Rough Visit

[HanSolo1977 261]

So I had my first appointment with the dietician on Friday. It started out quite rough.

I had my weigh-in and I gained weight since my initial visit with the Bariatrician last month. I was +4 I think. That could be a deal-breaker. I need to be at or below my initial weight for her to pass me through.

She gave some great info, but I'm not sure I like her yet.

She's tiny (which I couldn't care less about but…). And she bragged about how she started eating like we're supposed to and lost 10 lbs and how she didn't ever have a gym membership because she does the "Soup can" exercises--"even though I'm a dietician"

Sorry just felt down and needed to vent.

Hope the psych thing tomorrow goes better

-H

[pegrae 88]

Hans good to vent when you are upset, we just need to not eat when we are upset. Did you gain 41 lbs? I went to my PCP for my letter of support, I left with my tail tucked between my legs. I really like him and was so excited for him to hear my plan for WLS. We became very distant and talked about how people regain the weight, ext. He gave me the letter it was one sentence long, stating my BMI and comorbidities. Wow..... I was mad for days until I sat and really thought about it, he has tried to help me loose weight and each time I have not been very successful. I think he thinks I won't be able to stay with it.... short we need to take charge of our own destiny.. Be honest with your psych appointment and hop on board with loosing those pounds so you can get that pass through for your WLS... Best of Luck

[Jodi C 14]

That dietician sounds like a piece of work. That visit wasn't about her. It's about you. Who cares what she's done or can do. If you want this surgery, you CAN lose the weight. Focus on you and all the reasons you want this and forget the nutritionist who was rude and unprofessional at your visit.

Sent from my iPhone using the BariatricPal App

[Dub 9,922]

You got this, Hans.

I've had very spotty coverage with nutritional guidance from my plans NUT's

Now, my initial NUT from the first surgeon's group (wound up changing surgeons midway through my deal.....long story) was golden. Very insightful and helpful.

Don't sweat it. Their delivery can be wonky.....hopefully their information is solid. Focus on the content and not the messenger. You'll need them on your side for the approval steps.

Time the grind it out on some weight loss and manage yourself so you can nail those incremental weigh ins.

Remember that in due time you'll be able to have any sort of food again, It sensible amounts. No need to think you're going to need "one last hurrah " binge sessions with various treats.

Apply either their diet or one that you know is safe and effective and you're on your way.

[J.lynn 50]

Hans good to vent when you are upset, we just need to not eat when we are upset. Did you gain 41 lbs? I went to my PCP for my letter of support, I left with my tail tucked between my legs. I really like him and was so excited for him to hear my plan for WLS. We became very distant and talked about how people regain the weight, ext. He gave me the letter it was one sentence long, stating my BMI and comorbidities. Wow..... I was mad for days until I sat and really thought about it, he has tried to help me loose weight and each time I have not been very successful. I think he thinks I won't be able to stay with it.... short we need to take charge of our own destiny.. Be honest with your psych appointment and hop on board with loosing those pounds so you can get that pass through for your WLS... Best of Luck

I discussed the possibility of WLS with my PCP prior to initially meeting with a surgeon. I was hoping for some positive feedback and maybe even a referral. Boy, was I let down. He basically told me that long-term success is rare and that there is not a lot of research on patients 10+ years post-op because it does not benefit the bariatric "business" to document it. He recommended a prescription for phentermine (which I had already tried before), a visit with a dietician, and to increase my activity levels.

I left his office feeling so utterly dejected and hopeless. I had done copious amounts of research on this surgery and after many failed attempts at dieting, work out plans, and prescriptions, I felt it was my last hope of losing the excess weight I have carried since childhood. To have a medical professional completely poo-poo the idea was absolutely devastating.

Since then, I have come to realize that most people who have never been obese do not understand the mental and physical road blocks that come with the territory. They have never experienced the monster that is emotional hunger rearing its nasty head daily. The mindless stupor that I fall into during a binge until I quiet the monster. The gnawing guilt I feel after I realize what I have just consumed. I go to sleep convincing myself that I'll start anew tomorrow.

** I have since learned to recognize the signs between emotional hunger and physical hunger. They are subtle but once you have them figured out, they are VERY clear. I recommend googling this if you have issues with binging, there are a couple of good websites. The trick is to distract yourself. I have started teaching myself to play the guitar.

How many sessions do you have with the dietician? I would recommend going to a different one that makes you feel more comfortable.

Edited March 21, 2016 by J.lynn

[J.lynn 50]

Double post, sorry.

Edited March 21, 2016 by J.lynn

[Djmohr 6,965]

Don't let the tiny one get to you. Obviously she is a bit unprofessional. As someone else said focus on the content and yourself. You know what you need to do to get those pounds and more back off.

Focus on good high quality Protein and vegetables. Stay away from sugar, Pasta, rice, bread and potatoes for now.

Start walking everyday, move your body more everyday.

Drink lots and lots of Water and stay away from sugary drinks. I know it sounds like a lot but you really can do this if you want it bad enough.

Obesity is a disease, a metabolic disorder. Many doctors that do not specialize in this area don't get it the only long term cure for obesity long term is surgery and a lot of major life changes.

To be successful your mindset really has to change and be ready for the changes that come with this surgery. If you are gaining, you are likely not doing what you need to.

Trust me, every change you make is well worth it!

[HanSolo1977 261]

Thanks everyone. I was about +4 I think. I know it's in the 5 lb window, but the number does have to the same or less than my initial.

