Haven't posted since last Wednesday night—my head was spinning post-Pacific Bariatric required seminar.

I attempted to throw out a bit of dark humor that night with the off-key T/F question on our written exam Scripps requires, and it was hugely concerning to a few people—but overall, I've been dreadfully uncomfortable since the seminar, and tonight in my class was totally validated.

Check it out—

I travel frequently, and had to attend this particular seminar, and not a future date "field trip" with my entire class. I'm in the Kaiser SoCal program...in addition to six months of classes we have to meet with Scripps/Pacific Bariatric as well, since they perform the surgery contractually--last week was my chance to attend the seminar, and no one knew me in the auditorium (most classes go together as support groups and knew each other), and there were about 300 people in attendance.

After the presentation, the floor was open to questions.

Something I've been very concerned about is having a baby post-surgery, because I want ALL of the babies (even if that realistically means adoption), so I thought this was an excellent time to inquire as 1) this was the point of the seminar, and 2) I couldn't be the only woman thinking about this in the world.

When I raised my hand, this was the exchange between the surgeon (male) doing the presentation and me:

"You, in the back."

"Hi. I have a question about pregnancy post-surg—"

"Well, I can't tell you. I've never been pregnant, next question." (Laughter)

"No, excuse me—you need to answer this question please; I am here for information. What is the impact of this surgery on becoming pregnant and nourishing a baby during the pregnan—"

"Look, just wait 1-2 years and then talk to your doctor after the surgery. What I can tell you is that when you lose weight you'll be able to play with your children and that will be rewarding."

"No, you're not listening—I don't HAVE childr—"

"Next question, you, over there."

There was a murmur in the audience, but I just ducked low, embarrassed, thinking it perhaps WAS a dumb question. Went home. Did the exam and physical. Mailed off the paperwork yesterday certified delivery; haven't felt good about the entire experience. Thought it was "just me" overreacting...

Well.

In class tonight? The physiologist asked how the seminar went; told her it felt a bit off, and didn't elaborate further. She said,

"Yeah, that's what all of the classes have been reporting and we are having a meeting about it internally—apparently the surgeon was difficult, which is a shame, because he's considered one of the very best in the field. Did you notice anything? Did you ask any questions?"

"Yeah, we didn't click. I asked about post-surgery pregnancy and he just—"

"OH MY G-D, YOU ARE THE ONE EVERYONE IS TALKING ABOUT—I don't believe it! We are meeting because of this issue——all the students are talking and all of the doctors and counselors know! First, know that this won't happen again, and secondly, we are going to work as a team to put together information on post-surgery pregnancy because there really isn't much out there, and we think it is an incredible area of opportunity to cover since more than half of the population receiving this surgery are women, and women of childbearing age are becoming a normalcy (...)."

a) I don't feel like so much of a dolt now,

wasn't overreacting, and

c) now the Bariatric department is working on gathering information about post-surgery family planning for future patients.

Super stoked that a lot of sweetness is coming out of a sour situation. It means so much that enough of our peers; peers that don't even KNOW me, came back to KP and spoke up that what happened at the seminar was a problem in a big way. It wasn't a question they had, they didn't know if I was in KP or self-funded, the question may have not even been applicable to them...but there were people in that room who stepped up to the plate to make sure this didn't happen again, and suggested that the information should be integrated into the program.

#yas.

Anyway, that's the follow-up.

Onward.

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Edited August 11, 201610 yr by fatgirlsvelte

Awesome! I'm sorry he embarrassed you that way, but it sounds like good things are going to come from this. Good for you for trying to get your questions answered and putting yourself out there for those who are too afraid to do so.

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Thanks @Daniotra...but the real top-shelf people here are the ones that took the feedback from this back to KP and made change happen.

Admittedly, I was so embarrassed that I never intended to bring it up again. Had a draft written on Friday night for a post here, but it read like I was a "victim," and I couldn't find the right words to say "this Doc wasn't cool and I'm worried about having all the babies!"

Am thankful that our peers are willing to make noise, even when one of their own becomes an Ostrich (temporarily).

Good for you for trying to get your questions answered and putting yourself out there for those who are too afraid to do so.

