Your Surgeons and NUTs work for you!
I have noticed over a long period of time where people come here after meeting with a surgeon, surgeons nurse or NUT. They are either not happy at the information they have been giving or question what they have been told to do.
These people work for you. Plain and simple you need to remember that going into these appointments. You wouldn't have an issue questioning your primary prescribing you NSAIDs or telling them no to such a prescription. Remember that your surgeons for the most part preform these surgeries the same way on their patients, Your RNY looks like the RNY they did on the person before or after you. Your pouch is about the same size they have bypassed about the same amount of intestines, and their post-op calories and protein goals are based on averages or some other template protocol they have used since day 1.
In all of this everything being the same these people tend to forget that we are each individuals, we will lose weight at different rates, we may or may not lose as much as they want us to and based on our bodies we will eventually have to tailor what and how much we eat to optimize what works for us as an individual.
So as you come out of an appointment ask yourself "Did I go in there prepared?", "Did I honestly discuss my situation clearly".
I will use myself as an example.
I won't use my surgeons NUT and after one of my Follow ups I wasn't to pleased with what the nurse said, pretty much what most of us have gone through, the weight loss was there they just didn't like what I ate. So I went and found my own NUT who is very experienced in Bariatrics. I went into this appointment and honestly said here is what I eat and what I do, the what I eat list was very narrow mainly protein shakes, refried beans and ground meats. She estimated I was only getting 800 calories. She increased my calories to 1400 and gave me a list of foods to try and I had to send her food logs every week for a month. This worked great and got me going and I stuck to this.
Well as my workouts and fitness goals increased so did my hunger but I wouldn't eat because it would take me past my goals. I invested some time and had my RMR Tested my HR Zones, along with food and workout logs. Over the course of an hour we discussed what I was doing and my approach she tweaked a few things added some stuff.
The result was calories went from 1400 to 2300 I had to add carbs and protein was almost tripled.
Annual checkup with the surgeons office I told them the ame information and the results of the meeting with my NUT and they fully supported it.
What I am getting at is if you do your part then this process will be much more enjoyable and slightly less frustrating. Make them do their jobs and remember you are an individual and not a Stat in their records.
These people work for you. Plain and simple you need to remember that going into these appointments. You wouldn't have an issue questioning your primary prescribing you NSAIDs or telling them no to such a prescription. Remember that your surgeons for the most part preform these surgeries the same way on their patients, Your RNY looks like the RNY they did on the person before or after you. Your pouch is about the same size they have bypassed about the same amount of intestines, and their post-op calories and protein goals are based on averages or some other template protocol they have used since day 1.
In all of this everything being the same these people tend to forget that we are each individuals, we will lose weight at different rates, we may or may not lose as much as they want us to and based on our bodies we will eventually have to tailor what and how much we eat to optimize what works for us as an individual.
So as you come out of an appointment ask yourself "Did I go in there prepared?", "Did I honestly discuss my situation clearly".
I will use myself as an example.
I won't use my surgeons NUT and after one of my Follow ups I wasn't to pleased with what the nurse said, pretty much what most of us have gone through, the weight loss was there they just didn't like what I ate. So I went and found my own NUT who is very experienced in Bariatrics. I went into this appointment and honestly said here is what I eat and what I do, the what I eat list was very narrow mainly protein shakes, refried beans and ground meats. She estimated I was only getting 800 calories. She increased my calories to 1400 and gave me a list of foods to try and I had to send her food logs every week for a month. This worked great and got me going and I stuck to this.
Well as my workouts and fitness goals increased so did my hunger but I wouldn't eat because it would take me past my goals. I invested some time and had my RMR Tested my HR Zones, along with food and workout logs. Over the course of an hour we discussed what I was doing and my approach she tweaked a few things added some stuff.
The result was calories went from 1400 to 2300 I had to add carbs and protein was almost tripled.
Annual checkup with the surgeons office I told them the ame information and the results of the meeting with my NUT and they fully supported it.
What I am getting at is if you do your part then this process will be much more enjoyable and slightly less frustrating. Make them do their jobs and remember you are an individual and not a Stat in their records.
Paul C.
First 5K 9/27/20 46:32 - 11 weeks post op (PR 28:55 8/15/11)
First 10K 7/04/2011 1:03 First 15K 9/18/2011 1:37
First Half Marathon 10/02/2011 2:27:44 (PR 2:24:35)
First Half Ironman 9/30/12 7:32:04
First 5K 9/27/20 46:32 - 11 weeks post op (PR 28:55 8/15/11)
First 10K 7/04/2011 1:03 First 15K 9/18/2011 1:37
First Half Marathon 10/02/2011 2:27:44 (PR 2:24:35)
First Half Ironman 9/30/12 7:32:04
You are absolutely right...
I don't know about the rest of you, but I had to, up front, pay a $500 program fee to the NUT office, and like Paul, I don't like them and don't trust them. They are impossible to get in touch with, give wrong information - had me going on Flinstone gummies and Calcium Carbonate - luckily I found this site.
After reading this, I think I am going to seek out my own NUT and see what I can do. Thanks Paul, this was encouraging.
I don't know about the rest of you, but I had to, up front, pay a $500 program fee to the NUT office, and like Paul, I don't like them and don't trust them. They are impossible to get in touch with, give wrong information - had me going on Flinstone gummies and Calcium Carbonate - luckily I found this site.
