A gaping hole in our treatment/care?

Ipatton
on 11/24/15 9:30 am - Canada

A little bit about myself:

I am 1 year post-op and doing well.  I was set up too succeed because of my knowledge and background.  I have a PhD in Kinesiology and all of my research and education surrounds obesity, BMI and Weight Management.  It was a bit ironic that I was an "obesity expert" yet suffered from morbid obesity myself.  I teach human growth and development and physical activity at a university, I am a certified personal trainer and am working on writing my tests to become a Certified Exercise Physiologist (the highest certification a fitness professional can achieve in Canada)  

I always felt out of place, speaking at international conferences to the fittest, smartest people in the world when it come to obesity, while i was so overweight myself.  It wasn't until post-op and going through the bariatric process that it was pointed out to me from a colleague that I am in a unique position.  I understand the world we, as people living with obesity, live in very uniquely.  I know and understand the research and information, best practices and academic side, but I also have the lived experience, which no other "obesity expert" has.  

Along my Bariatric journey I have come to notice that there is a gaping hole in our support and education as patients.  We are given support for social, psychological and dietary aspects of our lives but then simply kicked out the door and told to be active.  For many of us this is something relatively new and intimidating.  If not done right, you can do more damage than good and there are a lot of mis-information and people spreading crap information.  

I think that there is a gap here that I fit perfectly into that could allow me to help, work in an area that is personal and something I am passionate about, and hopefully improve outcomes for us Bariatric patients.  This is a newer idea for me  and I was hoping to get some feedback from members about your own experiences? how did you navigate the active lifestyle pre and post op? do you have any horror stories? anything that really worked for you? What would you like or would have liked in the way of support?  Any thoughts/feedback would be great.  and if you are in the Durham Region, feel free to send me a personal message.   

Ipatton
on 11/24/15 9:30 am - Canada

A little bit about myself:

I am 1 year post-op and doing well.  I was set up too succeed because of my knowledge and background.  I have a PhD in Kinesiology and all of my research and education surrounds obesity, BMI and Weight Management.  It was a bit ironic that I was an "obesity expert" yet suffered from morbid obesity myself.  I teach human growth and development and physical activity at a university, I am a certified personal trainer and am working on writing my tests to become a Certified Exercise Physiologist (the highest certification a fitness professional can achieve in Canada)  

I always felt out of place, speaking at international conferences to the fittest, smartest people in the world when it come to obesity, while i was so overweight myself.  It wasn't until post-op and going through the bariatric process that it was pointed out to me from a colleague that I am in a unique position.  I understand the world we, as people living with obesity, live in very uniquely.  I know and understand the research and information, best practices and academic side, but I also have the lived experience, which no other "obesity expert" has.  

Along my Bariatric journey I have come to notice that there is a gaping hole in our support and education as patients.  We are given support for social, psychological and dietary aspects of our lives but then simply kicked out the door and told to be active.  For many of us this is something relatively new and intimidating.  If not done right, you can do more damage than good and there are a lot of mis-information and people spreading crap information.  

I think that there is a gap here that I fit perfectly into that could allow me to help, work in an area that is personal and something I am passionate about, and hopefully improve outcomes for us Bariatric patients.  This is a newer idea for me  and I was hoping to get some feedback from members about your own experiences? how did you navigate the active lifestyle pre and post op? do you have any horror stories? anything that really worked for you? What would you like or would have liked in the way of support?  Any thoughts/feedback would be great.  and if you are in the Durham Region, feel free to send me a personal message.   

tatirod
on 11/24/15 11:29 am, edited 11/24/15 3:28 am - Toronto, Canada

I am just over 2 weeks post-op, but the only thing that has been suggested to me by obesity experts is water aerobics and resistance training. I mentioned I am terrified of water (nearly drowned as a child) and there was no alternative. I can understand why water aerobics is good--because you put less stress on joints that are already stressed by weight. But what can you do to get started if you can't deal with the water? That said, I'm still getting in the pool because my health is more important than my fears.

I'm going to do some at-home yoga and low impact aerobics that I've found successful in the past. But, it would be nice if there were more recommendations or suggestions from the bariatric network. As obese patients, many of us suffer from psycho-social fears about exercising in public (well, I do, so I hope I'm not alone). What are the options for people like me? I find the gym in my condo a bit intimidating because it's full of very fit body builders. And, I have no idea how to use the equipment. I have a personal trainer lined up to help me learn how to use the equipment safely, but it would be nice if there was something offered for those of us post-surgery to learn the ropes. I have spent some time staring at the equipment and watching Youtube videos, but I need a living breathing person to show me I'm not injuring myself.

