Are the old-timers (vets) on OH Condescending???

I posted this as a response in a different thread, but then felt it belonged in a thread of its own.

Condescension is an interesting concept.

Showing or implying superiority. (I looked it up)

I've seen people saying that, and for whatever reason, I thought I'd address that when it comes to Flintstones. (Or calcium, or drinking with eating, or B12, or eating plans, etc etc etc)

What I know about weight loss surgery is superior to what someone else knows, if I know more. It isn't superior to others who know more than me. (obviously). Is my knowlege about vitamins superior to anyone else on this message board? Probably. Is it superior to most people? Probably not.

Here's the crux.... some people are given a plan by their surgeons. People here imply that the plan is the ultimate source of information. And to begin with, it should be! Most of us who have been around a while generally start a lot of answers to questions asked by new-ops with "What does your surgeon's plan say?" It's super-common, because we respect that surgically, your surgeon is the ultimate authority on YOUR BODY. He's been looking around the inner bits and changing them up. He knows you INSIDE better than you do, probably. His plan is important. Likely he has reasons for the things he wants his patients to do. None of us can be superior to him when it comes to the surgical bits. Some of us might not quite understand his reasons for his postop eating plan if it's quicker or slower than our own. But he's the one you signed up for surgically.

But then there's the vitamin thing. And this is one of the few things where you'll hear people openly disagreeing with your surgeon. (The other open disagreements I've seen are when the surgeon says that NSAIDS are okay, or that drinking with meals are okay).

So WHY, in a group like this one, when the vets are almost religious in their questioning a new-op about what their surgeon says, do the vets start to question the validity of your surgeon's plan on vitamins?

The reason is down to science, medical studies, and often what the ASMBS recommends for ALL post-ops. No matter what your surgeon suggests for your vitamins -- whether it's flintstones once a day or some special $1.50/pill vitamin five times a day -- there is a set of guidelines for all postops that is supported by multiple studies, and is suggested on the website for the American Society of Metabolic and Bariatric Surgeons (I think that is what the ASMBS stands for). Among other things they recommend that we get 1500 to 2000 mg of calcium citrate, and 200% of the US RDA for vitamins for adults. There are studies that show that individuals who use calcium carbonate are not going to absorb enough calcium from Tums (Carbonate) to help their bones to avoid deteriorating into dust, and can at the same time they do nothing for your bones, they can create hideously painful kidney stones. There are studies that show that if you don't get vitamin B12 in a way other than through your STOMACH, you won't get any at all. You lack the necessary chemicals in your pouch to turn B12 from a pill into the useful stuff your body needs. There aer studies that show that permanent neural damage can occur if you don't get your vitamin Bs in properly. And I believe there are even studies that show that patients that are told to take Flintstones are far mroe likely to develop a whole plethora of debilitating deficiencies if they think they're getting enough but they aren't.

NOW is there condescencion when I or other suggest that your surgeon's plan is wrong and you should not follow it but should instead follow OUR superior plan? I don't know. Perhaps it comes off that way, because we have read the studies, seen teh evidence, perhaps even experienced the deficiencies and care enough to emphatically suggest that following a plan that can lead into misery, pain, and permanent damage is wrong and misguided. It might seem presumptuous to say your doctor is wrong. But the thing is, nutrition, particularly micronutrients (Vitamins) is not something that your surgeon has specialized in. He (or she) has specialized in slicing and dicing and rearranging in a way that will help to cure you of obesity in the most permanent fashion known to modern science. Some doctors have even admitted that they believe that their patients (implication: fat and lazy patients) won't use ANY supplements if they make the requirements hard. So to keep it simple, to make it easier to follow, they try to get their patients to do something easy. Flintstones and Tums are EASY. Are they the BEST choice? Nope. Tums is even a BAD choice that won't do anything good for you and possibly a lot of bad. But they still make the recommendation, perhaps because of their experiences, or perhaps because they just (some of them anyone) don't think that "fat people" have what it takes to do hard things, like follow a more complicated vitamin regimen than "Flintstones and Tums".

