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To Tell or not To Tell my surgeon what went on tonight at support meeting-please advise



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My situation was that I had went to get a small unfill which is done by my surgeon,(for a week i couldnt keep anything more than 1 bite down) she was telliing me not to worry about numbers(such as how many grams of Protein and calories) and that if i can only get 1 bite of food down then that is fine, just eat one bite 3 times a day..SAY WHAT!!...she felt my band didnt need to be loosened, I stood my ground and she finally listened to me.

So when i got in my car, before i left the parking lot i was calling over to the nutritionist to state that those things totally contradicted what she (the nutrtionist) had been telling me since our very first meeting...and that the two of them should probably meet up and talk things over so everyone is on the same page lol. The nutritionist met with her and they did readjust a few guidelines..and in the end i decided to listen to the nutritionist..because i only plan to go for an adjustment, if the nutritionist looks at my meal logs (i see her every 2-3 months) and says my portions are too big, or if my weight loss stops....so as long as im losing and still at portions, then i must be doing something right.

Its so hard because every surgeon, baritrician, nutritionist all vary in their info from place to place...I go with what works for me, because i truly believe that with any format of losing weight (surgery or not) every person is different and different things work for different people.

I still say to talk to doc tho, because if its confusing you (understandably) then you need to feel comfortable with the info you are being given.

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As WLS gets more and more democratized, a certain type of patient will have access to it. Prior to its large-scale availability, the type of patient who would undergo the procedure was willing to do whatever it took to succeed. He/she was knew his/her life was at stake.

Now, with WLS criteria being lowered, and more insurance companies covering it, or loans being made available to cover it, the patient base is much much larger. And with that, you get some people who slip through the pre-op psych evaluations...or don't even have to get a pre-op psych eval.

So you get people like you report here...people who really don't have the mindset that is necessary and fundamental to success with the lapband (or sleeve, or bypass). People who will game the tool. (This is analogous to people who lose weight with something like Weight Watchers, but take all their points in chocolate, alcohol or other not-healthy foods. They may make it to goal, but they won't stay there long.)

These are the people who skew the success rate statistics due to their non-compliance with post-op rules.

It's a shame but it will become more prevalent as the procedures become democratized and normalized and available to a wider market.

I would definitely speak up because misinformation is being diffused by this person, and that misinformation is harmful not only for the person hearing it (who won't question it, as you did), but also for the success rate of the band in general. The person delivering that information needs to be trained correctly, so the practice who is employing her should know about this.

Ultimately it does no good for the practice if their patients don't succeed with the band, so they will want to hear your feedback.

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You see this is where there is an issue. The fact that there is such varying info out there. Most of what she said actually agrees with what I have been told and is the way that most banded patients in Australia eat.

There is no rule that say's you can't eat bread, pasta,rice. I eat most of these things regularly but in small quantities. Some of these may cause discomfort but everyone is different.

There are as many Dr's that say that carbonation is fine so long as you can tolerate it. I regularly use my sodastream to make soda Water and add a dash of lime to that.

I have never been told to only eat meat/protein once a day but also here we do not focus on low carb the way that Dr's in the USA do.

Yes I do eat the same way as I did before being banded but not as much. Maybe that is because my meals have always been fairly healthy. I don't eat much fast food, rarely eat pizza, have never been into fried foods etc etc.

So have a chat with your Dr but you may be surprised by his answer.

Wow someone else who has a sodastream, dont ya just love it.

Yes I drink soda in small amounts. At true results they tell you its ok, I dont know where some people think it makes your band slip. Im absolutly sure if it did true results would not allow you to drink any at all.

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You see this is where there is an issue. The fact that there is such varying info out there. Most of what she said actually agrees with what I have been told and is the way that most banded patients in Australia eat.

There is no rule that say's you can't eat bread, pasta,rice. I eat most of these things regularly but in small quantities. Some of these may cause discomfort but everyone is different.

