3mo follow-up review

[JennyBeez 289]

So I had my 3 month post-op follow up yesterday (at 14 weeks out). It went... about as well as my cynical little heart expected? Maybe better? LOL

My follow up was virtual, so I didn't have to go in to the hospital which is a plus. The dietician I saw today is mmmm... fifth I've spoken to in my program. I honestly would feel a little better if I could have the same dietician every time but I understand that can be hard to schedule. Plus it's still not the worst -- to be honest, I've only actively liked one of the dieticians and yesterday's I passively was ok with -- so at least it's better than the weirder three I've seen in between.

Review of my meds, of my health conditions as per usual. Somehow there's always something being left off from last time -- or several last times. Like, yeah, still have diabetes. My numbers are obviously a lot better now in my latest bloodwork, but considering it was one of the comorbidities that got me approved for this program/surgery it would be swell if I didn't have to surprise my care team 4/5 times by informing them of my past diagnosis.

Review of my eating habits. Fingers-rapped (gently) over a few things -- not getting enough fruits / veg with skin, not getting enough fibre in each my meals and snacks because it's mostly just in one or two meals. I mean, if my fibre intake is within the 25-35 per day range that they suggested, does it really frickin' matter if it's split up between 3 meals and two Snacks?

(Also, the fibre range wasn't brought up until yesterday -- it hasn't been mentioned to me at all by any of my care team, or in the pre-op and post-op guidelines and manuals they've distributed to date. The only actual numbers I've gotten from my care team has been about Protein, everything else has just been "keep it low fat" and "keep it low carb" and "stay away from sugars" etc in mildly vague terms. I figured out my own daily goals and limits for everything else by taking the average of what I could find online / in books / through the forum)

I asked specifically if my bloodwork reqs could be combined with the bloodwork my PCP wants since both of them want it every 3 months for mostly the same things, and I'd rather not take time off work for multiple blood tests -- or sacrifice my blood twice in a one-month period due to timing -- particularly because of the low Iron. And considering they both get copies of each other's test results anyway (thanks Ontario Health Care!). But no, no, we can't do that. They can't put his name down in the 'send a copy to this physician' area right in the form. Because apparently even though my PCP is the one to referred me to my endocrinologist, she's the one who referred me to the program. So they send the results to her, and she's on a network with my PCP which is how he gets my results as well. But they can't directly ADD him.

((Can my PCP just ask for the tests that he wants to check but they don't? Nope, cause in order for it to be approved by insurance they look to make sure there are corresponding requisites. Can I have my PCP just add them to his requisition? No, because as the surgery providers they need the requisition under their name for Ontario insurance purposes, and there are certain tests that my PCP can't request 'without reason' and that reason seems to be that everyone wants to bill the government insurance plan for every test they can, and my iron will 'replenish' so it's fine. Nevermind that I've had anemia on and off for most of my life and know from personal experience that the more often I'm tested, the more slowly my iron is replenished.))

((He was just a dietician. I shouldn't have bothered asking him. But the fact that he had an answer ready makes me feel like they get asked this a lot))

Other than that, it was ok. I've lost half the weight towards my goal weight. He reminded me to expect things to start slowing down. I nodded along even though I started a stall literally the day I hit my halfway score and even though my logic knew to expect and accept all this, my gut reaction was of course 'what have I done to eff this up???'. He was kind of crossing all his t's and dotting all his i's in terms of chiding me on dietary choices -- ie, every meal and snack being 50% protein, 25% non starchy veg, 25% complex carb. Suggested that I eat all these things that their own program handouts say not to start until between month 4 and 6, like nuts and seeds. I was ever so grateful for the internal consistencies. ((This happened with the last dietician at my 1 month -- which happened at my week 3. She was asking me why I hadn't been choosing to eat this or that, and I had to remind her that their handout and biweekly seminars both said not to until week 5-9))

All in all... I feel 'meh' about my follow up, but good about myself and good about my loss so far. And great about the salt & vinegar roasted edamame Beans I just had as a snack even though it was lacking a vegetable and isn't 'high enough in fibre per serving'.

In other news, I'm only day 7 into my second stall and have been fluctuation between calm acceptance and riotous panic that I'm messing up somehow even after nitpicking my diet and exercise with a fine tooth comb. My ADHD is saying I'm only working in one extreme or the other today/this week.

[ShoppGirl 5,061]

I live in the US but here my doctor actually sends the list of what he wants to my PCP asking them to order the labs. If I was you I would run that question by your doctor and explain your reasoning for it. Maybe there is a third option Ike both of them sending their requests to the lab at the same time and the lab eliminating the duplicate tests if they draw blood for both orders on the same day??

Edited June 28, 2024 by ShoppGirl

[MrsFitz 441]

How confusing re your bloods! I have quarterly bloods taken which have some overlap with those requested by the Bariatric team. I queried this and all they did was take one lot of bloods, put all the results on the system and alert both requesting consultants. I certainly didn’t want 2 separate lots of blood being drawn that say the same thing 😬

Isn’t it annoying when either you do as they ask and they tell you off or they haven’t told you to do something but should have and then tell you off for not knowing?? At least it seems that you have a grip on things, are able to keep on doing what’s best for you knowing that things are moving forward for you. Well done on your success so far. I hope your stall breaks sooner rather than later!