Frustrated with my doctor's office!

[wheelz_10 2]

This is my first post! Hope it's okay.

Today I talked to the dietitian. I'm not stalled out but I wanted to make sure I was correctly on track. She recommended 500 cals/day. I'm 6 months out and I've lost 99 pounds after RNY.

Here's the kicker! The last three times I've seen the nurse practitioner, she's recommended I eat "more" calories, because my activity level is too high for this amount of calories. Also, the last time I went, she told me I hadn't lost enough weight.

So I've seen the nurse practitioner three times. The first time, I was eating 500 cals/day, and complaining of exhaustion and dizziness. She gives me the ok to up to 600 cals.

The second time, I was eating 600. She didn't say anything about my rate of weight loss, but again recommended adding more. She did not mention a specific number.

Third time, I'm eating probably 700, she tells me I haven't lost enough and that again, I need to up more. I ask for a specific recommendation and she says that I need to let my morning weight determine my eating plan. I stopped exercising after this visit since my activity level is clearly "too high."

It's been maybe 6 weeks since I saw the NP, so in an effort to get back on track after Christmas, I called today and asked for a recommended amount of calories. There's a long distance bike ride in my hometown in April that I'd like to train for. After all, part of the reason I had this surgery was to be able to do more things. The dietitian says to stay on 500 cals until I lose 75% of my excess body weight, and then I can up it to 600 MAX.

What??????????????????????????????

In her defense, I didn't mention the long distance cycling or anything but I did mention I was going to the gym 3-4 times a week and riding the bike for 45 minutes. I guess maybe I didn't tell her explicitly enough that I'm actually exercising and not just slowly riding the bike? I don't know. My husband checked the bariatric road map they gave us when the program first started and apparently at six months you're supposed to just be "walking" and not really getting your heart rate up.

I know bariatric recommendations are like the wild west out here and no two programs are the same. I know that I should be listening to my dietitian. But how is it possible that these two people are so far off? I was eating 800-1000 calories because I calculated my total daily energy expenditure, and 1000 should have me losing 2 pounds/week. Why aren't they on the same page???

SW: 316

CW: 217

75% excess body weight: 186

GW: ????

Edited December 30, 2019 by wheelz_10

[apiane 174]

8 minutes ago, wheelz_10 said:

This is my first post! Hope it's okay.

Today I talked to the dietitian. I'm not stalled out but I wanted to make sure I was correctly on track. She recommended 500 cals/day. I'm 6 months out and I've lost 99 pounds after RNY.

Here's the kicker! The last three times I've seen the nurse practitioner, she's recommended I eat "more" calories, because my activity level is too high for this amount of calories. Also, the last time I went, she told me I hadn't lost enough weight.

So I've seen the nurse practitioner three times. The first time, I was eating 500 cals/day, and complaining of exhaustion and dizziness. She gives me the ok to up to 600 cals.

The second time, I was eating 600. She didn't say anything about my rate of weight loss, but again recommended adding more. She did not mention a specific number.

Third time, I'm eating probably 700, she tells me I haven't lost enough and that again, I need to up more. I ask for a specific recommendation and she says that I need to let my morning weight determine my eating plan. I stopped exercising after this visit since my activity level is clearly "too high."

It's been maybe 6 weeks since I saw the NP, so in an effort to get back on track after Christmas, I called today and asked for a recommended amount of calories. There's a long distance bike ride in my hometown in April that I'd like to train for. After all, part of the reason I had this surgery was to be able to do more things. The dietitian says to stay on 500 cals until I lose 75% of my excess body weight, and then I can up it to 600 MAX.

What??????????????????????????????

In her defense, I didn't mention the long distance cycling or anything but I did mention I was going to the gym 3-4 times a week and riding the bike for 45 minutes. I guess maybe I didn't tell her explicitly enough that I'm actually exercising and not just slowly riding the bike? I don't know. My husband checked the bariatric road map they gave us when the program first started and apparently at six months you're supposed to just be "walking" and not really getting your heart rate up.