There is ample evidence, research, guidelines on the professional website for these types of surgeons to back up the emphatic insistence by some postops that Flintstones is a bad choice. BUT some of the people who see that see condescension, see people who are in a way badmouthing their surgeon who has done this awesome thing for you in your surgery, and frankly, they also see a vitamin regimen that is EASY for them, and they don't want to believe that their surgeon might be giving them a vitamin plan that isn't the BEST for their bodies. It's hard to deviate from the plan, and it's natural to want to defend your surgeon and his plan. It was, you know, a center of excellence (mine was, and they suggested flintstones and tums, and when I asked, they admitted it was "better than nothing but really not suggested seriously").

So yeah, you can hate on those people who insist that Flintstones are a bad choice. You can say that the person who says it's a bad choice are being condescending or superior, or even snotty *****es. But ultimately those snotty *****es on Obesity Health are NOT living inside YOUR body. Your surgeon isn't inside your body. The nurses and nutritionists and everyone else is NOt living inside your skin. It's YOUR body, and if you think communing with rattlesnakes and drinking antifreeze is the best thing for your body, go right ahead. It's your body.

For MY body, I look at the evidence, I look at the studies, I read the anecdotal stories too, and then I make a choice. Do I use calcium citrate or carbonate. If I use carbonate, and the carbonate fans are right, I save a few bucks. If the citrate fans are right, they won't get all superior while I'm having to avoid any sudden moves so as to keep my bones from snapping. They won't be condescending when I'm reduced to a wheelchair because my bones are all but dissolved. They WILL however, have healthier bones if they are right. So if Citrate (according to a lot of studies) is the best, why not spring for it, even if it is a bit more inconvenient and a bit more expensive? And the same thing is true of Flintstones. If I want a chewable I can get a centrum (lousy flavor, but better flavor than Flintstones). The number of Flintstones needed to come close to 200% of the US RDA of most or all micronutrients makes the "cost" of flintstones nearly equal, and possibly more expensive than the Adult vitamins. So if I save no money, and I'm taking a vitamin designed for an adult gut and adult needs, I'm doing a favor to my body. I have to live in this body, I'm not going to gamble on Flintstones being "good enough" and hope it's true, when there are better vitamins out there that I know are better, have more complete vitamins in adult amounts.

So.... while this is WAY more than you asked for, it's been stewing inside me for a long time. It's NOT condescension, it's because some doctors don't think their (fat and lazy) patients can handle the truth. If a doctor recommends something less than the ASMBS, and I've read the (not so) scintillating suggested vitamins on that website, then I do think that my knowlege of postop vitamins is superior to the doctors.

Just kidding! I am interested in whether people feel this though ... because I really don't think that most long term vets feel this way (superior) and it's why I really don't post to newbies much. I think I have more to offer pre-ops and short term "vets" that are struggling with maintenance/regain.

I think we all go through a period (years 1 to 3 ) when we think we have this RNY thing down pat and can be a bit pleased with ourselves. Once we've got past that self satisfied hump and have experienced longer term maintenance and the possibility that we could put on a pound or 30, we tend to get a bit more humble LOL!

Yup, I feel a lot more humble now that I'm fighting against a small regain. It's not nearly as simple as it seemed at 2 years and 3 years out.

I probably got too wordy too. (My big fault.... never say with five words what you could say with fifty).

Ah well.

I think that there are a couple of things that stir the pot up a bit. Lack of inflection/expression so people don't hear the real tone behind a comment and of course HORMONES because they are rampant.

Aftercare is SERIOUSLY lacking in so many surgical programs.  It's shocking at times to hear what people are told by surgeons (who are experts in the mechanics of surgery but not aftercare), by nutritionists who don't know their heads from their behinds, or even by their friends who have had surgery and are trying to make money off of them by selling them inferior shakes etc.   

The best patient is The one who EMBRACES surgery by reading and researching rather than walking in blindly.  This is for the rest of your lives newbies.  When I went through six years ago information was Scarce compared to now.   I envy the newbies now who have a wealth of information available to them. Use it wisely :-)

All the best to newbies out there. Please understand that posts like this are written because we've seen or/and experienced a lot.  We want you to have an easier , even better journey than we did.  
Dawn

Nice to see you Dawn.

I think my 6-month supervised diet was a massive favor, that plus my voracious appetite for information. I was a total PAIN in the BUTT in my nutrition class. I questioned everything!

