Conflicting advice b/t PCP and surgeon

Lilyvalley
on 3/20/12 6:51 am - CT
 I went to my PCP today for what I though was a sinus infection.  She an I started going over my labs I recently have had done and I told her about yesterday's protein in my urine.  She wants me to take the protein down a notch.  My surgeon has his own ideas about protein consumption after surgery.  He has done several studies and believes that post-RNY we should consume 1g of protein for every 2.2 lbs.  He has not given me permission to reduce my protein even though by his standards, I should only be consuming 109g. (b/c I have lost 54 lbs. since surgery).  The current standards I hear most surgeons adhering to are b/t 60-80g. of protein.  My PCP wants me to consume less protein to focus more on water because she is afraid I am overtaxing my kidneys.  I have an appt. on the 29th with my surgeon and I will obviously discuss my concerns but he is pretty rigid.  I am just not sure who has my best interests and long term health in mind here.
        
_Donna_
on 3/20/12 7:01 am
109g of protein is A LOT, especially if you aren't at the gym every day working out hard and heavy. Are you?

RNY 5-5-2011

Lilyvalley
on 3/20/12 7:05 am - CT
 I am about 4x a week.  I think my surgeon has unrealistic expectations.

        
_Donna_
on 3/20/12 7:08 am
What do your labs show on your protein levels?
If they are good, then maybe you can lower your protein intake a little on days you don't go to the gym. Too much protein is hard on your kidneys.

RNY 5-5-2011

poet_kelly
on 3/20/12 7:09 am - OH
Wanna know what the ASMBS suggests?  They recommend 1.1 gram protein per kilogram of ideal body weight, which comes out to about half a gram per pound.  but that's per pound of ideal weight, not current weight.  Just to confuse you further.

I think they both probably have your best interests and long term health in mind here.  They just disagree on how to get there.

Here's what I'm wondering.  Are there ways to determine if your kidneys are being overtaxed?  Like any blood work that would determine that?  Your PCP is afraid of it but does she know it's happening or is there a way to find out if it really happening?

Does your surgeon know there was protein in your urine?  Does he think you should continue consuming that much protein even though there was protein in your urine?  What makes him not afraid that you're overtaxing your kidneys?

Perhaps getting answers to some of those questions would help you decide what to do.

Also, have you had labs done since surgery?  What was your protein level?  That would tell you if you are getting enough protein, if you're getting more than you need, whatever.

while they probably both have your best interests in mind, I'm guessing you are the one most concerned about your long term health.  And you are the one that has to live with the consequences of the decisions you make, about protein and about everything else.  So the decision is your.  You don't need your surgeon's permission to reduce your protein.  I think it would be wise to get his advice on the matter, but you do not need anyone's permission.

View more of my photos at ObesityHelp.com          Kelly

Please note: I AM NOT A DOCTOR.  If you want medical advice, talk to your doctor.  Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me.  If you want to know what your surgeon thinks, then ask him or her.    Check out my blog.

 

Lilyvalley
on 3/20/12 7:27 am - CT
 I just recently had my labs done and have not had a chance to go over them with my surgeon (I see him on the 29th).  Some of the more curious of my levels were:

B/Cr. Ratio    23.3 H     [6.0 - 23.0]

Protein total   7.2          [6.0 - 8.0]

ESR (sedimentation rate)   29 H         [0-20]

Blood Cell count components      Eosinophil % 4.7 H    [1 - 3]


When discussing this with my PCP this afternoon along with the protein in my urine she said it points to stressed kidneys.  I will see what the surgeon says but I
 don't think it will kill me to reduce the amt. of protein for a bit.

        
poet_kelly
on 3/20/12 7:33 am - OH
I think the B/Cr Ratio has something to do with kidneys.  I don't know what exactly.

Your protein total is actually great.  You don't want it to be much lower but it would not hurt if it were a little bit lower.

I have no idea what the ESR is.

I don't think it will kill you to reduce the protein a little either.

View more of my photos at ObesityHelp.com          Kelly

Please note: I AM NOT A DOCTOR.  If you want medical advice, talk to your doctor.  Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me.  If you want to know what your surgeon thinks, then ask him or her.    Check out my blog.

 

(deactivated member)
on 3/20/12 7:46 am - waukesha, WI
Since your protein is great.  I would lower my protein intake to see what happens in the next three months.  Your body is telling you to do so by dumbing protein in your urine especially if you did not have protein in your urine prior to surgery.  The only time I ate that much protein is in my better days when I was a body builder and than it was not much more than 100mg.  I personally would shoot for 80mg of protein but you could do a 90mg.  Listen to your body!  A kidney is a high price to pay for weight loss. 
Lilyvalley
on 3/20/12 7:50 am - CT
 No kidding, right?!  I will shoot for 90 on the days I work out and 80 on the others and see what happens.  Thanks for the advice, everyone!
        
(deactivated member)
on 3/20/12 8:25 am - waukesha, WI

Just a thought!  And, you might know this already.

Your weight loss will slow down, not because of lower protein intake, but because it starts slowing down as you get closer to six months and closer to your goal weight.  (I have to tell myself this all the time.  Over and over again!  I am 5 1/2 months out.)  (I also have to tell myself that I am 50 and can not expect to be 38, over and over and over again.) ( I also have to tell my self that I will never have a J-LO butt or a butt of any kind over and over again.)

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