Sorry if this comes off rude but....

I've been here for a little while and have read a lot of topics. Some things I've seen have really surprised me. I'm referring to topics where people ask questions that seem so basic that their surgeon or NUT should have explained to them on day 1. For example, I've seen people ask how much Water they're supposed to drink or how much Protein they need to get. Personally I had to meet with my NUT several times and sign papers saying that they explained everything to me, I got pamphlets and booklets and printouts and powerpoint presentations on what to eat and when along with meal ideas. This was all before I was given a date for surgery.

I'm just wondering if people simply aren't doing enough research ahead of time or if the doctors and nutritionists are dropping the ball.

Some people are self pay in either USA or outside the country. They may not have any classes.

I actually think the main reason is combination of overwhelmment and denial/non acceptance. I have a friend who is a dietician supporting a bariatric program. She is convinced about half her patients dont understand the instructions. She thought it is due to education level being lower in the supported population. Maybe.....but I think most can read just fine, it is the resistance to internalizing that is the issue.

I made a conscious choice to let go of my pride, my " knowledge" from decades of dieting, weight watchers etc. I followed instructions very closely that first year because Jane's way really hasn't worked so far. I wonder if some secretly harbor the notion that they already know.

I was self-pay, but nutrition education was still a required part of the program. There is really no excuse as far as I can see for any surgeon not to provide nutrition education as it is critical for success and a healthy outcome.

Unfortunately, quality of education does vary tremendously.

Also, not everyone has the same capacity and capability for comprehending/understanding, and listening/reading/literacy skills run the gamut.

Throw in possible language barriers, response to stress, etc. and a whole range of preconceived ideas and life experience, it's a wonder any of us get through this at all!

Something I'm curious about. Did any of you're NUTS or surgeons talk to you about stalls? Specifically the 3 week stall? Seems the only way we learned about it was on forums like these.

They either don't know about it, or don't bother to mention it to many people. I really wish they would warn people to ease the panic that sets in when it ultimately happens.

Mine certainly did not..when I went in for my 1 month post appt...I was frustrated about the stall (even complained here and that's how I found out it was normal). I even told my NUT I found out here...and she was a little offended and said "Yes it is normal, but don't believe everything you read on those forums."

I think it's like when you are buying a used car and the former owner neglects to tell you that sometimes the car won't start. Don't advertise the negative if you don't have to, it makes a better sell.

My NUT was very upfront about stalls. But, don't think it was something she stressed in the education classes because most of the time was spent on teaching us the importance of protein and fluid and helping us determine how to get in enough nutrition. The numbers on the scale were not a priority.

Agree. I am a "researcher" and a "planner" analytic type which helps. I was VERY well prepared thru my surgeon's office, bariatric coordinator, nut visit, and mandatory support meetings, 6 months supervised diet, etc... ALL preop requirements, but programs vary. Some folks live far from the city and so it's a 2+hour jaunt just to get to the Doc, let alone meetings where they might be better educated, some go to Mexico, (admittedly, I have no idea what the education protocol is for the various Medical Tourism options but I'd bet it varies as widely as it does here in the states). And not everyone absorbs information the same.

I was super lucky as my experience was "textbook" but I knew well what "could" happen and how I "might" feel afterwards and have several personal friends who experienced some of that. All of them went in with eyes open and regret nothing even though they had a rough go for a time.

Still my fav article on the subject...Success comes with a backbone, NOT a wishbone! http://www.obesityhelp.com/forums/amos/5307659/THERES-NO-CRYING-IN-BASEBALL-Wise-words-about-WLS/

I was talking more along the lines of the surgeon or NUT just saying something like this:

"You're going to lose quite a bit of weight the first couple to a few weeks after surgery, then it will probably come to a halt for a while because of these reasons".

Also, explaining that you aren't going to lose 100 pounds in a month.

I guess i'm just asking why they don't tell these patients who don't do years of research before hand (which is most people) about REALISTIC weight loss expectations and the 3 week stall. How hard would that be? Why do we see so many people with these crazy expectations of weight loss who think the second the scale doesn't move something is immediately wrong?

