Education Session

[MrsFitz 440]

Tonight I went to the required education session that my NHS Trust has as a non-negotiable requirement of being accepted for surgery. I will be honest and say I was left feeling completely underwhelmed with it.

There was about 16 of us, all pre-op but at different stages of the required tests etc plus some family members (hubby went with me) There was also a Bariatric nurse, a dietitian and a former patient who had had the bypass in 2022. She explained her journey but it seemed very…I don’t know, sterile? Wrong word I know but I don’t know how else to explain her approach. She’s obviously happy with how it all turned out for her but it all seemed very whitewashed, which I found odd. She only mentioned one case of dumping syndrome but everything else was a walk in the park, which had me internally questioning things. She said she was currently in a months long stall but again, everything was hunky-dory. Someone asked about a typical days eating and it seemed really carb-heavy - toast for Breakfast, sandwich for lunch, cheese and crackers for a snack, sausage and chips or mash for dinner etc etc. I asked about what additional Protein she had - didn’t/couldn’t answer, asked about exercise - some walking and that’s about it. She mentioned Hair loss being an issue but that it all grew back and was great.

I know I’m being picky but I honestly wanted a more rounded discussion about of lots of different challenges that we could face with WLS and living the life post-op. I’d say out of the group that was there, maybe 5 had done any wider reading or research. I did find out that the hospitals approach to caffeine post-op is you can have a couple of cups of tea/coffee a day but they would rather patients filled up on foods/drinks that added protein, especially at the beginning. I also found out about the Vitamins they give you and that they put the timings on the boxes to aid patients with timings etc, which was useful.

Something that was bothering me was if my BMI dipped below 40, would I still be considered for surgery as I don’t have any co-morbidities like diabetes, heart issues etc. I need to get it below 40 before I will be considered for knee surgery, and I’m hoping that will happen end of Oct/beginning of Nov all being well. I was reassured about that, saying that they go off the booking weight reported by the GP when referred initially 🙂

I will be completely honest and say that, apart from some very specific questions I had of my hospital, I actually find this forum of much more use and beneficial to me personally. I have found out so much information from people who are further along in their own WLS journey, plus I know I’ve felt really supported by lots of very lovely and helpful users. There is such a wealth of experience on here that I know that if I have a question, someone will be along to answer it!

Roll on the dietitian appointment next week 🤞

[FifiLux 435]

Yes sounds a bit vanilla of a presentation and she certainly doesn't sound like the best example, even for someone who had no issues with the surgery or recovery as not giving a great example of how to live life after by the sounds of it. Do you have to go to many of the sessions or is it just a once off?

Do you need to have the knee surgery first? I was told I had to lose weight for knee surgery but hospital said to have the weight loss surgery first for two reasons, one to still be considered a high enough BMI (like you I had/have no co-morbidities) to qualify for the state paid surgery and also to release some of the weight pressure my knees are under before going through another surgery.

[MrsFitz 440]

That’s the word I was looking for @FifiLux- vanilla. Thankfully just a one-off though you can choose to attend more sessions if you want…I don’t want!

As for knee surgery - I was only told to get my BMI down to below 40 and nothing else. After checking whilst at the session last night, dropping below won’t be an issue as my initial BMI was 45.3 when the hospital received my referral from the GP. The fact that I have started losing weight shows commitment, as far as the hospital is concerned, to WLS. The only time surgery would be refused based on a lower BMI is if it went below 30 which I can’t see happening for me!! The Musculoskeletal Therapy team will give me a call around the end of October to see how things are with regards to the steroid injections and physio I should be having by then, and to check on my weight loss so I can be referred. I did say that I hoped to be 40 or just below by this time. I guess I will find out more once I’m referred. Honestly, I would prefer at least one knee replacement before WLS, purely because the recovery from the knee op can be pretty unpleasant and take several months but I know I have to be guided by the hospital with it all. I would like to have at least some movement when the heavy duty weight loss kicks in 😉

[FifiLux 435]

Ah that is ok then I thought it might be if you got to 35 which isn't that far off considering how well you have been doing already.

For the surgery here you have to have a BMI of 35 or greater or else 30 with co-morbidities.

[MrsFitz 440]

7 minutes ago, FifiLux said:

Ah that is ok then I thought it might be if you got to 35 which isn't that far off considering how well you have been doing already.

For the surgery here you have to have a BMI of 35 or greater or else 30 with co-morbidities.

