Jump to content
×
Are you looking for the BariatricPal Store? Go now!

Frustrated with my doctor's office!



Recommended Posts

This is my first post! Hope it's okay.

Today I talked to the dietitian. I'm not stalled out but I wanted to make sure I was correctly on track. She recommended 500 cals/day. I'm 6 months out and I've lost 99 pounds after RNY.

Here's the kicker! The last three times I've seen the nurse practitioner, she's recommended I eat "more" calories, because my activity level is too high for this amount of calories. Also, the last time I went, she told me I hadn't lost enough weight.

So I've seen the nurse practitioner three times. The first time, I was eating 500 cals/day, and complaining of exhaustion and dizziness. She gives me the ok to up to 600 cals.

The second time, I was eating 600. She didn't say anything about my rate of weight loss, but again recommended adding more. She did not mention a specific number.

Third time, I'm eating probably 700, she tells me I haven't lost enough and that again, I need to up more. I ask for a specific recommendation and she says that I need to let my morning weight determine my eating plan. I stopped exercising after this visit since my activity level is clearly "too high."

It's been maybe 6 weeks since I saw the NP, so in an effort to get back on track after Christmas, I called today and asked for a recommended amount of calories. There's a long distance bike ride in my hometown in April that I'd like to train for. After all, part of the reason I had this surgery was to be able to do more things. The dietitian says to stay on 500 cals until I lose 75% of my excess body weight, and then I can up it to 600 MAX.

What??????????????????????????????

In her defense, I didn't mention the long distance cycling or anything but I did mention I was going to the gym 3-4 times a week and riding the bike for 45 minutes. I guess maybe I didn't tell her explicitly enough that I'm actually exercising and not just slowly riding the bike? I don't know. My husband checked the bariatric road map they gave us when the program first started and apparently at six months you're supposed to just be "walking" and not really getting your heart rate up.

I know bariatric recommendations are like the wild west out here and no two programs are the same. I know that I should be listening to my dietitian. But how is it possible that these two people are so far off? I was eating 800-1000 calories because I calculated my total daily energy expenditure, and 1000 should have me losing 2 pounds/week. Why aren't they on the same page???

SW: 316

CW: 217

75% excess body weight: 186

GW: ????

Edited by wheelz_10

Share this post


Link to post
Share on other sites

8 minutes ago, wheelz_10 said:

This is my first post! Hope it's okay.

Today I talked to the dietitian. I'm not stalled out but I wanted to make sure I was correctly on track. She recommended 500 cals/day. I'm 6 months out and I've lost 99 pounds after RNY.

Here's the kicker! The last three times I've seen the nurse practitioner, she's recommended I eat "more" calories, because my activity level is too high for this amount of calories. Also, the last time I went, she told me I hadn't lost enough weight.

So I've seen the nurse practitioner three times. The first time, I was eating 500 cals/day, and complaining of exhaustion and dizziness. She gives me the ok to up to 600 cals.

The second time, I was eating 600. She didn't say anything about my rate of weight loss, but again recommended adding more. She did not mention a specific number.

Third time, I'm eating probably 700, she tells me I haven't lost enough and that again, I need to up more. I ask for a specific recommendation and she says that I need to let my morning weight determine my eating plan. I stopped exercising after this visit since my activity level is clearly "too high."

It's been maybe 6 weeks since I saw the NP, so in an effort to get back on track after Christmas, I called today and asked for a recommended amount of calories. There's a long distance bike ride in my hometown in April that I'd like to train for. After all, part of the reason I had this surgery was to be able to do more things. The dietitian says to stay on 500 cals until I lose 75% of my excess body weight, and then I can up it to 600 MAX.

What??????????????????????????????

In her defense, I didn't mention the long distance cycling or anything but I did mention I was going to the gym 3-4 times a week and riding the bike for 45 minutes. I guess maybe I didn't tell her explicitly enough that I'm actually exercising and not just slowly riding the bike? I don't know. My husband checked the bariatric road map they gave us when the program first started and apparently at six months you're supposed to just be "walking" and not really getting your heart rate up.

I know bariatric recommendations are like the wild west out here and no two programs are the same. I know that I should be listening to my dietitian. But how is it possible that these two people are so far off? I was eating 800-1000 calories because I calculated my total daily energy expenditure, and 1000 should have me losing 2 pounds/week. Why aren't they on the same page???

SW: 316

CW: 217

75% excess body weight: 186

GW: ????

Okay this is bonkers. WITHOUT heavy exercise, my nutritionist wants me between 900-1200 cal. I think that's way too much especially because I have a sedentary job. So I've looked at the forum and what most people do, and I stay between 600-800, w/ 60-90g of protein/day, I've lost a little over 74 lbs in 5 months. My nurse practitioner, surgeon, AND NUT would LOVE if I could exercise as much as you do. So I think you're right that you need more calories. You cannot be doing all that and only eating 500 calories you're going to pass out. I would maybe ask your PCP or seek out an outside nutritionist. You know your body.

