has been a surprise to me. i feel like i was fully prepared.

i also agree that maybe the folks who have a lot of hoops to jump through for insurance purposes MAY be better informed. just due to the simple fact that so many insurance companies require multiple visits with a nut, support groups, psych evals, etc. i know for me it was many months, even AFTER i had done all my research, before i got all the insurance requirements met.

Edited August 3, 2014 by mi75

[moonlitestarbrite 902]

i think most docs do a basic job of informing patients.. the more informed, the better the outcome. but not all docs track outcome. which is why some insurances require surgery in a center of excellence. ( where they track for at least 3 years)

surgeons, as a group, are notoriously bad at relationships with patients.

its really up to the patient. no matter what type of treatment you are getting. if you choose to be poorly informed, your outcome will not be as good as someone who is informed. its all about personal responsibility. maybe something a lot of us obese people arent to good at.

[Kindle 8,667]

I some cases, it may be a matter of ligitimate inability to comprehend directions provided. Maybe the patient has a learning disability. But I'd be willing to bet in most cases people are too lazy and have no interest in taking responsibility for themselves. They don't read the paperwork because it's just "so much". Or they aren't listening when the dr/nut is talking to them. I am a vet tech and believe me, even in veterinary care, client compliance is ridiculously low. I've even attend CE conferences with seminars designed to show us better ways to assure compliance.....all because these people are lazy (I'm giving them the benefit of the doubt that it's not because they are that stupid) It doesn't matter how much time I and the doctor spend going over medication dosing or postop care instructions, people just DONT LISTEN. I feel it's a complete waste of my time and breath to even bother talking to them. So when they call with a problem, I go over it AGAIN And I explain that all of that is on the paperwork they got that they just "threw away" or "can't find". Or my favorite - "I know that's what you told me, but my friend said....." So let your expert friend take care of your pets and quit wasting your money and my time. I'm sure doctors and nurses experience the same frustration I do.

And really, with all of the information available on the web, there's no reason not to be fully informed of every twist and turn of WLS. I went to Mexico, so didn't have any insurance hoops, but I researched for months and asked tons of questions both from online strangers and the surgeon's staff. In other words I took responsibility for my decision...I didn't expect anyone to hold my hand through it. And when it came to pre and postop medical instructions I followed my doctor's advice only. If I was unsure about something, I asked them, not you guys (no offense)

Or sometimes these people know the "right" answer to their questions but want to try and find someone to help rationalize their bad behavior. Unfortunately I've been slammed for the "kick in the ass" replies that these people actually need. So I've learned to move on and let these guys continue to self sabotage and be miserable.

Good post. Glad I'm not the only one.

Edited August 3, 2014 by Kindle

[Kissifur 244]

I have read a lot of questions from people regarding things that seem like don'ts. However those questions have just as much value for me as the million questions about stalls or the I'm two seconds out from surgery and have only lost 10 lbs what did I do wrong?

When I was about 2 weeks out I was unable to get my Water down and ended up dehydrated. Someone asked a question regarding the use of straws because that worked for them. Instead of a simple yes or no the soap boxes were out in force. A few days later I found that using straws helped me get my Water down. While straws were on my doctors list of donts, dying of dehydration was on my list of donts. I talked to my doctor about it and to my surprise he said if it works for you go ahead (the only concern was possible discomfort from air and not stretching my sleeve or a life threatening event). So I totally understand why people ask other patients and their doctor to see if the rule is smoke or fire and not necessarily because they are of below average intelligence or irresponsible.