Bariatric Specialist VS the Nutritionist, Round 1, Fight!

[BlueBongo 52]

(The original post didn't make sense as I wrote it when it was late and I was half asleep... so I copied and pasted what I wrote in the comments that should've been the ORIGINAL post!)

I am 33 (turning 34 on Thursday!), live in Phoenix, and have dealt with weight issues more significantly the past 8 years. In 2013 I was diagnosed with Pseudo tumor cerebri (inter cranial hypertension) with serve papilledema.

There are several WLS programs in Phoenix attached to various hospitals. My insurance covers either Dignity Health (St Joe's Hospital) or Bridges (St Luke's Hospital).

I had already made a plan to have the bypass in August 2015 after a stay in the ER from my brain almost exploding when I flew to Hawaii (I work for an airline...all my favorite hobbies are at high elevations and altitudes . I made my initial appt with a bariatric specialist/doctor...not a surgeon, on Sept 2 through the dignity health program. She is the one who put me on a lean and green diet. No fruit, no sugar, no carbs, no Beans, no dairy, etc, etc. 2 Protein Shakes a day. Advised me not to follow what ANY nutritionist told me because they were not properly trained (ie...they were taught using the food pyramid and she believes that is incorrect). I'm 3.5 months into the program with Dignity Health, but they are not helpful in letting me know when I might expect to meet the surgeon or all of that. I've given them all of my documents except the letter from my PCP.

Before my initial appt with my current program, a close friend of mine decided she also wanted to consider gastric bypass. So we went to a seminar hosted by the Bridges program that was helpful, informative, and answered sooooooo many questions as she has pcos. Sooo... I've been with her to some of her classes and support groups. My program isn't so user friendly, and Bridges has a central "patient advocate" that you give everything to paperwork wise and they deal with the insurance. I've got nothing like this with Dignity Health, but am to understand that somehow it is a better "program"...

As for my isurance.. it pays 100% minus my $225 deductible via bcbs.. requires a 6 month diet, and that's about it.

I don't know if it's worth changing programs, but my bariatric "specialist" seems like a bit loony and doesn't seem to have my best interests in mind. She irks my soul. Both programs use the same nutritionists and psychiatrists, as I just did both of those appts recently it shouldn't be an issue if I did switch.

I should also mention when I saw my nutritionist, who I will be following up with about once a month through this process... she has told me that the bariatric specialist I have been seeing for Dignity Health has patients that often fake their fitness pal accounts because she has us on these starvation diets for months on end, and it isn't safe. It just seems weird to me.

Edited November 15, 2015 by BlueBongo

[James Marusek 5,244]

I'm sorry, you lost me. What is Program A and B?

Both the bariatric surgeon and nutritionist should be on the same page. What is a bariatric specialist?

Here is my experience. Many health insurances require conditions be met before they will approve the surgery. Some of these relate to minimum BMI limits and co-morbidities. Others relate to diet and exercise. In my case, my BMI was above the limit meaning that I was obese, also I had several co-morbities such as High Blood Pressure, sleep Apnea, Diabetes. My insurance company required that I undergo a 6 month diet and exercise program to show that I was trying to lose weight on my own and unable to do so.

So in the pre-op stage, my doctor had me keep food journals to track what I ate (this highlighted where I was eating excess calories), prepare healthy meal plans, attend bariatric surgery support group meetings, perform daily exercise. All this information was eventually used in a letter that the doctor sent to my insurance company to support the need for the surgery.

At the end of 6 months, I lost 20 pounds and my RNY surgery was approved by my insurance company.

Since you are on a 700-800 calorie diet, you will need to take Protein shakes or your body will begin to degrade. For example you may lose hair. It probably also means that because you are consuming less food, you body does not have the material necessary to produce some of your needed Vitamins. Therefore taking a Multivitamin each day is probably an important part. I can't see that your specialist would object to this.

I guess the most important part of whatever decision that you make is to keep an eye on your goal. At this point it is to obtain approval for the surgery from your insurance company.

[jess9395 5,449]

People switch doctors all the time for a variety of reasons. If your concern is your insurance company call and ask, but I can't imagine it will be a problem. If your concern is the new doctor's requirements call them and ask them.

Long term success is often much better with more support.