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These are the thoughts that passed my mind when I read this thread.

The statement "half of the population receiving this surgery are women", isn't really true. Most of the individuals receiving weight loss surgery are women. I am not sure of the statistics but it may be 4 to 1. I don't know why because obesity is shared somewhat equally between men and women.

Asking about pregnancy after surgery is a good question. I am 3 years post-op RNY gastric bypass surgery. Prior to surgery, I attended a half day training session about the surgery and post-surgery requirements. We were given a 2/3 inch thick binder of information. This subject was addressed in the information. One of the viewgraphs in the presentation read:

Avoid Pregnancy

* It is recommended to wait at least 12-18 months following surgery.

* Low caloric intake cannot support a pregnancy.

* If you have been told by a doctor that you cannot get pregnant...DO NOT COUNT ON THAT!!!!

From my perspective, I would rather assess the quality of my surgeon by his/her technical expertise in performing the surgery than in his/her bedside manners. But maybe that is just me.

I'm sorry that happened but it is heart warming to hear other people spoke up on the matter. Bias against women's health issues in medicine and research is well documented and starting to get some more attention nationwide. It's sad that things have been this way for so long, and I'm not holding my breath but do hope we start to see more positive changes.

Oh, darling, it's baffling to me that you doubted yourself. You were completely correct and appropriate to ask and press for a useful reply. It's also baffling to me that the surgeon was such an extreme jerk.

It is gorgeous that you were vindicated by your peers and the KP staff and that the incident is leading to change.

Avoid Pregnancy

* It is recommended to wait at least 12-18 months following surgery.

* Low caloric intake cannot support a pregnancy.

* If you have been told by a doctor that you cannot get pregnant...DO NOT COUNT ON THAT!!!!

Very weirdly worded. I can't tell if that's a "go for it at the right time" or "egad, woman, have yourself spayed!"

From my perspective, I would rather assess the quality of my surgeon by his/her technical expertise in performing the surgery than in his/her bedside manners. But maybe that is just me.

You're not alone on that, but I'd hope to find balance in a surgeon. But maybe that is just me.

Interesting that it comes up now. Yesterday something brought to mind a letter to the editor in the New York Times many years ago. It responsed to an article about surgeons' bedside manners. The letter-writer was irate at having felt like a side of beef rather than a human being when the surgeon spoke to or about (to residents, interns and third-years, et al.) her. A few days later, a letter in response to the letter appeared: A man, not a medical type, expressed the view (I paraphrase) that no decent human being would be able to carve up another human being; that a surgeon must look at the patient as the medium for his/her art rather than a human in order to do surgery. I fully get that, but, in the setting the OP described, the surgeon was in a lecture hall, not an OR, scalpel in hand.

My baby factory is closed, period, end of discussion. LOL. But as a nurse, I am distressed many times by the attitudes of doctors when it comes to patient education. It's a pet peeve of mine to not give patients all the information they need. With repetition, since what we know about learning is that most people don't retain information well until they've heard it several times. I'm glad KP is responding to this problem. As a medical professional, I have never been impressed with KP, but I'm hearing a lot of things recently that indicate they're improving the things that concerned me.

I do know personally several people who have had successful healthy pregnancies after WLS - they were bypass patients not sleeve patients, so if they can have healthy pregnancies after I'm certain sleeve patients can. The biggest thing I've seen is absolutely do not let yourself get pregnant during the first year, preferably 18 months. Certainly as long as you're still losing weight. That's where the danger period is, and so many people who are overweight have had fertility problems, so they think they can't, but losing the weight fixes the fertility problems, and BAM, they're preggers. Have patience, and it'll all be OK.

Most women here who are a couple of years or more past surgery are reporting diets with intakes over 1,000 calories with many taking in 1,200 - 1,500. That's sufficient for supporting a healthy pregnancy, especially if you're able to bump it a few hundred without difficulty.

As with everything else, listen to your doctors. It sounds like you don't have a choice with the surgeon, but after surgery you can find someone knowledgeable with this area, who can guide you through it.

Good luck!!!