 

Referral: February 2015; TWH Orientation: April 2015; Social Worker: June 10, 2015: Nurse Practitioner: June 11, 2015; Nutrition Class: June 15, 2015; Psychometry Assessment: June 16, 2015; Nutrition Assessment: July 22, 2015; NP follow-up: July 28, 2015; Surgeon Consult: August 28, 2015; Surgery: November 6, 2015; Operation: VSG

Patm
on 11/24/15 6:01 pm - Ontario, Canada
RNY on 01/20/12

If you decide to go to a pool many have lie preservers you can use. Please do not let you fear of water stop you

  

 

 

 

Dreamy74
on 11/24/15 11:41 am
RNY on 02/04/15

I would have to respectfully disagree with you.  At my 3 month follow up (I am through TWH) the dietician and nurse practitioner gave me some sheets on recommended exercises I could start to do right away, and in the coming months.  Long brisk walks were suggested to start right away, then yoga, and in 6 months time, swimming and cycling and even running.  Weight training was also mentioned, to potentially help with loose skin (but they did warn plastic surgery is inevitably required in most cases).  The papers also suggested a gym membership, purchasing a treadmill, joining a running/walking club and more (I don't have the papers in front of me, they are in my booklet).  I suppose it depends on what Centre you are with but I have never felt pushed out the door re: exercise.

They even had a support group back in the Spring with a speaker (I forget her name) who does marathons.  That was a great source of information, how to get started, etc. etc.

I am 9 months and 2.5 weeks out from surgery.  So far I have done yoga, walking (OMG LOTS of walking), a few tries at running, swimming, climbing the stairs on lunch at work and dancing.  I am down 110 pounds with about 20-30 more pounds to go.

It isn't easy being green - Kermit the Frog

    

Ipatton
on 11/24/15 1:25 pm - Canada

I get what you are saying, and I am glad you feel as if you have been given ample information re exercise and congrats on your success!

 

I guess my position is that exercise, just like any other science, is not a one size fits all and the people giving information should be qualified and knowledgeable.  With all due respect, Dietitians, nurses, and even physicians are not at all qualified or trained in exercise science to be giving specific information.  That would be the equivalent of me giving psychological counselling because I took a 1st year psych course in my undergrad.  

Being told to walk and swim and aquatics etc is a great start, yoga is awesome.  However many, if not all of us have imbalances, postural issues, structural limitations.  For the average Bariatric patient, being told to get gym membership is not enough, I think there needs to be customized programing and education to make people comfortable and confident in activity, while addressing their specific needs re imballances etc.    

Ipatton
on 11/24/15 1:25 pm - Canada

I get what you are saying, and I am glad you feel as if you have been given ample information re exercise and congrats on your success!

 

I guess my position is that exercise, just like any other science, is not a one size fits all and the people giving information should be qualified and knowledgeable.  With all due respect, Dietitians, nurses, and even physicians are not at all qualified or trained in exercise science to be giving specific information.  That would be the equivalent of me giving psychological counselling because I took a 1st year psych course in my undergrad.  

Being told to walk and swim and aquatics etc is a great start, yoga is awesome.  However many, if not all of us have imbalances, postural issues, structural limitations.  For the average Bariatric patient, being told to get gym membership is not enough, I think there needs to be customized programing and education to make people comfortable and confident in activity, while addressing their specific needs re imballances etc.    

(deactivated member)
on 11/24/15 1:42 pm - Bumfuknowhere, Canada

Some centres have physiotherapists that you see prior to surgery then again at all your follow-up appointments, where they assess you and recommend exercises based on your own individual abilities.  

Dreamy74
on 11/25/15 6:32 am
RNY on 02/04/15

Hi lpatton.  In reply to your last post I would have to say that the dieticians and nurse practitioners gave me ideas about exercise.  It was up to me to find other qualified persons to help me in my exercise journey if I felt it necessary (i.e. yoga instructor, personal trainer, swimming lessons coach, dance instructor).  I think all health care professionals involved in bariatrics are able to recommend exercise.  It just comes down to how much personal responsibility one wants to take.  It's like saying just because we've had bariatric surgery, we need our hands held with every aspect of the process afterwards. Should we also be given access to a personal bariatric chef?  Where does one draw the line at aftercare services?  It would exhaust OHIP and our tax payer dollars. I take full responsibility for using my tool and to seek out information and expertise in the aftermath of my surgery.  If I feel that I am struggling with exercise or need special care in that regard I would seek out the advice of a physiotherapist.

 

It isn't easy being green - Kermit the Frog

    

Ipatton
on 11/25/15 8:24 am - Canada

So it looks like some of you might be misunderstanding me.  I pointed out there is a gap in our care that I believe I can do some good in filling, or I would at least like to explore the idea, i never suggested, or meant to imply that OHIP cover it, I am well aware of our Health care system and especially the Bariatric care and strain for dollars.  

I do believe that in many cases, seeking out a personal trainer can be problematic, very few are qualified to actually work with morbidly obese individuals.  I thought this was an area of need because I have spoken one on one with many bariatric patients both pre and post-op who have felt overwhelmed and uneasy about the activity side of things and some talked about how personal trainers made it worse by simply running them through boot camp like workouts before they were ready. I think I can provide something more comprehensive, evidence based and beneficial to our outcomes. I was looking for input and experiences some of you have had regarding exercise, not necessarily arguing over whether or not the government would pay for it.  In a perfect world there should absolutely be some level of kinesthetic coaching at least to begin, but again reality is not that kind.   

Sorry for the mis-understanding

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