3 Month Post Op with P.A.

[Beckmo]

I probably have no right to be grumpy... but I am! I went to my 3 mos. post-op and saw the PA. I was feeling very tired, kind of weak, and curious about my labs. It is a worry for me that I will fail at the DS. I feel like I failed the RNY.

Well... this is what I came away with... I need to take in 1500 cal. (tired and weak from low cals), I need to stop taking the Vit. D, A, and K supplements and to not listen to any forums I may have got that info from as those forums will kill me (I believe the best and most accurate info is from Bariatric Facts), Count Calories (this just spirals me in depression to do... HATE IT... a major trigger), what exercise do you do? That's not enough you need to do more than that. (I swim laps for 40 mins. 1-2 times a week. I don't have a car. Now membership ran out), then "do you have diarrhea? how many carbs do you eat"... Well, no, no I don't have diarrhea (he seemed surprised by that...) I know carbs cause the rhea, but questioning me twice will not change my answer.

Now... I feel panicky... I am trying to eat protein, trying not to eat any carbs (or extremely low), be careful on calories (but still not counting).

Oh Yes, I forgot... I did get the lecture about this is the last surgery possible... this is it. If I don't follow the rules on this... that's it, there isn't another surgery. yada yada yada..... etc., etc., etc.... Yeah, like that doesn't make me feel like a failure!!

Grumpy, yeah, still am. I am a bit OCD... so this freaks me out. Where should I be at 3 mos. out? What is a "normal" diet?

 

[Charris]

Oh @DianaCox really is going to get irritated with your doctor real quick!

 

[southernlady]

Where should I be at 3 mos. out? What is a "normal" diet?

Assuming normal progression and NO complications, then ou should be able to eat anything your body will tolerate. But add new foods slowly as you never know how your guts will like them. And stick with protein/fat as much as you can.

Well... this is what I came away with... I need to take in 1500 cal. (tired and weak from low cals), I need to stop taking the Vit. D, A, and K supplements and to not listen to any forums I may have got that info from as those forums will kill me (I believe the best and most accurate info is from Bariatric Facts), Count Calories (this just spirals me in depression to do... HATE IT... a major trigger), what exercise do you do? That's not enough you need to do more than that.

Horse shit on the calories. Ignore actual calories, count how many grams of protein, fat, and carbs you ingest.

Don't you DARE stop taking any of those vitamins UNLESS YOUR LABS tell you otherwise.

As for not listening to online vets...maybe print it for HIM: http://bariatricfacts.org/threads/dear-family-and-friends.3627/
Esp this part:

So, in summary, YES, WE DO KNOW BETTER. Over the years, through sharing our experiences, we have arrived at something of a consensus about the care and feeding of a DS, which differs greatly from the very very wrong advice that the surgeons' practices try to force on their patients.

We also know that we are all individuals, who have received DIFFERENT versions of the DS (limb lengths vary), with our own individual metabolic issues, as well as individual ages, genders, underlying medical conditions, level of activity and lifestyles. Not only that, but each individual changes over time, and so you MUST stay on top of everything and change as necessary. The advice can and MUST be individualized. There is no one-size-fits-all advice for DSers - just advice that is used on a trial and error basis, by monitoring labs and how you feel.

Finally, we vets are the ones who have a vested interest in making sure we stay healthy over time, and we are the ones who are tracking and sharing the results we have discovered works better than what our doctors are - without evidentiary basis - trying to slough off on us. WE are living with this surgery, and WE know that the doctors are wrong. And we know that we have "saved" many people from the brink of death, reoperation and weight regain, by sharing what we know.

What *I* would do if it were me, IF you are healed, no need to see that office again. Get your PCP on board with pulling labs and if they won't or can't and you don't want to deal with his office, go around him and order your own damned labs. http://bariatricfacts.org/threads/did-you-know-you-can-order-your-own-labs.2068/

 

[Clematis]

Just tell them what they want to hear. Smile and nod. Then do it the RIGHT way.

 

[Larra]

Unfortunately we see lots of surgeons giving out terrible nutritional advice, and this is worse than most. Clearly there is no understanding on the part of your surgeon as to the needs of someone with the malabsorption of the DS. If you don't take those supplements of D, A, and K, your levels will tank, and it will be far more difficult to get them back up to normal that it is to maintain them at normal levels. Same for protein.
And counting calories is meaningless when you malabsorb 80% of the fat you consume and 40-60% of the protein you consume (which is why you need to emphasize protein in your diet).
The only thing I agree with is that the DS is the strongest and most effective bariatric operation available, there is nothing better for you or anyone else to revise to. But that doesn't mean that you were a failure with your gastric bypass. The failure rate for that operation is far higher than most pre-ops realize. If they knew, they would insist on something better. You had an operation with limited effectiveness and IT failed, not you. If you focus on protein and limit carbs, you should do much better with your DS.