Here it’s a BMI of 40 or over or 35 with co-morbidities. I know it probably sounds counterintuitive but I don’t want to lose much more pre-surgery once I get to around 18 stones (252lbs) because I don’t want to run the risk of falling off the weight loss wagon and having it bounce back up again, thus putting any surgery in jeopardy. It’s just a little frustrating when I have no idea when WLS may take place 🫤

[catwoman7 11,212]

I was one of those "model patient" presenters at my clinic for the three years before COVID! I loved doing that! I had a partner - a VSG patient (I was RNY). I'd had a stricture at four weeks out - she never had any complications. I'm hoping we didn't sound too "vanilla" - but neither one of us had any issues (other than my stricture - which is a mild issue and very easily fixed). We were both super happy with our surgeries and both lost a ton of weight (she lost 100 lbs, I lost over 200). Although I think people found us entertaining (we were quite a pair!) and most groups asked us lots of questions. We always told the groups about the three-week stall (since it happens to almost everyone, and very few clinics mention it to their patients, so people freak out when it happens to them). Also told them about how we ate a month out, a few months out, a year out (our clinic's plan wasn't low-carb, like many of them are - it was balanced - although even given that, the typical eating YOUR presenter does sounds carb-heavy even to me). We mentioned how we typically eat when we're at a restaurant. Talked about the extra skin (my partner even lifted her shirt to show them her extra skin). Also talked about our experience with Hair loss (since extra skin and hair loss are huge concerns among pre-ops). Also talked about Constipation (we both have chronic constipation) and how we deal with it. And how we dress to "hide" all the extra skin (although I've since had mine removed). We always mentioned how most people lose their interest in food and hunger for several months after surgery, and how they should milk that for everything it's worth since it's way easier to lose weight when you don't give a flip about food. Basically stuff they likely would not have picked up during the classes they had with dietitian and the health psychologist.

when I went through the classes in 2015, the presenter was kind of underwhelming, like yours. I'm sure he would have answered some of the questions we addressed when we were presenters, but he didn't, and the "students" wouldn't necessarily know enough at that point to even know what to ask. Shelli and I decide early on to talk about the issues they SHOULD ask about, but wouldn't know to.

P.S. now I'm sitting her wishing I was still doing that - it was great fun! But COVID hit, so everything went online, and they didn't have the "model patient" class. Since everything is in person again, they may have some people doing it, but the two of us are pretty far out now (nine years), so they may have gotten people who had their surgeries just a year or two ago.

Edited August 15 by catwoman7

[SleeveToBypass2023 2,598]

I wish I could do something like this!!! I definitely have things I could tell them about BOTH surgeries!!! I might look into it, although I have no idea where to even start.

[MrsFitz 440]

You discussed loads of other things there @catwoman7 in your ‘model patient’ session, which, IMHO was missing from last nights session. It’s just that everything was glossed over and it really didn’t get to the bones of things I guess. And you definitely hit the nail on the head about people not knowing what questions to ask, so not asking them. I think things like taking measurements and photos for example, would be useful, what to take to hospital, explaining changes in tastebuds, foods to eat for those first couple of stages, etc.

I know, I know, I AM being so very picky, I know it. I guess I was just disappointed and left feeling a bit sad for those who are just relying solely on the hospital sessions because I don’t think it was a proper representation. We all hope that surgery goes well and that we have no complications or issues or need additional help. I also think hospitals have to be honest with the things that can go wrong because it’s generally the negative things in life that impacts our weight and generally leads to weight gain.

But, it’s done now so 🤷‍♀️

[FifiLux 435]

1 hour ago, MrsFitz said:

But, it’s done now so 🤷‍♀️

Exactly, box ticked and now on to the rest of the steps they will have you do and as you say here is a great resource.

[ShoppGirl 4,785]

At least your program tried. Mine doesn’t even have anything in the way of patient education. They send you the nutritionist because because its a requirement but as any in of the providers or staff in their office and you will get a different answer bout nutrition specifics. This even includes the pre op and liquid diets and even the book they give you doesn’t match what they say. Then to complicate things even further they send in a nutritionist at the hospital with a whole differnt little book. Not sure what to follow. Just tried to pick tne most restrictive and hope For ghe best.

[MrsFitz 440]

19 minutes ago, ShoppGirl said:

At least your program tried. Mine doesn’t even have anything in the way of patient education. They send you the nutritionist because because its a requirement but as any in of the providers or staff in their office and you will get a different answer bout nutrition specifics. This even includes the pre op and liquid diets and even the book they give you doesn’t match what they say. Then to complicate things even further they send in a nutritionist at the hospital with a whole differnt little book. Not sure what to follow. Just tried to pick tne most restrictive and hope For ghe best.