Share this post


Link to post
Share on other sites

3 minutes ago, apiane said:

seek out an outside nutritionist. You know your body.


Actually that’s the best part!!! I went to school to be a dietitian!!!!!!!! I don’t practice or see patients but I definitely know a thing or two.

IM SO GLAD YOU THINK ITS BONKERS TOO. I called the office back and left a voicemail detailing their inconsistencies and my frustrations.

Share this post


Link to post
Share on other sites
Guest

hey guys !!! B thankful. Since my surgery I did a six week visit and haven't heard from them since. The six week visit was bloodwork and " a sales pitch for "their" supplements Call us in the Spring to set up your next appointment.

Share this post


Link to post
Share on other sites

I feel your frustration. I had surgery a week ago and was told at discharge to call my surgeons office to make a postop appt. And to call the Dietician to make follow up appts. I got the surgeons apt. 4 weeks out. However I've never recieved a call back from the dietician office and I left 2 vm msgs. ! I feel like they are not there to help at all. I was told at preop dietary mtgs. to follow the program book, but it is not specific enough to be helpful. TBH, I have found the answers I've needed this far from the vsg redditt community. Good advice from real people.

Share this post


Link to post
Share on other sites
Guest

I agree JB1 . Once they have your money, you are on your own. That has been my experience anyway. I do not even have a direct number to my clinic. I have to go through a network of a surgical group. When I call I get a receptionist that answers for all of the surgeons, then she takes a message.

Share this post


Link to post
Share on other sites

I appreciate you guys! I'm obviously having a similar experience with my doctor. I was really nauseous last week and called to ask if they thought it could be related and the surgeon got on the phone and said "you're too far out for it to be related" and that was that. I thought they were supposed to be there to help this whole first year.

Share this post


Link to post
Share on other sites

18 hours ago, wheelz_10 said:


Actually that’s the best part!!! I went to school to be a dietitian!!!!!!!! I don’t practice or see patients but I definitely know a thing or two.

IM SO GLAD YOU THINK ITS BONKERS TOO. I called the office back and left a voicemail detailing their inconsistencies and my frustrations.

Okay then you are DEFINITELY in a position to make your own nutritional decisions. Best thing I can recommend is to search through these message boards and see if you can find cal intake for people who are as active as you and are still losing weight, and base your plan around them. That's been what's been super helpful to me.

46 minutes ago, wheelz_10 said:

I appreciate you guys! I'm obviously having a similar experience with my doctor. I was really nauseous last week and called to ask if they thought it could be related and the surgeon got on the phone and said "you're too far out for it to be related" and that was that. I thought they were supposed to be there to help this whole first year.

This blows my mind. All of the respondents posts do. My surgeon's office is SO HELPFUL. I had a 1 week, 1 month, 3 month, and will have a 6 month and then yearly appointments. They have all been with the nurse practitioner (which is fine) except the 1 month was with my surgeon. Every time I see the NP I also see the NUT for about 10 mins just as a check in. Last time she just said I'm doing so well, keep doing what I'm doing. But I have her card with her direct line if I need it. Every time I've called their office they either get my an answer on that call, or call me back the same day with an answer. They gave me a card with things to watch for and the day and night phone numbers to call. I guess I should consider myself lucky.

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Trending Products

  • Trending Topics

  • Recent Status Updates

    • Prdgrdma

      So I guess after gastric bypass surgery, I cant eat flock chips because they are fried???  They sell them on here so I thought I could have them. So high in protein and no carbs.  They don't bother me at all.  Help. 
      · 1 reply
      1. NickelChip

        It's possible for a very high fat meal to cause dumping in some (30% or so) gastric bypass patients, although it's more likely to be triggered by high sugar, or by the high fat/high sugar combo (think ice cream, donuts). Dietitians will tell you to never do anything that isn't 100% healthy ever again. Realistically, you should aim for a good balance of protein, carbs, and fat each day. Should you eat fried foods every day? No. Is it possible they will make you sick? Maybe. Is it okay to eat some to see what happens and have them for a treat every now and again? Yes.

    • NovelTee

      I'm not at all hungry on this liquid pre-op diet, but I miss the sensation of chewing. It's been about two weeks––surgery is in two days––and I can't imagine how I'll feel a couple of weeks post-op. Tonight, I randomly stumbled upon a mukbang channel on YouTube, and it was strangely soothing... is it just me, or is this a thing? 
      · 1 reply
      1. NickelChip

        I actually watched cooking shows during my pre-op, like Great British Baking Show. It was a little bizarre, but didn't make me hungry. I think it was also soothing in a way.