I can tell you for certain that when the information given has to do with weight loss, they will listen.

Did not get this talk at my program. I recall one woman mentioning she was "stalling" at a support group and the NUT saying some do experience them but honestly I assumed it was an anomaly.

I don't remember my NUT going over any type of meal plan, she would dispense opti fast, sample Vitamins , and would show a fake piece of chicken breast with fake veggies, on a smaller size plate, Protein first then veggies, that's about what I learned, anything else was from support group and obviously that still wasn't enough knowledge, I also live in a new state haven't found a support group that holds meeting, I have this sight

I had one of those programs that provided a comprehensive handbook. Like many others it had an overview of the 3 major bariatric surgeries (lap-band, sleeve & bypass), sample menu plans with both omni and vegetarian options, sample menu plans, list of Vitamin options, list of protein supplement options and step by step calories goals and menus for each stage from pre-op up to a year post-op. The first few months post op this was my bible. I refereed to it at every stage. When I was shopping for Protein shakes and vitamins, I took those pages out and carried them with me to the store.

I've heard of people who ere self pay Mexico saying the nutrition packet was a separate fee so they declined it and used the forums to figure out what to eat/drink.

My NUT was very upfront about stalls. But, don't think it was something she stressed in the education classes because most of the time was spent on teaching us the importance of Protein and Fluid and helping us determine how to get in enough nutrition. The numbers on the scale were not a priority.

Unfortunately, the numbers on the scale are a priority to most. You of all people know the predominant posts and questions on these forms are about stalls.

I'm just saying I find it odd that surgeons and NUTS don't really discuss it. After all, the main purpose of the surgery is to lose weight, so of course people are going to be hyper focused on that part of it.

But alas, I guess it will continue to be up to you to educate people about the reality of stalls with your awesome advice

a dietician supporting a bariatric program. She is convinced about half her patients dont understand the instructions. She thought it is due to education level being lower in the supported population. Maybe.....but I think most can read just fine, it is the resistance to internalizing that is the issue.

I'm considered educated by all standards and the English language and communication are the bases of my livelihood. When I found the earliest instructions confusing, it was because of anxiety over making mistakes. I was a bit compulsive about requesting clarification and repeating it back to be absolutely sure I was following. Soon enough things made sense and subsequent instructions weren't confusing. Lots of other bariatric people have told me the same. The difference may be that yet others don't ask for clarification or don't even know they're misunderstanding.

Please explain what you mean by "supported population," a new term to me, and whether it's the recipient of "supporting a bariatric program?"

I do agree with all of these comments, but this site is HOW people get educated.

These people who are asking these questions are in the comfort of their own home or offices.
In their sweat pants with music on, not in a stuffy doctors office slightly embarrassed and slighty nervous about why they are there.

We are all comfortable on here to ask stupid questions, silly questions, asking for heart felt advice, asking for support.

Perhaps these people were explained the information in detail but they were so numb by the experience, that they simply forgot. Perhaps, just like all of us we are more comfortable asking "bariatric pal friends" their advice than listening to a doctor who has repeated themselves 15 times that day.

Who are we do judge HOW people educate themselves. This site saved me from myself some days.

I used this site, among MANY MANY others and I felt completely un-judged, comfortable, confident with everything I put out there and everything I received.

This is a site where we should not judge others for not educating them selves .... WHEN THIS IS WHY WE ARE ALL HERE. Education and support.

*end rant*

So glad to see this topic! I am 3 weeks post-op as I am posting this--and have been nothing short of appalled @ some of the clueless comments--Almost as if every bit of prep suddenly "doesn't apply to you" and you have NO CLUE what to do with yourself regarding hydration, Protein...and the bit about asking a bunch of forum people "what should I be doing???"---hello---call your surgeon...Like anyone wants to accept liability?

NO ONE undergoes any form of WLS without education, literature being provided, multiple counseling sessions...

