Hi - I’m new.

I just started everything - and my Dr is thrilled about my plans.

Saw the dietician - and I’m ANGRY - she asked me (well told me) to take a med that my Dr. said I really don’t have to - so I’m angry - do I listen to her or to the DOCTOR who is treating me. I’m diabetic and she’s more concerned about the diabetes than the dietary part...

sorry for the vent.

How much influence does the dietician have in the approvals process? Does the PCP (primary care physician) trump the dietician?

I am self pay so although I told my pcp and had a manditory session w a nutritionists, I feel that only myself and the surgeon could make the decision to move forward. (regardless of being self pay, there was never any pressure from the clinic to move forward, everything was at my pace.) I did tell my PCP as she has a right to know and she was supportive. If she wasn't for valid reasons, I certainly would have had to have had a rethink.

I can't answer your questions, but I would think that you might have to ask your insurance company what they require.

Call the Dr.and ask him what he wants for sure. And his opinion should be the one you follow. Is the dietican his referral. After the surgery you may have to deal with this person again so keep the lines open. After banding diabetes is much easier controlled so you may have these issue.

i is no dumy

I actually asked her today would she be the person I’d be following up/through the entire process with and she confirmed it. She’s nice and I’ve cooled off a little - I wrote her a note and blind copied the physician (ok I totally guessed his email address so maybe I didn’t blind copy him at all) but I am going to follow him first and listen to her advice -

Thank you for your message following up on our appointment today.

I don’t know if I communicated that I had a detailed conversation about this med (xxx) with Dr. at my appointment last week. I discussed the abdominal cramping and diarrhea which caused me to not eat (and impaired my work activities) - it was and is a vicious cycle - Dr. said take the xxx dose with my PM meal.

I will report the breakfast/lunch/dinner #’s to you in a week as requested. Please let me know if I should follow your direction or Drs?

Hope that wasn’t too passive aggressive - but I KNEW when she started questioning my numbers (6.5 a1c) I was going to blow a gasket - I’ve been diabetic for 10+ years and I’m not a fan of dietitians - she did not like the foods reported in my food journal because she is not a fan of Protein shakes - at all - and I do use them as a Meal Replacement and have when I’m on the go.

anyway...just wondering how much emphasis they put on the dietitians counseling - I think I can switch to another office and get a different counselor -

just jumping through hoops...

and thank you ladies for commenting...

thank you very much.

I know with my program some of the people involved are on the approval board and some aren't. I believe my dietician is, but my behavioral health specialist is not, but it could be different from hospital to hospital.

I guess I’ll shut my mouth and do whatever she says - the end justifies the means.

I just don’t like playing monkey in the middle -

Perhaps the surgeon you go to will have a dietician that they recommend who understands bariatric surgery a bit better. again I am not sure how it works w insurance and if you have to use the ones they send you to.

I hate that everyone has their fingers in it - and honestly I’ll call the Dr. tomorrow and ask the nurse to get him a message...in the mean time - I have an appointment with him in 2-3 weeks and I’ll ask him live and in person when I see him.

The physician's opinion will carry the most "weight" (excuse the play on words ). They have the greatest amount of schooling and responsibility. That expertise is what you're paying top dollar for!

The physician's opinion will carry the most "weight" (excuse the play on words ). They have the greatest amount of schooling and responsibility. That expertise is what you're paying top dollar for!

I feel confident my Dr. will make me feel better about this part - I just have an attitude about dietitians - I probably need to stop being so defensive -

Thank you all again!!! Can’t wait till this moves along.

It's a shame that your "team" is not all on the same page. My dietitian is awesome and ALWAYS defers to the doctors. She offers her opinion, but will always preface it with, "If this is a contridiction to what to the doctor tells you, call me and we'll work out another plan." I don't like "know it alls"--in any field!

It's infuriating when not everybody is singing from the same sheet of music, but getting angry about it isn't going to get you anywhere unless you decide to find another surgeon and start all over again. Even if your dietitian only gets half a vote in approving your surgery, you can't afford to lose even half a vote.

And bottom line is that only a doctor (or in some states, a nurse practitioner) can prescribe medication for you.

Thank you guys - I talked to my Dr’s office today and they assured me that the DOCTOR is in charge and follow his orders - that’s all I needed to hear - I have to see my Dr. and the dietician for 6 months before approvals go through - and My DOCTOR (his nurse assured me) is the one in charge of everything here!!!

Thanks for listening to my vent...

I’m so excited!!!