Completely battered and bruised after SW/Nut/Internist appointments at Humber today

I'll try to make a long story short.  I met with Jennifer, the SW, first today.  I actually expected it to be the worst of the bunch.  She was very nice and we talked for a while after she finished her questionnaire.   She said I am very insightful and from her perspective, I am ready for the surgery.   Then came the Nutritionist....  Ugh.  I can't remember a time when somebody yelled at me for an hour straight.  I stopped listening to what she had to say about half way through as I spent the rest of the appointment trying not to burst into tears.  Basically because I haven't wasted my time doing weigh****chers or Nutrisystem in the past, that I'm not an ideal candidate.  I have to go out and try...and fail...expensive weight loss methods before I'm ideal....despite being overweight ALL of my life.   Even when I was in high school and figure skating full time, I was 160 lbs at my lowest weight.   And stupid me for being honest about the contents of my food log.  
 
I couldn't get any questions in or explain myself because she spent the entire session ranting and raving at me about how all of 'these people' are gaining weight back after surgery because they eat crap right away and never stop.  So after an hour of this I go to see the Internist.

I got the expected 3 minute rush job with Dr. Glazer.  Then he tells me I have a heart murmer with low blood pressure and now I have to return for an ultrasound on my heart. 

I'm left feeling extremely upset and emotional.  I have no idea if they will accept me now considering the heart murmer.  I might try and talk to my surgeon about having the VSG instead of the RNY....but I really don't want to break the bank in paying f******oney for another trip to Toronto if they're just going to say no. 

there is one Nut at HRRH I've refused to ever see again and others have had problems with her so I assume that's who you got.  She's one cranky lady.  Odd how the social worker thought you were ready and the nut reams you out.  Did you know you had a heart murmur and low blood pressure - hang in there and hopefully things will turn out.


Cheers

Sorry you had such a rough go today with the nutritionist.  You have to wonder whether she has ever been overweight herself or struggled with food issues and body issues. Her superiority complex is not attractive. You can get your point across without making people feel small.  The fact that you tuned her out supports that point. 

Don't let her actions impact your journey.  I am sure all of us will meet a**holes along the way.  Take the good and leave the rest.

Are they sending you to see a cardiologist?  Personally speaking, I would want to speak to one to see exactly what the murmur means in terms of stress on the heart, exercise, risks during surgery, etc.

Certainly if a longer surgery puts stress on your heart because of the murmur, VSG might be the preferred route. Can you arrange a phone call appointment with the surgeon versus coming back to Toronto to see him to discuss the VSG?  

Take a deep breath - it's better to know what is going on with your body than for it to come as a surprise during surgery.  Some friends I know who have murmurs don't have any side effects but each person is different.  See a specialist maybe through your Family doctor in Kingston and get all your questions answered.

Good luck!

Some people are such royal B#@$#'s. She sounds like my mother, and how I used to tune her out at the kitchen table after an hour of yelling when i was a kid lol. Chin up girlfriend, you'll get through this. I agree about arranging a teleconference with your surgeon.

 So what did the Nutrutitionist want to see in your food log?  I don't get it....if you were eating perfectly healthy and never had any struggles with food...you'd probably be thin and not need the surgery to begin with in the first place, no?

My eating is a big mess...and it never even crossed my mind that I may have to lie about it in order to get approved for wls.  Now you've got me thinking!

I think I know who you are talking about, I think her name is Stacy or something close, I had her too. She is tough but again like most of us we had a critical and insensitive relative, so I sucked it up..
slrm3m ohh yeah it is more like a job interview, they are looking for ways to cut down on the surgery since the government is paying for it, according to the Nut, she told me that her job is to look for the government interest by not qualifying those who are not ready. I understand where she is coming from, but also I think that we deserve someone to look after our interest and being sensitive while being honest is one thing that could be done.
If this was a private insurance company, imagine the Nut saying something like, I am here to look after the interest of the owner of the company!!

Cheer up, I think if you were not approved by the Nut they would not schedule you to see the internist, the worst that can happen is keep rescheduling you to meet with the Nut until she gives the O.K,

Best of luck
Zenia

One of the requirements on the OHIP schedule of benefits is that you have failed previous diets. "The patient has attempted weight loss in the past without successful long-term weight reduction;"

So go back - ask for a different nut, call HRRH and ask for supervisor- someone here might have a name to share- complain about her behaviour- yelling is WRONG is so many ways. Tell the new nut that you misunderstood- and yes you have tried x, y and z diets. They don't have to be commercial ones- just diets.



Bariatric surgery
S120 (gastric bypass or partition) and S189 (intestinal bypass) are insured services only
when all of the following four criteria are satisfied:
1. Presence of morbid obesity that has persisted for at least the preceding 2 years, defined
as:
a. Body mass index (BMI) exceeding 40;
or
b. BMI greater than 35 in conjunction with any of the following severe co-morbidities:
i. Coronary heart disease;
ii. Diabetes mellitus;
iii. Clinically significant obstructive sleep apnea (i.e. patient meets the criteria for
treatment of obstructive sleep apnea);
or
iv. Medically refractory hypertension (blood pressure greater than 140 mmHg
systolic and/or 90 mmHg diastolic despite optimal medical management);
2. The patient's bone growth is completed (18 years of age or documentation of completion
of bone growth);
3. The patient has attempted weight loss in the past without successful long-term weight
reduction;
and
4. The patient must either:
a. be recommended for the surgery by a multidisciplinary team at a Regional
Assessment and Treatment Centre in Ontario;
or
b. participate in a multidisciplinary surgical preparatory regimen of at least three months
duration where the patient's participation meets all of the following requirements:
i. Consultation with a dietician or nutritionist;
ii. Reduced-calorie diet program supervised by dietician or nutritionist; and
iii. The patient's permanent medical record must contain documentation of the
patient's participation in the multidisciplinary surgical preparatory regimen at
each visit.
[Commentary:
The purpose of the patient's participation in an organized multidisciplinary surgical
preparatory regimen is to improve surgical outcomes, reduce the potential for surgical
complications, and establish the patient's ability to comply with post-operative medical care
and dietary restrictions.]

I know I was out of country, but I had not done those expensive diets, my surgeon only wanted me to lose 20 before my surgery, and I lost 25 before surgery.  He wanted to see the intent.
I have a heart murmor and bradycardia.   During my rny I was 34 beats per minute and 24 during plastics, they still did it.   Get your family docs to order the tests.
You can do this.  Chin up :)

Bonnie

When I saw Dr. Glazer he told me I had a heart murmur too.  I also went to have a heart ultra sound done.  There is a clinic his office sent me to, not real far from the hospital up on Norfinch Dr.  Anyway they found absolutely nothing wrong with my heart, and my family doctor of about 30 years said he never once head anything irregular in my heart over numerous check ups.  So sometimes things are not what they seem.

I can't possibly know if that will be the same outcome for you, but in any case, many people have been told the same thing by Dr. Glazer and they've had surgery anyway.


Best of luck to you
Cheryl

Hi

Good luck with your upcoming appointments, keeping my fingers and toes crossed that all will work

out for you in your upcoming surgery as well.

Keep the faith, all good things come in time, and it will move very fast once it starts.  I had issues as

well in order to get my surgery, but it all worked out. Many others on the board have faced similar or

even more difficulty getting the surgery.

Take care

Eileen