I promise I'm not judging anyone. I promise, this isn't in response to any particular thread already existing on this forum.

I'm genuinely confused. I "think" in the US that most of us who are in programs paid by insurance, must go through a supervised weight loss period prior to insurance approval. It ranges from 3-6 months or even longer--maybe even a year or more? During that time, in my plan at least, we painstakingly go over my doc's pre-op and post-op diet regimen along with the vitamin and water schedules so that there isn't any doubt about what I'm supposed to be doing at any point in time after surgery.

So how is it that I read all over the internet (not just here on BP) about patients asking what they're supposed to eat immediately post-op, or x days post-op, or x weeks?

I swear how I don't understand this scenario? Is it different if you're self-pay maybe? I'm sure it's quite diff if you have surgery out of the country through medical tourism, perhaps? Do surgeons really put their patients through this life-changing, anatomy-altering surgery without fully explaining what to do once the surgery's over? It just seems so scary larry sketchy...as in a recipe for disaster!?

So confused and concerned about these peeps! (don't mind me...I'm easily amused by the googly eyes on these guys!)

kthanxbye.

I am in New Zealand, and my instructions were more vague than the ones I see posted here. Here we do almost no gastric surgery in public hospitals (most healthcare is free, public) so people pay to do it privately (here private hospitals, and insurance, is for things that are non essential, or where you don’t want to be on a wait list eg for a new hip for months). My private insurance paid 25% - they had no pre surgery requirements - decide to do it, op within a month. I paid 75%

My post op plan is clear about the need to transition from clear liquid - liquids - purée - Mash - soft food, but the timetable is all up to me. And it isn’t as clear as it could be about the pace of eating/drinking, I think. So I have lifted a set from this forum, and am happily sticking to those. My surgeon was ok with it, but also ok with setting my own timetable. I am happier being directed - after all, making good food choices isn’t exactly my thing, right? ???

Can anyone tell me what is a jp tube n why must u go home with it attached to you . also. RD. SORRY GUYS BUT IM NEW HERE. Thank you

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lovely,little stinker,isn't it? JP is a Jackson-Pratt drain, named for the Medical dudes who developed/refined this little rubber fellow. Used primarily in gynecology , Bariatrics, and abdominal surgeries, although I guess a surgeon could use it other areas where he/she expects a surgical wound that produces more fluid than the body can easily reabsorb. When it is removed, it should not hurt, maybe a tugging sensation, maybe you don't feel much at all.
Now I haven't had my bariatric so don't know if Dr Needleman
routinely uses them in his surgeries The once I had one before, I did feel something. Now no ROFLMAO but I felt. swooshy sensation, like you punched your finger into bread dough and then pulled it out. Still have a teensy tiny bit wider area in my incision scar, yours will not even do that. I had mine,in for than a day or two.
If you have one placed then your Doctor is looking out for you. ???

My surgeon requires three months of group meetings with the nutritionist (or three individual meetings if you are from out of the area, like me), psychologist screening, sleep study (I am already on C-PAP), exercise physiologist, and a quiz from the nutritionist at the end to determine if you are ready. I was issued a 1" binder with all of the pages professionally printed in thick, laminated card stock. None of the information within the binder contradicted any other information.

Since I was seen by a different bariatric surgeon back in April in Idaho and was referred to this surgeon in Salt Lake City, my "supervised weight loss" (from the insurance standpoint) actually started in April, so they fast-tracked me through the nutrition visits. I was scheduled each week with an individual appointment to see the nutritionist. Since June 29, 2019, (when I first saw the surgeon) I have had 16 appointments in six visits. I live in Ammon, ID and have to drive to Salt Lake City, UT each time. It is approximately 500 miles round trip. I have seen the surgeon three times so far. When I took the NUT quiz, there was an interview after to make sure I had absorbed the information - this was a contingency for my pre-op appointment. The surgeon said that if I do not get past the NUT, he would make me reschedule the pre-op appointment. That was not necessary since I passed the quiz and interview just fine.

Overall, I feel that I am in good hands and am well informed on what I am getting myself into. I wish this were the case for everyone...

Good luck!

Well if you wake up with a bee hive tattooed on your tummy you will know you had your surgery in the "Land of Milk and Honey". They are getting a great patient, I hope they know THAT!

10 hours ago, PALOMABELLA said:

Can anyone tell me what is a jp tube n why must u go home with it attached to you . also. RD. SORRY GUYS BUT IM NEW HERE. Thank you

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My surgeon required that I have it for about 2 weeks to draw out excess fluids from the surgical site. Some surgeons do not use it. Its a mater of practice and preference. I like to believe that every little precaution and step my surgeon took lead to my flawless recovery.