There are as many Dr's that say that carbonation is fine so long as you can tolerate it. I regularly use my sodastream to make soda Water and add a dash of lime to that.

I have never been told to only eat meat/protein once a day but also here we do not focus on low carb the way that Dr's in the USA do.

Yes I do eat the same way as I did before being banded but not as much. Maybe that is because my meals have always been fairly healthy. I don't eat much fast food, rarely eat pizza, have never been into fried foods etc etc.

So have a chat with your Dr but you may be surprised by his answer.

I pretty much agree with you elcee. We are supposed to be able to eat what we want, but in smaller portions.

The only problem I have with this Nut is, a Nut is suppose to teach us nutrition. I think this girl would probably do well, if she stuck with teaching nutritional values to food.< /p>

LOL, The USA is one of the most obese countries, b/c of pizza and fried food. I've always convinced myself pizza was a highly nutritious food, to be eaten every day. I think we're a fast food country, we're to busy to eat healthy,lol.

I keep wondering how you're doing, after all your company and birthday celebrating?

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Tell the surgeon, he needs to know. This is serious stuff.

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I would definitely tell your surgeon what was said. Your surgeon, being the employer, is responsible for ensuring that all members of his team are "on the same page" so that his customers (patients) aren't given improper information. It's in the doctor's best interest to provide training for his employees to provide the appropriate standard of care within the specialty.

He needs to know and she shouldn't be fired, just educated re bariatrics.

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Perhaps she trained in the UK, Europe or Australia. Ŵhat she says is not far from what I was taught. When I was banded in 2006, the guidelines you quote were the ones I was taught but we are now told that research studies have found no link between carbonation and slips, that we need no more Protein than non-bariatric patients and that, unless we find it difficult, we can eat all foods. I am told this, not just by one nutritionist but by all the other UK bandsters I meet from their docs and from our national health service which covers the whole of the UK. I am told (but this is only hearsay) the information given in Australia and New Zealand and in Germany and Belgium is the same.

So maybe it is just that as a newly trained nutritionist, she has learned fhe latest theories.

In the same way that some docs still tell their patients that food must be held above the band for 20 minutes and neve gell people about the more recent research.

Kate

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I agree with others that many providers offer different advice. My surgeon himself has told me there is no such thing as a forbidden food for LB patients, but patients may have foods that don't agree with them and they don't eat those foods. He and his team believe that to be successful you have to learn to live a normal life with the band, that might include eating chips at a party or something, certainly not every day, but on occasion. The more restrictions (food not band) you have, the more likely you are to slip up or fail and then it's a domino effect.

My doc also said they are learning more and more about the band every day, he used to tell people to stop drinking 15 mins before a meal, he no longer says that, he feels current research says you can drink up to the meal, that is a change.

In your shoes I would just mention to the doc you heard some different info from the NUT at support group and you wanted to confirm if it applies to you. He may surprise you and agree with something like the soda (my doc again is ok with it and has never had a patient slip b/c of carbonation).

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Maybe just ask him for clarification since you're getting conflicting information. I'll be interested to hear what he says.

That is the way I would handle it. :)

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Yes I would say something but more like "so I'm confused as to what I can eat"and go on to tell him what she said. That way it won't seem like tattle tailing.

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thank you all so very much for your advice. Like I said, I certainly do not want to get her fired, she and I talk, laugh at the meetings and are friendly and I hate to see her lose her job, she's very sweet and is a very good nutritionist as far as food goes but I think needs trainging in bariatrics. I must add that I've learned most of what I know from all of you and I thank you for that. My surgeon is very good but is lax (sp?) on food choices, he says eat what you want but less of it but I'd like to see you eat healthy type of attitude. I mean like most of you, I didn't do a post op diet of 2 to 4 weeks of liquid diet, I did 2 days of liquid and went into straight mushies and soft foods after that. Oh lordy, I need to go to lap band school!

