Desperate Couple--- please help?

Jupiter6
on 9/30/07 11:41 pm - Near Media, Pa- South of Philly, NJ

My sig ot and I decided to both undergo RNY back in January, after getting the go-ahead from our respective insurances. The story's on my profile, but the long and short of it is that I had mine in July, he had to do the six month Aetna protocols first--- and was denied after all his testing and hard work because despite their initial go-ahead, his employer actually has an exclusion. Heartbroken doesn't even come close-- but that's a story for another time. Pre- op, we both dieted. I weighed 368 (at 5'5") and lost 68 pounds from March to mid-July on a 1200 calorie diet (about 50% carbs, 30% protein or more 20% or less fat). My boyfriend weighed 379, and lost 50 pounds in the same time period eating similarly, but eating 1600 calories a day. Problem is, he's having been plateauing at 330 pounds for almost two months now. He exercises MUCH more vigorously than I do-- 45 minutes a day of high resistance exercise biking, plus walking and some light weight training. I know that he has been compliant. He *does* have a hard time getting his heart rate high due to the blood pressure meds he is on, but exercises full out and sweats profusely when he does. Clearly he has to change-up his routine somehow, but since he's no longer in the RNY program, we have no access to a nutritionist any longer and his insurance does not pay for one locally. Any advice from the board nutritionists as to where he should be headed next to break this stall and get back on track?

"Oh sweet and sour Jesus, that is GOOD!" - Stephen Colbert Lap RNY 7/07-- Lap Gallbladder 5/08--
     Emergency Bowel Repair 6/08 -Dr. Meilahn, Temple U.   Upper and Lower Bleph/Lower Face Lift
     12/08
     Fraxel Repair 2/09-- Lower Bleph Re-Do 5/09  -Dr. Pontell, Media PA Mastopexy/Massive
     Brachioplasty/ Extended Abdominoplasty (plus Mons Lift and Upper Leg lift) / Hernia Repair
     6/24/09 ---Butt Lift and Lateral Thighplasty Scheduled 7/6/10 - Dr. Ivor Kaplan VA Beach
     Total Cost: $33,500   Start wt: 368   RNY wt: 300 Goal wt: 150   Current wt: 148.2 BMI: 24.7

DanielleH_RD
on 10/1/07 1:26 pm - CA

Unfortunately in this forum, I can only offer generalities. His weight gain can be stalled by having his calories too low or too high. If his exercise is very vigorous, he may need to up his calories by 2-300 per day (as a start) to keep his metabolism from slowing down. It's known as "eat to lose". It may be worth a try. I recognize he is not eligible for a "program" dietitian, but would he consider going on his own? Considering the meds he is on, it may be a good idea to have a qualified RD guiding his weight loss. There is a RD locator on the American Dietetic Association website at www.eatright.org. I also know of a great on-line resource that is very affordable... Hopefully I adressed some of your concerns. Please let me know if there's something I missed.

Danielle Halewijn, RD,CNSD
Director of Nutrition, eNutritionCare.com
eNutritionCare.com
http://www.enutritioncare.com
DISCLAIMER: Any information contained within is meant to be general nutrition advice. Please consult your Registered Dietitian about your specific problem!

sarard
on 10/2/07 5:14 am - Costa Mesa, CA

Hi Shari, Is your significant other still interested in WLS? If so, tell him not to give up. The EXACT same thing happened to one of my patients last year. It's sooo fustrating. She appealed it with her HR department and with her persistance, she won. It took her 6 months, but she did it. She considered hiring an attorney (there are plenty who specialize in this) but eventually didn't need to. The lawyer was going to charge her $1500.00 for the work. Not bad. In any event, I would HIGHLY encourage your significant other to keep appealing this with his HR department. Strong letter writing will help. Tell him to try to get his boss on his side. Or at least let his boss know he is appealing this. I can refer you to my previous patient if you'd like. She can give you details of what she had to do. She is in Irvine, California - but you could easily communicate by email or telephone. Let me know if you'd like me to send her information over. Good luck. Sara

Sara Nejat-Bina, RD, CNSD, CDE
Registered Dietitian

Jupiter6
on 10/2/07 12:36 pm - Near Media, Pa- South of Philly, NJ

RNY on 07/16/07

Thank you so much for the ideas, Sara. Yes-- we'd be quite interested-- please pass on my contact information to your client if you would be so kind. It's a trying situation, but I know he will persevere and do what needs doing-- and every bit of advice helps!

-Shari

"Oh sweet and sour Jesus, that is GOOD!" - Stephen Colbert Lap RNY 7/07-- Lap Gallbladder 5/08--
     Emergency Bowel Repair 6/08 -Dr. Meilahn, Temple U.   Upper and Lower Bleph/Lower Face Lift
     12/08
     Fraxel Repair 2/09-- Lower Bleph Re-Do 5/09  -Dr. Pontell, Media PA Mastopexy/Massive
     Brachioplasty/ Extended Abdominoplasty (plus Mons Lift and Upper Leg lift) / Hernia Repair
     6/24/09 ---Butt Lift and Lateral Thighplasty Scheduled 7/6/10 - Dr. Ivor Kaplan VA Beach
     Total Cost: $33,500   Start wt: 368   RNY wt: 300 Goal wt: 150   Current wt: 148.2 BMI: 24.7

Iced Latte
on 10/9/07 5:39 am - Northeastern, LA

RNY on 08/13/07

Read some of the literature by Jim Karas about interval strength training for weight loss. It may be the change he needs to get going.

Jupiter6
on 10/9/07 8:35 am - Near Media, Pa- South of Philly, NJ

RNY on 07/16/07

I'm convinced interval training is "where it's at" myself as well. I'll pass the tip on to him-- thanks!

"Oh sweet and sour Jesus, that is GOOD!" - Stephen Colbert Lap RNY 7/07-- Lap Gallbladder 5/08--
     Emergency Bowel Repair 6/08 -Dr. Meilahn, Temple U.   Upper and Lower Bleph/Lower Face Lift
     12/08
     Fraxel Repair 2/09-- Lower Bleph Re-Do 5/09  -Dr. Pontell, Media PA Mastopexy/Massive
     Brachioplasty/ Extended Abdominoplasty (plus Mons Lift and Upper Leg lift) / Hernia Repair
     6/24/09 ---Butt Lift and Lateral Thighplasty Scheduled 7/6/10 - Dr. Ivor Kaplan VA Beach
     Total Cost: $33,500   Start wt: 368   RNY wt: 300 Goal wt: 150   Current wt: 148.2 BMI: 24.7

Desperate Couple--- please help?

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Desperate Couple--- please help?