6 month post-op check up--not a great experience
I had my 6-month check up last week. I have lost about 105 lbs and feel like a million bucks! I am exercising, handling meals well, and now even people that don't know me well are seeing the weightloss and complimenting me. I went to my appointment, with lab results in hand (which I was also really proud of because my numbers were great). Since my official weight loss at this appointment was now triple digits, I was kind of wondering if I'd get any sort of special recognition.
My surgeon walks in, seemed his typically friendly self, looks at the computer and mentions that I'm at "49.3%"... mumbles I should be closer to 60%. He sits across from me on the side of the exam table and starts talking (gently) about how some people are slow losers and that in some cases there can be a medical reason, but that more often than not it's because they're not sticking to the meal plan. I honestly thought he was joking--leading up this big long thing then would laugh and say "Nooo, you're doing great!" He kept talking and I realized he was serious. I felt my neck flush and my eyes started brimming with tears. He even said "Obviously I'm upsetting you?" while he was talking. I just lost it and started bawling in the the exam room. In the moment I kept apologizing and saying it was just me being emotional, but the more I think back about it, the more angry I am. He's always been friendly and easy to approach, and he wasn't mean or callous in anything he was saying, I just felt like he was accusing me of being a bad patient and apparently I don't handle criticism on this topic well. He reviewed my bloodwork and commented that it shows I'm taking my vitamins like I'm supposed to. I didn't think of saying this at the time, but now I'm thinking that if he had proof that I'm taking my vitamins well, why would he think I'm cheating on the diet?
So now I'm at a bit of a crossroads. The truth is that I don't want to go back to him for my next follow up appointment. I sobbed in his office for a good 10 minutes after my visit with him (while the nurse got me the orders for my next set of labs). I got myself together long enough to schedule my next appointment and then face everyone in the watiing room. But then sobbed in my car for most of the 200 mile trip back home. My local PCP is familiar with the surgery and is actually the one that's been ordering my labs since I was self-pay for the surgery.
I think what upsets me the most is that I was NEVER given a goal weight, or had any reference made at any of my other follow up appointments about any concrete benchmarks. At this appointment I was judged against a number I knew nothing about. Apparently in their system, my "ideal body weight" is 135 lbs (I'm 5'6") and my starting weight is 367.5 lbs. When they weigh me on their nifty scale, my "non fat mass" is around 150lbs. The execercise physiologist commented early on that I've got a lot of muscle and bone (good German lineage, haha) and that I should keep an eye on that number so that it doesn't go down too much (but it will some). So I figured that amount plus body fat and that's how I arrived at my theoretical goal weight of 160. Truth is I'd be happy at 199.9. Weighing in the 130's NEVER crossed my mind.
I think my 2 options are to either say "kiss off" and not go back. The problem with that is I'm a self-pay patient, and my fee included 12 months of complication insurance. Yes I'm 6 months out and haven't had a single complication, but there's still a chance. I'm sure it's contingent on my attending follow up appointments. Or I was thinking of calling the office and asking what percent of excess body weight loss I should be at by 9 months out (when my next appointment is) and working toward hittng that mark, even if I'm already 10% behind. I appreciate any opinions, and thanks for listening.
I never would have expected that my first negative experience post-op would have been caused by the surgeon!
My surgeon walks in, seemed his typically friendly self, looks at the computer and mentions that I'm at "49.3%"... mumbles I should be closer to 60%. He sits across from me on the side of the exam table and starts talking (gently) about how some people are slow losers and that in some cases there can be a medical reason, but that more often than not it's because they're not sticking to the meal plan. I honestly thought he was joking--leading up this big long thing then would laugh and say "Nooo, you're doing great!" He kept talking and I realized he was serious. I felt my neck flush and my eyes started brimming with tears. He even said "Obviously I'm upsetting you?" while he was talking. I just lost it and started bawling in the the exam room. In the moment I kept apologizing and saying it was just me being emotional, but the more I think back about it, the more angry I am. He's always been friendly and easy to approach, and he wasn't mean or callous in anything he was saying, I just felt like he was accusing me of being a bad patient and apparently I don't handle criticism on this topic well. He reviewed my bloodwork and commented that it shows I'm taking my vitamins like I'm supposed to. I didn't think of saying this at the time, but now I'm thinking that if he had proof that I'm taking my vitamins well, why would he think I'm cheating on the diet?
So now I'm at a bit of a crossroads. The truth is that I don't want to go back to him for my next follow up appointment. I sobbed in his office for a good 10 minutes after my visit with him (while the nurse got me the orders for my next set of labs). I got myself together long enough to schedule my next appointment and then face everyone in the watiing room. But then sobbed in my car for most of the 200 mile trip back home. My local PCP is familiar with the surgery and is actually the one that's been ordering my labs since I was self-pay for the surgery.