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If you read Paul O Brien's book The LapBand solution it ok's low calorie soft drinks, bread, Pasta and rice, which mirrors the advice we are given at his clinic - eat healthy in smll portions, 40g or so of Protein a day should be ok, tc. It even reports that based on clinic anecdotal data moderate wine drinkers lose more weight. Paul o brien is a band pioneer and trained a lot of US docs so it's a credible source. Australians lose weight with lapbands just like Americans do despite this differing approach. We don't lose all our muscle either.

Do what suits you and stay true to your own nutritional philosophy - eat the way you believe you lose and feel best and you wont go wrong but don't be so sure that she is wrong and you are right - you may end up looking a bit arrogant and rather silly if you make a big song and dance over this.

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I think you shold tell your surgeon. When I was having my surgery, one of the nurses who was giving me post-op care was a total b*tch. When I didn't immediately wake up after the asesthesia she started YELLING at me and threatening to force me out of bed. It was insane. I told my doctor about this and he was SO greatful! A doctor's staff represents the doctor and if they are doing a cr@ppy job then they make the doctor look bad and docs obviously hate this.

Also, remember that some of the stuff she was saying isn't necessarily wrong. It may contradict what YOU were told, but it's not entirely wrong. For example the carbonation: my doc has absolutely no issues with soda. (I have cut it out of my diet anyways because its unhealthy, but not because I was told i was at risk for a slipped band) I have read on here such a broad spectrum of opinions on soda and really, there is no right or wrong answer. Some docs are fine with it and some docs make their patients sign a contract saying that they will quit after surgery.

So while it may have seemed like the NUT was speaking total hogwash, it could be that she just learned differently. If it directly contradicts what your doctor is telling his patients then maybe he should know...

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If you read Paul O Brien's book The LapBand solution it ok's low calorie soft drinks, bread, Pasta and rice, which mirrors the advice we are given at his clinic - eat healthy in smll portions, 40g or so of Protein a day should be ok, tc. It even reports that based on clinic anecdotal data moderate wine drinkers lose more weight. Paul o brien is a band pioneer and trained a lot of US docs so it's a credible source. Australians lose weight with lapbands just like Americans do despite this differing approach. We don't lose all our muscle either.

Do what suits you and stay true to your own nutritional philosophy - eat the way you believe you lose and feel best and you wont go wrong but don't be so sure that she is wrong and you are right - you may end up looking a bit arrogant and rather silly if you make a big song and dance over this.

Oh no, by not means do I feel I'm right or she's wrong, I'm just confused more than anything as I've read, been told so many different things that I do not know what to eat or drink at this point in my journey 8 mos out. As far as alcohol I don't drink so that is out for me. And I can assure you I will not make a big deal out of this as I don't like to cause friction between people or hurt others. I will simply talk to my surgeon tomorrow and clarify what I can and cannot eat and drink and if he asks why I'm asking then if I feel compelled or obligated at the time to say something I will as he needs to know because his medical practice depends on his success of his fellow employees and patients. Thanks for your comments.

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You see this is where there is an issue. The fact that there is such varying info out there. Most of what she said actually agrees with what I have been told and is the way that most banded patients in Australia eat.

If you read Paul O Brien's book The LapBand solution it ok's low calorie soft drinks, bread, Pasta and rice, which mirrors the advice we are given at his clinic - eat healthy in smll portions, 40g or so of Protein a day should be ok, tc. It even reports that based on clinic anecdotal data moderate wine drinkers lose more weight. Paul o brien is a band pioneer and trained a lot of US docs so it's a credible source. Australians lose weight with lapbands just like Americans do despite this differing approach. We don't lose all our muscle either.

Do what suits you and stay true to your own nutritional philosophy - eat the way you believe you lose and feel best and you wont go wrong but don't be so sure that she is wrong and you are right - you may end up looking a bit arrogant and rather silly if you make a big song and dance over this.

So in general Australians have been told they can drink carbonation. Is there a higher incidence of band slippages in Aussieland?

Just wondering if there is any data on this

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