    • Clueless_girl

      How do you figure out what your ideal weight should be? I've had a figure in my head for years, but after 3 mths of recovery I'm already almost there. So maybe my goal should be lower?
      · 3 replies
      1. NickelChip

        Well, there is actually a formula for "Ideal Body Weight" and you can use a calculator to figure it out for you. This one also does an adjusted weight for a person who starts out overweight or obese. https://www.mdcalc.com/calc/68/ideal-body-weight-adjusted-body-weight

        I would use that as a starting point, and then just see how you feel as you lose. How you look and feel is more important than a number.

      2. Clueless_girl

        I did find different calculators but I couldn't find any that accounted for body frame. But you're right, it is just a number. It was just disheartening to see that although I lost 60% of my excess weight, it's still not in the "normal/healthy" range..

      3. NickelChip

        I think it's important to remember that the weight charts and BMI ranges were developed a very long time ago and only intended to be applied to people who have never been overweight or obese. Those numbers aren't for us. When you are larger, especially for a long time, your body develops extra bone to support the weight. Your organs get a little bigger to handle the extra mass. Your entire infrastructure increases so you can support and function with the extra weight. That doesn't all go away just because you burn off the excess fat. If you still had a pair of jeans from your skinniest point in life and then lost weight to get to the exact number on the scale you were when those jeans fit you, chances are they would be a little baggy now because you would actually be thinner than you were, even though the scale and the BMI chart disagree. When in doubt, listen to the jeans, not the scale!

    • Aunty Mamo

      Tomorrow marks two weeks since surgery day and while I'm feeling remarkably well and going about just about every normal activity, I did wind up with a surface abscess on on of my incision sights and was put on an antibiotic that made me so impacted that it took me more than two hours to eliminate yesterday and scared the hell out of me. Now there's Miralax in all my beverages that aren't Smooth Move tea. I cannot experience that again. I shouldn't have to take Ativan to go to the lady's. I really looking forward to my body getting with the program again. 
      I'm in day three of the "puree" stage of eating and despite the strange textures, all of the savory flavors seem decadent. 
      I timed this surgery so that I'd be recovering during my spring break. That was a good plan. Today is a state holiday and the final day of break. I feel really strong to return to school tomorrow. 
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Now that I'm in maintenance mode, I'm getting a into a routine for my meals. Every day, I start out with 8-16 ounces of water, and then a proffee, which I have come to look forward to even the night before. My proffees are simply a black coffee with a protein powder added. There are three products that I cycle through: Premier Vanilla, Orgain Vanilla, and Dymatize Vanilla.
      For second breakfast on workdays, I will have a low-fat yogurt with two tablespoons of PBFit and two teaspoons of no sugar added dried cherries. I will have ingested 35-45 grams of protein at this point between the two breakfasts, with 250-285 calories, and about 20 carbs.
      For second breakfast on non-workdays, I will prepare two servings of plain, instant oatmeal with a tablespoon of an olive oil-based spread. This means I will have had 34 grams of protein, 365 calories, and 38 carbs. Non-workdays are when I am being very active with training sessions, so I allow myself more carbohydrate fuel.
      Snacks on any day are always mixed nuts, even when I am travelling. I will have 0.2 cups of a blend that I make myself. It consists of dry roasted peanuts, cashews, pumpkin seeds, sunflower seeds, pistachios, and Brazil nuts. This is 5 grams of protein, 163 calories, and 7 carbs.
      Breakfast and snacks have been the easiest to nail down. Lunch and dinner have more variables, and I prepare enough for leftovers. I concentrate on protein first, and then add vegetables. Typically tempeh, tofu, or Field Roast products with roasted or sautéed vegetables. Today, I will be eating leftovers from last night. Two ounces of tempeh with four ounces of roasted vegetables that consist of red and yellow sweet peppers, sweet potatoes, small purple potatoes, zucchini, and carrots. I will add a tablespoon of olive oil-based spread, break up 3 walnuts to sprinkle of top, and garnish with two tablespoons of grated Parmesan cheese. This particular meal will be 19 grams of protein, 377 calories, and 28 grams of carbs. Bear in mind that I do eat more carbs when I am not working, and I focus on ingesting healthy carbs instead of breads/crackers/chips/crisps.
      It's a helluva journey and I'm thankful to be on it!
       
      · 0 replies
      1. This update has no replies.
  • Recent Topics

  • Hot Products

  • Sign Up For
    Our Newsletter

    Follow us for the latest news
    and special product offers!
  • Together, we have lost...
      lbs

    PatchAid Vitamin Patches

    ×