She was telling us the "flintstones and tums" and I had to ask about the ASMBS recommendations for 200% USRDA and the Citrate versus Carbonate.

EVERYthing that she said I had a comment or a question.

I'm sure the others in the session were hating me by the end.

I could not have said it better.  

I have been here for over 5 years and lately I find myself becoming increasingly irritated with newbie complaints about the "tone" of posts by the vets.  I think you have given me the solution that I need (at least for the short term)... Perhaps just not responding to any posts from newbies for a while...

Lora

  Well said!

I'm a newbie, and I've learned a lot from the Vets. I've started educating myself on my vitamin and mineral needs, and plan to continue learning. Sure, I follow my surgeon's protocols, but I have a mind, too. I know when I'm dragging that I need to make sure my iron supplements are higher than what's just in a multivitamin.

Although Flintstones are on my surgeon's list for the first 6 weeks post-op, even he doesn't want people to take them. When we were going over everything prior to setting up my date, he asked which vitamins I was planning to take. I told him which ones, and he was glad it wasn't Flintstones! LOL

I sometimes get a little upset when someone starts implying that there's "This one vet who always ____________" and fill in the blank, and a bunch of others jump on the bandwagon slamming into the one "we all know who you mean" vet.

There isn't one person who is 3+ years out who is here to get their jollies out of belittling newbies. Not one of us who wants people to feel put down. Not one of us who spends any of our time REPLYING if we don't sincerely want to help.

I say that it's essential assumption time here on this forum to ASSUME that everyone means well. If they make you upset, ignore them, if you just can't help but have your blood pressure go up because one person rubs you the wrong way, block them. But it's also important to believe that the person MIGHT have something to say.... so unblock them periodically.

There were a lot I blocked in the beginning (most didn't have RNY but DID frequent this forum). Some are my friends now.

If you BELIEVE someone is a smarmy so-and-so, and say so, others will reinforce that belief. But if you believe someone means well (even if it doesn't help YOU) then it's easier to ignore.

Ultimately it's the "Bash the vets" that chase away the people with the most long-term maintenance knowlege.

I admit that I am growing increasingly weary of the posts from newbies about he "tone" of vets posts, especially since the likelihood that THEY will still be here 2 or 3 years post-op, let alone 5 or more years post-op, to offer help to the latest batch of newbies is pretty damn slim.

I have so much on my plate right now that I am nearly ready to just walk away since it is clear that there are a lot of newbies who don't appreciate the fact that the vets take time away from their busy lives to try to offer the benefit of their knowledge and experience.  What would this board be like if NONE of the vets stuck around?!?  A bunch of people stumbling around in the dark, taking Tums, Flintstones vitamins, and Viactive chews, freaking out about how they have stopped losing after only 3 weeks (and their surgery has "failed"), not having any idea that they cannot take their iron with their calcium, not having anyplace to get knowledgeable feedback about the psychological aspects of post-op life...

Lora

I go through cycles. I'm likely to suddenly go *poof* when school starts. Even before that, I have a LOT of work to do to get ready for the new school year. I've decided to do a massive overhaul on how I teach my classes, and so this means a couple hundred hours of work I'll need to put into it, so when my stepson leaves to return to college on Wednesday I probably will be busy every other day from now until I go back to school.

I think the thing that bugs me is when one person posts a whole new thread about how this one person (or couple of people) are real __________ and you fill it in, and a whole bunch of other people pile on to say how awful this unnamed person is. Now I could be really self-centered and think they're talking about me... and who knows, perhaps my wordy-school-marm-persona really does rub people the wrong way. I mean, not evveryone liked their teachers and I'm sure I remind a few people of some teacher they hated. So it could be me even when I'm pretty sure it isn't (because I'm all full of myself and thinking I'm likeable).... but if it isn't me, then it's probably one of the people I like a whole whole lot, like Nik, or you, or Kelly, or (and I could throw in another couple names of super awesome people that I really loved but who were chased away by these whiners and it makes me mad they're gone).

But I come back because I like to help. I'm a teacher, and I like to try to explain stuff. And I like the people here who've been around a long time.... I feel a sense of camaraderie with the people who are on this side of the surgery curve. Who understand what it's like here. I try to give comfort to the people who are in the "sprint" part of this experience, but I GET comfort from those who've got to goal and are still here.