I know bariatric recommendations are like the wild west out here and no two programs are the same. I know that I should be listening to my dietitian. But how is it possible that these two people are so far off? I was eating 800-1000 calories because I calculated my total daily energy expenditure, and 1000 should have me losing 2 pounds/week. Why aren't they on the same page???

SW: 316

CW: 217

75% excess body weight: 186

GW: ????

Okay this is bonkers. WITHOUT heavy exercise, my nutritionist wants me between 900-1200 cal. I think that's way too much especially because I have a sedentary job. So I've looked at the forum and what most people do, and I stay between 600-800, w/ 60-90g of protein/day, I've lost a little over 74 lbs in 5 months. My nurse practitioner, surgeon, AND NUT would LOVE if I could exercise as much as you do. So I think you're right that you need more calories. You cannot be doing all that and only eating 500 calories you're going to pass out. I would maybe ask your PCP or seek out an outside nutritionist. You know your body.

[wheelz_10 2]

3 minutes ago, apiane said:

seek out an outside nutritionist. You know your body.

Actually that’s the best part!!! I went to school to be a dietitian!!!!!!!! I don’t practice or see patients but I definitely know a thing or two.

IM SO GLAD YOU THINK ITS BONKERS TOO. I called the office back and left a voicemail detailing their inconsistencies and my frustrations.

[Guest]

hey guys !!! B thankful. Since my surgery I did a six week visit and haven't heard from them since. The six week visit was bloodwork and " a sales pitch for "their" supplements Call us in the Spring to set up your next appointment.

[JB1 37]

I feel your frustration. I had surgery a week ago and was told at discharge to call my surgeons office to make a postop appt. And to call the Dietician to make follow up appts. I got the surgeons apt. 4 weeks out. However I've never recieved a call back from the dietician office and I left 2 vm msgs. ! I feel like they are not there to help at all. I was told at preop dietary mtgs. to follow the program book, but it is not specific enough to be helpful. TBH, I have found the answers I've needed this far from the vsg redditt community. Good advice from real people.

[Guest]

I agree JB1 . Once they have your money, you are on your own. That has been my experience anyway. I do not even have a direct number to my clinic. I have to go through a network of a surgical group. When I call I get a receptionist that answers for all of the surgeons, then she takes a message.

[wheelz_10 2]

I appreciate you guys! I'm obviously having a similar experience with my doctor. I was really nauseous last week and called to ask if they thought it could be related and the surgeon got on the phone and said "you're too far out for it to be related" and that was that. I thought they were supposed to be there to help this whole first year.

[apiane 174]

18 hours ago, wheelz_10 said:

Actually that’s the best part!!! I went to school to be a dietitian!!!!!!!! I don’t practice or see patients but I definitely know a thing or two.

IM SO GLAD YOU THINK ITS BONKERS TOO. I called the office back and left a voicemail detailing their inconsistencies and my frustrations.

Okay then you are DEFINITELY in a position to make your own nutritional decisions. Best thing I can recommend is to search through these message boards and see if you can find cal intake for people who are as active as you and are still losing weight, and base your plan around them. That's been what's been super helpful to me.

46 minutes ago, wheelz_10 said:

I appreciate you guys! I'm obviously having a similar experience with my doctor. I was really nauseous last week and called to ask if they thought it could be related and the surgeon got on the phone and said "you're too far out for it to be related" and that was that. I thought they were supposed to be there to help this whole first year.

This blows my mind. All of the respondents posts do. My surgeon's office is SO HELPFUL. I had a 1 week, 1 month, 3 month, and will have a 6 month and then yearly appointments. They have all been with the nurse practitioner (which is fine) except the 1 month was with my surgeon. Every time I see the NP I also see the NUT for about 10 mins just as a check in. Last time she just said I'm doing so well, keep doing what I'm doing. But I have her card with her direct line if I need it. Every time I've called their office they either get my an answer on that call, or call me back the same day with an answer. They gave me a card with things to watch for and the day and night phone numbers to call. I guess I should consider myself lucky.