Some people just want / expect an easy out...And that just isn't going to happen...There are rules in this--and for good reason.

I can't agree more about the wide array of variables when services are recieved at a place that is NOT a Center of Excellence...Those 3 words mean a LOT...and the level of education, support and continuity of care are night and day from some of the more "high volume clinics"...

Many thanks to the OP for opening up a wonderful place to vent.

Edited December 10, 201510 yr by karen091866

NO ONE undergoes any form of WLS without education, literature being provided, multiple counseling sessions...

Some people just want / expect an easy out...And that just isn't going to happen...There are rules in this--and for good reason.

I can't agree more about the wide array of variables when services are recieved at a place that is NOT a Center of Excellence...Those 3 words mean a LOT...and the level of education, support and continuity of care are night and day from some of the more "high volume clinics"...

Many thanks to the OP for opening up a wonderful place to vent.

Actually I get most of my information from the forums and am very grateful for them. Insurance paid for my surgery at a center of excellence and I never met with a nutritionist prior to surgery and did not have any counseling sessions let alone multiple ones. So please do keep in mind that situations vary.

I love my surgeon and have nothing but good things to say about him. I had a nutritionist visit me the day after surgery before I got discharged and the information she handed me was a couple of handouts I had already received from a coordinator. So while I love my surgeon and I think he is fantastic, the actual materials provided were not very helpful.

Edited December 10, 201510 yr by VDLT

I am going thru a center of excellence and though I'm confident about the surgery, I don't think they've done a good job preparing me for it.

I've received a few random pieces of paper and have heard lots about eating Protein and not smoking.

My "counseling" consisted of listening to a retired counselor talk a out her grandkids & her religious beliefs for 4 hours, then 20 minutes of standardized tests that anyone with a brain would know how to defeat if they wanted to. My 7 hours of "education" thus far have consisted of watching movies about how wonderful life will be af ER surgery, and brief 15 minute intros by the gazillion different players in the program, with a few random paper handouts ("it's important to set goals!" Says the psychologist on staff, she hands out some goal setting sheets, then leaves...). The only person who came prepared with a coherent list of what to do was the insurance coordinator, God bless her soul!

I think each of the individuals in the program is knowledgeable and cares about the patients. And maybe I'll get some kind of coherent direction at my pre-op; if I do, I'll edit this post. But really, how hard would it be for them to put together a binder of pre and post op instructions, things to expect, etc?, and give that to you once you meet with the surgeon (cuz at that pt you are clearly serious)?

Wow, I didn't mean for this to turn into a full-on rant! Guess it was bugging me more than I realized!

All of the rebuttals and counter-arguments / hissing, etc... aside, each of us will attend follow-up appointments with our surgical team or WLS clinic...so THAT is where your information should primarily come from.

Anyone who elected to have surgery from a place that "poorly prepared them" should have done some shopping around. You get what you pay for...and after-care is a HUGE part of WLS and success.

There are some things that simply shouldn't be Googled....

I just ranted about this...http://www.bariatricpal.com/topic/356983-they-wont-help-themselves/

I just meant she is in a support role at a hospital that serves many (is it medicare or medicaid?) recipients in the inner city. I do not in fact believe it is a literacy issue, but she theorized it is. She is the skinniest tiniest woman you ever met so she really has no personal experience with weight issues.

a dietician supporting a bariatric program. She is convinced about half her patients dont understand the instructions. She thought it is due to education level being lower in the supported population. Maybe.....but I think most can read just fine, it is the resistance to internalizing that is the issue.

I'm considered educated by all standards and the English language and communication are the bases of my livelihood. When I found the earliest instructions confusing, it was because of anxiety over making mistakes. I was a bit compulsive about requesting clarification and repeating it back to be absolutely sure I was following. Soon enough things made sense and subsequent instructions weren't confusing. Lots of other bariatric people have told me the same. The difference may be that yet others don't ask for clarification or don't even know they're misunderstanding.

Please explain what you mean by "supported population," a new term to me, and whether it's the recipient of "supporting a bariatric program?"