How much guidance are you receiving before bypass surgery

[Myturn4me 0]

I met with my surgeon in February 2020 and he said bypass will be my best option. Based on my health insurance I have to meet with a Dietitian for 6 consecutive visits and have to talk with a Dietitian at the insurance company for 12 consecutive months as part of the requirements for surgery. I have a couple other requirements to meet also before being approved. I don't feel like I am getting knowledge on the Dietitian side of things from the hospital. They just ask if I have questions and their answers are always you will need to ask your surgeon when you see him again and that will not be until February 2021.

I just want to know how to plan meals and how to make the most out of each stage of eating.

I want to know how much it is going to hurt because I don't like pain.

I just feel like I am not getting guidance on things and I feel like I am all by myself.

Thank you for your time.

[BigSue 1,389]

My program requires a weight loss surgery seminar (general information about WLS), a one-on-one nutrition consultation with their dietitian, and a group nutrition class (general nutrition information and some info about the post-surgery diet). I also had a 3-month medically-supervised weight loss requirement from my insurance company, which was with my PCP, who did not provide any guidance other than "eat less and exercise more." A couple of weeks before my surgery, I had to attend what they called a "consent class," where they went over all of the possible complications of surgery plus detailed pre-op and post-op instructions.

Most of the information from the classes is included in the bariatric patient manual for my program. Does your surgeon have something like this? I think most programs do. If yours doesn't, you can search for manuals from other programs to get an idea, although every program varies a bit and you'll need to follow your own surgeon's instructions. You could call your surgeon's office and ask them if they have a document like this. There is a lot of information online about post-surgery meal planning and recipes (check out https://www.bariatriceating.com/blogs/recipes and http://theworldaccordingtoeggface.blogspot.com/). There are a lot of videos on YouTube about bariatric meal preparation, as well as people telling their personal WLS stories.

Pain can vary a lot from patient to patient, but I can tell you I had very little pain. The first day, when I woke up from surgery, I was in a lot of pain that I'm pretty sure was gas pain, but that went away very quickly, within 24 hours. I haven't felt any pain from the incisions. For the first few days, I had a little internal discomfort when I consumed fluids. I was given Toradol for pain while I was in the hospital, and I was sent home with several prescriptions, including hydrocodone + acetaminophen for pain (which I didn't take at all, and I didn't even feel the need to take regular Tylenol), ondansetron (Zofran) for nausea, and hyoscyamine for cramps/spasms. I haven't needed any of it after the first few days.

[toodlerue 452]

My i insurance Cigna has a dietitian & a RN call me every week or so to check on me I received so much help from them. See if your insurance has something like that!

My bypass was for medical purposes only. I had a high BMI for my height (36%). Half of my stomach was above my diaphragm. Since my doctor was a Thorasic surgon (and the leading lung replacement doc in my state). The only direction I got from him was to get all my info from the internet!

I didn't have any insurance hoops to jump through although it was pretty easy for my daughter to get approval.

Edited July 30, 2020 by toodlerue

[New&Improved 1,780]

7 hours ago, Myturn4me said:

I met with my surgeon in February 2020 and he said bypass will be my best option. Based on my health insurance I have to meet with a Dietitian for 6 consecutive visits and have to talk with a Dietitian at the insurance company for 12 consecutive months as part of the requirements for surgery. I have a couple other requirements to meet also before being approved. I don't feel like I am getting knowledge on the Dietitian side of things from the hospital. They just ask if I have questions and their answers are always you will need to ask your surgeon when you see him again and that will not be until February 2021.

I just want to know how to plan meals and how to make the most out of each stage of eating.

I want to know how much it is going to hurt because I don't like pain.

I just feel like I am not getting guidance on things and I feel like I am all by myself.

Thank you for your time.

I met with the surgeon a few times he explained each surgery in detail but I had already made up my mind to have the RNY bypass... He gave me some papers to read but I did tons of online research and months on this website to learn everything I needed....

Did see a dietitian once but she was clueless so I did it myself and it has worked out well... These days with access to Google and the www are able to find whatever we want... Not like the old days going to library hunting for out of date books LOL

[catwoman7 11,214]

as someone else said, pain is all across the board with these surgeries, but most of us have little to no pain. I had pretty much no pain with this at all. I was sent home from the hospital with a bottle of pain pills which I never opened - I just didn't need them.

the insurance-required diets are all so different that it's sort of pointless to even go into them. It's not a specific across-the-board diet - the insurance company just wants to be assured that you're capable of sticking to a plan. You'll likely get specific stages of eating from your bariatric clinic once you get closer to surgery date. We had I think four classes and they went over the guidelines pretty thoroughly. They'll have guidelines for the couple of weeks pre-op, and then several months post-op eating. But for the insurance-required diets that a lot of us have, the surgeons aren't involved in this and may not even be aware of what exactly they're having you do. It's really just for insurance approval.

my six-month insurance-required dietitian meetings weren't done through my bariatric clinic (my insurance company said it could be through any PCP or dietitian sometime within the past two years - they just needed documentation of the meetings). I actually had two different dietitians since the first one had to take a leave of absence for a couple of months due to caregiving responsibilities. Anyway, both had me gradually increase my Protein, gradually cut back on carbs, focus more on lean Proteins, fruits, and vegetables, had me gradually wean off carbonated beverages and caffeine, and start exercising regularly. In other words, start developing healthy habits. There wasn't a specific weight loss requirement (although I did lose 30 or 35 lbs), the company just wanted to see if I was capable of sticking to a program - which I was. It also helped to prepare me for what life after surgery would be like.

[Hop_Scotch 1,632]

2 hours ago, New&Improved said:

I met with the surgeon a few times he explained each surgery in detail but I had already made up my mind to have the RNY bypass... He gave me some papers to read but I did tons of online research and months on this website to learn everything I needed....

Did see a dietitian once but she was clueless so I did it myself and it has worked out well... These days with access to Google and the www are able to find whatever we want... Not like the old days going to library hunting for out of date books LOL

I am sure as you did so much homework that you would have made sure the dietician you saw was experienced in your preferred surgery method and had received good reviews. Just because we disagree or don't like what a professional dietician tells us, doesn't make them clueness, perhaps its means we don't have an open mind.

[JRT Mom 919]

16 hours ago, Myturn4me said:

I met with my surgeon in February 2020 and he said bypass will be my best option. Based on my health insurance I have to meet with a Dietitian for 6 consecutive visits and have to talk with a Dietitian at the insurance company for 12 consecutive months as part of the requirements for surgery. I have a couple other requirements to meet also before being approved. I don't feel like I am getting knowledge on the Dietitian side of things from the hospital. They just ask if I have questions and their answers are always you will need to ask your surgeon when you see him again and that will not be until February 2021.

I just want to know how to plan meals and how to make the most out of each stage of eating.

I want to know how much it is going to hurt because I don't like pain.

I just feel like I am not getting guidance on things and I feel like I am all by myself.

Thank you for your time.

Do you have a e-reader like Kindle? There are TONS of free or low cost books that will help with your meal planning and the different stages of eating.

As far as pain, I think you will be surprised at what a small amount you have. The hospital should stay on top of your pain relief the first day or two so the worst pain you will have will most likely be the gas pains from the surgery. My doc doesn't even send anyone home with pain meds because it's usually minimal!

If you feel like you aren't getting guidance from your bariatric team you might have to get sorta pushy about it. Make a list of questions that you have and when you go in for a visit be sure to bring your list and get them all answered. Be proactive about your care and you'll get a far better outcome!