My surgeon made me cry today at my pre-op appt

Today was my pre-op appointment with my surgeon.  I did not lose any weight during my 4 month dietary pre-op requirement.  (My nut. told me that as long as I didn't GAIN any weight, I'd be fine.)  Well, today my surgeon gave me a giant lecture about how I haven't made a commitment for change and that, as a result, I was probably going to fail to keep the weight off.  A lot of what my dietician and I have focused on seems to be post-op expectations.  I understand the drastic change I'm about to go through, and feel like I'm ready for it.  I just felt like I had the rug pulled out from under me today, because I thought I was on track and doing what my dietician told me to, and then I got opposite feedback from the Dr.  He talked to me about how this surgery is about getting healthy and reducing co-morbidities, which I totally agree with.  THEN I made the mistake of asking him when he sets a goal weight with patients.  ohmygod, you'd think I'd slapped him.  He asked me if I wanted him to start over from the beginning, because if I thought it was about reaching a "goal weight", I hadn't been listening.  So frustrating!  I understand his logic behind not setting a goal (if you don't meet it, you're discouraged, if you do meet it, you feel like you're done), but I just thought EVERYONE got a target weight goal.  Whoops.

I like that he's so straightforward, but it made me cry that he was questioning my commitment and potential.  Bottom line - I can't fail at this, and his uncertainty made me question myself.  I'm hoping he was just trying to scare me into compliance. 

Sounds like you got a dose of tough love today.  Without roughing you up further, consider what changes have you made in the past four months.  Have you swapped any white flour products for brown (like white bread for wheat bread)?  Have you added exercise to your daily routine?  Have you reduced the amount of fast food or eating out in your regular routine?  What post-op expectations have your started to follow (no soda, smaller portions, more water)?  My guess is you have made some kind of change or you wouldn't have been able to maintain your current weight.  These are all good questions to ask yourself and use the next two weeks to really begin practicing the post-op expectations you have discussed with your NUT.  Good luck and keep your chin up....you can do it!

It sounds like your dietician and surgeon are on different pages. Do they normally work together? If so, please let him know what you were told so they can have the same thoughts on pre-op preparedness. It appears he expected some weight loss prior to surgery (which some surgeon’s require). 

Many surgeons do not set goal weights, which is probably best since it does impact some people with how they perceive their surgery success. My surgeon did set a goal weight and I looked at him like he was crazy, that number didn't even seem imaginable. Well I did hit his goal weight.

I DO believe you should set a personal goal based on weight or size that is REASONABE and OBTAINABLE. A normal BMI shouldn't be the driving force IMO; we
all know how those charts are antiquated.

OMG! I can only imagine how you must have felt. Talk about being harsh! OOCH..... Maybe your right, maybe he does it to all of his patience to scare you into compliance. After all they are Dr's. Just by you complying with your dietician shows that you are dedicated to this dramatic change. Maybe if you tell him that you followed the diet that the dietician provided you and taught you to follow, maybe he will see how dedicated you are. Dont be discourage, once you start the liquid diet before surgery im sure you will loose some weight.

There maybe other factors as to why you didnt loose any weight. i didnt loose any weight during the 6 months w/a  dietician but i gained 10 lbs. Have you gone to see your family dr for your clearance. Not sure if you will need it but my insurance required that i get clearance from my Family Dr and it came out that my Thyroid levels were 3 X's over the normal levels. Which is partly why i didnt loose any weight but gained and i also did stick to my diet. It sux that after you do so much you still dont loose any weight. It also discourages you but no worries, im sure everything will turn around for you.

Im scheduled to have my surgery on Thursday, November 8th... Yeah... im excited

I already had my family doc appt, and she didn't seem too surprised that I didn't lose any weight yet - I've gone off of anti-depressants in the past few months, which could be a partially contributing factor.  I had my thyroid levels checked and they were okay.  My only other explanation was my PCOS.  My vitamin levels were fine, everything else checked out. 

I guess, bottom line is: he's still going to do the surgery either way, and I can just prove my commitment to it on the other side now.  All of my pre-op requirements are done now - I won't be back to the hospital until surgery day!

Good luck with your surgery - hope your doctor is nicer. 

It does sound like you had some tough love today.  In my program, I had to do 6 months of the dietician/Nutritionist supervised diet. They wanted us to try to lose 10% of our starting weight ( for me 28 lbs ) and I did lose that before my surgery!  I don't know why your NUT wasn't helping you lose the weight... I know it really helped me with the 2 week pre-op liquid diet that I had to do and the 2 weeks of liquids after the surgery!  My surgeon's practice was very clear up front, that if we gained or did not lose any weight in the 6 mos period, that he would not do our surgery.  Are you really committed to what this new life will take?  Believe me, there have been a few times that I questioned what have I done?  But then, I clear my head and move forward.... it is worth it !!  I am 6 weeks post-op tomorrow and am down 22 lbs since the surgery !!   Good Luck, you can do this....

My surgeon made me lose fifty pounds to make the surgery safe for me. I did it but we butted heads more than once. We actually got into a yelling match in the exam room, and it was over my pre-op weight loss or lack of loss. I left and swore i'd lose all the weight on my own and to heck with him.

I got so depressed that I started eating breakfast and lunch and a snack. Normally I really only ate dinner. By eating during the day my sugar levels evened out (still to high tho) and the weight started coming off. Then I started avoiding carbs and the weight came off quickly. Four months later the surgeons office called to see if I was interested in coming in for an appt to discuss RNY surgery. I said yep and when I went in he gave me a date for my RNY.

I knew I couldn't keep it off on my own. To this day carbs are still my downfall.

Try atkins or some other low carb plan. You will be amazed how well you will do. You have to decide you really want this. You will have to eat this way post surgery so why not get used to doing it now?

Good luck, remember this surgery is only a tool. Our success or failure is based on how well we use the tool!!!!

Sorry you had that experience. I do second the poster who said to check with the office and find out why it appears the NUT and the surgeon are not on the same page. I would be concerned if they are not in agreement and how it will impact you post surgery.

It sounds as if your surgeon is putting the emphasis on being healthy, which is a good thing. He may not be particularly deft at communication. Please try not to let this conversation devastate you.

ETA: my surgeon doesn't set a goal weight. I decided my goal on my own.

I had my pre-op nutrition appointment this afternoon - and I did ask her what was up with the differences between what the two of them were telling me.  I went through things with her bit by bit and she thinks that maybe he was already fired up from the patient before me (he did mention that he'd spent 1-1/2 hrs on his last appt that was supposed to be 20 minutes, talking over the same stuff as he was going through with me), so he may have been slightly harsher with me than he would have been normally.  Weight loss is not REQUIRED pre-surg, but is encouraged.  Today I came prepared with all of my pre-op questions, had my patient binder pretty much memorized, and know what to expect, so she's confident in my readiness.  Now I just have to show HIM. 

Most surgeons like their RNY patients to lose a decent amount of wt prior to surgery.  There is a surgical aspect to this preference, as the wt loss just prior to surgery greatly helps remove fatty liver deposits. If the fatty liver deposits are substantial, then it makes the LAP RNY difficult for the surgeon. I did lose about 27 pounds in the 3 weeks prior to my surgery. Then, in the surgery room, I had to sign a form acknowledging I was there for LAP RNY but "if conditions warranted" I gave my consent to an OPEN RNY procedure.  DAVE