It’s really confusing when different providers have varying requirements and approaches isn’t it? Don’t they realise that all they’re doing is adding to patients stress? I hope you’re doing OK after your surgery now @ShoppGirl?

[ShoppGirl 4,785]

1 hour ago, MrsFitz said:

It’s really confusing when different providers have varying requirements and approaches isn’t it? Don’t they realise that all they’re doing is adding to patients stress? I hope you’re doing OK after your surgery now @ShoppGirl?

I am. I literally just came from my one week post op. I had an unexpected gall bladder removal so a lot of my appt was my fears about that. Seems like the scary stuff is far less likely and the most likely will just be the issues with fatty food. She also cleaned my incision from the drain that came uncovered in the shower just because I’m over anxious about infection and when she seen how much pain I’m in when I laid down And sat up she said that I need to be on pain meds and I’m trying to be too tough. I just placed my Walmart order and added Tylenol. I’m gonna try they first. She also said with the SADI that it’s not uncommon to have issues with B12 but now that we add in the gall bladder thing she wants to start me on monthly injections. This should be interesting since i can’t even look when someone else gives me a shot. Guess like anything else I will get used to it.

[MrsFitz 440]

Blimey @ShoppGirlyou have had a lot to deal with this week! Gallbladder- I had mine out last year but I wasn’t told anything to avoid foods, drinks or anything but was warned that gall stones can come back in the bile duct. After a bit of a rocky start (lots and lots of Fluid leakage as my gallbladder was horribly inflamed which resulted in a much longer surgery blah blah blah) I’ve been fine ever since. Fingers crossed all will go well with that aspect of the week for you. Please take your pain meds and give yourself whatever respite you can. You’ve had 2 major operations this week and you are really going to be feeling it 😮 Would a heat pad give you any additional relief?

Injecting yourself - I inject one lot of meds weekly and another fortnightly and, believe it or not, I think it’s easier to self-inject than have someone else do it for you. I just grab a fat roll at the top of my thighs, hold the pen against my skin and press the button. I’ve to count to 10 before releasing. A quick wipe down with a sterile wipe and I’m good to go. Yes, it very occasionally hurts, like if I haven’t grabbed enough for the injection, plus you have to rotate your injection site as you can end up pretty sore with it if not (never had that problem, thankfully 🤞) You can also inject in your stomach if that’s a better choice for you. I was told that I have to have B12 injections every 3 months - I’m going to look like a dart board!!

[ShoppGirl 4,785]

14 minutes ago, MrsFitz said:

Blimey @ShoppGirlyou have had a lot to deal with this week! Gallbladder- I had mine out last year but I wasn’t told anything to avoid foods, drinks or anything but was warned that gall stones can come back in the bile duct. After a bit of a rocky start (lots and lots of Fluid leakage as my gallbladder was horribly inflamed which resulted in a much longer surgery blah blah blah) I’ve been fine ever since. Fingers crossed all will go well with that aspect of the week for you. Please take your pain meds and give yourself whatever respite you can. You’ve had 2 major operations this week and you are really going to be feeling it 😮 Would a heat pad give you any additional relief?

Injecting yourself - I inject one lot of meds weekly and another fortnightly and, believe it or not, I think it’s easier to self-inject than have someone else do it for you. I just grab a fat roll at the top of my thighs, hold the pen against my skin and press the button. I’ve to count to 10 before releasing. A quick wipe down with a sterile wipe and I’m good to go. Yes, it very occasionally hurts, like if I haven’t grabbed enough for the injection, plus you have to rotate your injection site as you can end up pretty sore with it if not (never had that problem, thankfully 🤞) You can also inject in your stomach if that’s a better choice for you. I was told that I have to have B12 injections every 3 months - I’m going to look like a dart board!!

Yikes. That sounds like you are going to look like a pin cushion. Your needle may be a little longer than what my B-12 will be. She said it’s short so you just punch it in like a dart and it doesn’t go into the muscle or anything. I have to start with once a month and then we will check labs a couple of times starting with my next appointment at one month and tweak it from there.

whats odd with the gallbladder is that i never had any symptoms. But they got the pathology report back which of course I don’t understand but the NP said it was very inflamed and I had gallstones. So I guess the timing was good to keep me from going through all this again in a few months.

I am going to take it more easy. A Heating pad sounds like it would feel good. I’m going to call right now and ask if that’s okay.

Edited August 15 by ShoppGirl

[BlondePatriotInCDA 494]

I too found the required group meeting pointless. I did it online because I'm not a group therapy type. The topics were just listening to others who've gone through it and to be frank like you I found it boring and lacked any real info. I too find this forum a better alternative. So..just go through the hoops and come out the other side!