Well every surgeons requirements vary. But i follow a youtube chef named darius cooks on social media, he eats literally whatever he wants. But he paid out of pocket, so im not sure if he wasn’t given an eating plan, has a less strict eating plan or just doesn’t care. But i’ve seen that too. Everyone’s different.

Personally i started eating around 1 week, soups or dairy products. I just refused to do a pureed food phase and i was fine.

[mention=327398]BusyMom945[/mention] Wow! That would drive me batshit crazy in about 2.2 seconds! It's a short trip and I have a high performance crazy meter. I'm a planner/"practicer". I was the kid who actually LIKED repetitive piano practice. I used to transcribe my notes 3 times in college just so I could memorize minutia I'd never need. LOL. Compulsive much? Congrats on working your plan and staying in the moment!
[mention=322880]Barbzilla[/mention] Yes, I'm seeing that all of our plans are so different! And agree, Google is our friend or maybe they're our frenemy...I haven't quite got a definitive on that one yet. But I absolutely 200% (if that's possible) agree that having everyone jump in with their realities is super important to me and to my survival and well being! I soooo do not want for anyone's take away on this topic to be that I think people are uneducated people or that they shouldn't ask their questions here! Cuz God knows, I can read something and study it for weeks and months, and I still need to ask people questions about the material--if for nothing else, clarification and affirmation. Everyone is so super about that on this board!!!

When I teach patients amd their families in post op, I notice that whole learning style thing is evident (visual, auditory, tactile)
So, people learn differently. Also, some of us have a knack for health care info, others have their gifts/strengths in other areas.
The people in our country are not, for the most part, stupid.

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2 minutes ago, momrn247 said:

When I teach patients amd their families in post op, I notice that whole learning style thing is evident (visual, auditory, tactile)
So, people learn differently. Also, some of us have a knack for health care info, others have their gifts/strengths in other areas.
The people in our country are not, for the most part, stupid.

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Agree 10000%

I was self pay, they gave me a booklet of each phase and what I should be and shouldn’t be eating yet. That was basically it.

I'm self-pay, but my surgeon has a 3-month program he makes everyone go through, with 4 nutritionist visits, 4 visits with his PA, at least one visit/assessment with his psychologist, and a bunch of pre-tests (blood, ekg, echocardiogram, upper endoscopy, pulmonary, and if you score high enough on a particular survey, also a sleep study), plus a group class and a second meeting with him, two weeks before surgery. He also wants everyone to lose 10% of their initial weight, but if you have compelling enough reasons, he can sometimes be convinced to set that requirement aside.

I feel like a lot of what I know about post-op is from reading books (Colleen Cook's The Success Habits of Weight Loss Surgery Patients 3rd Edition and ... something put out by the American Diabetes Association; Googling, it looks like maybe it was 21 Things You Need to Know About Diabetes and Weight-Loss Surgery?), forums, blogs (I love Banana Tummy and hope she is still doing well!), medical websites, studies available on PubMed, and the handouts my team hasn't yet given me but I found on their website and Google. I have been reading compulsively, and I wonder how well prepared I would be if I hadn't been doing that, even with my surgeon's program.

(I mean, I would still know not to gobble Cinnabons. This whole, like, "protein first" thing ... yeah, they made sure I got that.)

I wouldn't mind a quiz! But there isn't one. Other than "don't gain weight before the surgery," I guess.

I had to do six months of nutritionist appointments and had to see a counselor twice and lose ten pound, plus go through the usual pre op diet to shrink my liver.
I then had to see the Bariatric nurse practitioner several time over the first 18 months. I now see them yearly and do yearly blood work. So I have a hard time understanding people who do none of these things.

I think, as with anything, different doctors will have different protocol and frankly, sometimes their protocol isn't the only way, or the best course of action. Pretty much everyone I know with a chronic illness is reading about and joining support groups for their condition, and often they're the ones coming to their doctor with suggestions, alternative protocol, etc. WLS is no different. We share and seek guidance from others who are going through the same thing, because we want to make informed decisions or simply because we need the support.

I think some people are just afraid. You’re just home from the hospital, you’re in pain, shuffling through papers to double check you’re eating the right thing is overwhelming and everything hurts to eat at first. Some people get a lot more instruction and some people just like posting and are reaching out for support.

I did not have to lose weight prior to surgery. I have Cigna insurance. There is also no requirement for me to see any doctor post op. I see all my doctors on my own accord but it’s not mandatory. Guessing insurances differ.