I'm not sure if they'll let me switch to the other dietician. I will ask about that today

@@Dub & @@Djmohr her info is solid. I'm already switching over to what she is suggesting I do. I've recovered most of the weight I gained. I just have to decide if I can put up with her or not. I used to have a great dietician, but she has since left the business.

I'll make another post tonight and respond to everyone else. (Hard to move around on my phone) Thanks everyone for the words of encouragement

[CowgirlJane 14,259]

Naturally thin people can be wonderful advocates and they can be the most clueless. My advice in this whole process is to not personalize it to the extent possible. Alot of dumb stuff will be said but among that is the good advice and support. Unfortunately, a high quality, perceptive, knowledgable nutritionalist/dietician that can articulate the knowledge well seems to be a rare commodity.

I am at maintenance and I was super thrilled when I "lost" a 10# regain. However, there is no comparison between dropping 10# and losing 100-200# or whatever. People who lose 10# sometimes think - just do that 10X and you are golden! Well, it isn't quite so easy as all that - especially when you factor in long term maintenance. When a person is morbidly obese, their body is different.

Good luck - going through the process isn't too much fun but you will get there!

[VSGAnn2014 12,992]

@@HanSolo1977 ... hang in there. And congrats on relosing the small amount of weight you'd regained.

The rest of this is just a comment on nutritionists and dietitians and the advice available to WLS patients.

I realize nutritionists and dietitians must be a varied group. But I haven't yet met anyone in those lines of work who's ever been overweight, much less obese. Maybe what they learn about nutrition helps them not to gain weight. Or maybe their fascination with being naturally slim draws them into this line of work.

Based on my interactions with three NUTs (and having another one who's a close family member), I know that their levels of empathy for WLS patients can vary considerably.

It's not like the basic nutritional information related to WLS is rocket science. Because it's not. Macronutrients aren't complicated. But after being on WLS message boards for longer than two years, it's abundantly clear to me that everyone's body doesn't respond exactly the same to food. Some of us lose fast, some don't. Some are carb-tolerant, others aren't. Some maintain easily on 2,000 calories a day, others at the same size regain if they eat more than 1,200 cals/day. And these maintenance differences don't seem related to how much they exercise, their ages, etc. What's that about?

I truly wish there was more good science done in the fields of nutrition and dietetics that helped us understand what accounts for individual differences.

It seems to me that, for now, those who want to be very successful long-term have to perform science on themselves to fine-tune their own long-term nutritional programs. That doesn't mean the basic principles should be ignored. But it means that there's not a cookie-cutter, one-size-fits-all program for everybody.

[needtorecover 574]

Many natural thin folks have a hard time wrapping their minds around obesity and why people can't stop eating. For them, it's easy because their "full" signals aren't confused like ours, or they don't eat for comfort, or they're just blessed with remarkable metabolisms and never even have to think about it. My slender PCPs advised me away from WLS. I saw a dietician who swore if I just stuck to her 1800 calorie a day diet the weight would come off and stay off. One of my doctors told me to do South Beach, and another told me to start a walking program

All fantastic ideas, if my body would cooperate and I wouldn't backslide. In any case, you may want to look for a new dietician. Like others said, she made the appointment about her it sounds like ("I lost 10 pounds so it's not THAT hard!"). It is tough finding a dietician who is compassionate and understanding towards obese individuals but they're out there.

Hope the psych eval goes well!

Edited March 21, 2016 by needtorecover

[IncredibleShrinkingMan 437]

+4 is not that bad...I had +9 at one of my visits and then came back down to loss territory by the final meeting. The psych said the nutritionist shared some concern with him, but he didn't think much of it. You'll be fine.

[kaitlynm 335]

I think someone else already said it, but just put up with the NUT to get their sign off. Luckily I only had one encounter with the NUT at my Surgeons office. It was a required group meeting and all she did was read from the bariatric manual that my Doc provides. I had to pay $100 for that! Total waste of time and money, but at least I got the sign off. Try the high Protein, low carb and fat diet. That is what you will be doing the rest of your life so you might as well get used to it now. It is not so bad once you get used to it. The ultimate goal is the surgery, and it sounds like there are a lot of not so competent NUTs out there.

[HanSolo1977 261]

Sorry I did not report back last week. Real life is always getting in the way

So the psych was interesting. Very nice guy, but I think he's concerned about my care taking and such. It was mostly all questions and Monday I have to go do 2hrs of tests. I'm a little worried I came off like a flake. I completely forgot to ask him about my singing post op. It's really high on my list that I don't fudge up my voice. I make a bit of money singing.

I asked about the NUT. He suggested talking with her. I think I'll do that to start with. After all, you can't improve a situation without bringing it up. He also said that it would not be a problem if I switched. The only thing he would worry about if I started changing everybody around.

So now to test and worry until my next appointments in April

Incidentally, I've dropped below my initial weigh in! I've been trying to make my meals smaller and more nutritious. Hungry a lot but dealing

Edit: thanks everyone for the encouragement. It's much appreciated.

Edited March 24, 2016 by HanSolo1977

[2goldengirl 2,076]

@@HanSolo1977, I don't know that the psychologist would know anything about how the surgery could affect your voice. Definitely a surgeon question. There is a thread here for singers. As I remember, many who posted said they actually improved after surgery, either from hernia repairs or just being able to move air better without fat getting in the say.