If you do stay with your current program make sure you are taking enough Vitamins, especially the B Vitamins and Iron if you are a pre menopausal woman. That will help with the energy levels.

[BlueBongo 52]

I wrote that last night and in re-reading what I wrote.. I realize it makes little to no sense. I will be editing and re- posting in a more alert state of mind after work this morning.

[Inner Surfer Girl 12,015]

I wrote that last night and in re-reading what I wrote.. I realize it makes little to no sense. I will be editing and re- posting in a more alert state of mind after work this morning.

Great. When you do so it would help to know why you are required to be on such a low calorie diet pre-op. Is there a particular objective?

[BlueBongo 52]

I will just do it as a reply to my original while still on the clock.

I am 33 (turning 34 on Thursday!), live in Phoenix, and have dealt with weight issues more significantly the past 8 years. In 2013 I was diagnosed with Pseudo tumor cerebri (inter cranial hypertension) with serve papilledema.

There are several WLS programs in Phoenix attached to various hospitals. My insurances covers either Dignity Health (St Joe's Hospital) or Bridges (I don't remember exactly which hospital they are affiliated with).

I had already made a plan to have the bypass in August 2015 after a stay in the ER from my brain almost exploding when I flew to Hawaii (I work for an airline...all my favorite hobbies are at high elevations I made my initial appt with a bariatric specialist/doctor...not a surgeon, on Sept 2 through the dignity health program. She is the one who put me on a lean and green diet. No fruit, no sugar, no carbs, no Beans, no dairy, etc, etc. 2 Protein shakes a day. Advised me not to follow what aNY nutritionist told me because they were not properly trained (ie...they were taught using the food pyramid and she believes that is incorrect). I'm 3.5 months into the program with Dignity Health, but they are not helpful in letting me know when I might expect to meet the surgeon or all of that. I've given them all of my documents except the letter from my PCP.

Before my initial appt with my current program, a close friend of mine decided she also wanted to consider gastric bypass. So we went to a seminar hosted by the Bridges program that was helpful, informative, and answered sooooooo many questions as she has pcos. Sooo... I've been with her to some of her classes and support groups. My program isn't so user friendly, and Bridges has a central "patient advocate" that you give everything to paperwork wise and they deal with the insurance. I've got nothing like this with Dignity Health, but am to understand that somehow it is a better "program"...

As for my isurance.. it pays 100% minus my $225 deductible via bcbs.. requires a 6 month diet, and that's about it.

I don't know if it's worth changing programs, but my bariatric "specialist" seems like a bit loony and doesn't seem to have my best interests in mind. She irks my soul. Both programs use the same nutritionists and psychiatrists, as I just did both of those appts recently it shouldn't be an issue if I did switch.

Just looking for advice.

[citygirl1962 50]

I would make am appointment with a doctor at Bridges.

[BlueBongo 52]

Thank you!

[BlueBongo 52]

Switched programs and it was the best thing I could do. Found out that the one I had been in actually had no surgeons.. hadn't had surgeons for over six months yet the doctors were still seeing new patients.

Things are good. Thanks for all the advice!

[TMG1980TMG 136]

Switched programs and it was the best thing I could do. Found out that the one I had been in actually had no surgeons.. hadn't had surgeons for over six months yet the doctors were still seeing new patients.

Things are good. Thanks for all the advice!

thats crazy!

I wonder what their plan is after 6 months and people want to get surgery?!?

[GBLady41 393]

Switched programs and it was the best thing I could do. Found out that the one I had been in actually had no surgeons.. hadn't had surgeons for over six months yet the doctors were still seeing new patients.

Things are good. Thanks for all the advice!

I am sooo glad that you switched. That other program needs to be investigated. I'm sure your new program will be supporting and get you where you need to be. Now that you have the support, be sure to ask them whatever questions you may have.

[Inner Surfer Girl 12,015]

I too am glad you switched. Sounds like you are in good hands.

That first program sounds a bit looney to me, too.

[Amanda Dutton LPC 217]

A complete bariatric program is SO important for us! I'm sad to hear that the first doctor felt that a nutritionist would steer you wrong. I, too, feel that you made the right call by switching. We need all the support we can get, before and after surgery, so being in a program that takes a "whole person" approach is key.

Good luck in your journey, and keep us updated!