@@James Marusek, my responses in bold:

The statement "half of the population receiving this surgery are women", isn't really true. Most of the individuals receiving weight loss surgery are women. I am not sure of the statistics but it may be 4 to 1. I don't know why because obesity is shared somewhat equally between men and women. ​The majority of the individuals in my class are men. Perhaps it is different nationally? I'm quoting verbatim what was said, and can't speak to the blanket statement. SoCal KP may have an arch, who knows.

---

From my perspective, I would rather assess the quality of my surgeon by his/her technical expertise in performing the surgery than in his/her bedside manners. But maybe that is just me. Thought on this point, and my opinion—I don't accept this at all. If a patient cares enough to inquire and understand, the information needs to be given point blank, not totally dodged. Follow-up from KP was, and again verbatim, that this doctor was considered one of the best in the field and pioneered the VSG—didn't realize he was retired. Anecdotal, was also informed this morning that historically he was considered the worst in the field with bedside manners (which is sort of hilarious). All in all, it sounds like it was just a bit of a disaster overall—old and retired, brilliant, and salty surgeon of the Old School, who is a legend for his behavior.

Assessing the quality of work is critical, but nothing excuses being a jerk. I don't care how good someone is—a certain level of professionalism from my POV is necessary.

@@theantichick thanks for the great feedback here.

Just found out that this surgeon was retired, and a legend for his poor bedside manners are a part of that legend, inclusive of him being a pioneer in the VSG procedure. So...respect for his technical understanding is there, but for Heaven's sake he was flippant.

As far as the pregnancy goes, I'd love to have a baby naturally, but am definitely just in the forecasting stages. I'm 29 now, and my employer pays for 75% of all adoption costs. All in all, I may end up adopting, which is just as (important/appealing/fulfilling/fill in the blank here). It's going to be at least 33-35, so timeline wise, pregnancy should be fine if it happens post-surgery.

As far as KP goes? I've heard some not so killer things elsewhere...but my team here is stellar. I've been in treatment for a few ongoing issues for the last few years now, and I genuinely feel like I'm in great hands—the only other time I've felt this expertly cared for was in MN with Mayo.

Thanks again, @@theantichick. Good to have a medical professional jump in here.

@@WLSResources/ClothingExch I read this piece in the NYT too...

Overall (this is a general statement @WLSR/CE, not aimed at you specifically) Also agree that a surgeon's perspective can be different, but in the case of educational inquiries, being put aside is not appropriate.

I didn't ask, "Hey, cute white coat Doc, where did you get it?" The seminar served specifically has a platform for education, and I (as well as a few others, not exclusive here) had disregarded concerns, and IMO, this impacts the patient's choice on surgery locations and other considerations.

Regardless of the event though, good is coming out of the situation, so all will be OK.

@@fatgirlsvelte said "The statement "half of the population receiving this surgery are women", isn't really true. Most of the individuals receiving weight loss surgery are women. I am not sure of the statistics but it may be 4 to 1. I don't know why because obesity is shared somewhat equally between men and women. ​The majority of the individuals in my class are men. Perhaps it is different nationally? I'm quoting verbatim what was said, and can't speak to the blanket statement. SoCal KP may have an arch, who knows. "

Eighty percent of patients who undergo bariatric surgery, which involve procedures that either limit the amount of food that can be consumed or reduce food absorption, are female, despite equal rates of obesity among American men and women. https://health.ucsd.edu/news/releases/Pages/2015-04-29-men-less-likely-to-have-bariatric-surgery.aspx

*shrugging.*

@@fatgirlsvelte said "The statement "half of the population receiving this surgery are women", isn't really true. Most of the individuals receiving weight loss surgery are women. I am not sure of the statistics but it may be 4 to 1. I don't know why because obesity is shared somewhat equally between men and women. ​The majority of the individuals in my class are men. Perhaps it is different nationally? I'm quoting verbatim what was said, and can't speak to the blanket statement. SoCal KP may have an arch, who knows. "

Eighty percent of patients who undergo bariatric surgery, which involve procedures that either limit the amount of food that can be consumed or reduce food absorption, are female, despite equal rates of obesity among American men and women. https://health.ucsd.edu/news/releases/Pages/2015-04-29-men-less-likely-to-have-bariatric-surgery.aspx

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