I think what upsets me the most is that I was NEVER given a goal weight, or had any reference made at any of my other follow up appointments about any concrete benchmarks. At this appointment I was judged against a number I knew nothing about. Apparently in their system, my "ideal body weight" is 135 lbs (I'm 5'6") and my starting weight is 367.5 lbs. When they weigh me on their nifty scale, my "non fat mass" is around 150lbs. The execercise physiologist commented early on that I've got a lot of muscle and bone (good German lineage, haha) and that I should keep an eye on that number so that it doesn't go down too much (but it will some). So I figured that amount plus body fat and that's how I arrived at my theoretical goal weight of 160. Truth is I'd be happy at 199.9. Weighing in the 130's NEVER crossed my mind.
I think my 2 options are to either say "kiss off" and not go back. The problem with that is I'm a self-pay patient, and my fee included 12 months of complication insurance. Yes I'm 6 months out and haven't had a single complication, but there's still a chance. I'm sure it's contingent on my attending follow up appointments. Or I was thinking of calling the office and asking what percent of excess body weight loss I should be at by 9 months out (when my next appointment is) and working toward hittng that mark, even if I'm already 10% behind. I appreciate any opinions, and thanks for listening.
I never would have expected that my first negative experience post-op would have been caused by the surgeon!
Wow, I am completely baffled. I am shocked that he would be so focused on a stupid percentage like that. I am pre-op, so I haven't experienced any of it yet, but I am so sorry that happened to you. I don't think you were being overly emotional....I think you went in there extremely proud of yourself (which you should be!!) and you were just completely blindsided by his remarks. Shame on him for not congratulating you. I would continue to do your thing and not be focused on those percentages/numbers. I would keep going to your appointments for the sake of your 12 months of insurance you paid, but be ready to DEFEND yourself next time. Tell him you are really proud of yourself and you know that you have been following your dietary instructions.Tell him all of the things you are able to do that you couldn't before and how great you feel. And be ready to ignore his negative comments.
That really ticks me off that he would be that way, considering all that you have lost and accomplished. Please don't starve yourself or anything trying to attain his "perfect percentage" at your 9 mo. visit.
That really ticks me off that he would be that way, considering all that you have lost and accomplished. Please don't starve yourself or anything trying to attain his "perfect percentage" at your 9 mo. visit.
Surgery date of 4/30/12 
Your surgeon is an ass. There is no way that ANYONE can tell you how fast your body will or SHOULD lose and your surgeon should know that better than anyone! Don't waste your time calling and asking them a "should" question because it is meaningless and will do nothing but upset you if your body has other ideas. Those "shoulds" are often based on nothing more than the numbers that the surgeon wants to be able to report for his/her "success" statistics.
I guess my advice would depend on WHEN your next appt is scheduled for. My surgeon did not have any scheduled appointments between 6 months and 1 year. If you are scheduled for a visit in before the 1-year mark, I would probably go (since you are self-pay and have the complication "insurance"), but if the doctor starts in on the BS again, I would make it clear to him that I was being compliant and don't need him being negative and critical (and, if he persisted, I would tell him that unless he had something medically relevant to say, the appointment is over...)
Lora
I guess my advice would depend on WHEN your next appt is scheduled for. My surgeon did not have any scheduled appointments between 6 months and 1 year. If you are scheduled for a visit in before the 1-year mark, I would probably go (since you are self-pay and have the complication "insurance"), but if the doctor starts in on the BS again, I would make it clear to him that I was being compliant and don't need him being negative and critical (and, if he persisted, I would tell him that unless he had something medically relevant to say, the appointment is over...)
Lora
14 years out; 190 pounds lost, 165 pound loss maintained
You don't drown by falling in the water. You drown by staying there.
If that is the only reason they scheduled the additional checkup, I personally would cancel it and reschedule for the normal one year appointment, because there isn't a damn thing wrong with your progress!
Lora
Lora
14 years out; 190 pounds lost, 165 pound loss maintained
You don't drown by falling in the water. You drown by staying there.
Thanks, Lora. Hadn't thought of that as an option, but that's a good idea.
Another friend made an interesting point I hadn't thought of. I'm in a study that the surgeon is a part of. I'm in the control group so I didn't actually have the whatever done, but I get my vitamins for free for the first 15 months for being in it. She wondered if he's concerned about the numbers in his study looking good. Or that the study is based upon a hypothesis he made, and that so far the rolling trend of the participants is disproving it.
Another friend made an interesting point I hadn't thought of. I'm in a study that the surgeon is a part of. I'm in the control group so I didn't actually have the whatever done, but I get my vitamins for free for the first 15 months for being in it. She wondered if he's concerned about the numbers in his study looking good. Or that the study is based upon a hypothesis he made, and that so far the rolling trend of the participants is disproving it.
Yep, I would almost bet money that the study is at least part of the reason! All the more reason for you not to let him get to you. The longer I think about it, the more the way he treated you annoys me. I had lost exactly 100 pounds at the 6-month mark (of the eventual 185+ that I lost) and my surgeon was SO excited for me and pleased with my progress and with the types of questions I was asking. That's such a far cry from being scolded and accused of being non-compliant! I really wish you had received that reaction from your surgeon.