After reading this, I think I am going to seek out my own NUT and see what I can do. Thanks Paul, this was encouraging.
It isn't that I don't trust them I do but I trust them for their expertise.
I trust my surgeon when it comes to my Pouch and innards.
I trust my NUT when it comes to my diet (I am not on a diet but rather diet as in what I should eat)
I trust my PCP when it comes to my Labs
I Trust my GI when it comes to how my Innards are working and any ulcers.
So you do need to trust them they do have a stake in your success even if it is their stats, but if your surgeon is only intrested in their success rate then you probably have the wrong surgeon.
I trust my surgeon when it comes to my Pouch and innards.
I trust my NUT when it comes to my diet (I am not on a diet but rather diet as in what I should eat)
I trust my PCP when it comes to my Labs
I Trust my GI when it comes to how my Innards are working and any ulcers.
So you do need to trust them they do have a stake in your success even if it is their stats, but if your surgeon is only intrested in their success rate then you probably have the wrong surgeon.
Paul C.
First 5K 9/27/20 46:32 - 11 weeks post op (PR 28:55 8/15/11)
First 10K 7/04/2011 1:03 First 15K 9/18/2011 1:37
First Half Marathon 10/02/2011 2:27:44 (PR 2:24:35)
First Half Ironman 9/30/12 7:32:04
First 5K 9/27/20 46:32 - 11 weeks post op (PR 28:55 8/15/11)
First 10K 7/04/2011 1:03 First 15K 9/18/2011 1:37
First Half Marathon 10/02/2011 2:27:44 (PR 2:24:35)
First Half Ironman 9/30/12 7:32:04
I agree. We hire them to provide a service for us. If they do not do a satisfactory job, we can fire them. However, if you've ever managed employees at a job, you know that it requires some work from you. You have to select the right employees, you have to provide them with clear expectations of what you want from them, you have to let them know if they are not doing something the way you want them to do it, etc.
Just like whenever you decide to hire other employees, you can interview doctors or other health care providers before you decide whether or not you want to work with them. I have scheduled appointments to interview a number of health care providers. I interviewed my surgeon, my PCP, my therapist... I ask them about their education, if they have experience dealing with certain issues that are important to me (for instance, I wanted a therapist with experience dealing with PTSD), ask them how they deal with certain problems including emergencies (like, will I be able to reach them in an emergency? will they work me in at a moment's notice if it's an emergency?), etc. I've never actually had one balk at being interviewed, but if I did, I'd kknow right off that they were not the doctor for me.
Just like whenever you decide to hire other employees, you can interview doctors or other health care providers before you decide whether or not you want to work with them. I have scheduled appointments to interview a number of health care providers. I interviewed my surgeon, my PCP, my therapist... I ask them about their education, if they have experience dealing with certain issues that are important to me (for instance, I wanted a therapist with experience dealing with PTSD), ask them how they deal with certain problems including emergencies (like, will I be able to reach them in an emergency? will they work me in at a moment's notice if it's an emergency?), etc. I've never actually had one balk at being interviewed, but if I did, I'd kknow right off that they were not the doctor for me.
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.
What really gets me mad is that going to a NUT is supposed to be part of your education. Why would we need to go to one at all if we already have all the information? It's not our job to educate them, except to tweak a good plan based on our individuality. I agree we should educate ourselves and be prepared with questions, but it's their job to know that RNY patients shouldn't take calcium carbonate. I don't think a physician would take offense if I told him/her that no thanks, I can't take the NSAID because I have RNY, can we try something else? I think a bariatric-specialist NUT would take offense if I said, oh no, I shouldn't be taking carbonate or something wimpy like Flintstones because I'm a bariatric patient.
I'm so glad Paul found one that is knowledgeable! I think this is our only option, if we choose to have a NUT at all, is to find one that is up to date on the latest bariatric nutrition.
I'm so glad Paul found one that is knowledgeable! I think this is our only option, if we choose to have a NUT at all, is to find one that is up to date on the latest bariatric nutrition.
Lapband Nov 2006; revision to RNY 8/17/2011
5'3", HW: 205 / Consult: 189 / SW: 184 / CW: 140 / GW: 130
5'3", HW: 205 / Consult: 189 / SW: 184 / CW: 140 / GW: 130
I agree, they should know those things. And I think we should complain to our surgeons if they refer us to a nut that doesn't know such basic stuff.
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.
I am very lucky to have a NUT who knows a whole lot more than I do, and has lots of suggestions that really work for me, a surgeon who listens to my questions and we can converse. Same with the NPs in the office. I feel free to ask why, and to ask about alternatives, and I get a thoughtful response back. I'm looking forward to my three-month check-up, because there are some things that are bugging me, and I think they can help.
But if I didn't feel comfortable working with this team, I would have looked for another.
But if I didn't feel comfortable working with this team, I would have looked for another.
Eliza
Consult:239 SW:217 1mo:195 2mo:182 3mo:169 6mo:139 9mo GOAL CW: +2 from underweight
Consult:239 SW:217 1mo:195 2mo:182 3mo:169 6mo:139 9mo GOAL CW: +2 from underweight
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