Lora
Lora
14 years out; 190 pounds lost, 165 pound loss maintained
You don't drown by falling in the water. You drown by staying there.
I agree with Lora....I think he is DEFINITELY thinking of his study results. You are doing wonderfully and I suggest you carry on as before, study be damned!!
I am so grateful my surgeon had realistic expectations of my progress and what it meant to be "successful". Hell, I thought his goal wasn't aggressive ENOUGH and set out to prove him wrong!! Of course, his definition of "success" was based on averages for my surgery type and he was WISE to give me those numbers....but at the time, I thought "hell no, I am NOT having this surgery to weigh 185 pounds....I want to weigh 140". I did, for a time....and didn't like the way I look. I now live between 150-155 and have been pretty much for 10 years.
Good luck, OP!
I am so grateful my surgeon had realistic expectations of my progress and what it meant to be "successful". Hell, I thought his goal wasn't aggressive ENOUGH and set out to prove him wrong!! Of course, his definition of "success" was based on averages for my surgery type and he was WISE to give me those numbers....but at the time, I thought "hell no, I am NOT having this surgery to weigh 185 pounds....I want to weigh 140". I did, for a time....and didn't like the way I look. I now live between 150-155 and have been pretty much for 10 years.
Good luck, OP!
Marilyn (now in NM)
RNY 10/2/01
262(HW)/150-155(GW)/159(CW)
(updated March 2012)
I agree with the person that said your surgeon is an ass!! You lost freakin 105 pounds in 6 months!! What the hell did he expect? Not everyone loses at the same rate. I am lucky (post surgery) to lose 5 pounds in a month so I know that afterward I am not going to be one of the fastest losers in town. The important thing is that you are losing at a steady, healthy rate (and I think a very fast rate!). I think if you do decide to go back, I would just gear up for whatever he says and make it clear that you are only there because of the 12 month self-pay issue or you would be going elsewhere. If you feel up to it you can tell him what everyone else is saying and mention how you did your own research and it doesn't agree with his expections and you are very disappointed in his attitude. Is there any kind of patient survey in this study he is involved in? That would be the best revenge. Sorry for rambling on but I am just so angry for you!! You hang in there and know that it is him not you!! Take care and congrats on a fantastic job at losing!! Janet
I'm sorry that was your experience.
My observation, from hanging out on OH for a few years, which I admit is not very scientific, is that people lose at different rates. Sometimes if someone is losing really, really slow (and I don't really think 105 pounds in six months is really, really slow), it means they aren't sticking to the plan. But usally, even then, it's just how their body works. It's hard to put a number on what's normal because it varies so much.
I understand why you were so upset. I would have been too. But you don't have to allow his remarks to continue upsetting you. It's normal to give what a doctor says a lot of weight. A lot of us were raised to think doctors were pretty much gods. But the truth is, he's just one person, with one opinion. And one opinion of one person does not take anything away from all you've accomplished. It really doesn't.
You have more than the two choices you mentioned. You could call to find out if the "complications insurance" really does depend on you attending the follow up appointments. Actually, don't just call and ask that. Read the policy. Read the fine print.
You could write the surgeon or call the surgeon, or talk to him at your next visit, and tell him that he upset you. You could basically tell him everything you wrote here. And you could also tell him what you want him to do different in the future. You could tell him, for example, that you do not want him to comment on the amount of weight you've lost. You could tell him that you just want him to let you know if he sees any signs of complications.
You could decline to get on the scale at your next appointment. Then there could be no comment on the percentage of weight you've lost.
My observation, from hanging out on OH for a few years, which I admit is not very scientific, is that people lose at different rates. Sometimes if someone is losing really, really slow (and I don't really think 105 pounds in six months is really, really slow), it means they aren't sticking to the plan. But usally, even then, it's just how their body works. It's hard to put a number on what's normal because it varies so much.
I understand why you were so upset. I would have been too. But you don't have to allow his remarks to continue upsetting you. It's normal to give what a doctor says a lot of weight. A lot of us were raised to think doctors were pretty much gods. But the truth is, he's just one person, with one opinion. And one opinion of one person does not take anything away from all you've accomplished. It really doesn't.
You have more than the two choices you mentioned. You could call to find out if the "complications insurance" really does depend on you attending the follow up appointments. Actually, don't just call and ask that. Read the policy. Read the fine print.
You could write the surgeon or call the surgeon, or talk to him at your next visit, and tell him that he upset you. You could basically tell him everything you wrote here. And you could also tell him what you want him to do different in the future. You could tell him, for example, that you do not want him to comment on the amount of weight you've lost. You could tell him that you just want him to let you know if he sees any signs of complications.
You could decline to get on the scale at your next appointment. Then there could be no comment on the percentage of weight you've lost.
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.
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