 

[Beckmo]

Thank you so much to all of my "knowledgies"!! You all are definitely helping me get out of my "crazies" in my head. He (P.A. to surgeon) that I should just take the D3 once every 2 weeks, the A1 once a week and the K not at all since my Mother is on Coumadin. I was taking the Bariatric ADEK when labs were drawn and my Vitamin D, 25-Hydroxy, Total was Low. It should have been between 30.1-100.0 and mine was 28.4. I am not taking Bariatric Advantage ADEK any more... I take 2 prenatal vitamins a day. It is so hard to figure this all out at first, I guess... esp. when you have a PCP that turns it over to the Surgeon and the P.A. at the Surgeon's office that tells you to stop it!

Thank heavens for all of YOU!!

 

[Beckmo]

If you focus on protein and limit carbs, you should do much better with your DS.

At 3 months, how much protein a day should I be getting? Limit my carbs to under 50gm?

 

[chevtow]

Thank you so much to all of my "knowledgies"!! You all are definitely helping me get out of my "crazies" in my head. He (P.A. to surgeon) that I should just take the D3 once every 2 weeks, the A1 once a week and the K not at all since my Mother is on Coumadin. I was taking the Bariatric ADEK when labs were drawn and my Vitamin D, 25-Hydroxy, Total was Low. It should have been between 30.1-100.0 and mine was 28.4. I am not taking Bariatric Advantage ADEK any more... I take 2 prenatal vitamins a day. It is so hard to figure this all out at first, I guess... esp. when you have a PCP that turns it over to the Surgeon and the P.A. at the Surgeon's office that tells you to stop it!

Thank heavens for all of YOU!!

If your PCP isn't on board, find a new one!! You can't just take the shit they shovel, at least not if you want to live to old age. Take charge of your health.

 

[Beckmo]

If your PCP isn't on board, find a new one!! You can't just take the shit they shovel, at least not if you want to live to old age. Take charge of your health.

Yep, I am going to make an appointment to just cover just that! It might just be "In search for the New PCP with DS Knowledge" series.... Hopefully, not a LONG series!

 

[k9ophile]

Your mother is on Coumadin so you shouldn't take Vitamin K? Is he afraid your K levels are contagious and that your mother will catch the K you're throwing off? Ok, I'll turn off my sarcasm and tell you that you have as much right to feel grumpy as you do to feel happy when those feelings hit. Yep, nod your head, smile, and keep in contact with this group.

 

[DianaCox]

I want you to go back and reread this thread: http://bariatricfacts.org/threads/hello-revision-to-ds-here-in-az.3174/

We warned you about Juarez. I think you're lucky to be alive. Now go get your surgery report and post what it says. I'd like to know what he did to you.

But you don't need to see him again either. Tell him to fuck off if he is going to try to make you feel bad, and gives you terrible nutritional advice to boot.

 

[Charris]

@Beckmo I didn't realize you had Juarez and are right here in AZ with me. I had a distal RNY with him when Phang just started. We only had 3 surgeons in AZ and he was the best. Now I think he probably should retire and bow out gracefully. Man when I went to see him he has not aged well at all.

But what Diana said and get your report EVEN though he wrote doesn't mean that's what he actually did, he has been accused of doctoring reports. I had a sleeve scheduled for Sept 9, 2013 but met these guys and cancelled. So because they were pissed because they got the approval. They told insurance that my authorization in CA was fraud. Stolen identity stuff.

When I has my DISTAL RNY I was told to take a Flintstone vitamin. Plus I got empacted so he told me to don't take any iron ever.

 

[DianaCox]

"So because they were pissed because they got the approval. They told insurance that my authorization in CA was fraud. Stolen identity stuff."

Clarissa, what is this about? I don't recall hearing that! HOW DARE HE (or his office) DO THAT!! What if anything did you do to rebut him and report him?

 

[Charris]

@DianaCox I've mentioned that before but it was on the pb site. I told Juarez I wanted the ds. He told me never can't be done I was too small. So I said I know others who had the same amount to loose. He told me well go to those other doctors. So that's when I emailed Keshishian and got the ball rolling.

My surgery was scheduled like for the 9th and I called cancel the procedure because mom's had went in ICU and was dying. Well they went to verify everything Juarez staff called and said we talked to insurance and they said you asked for your authorization canceled. I said yes and regurgitated the convo Juarez and I had. So the lady says well we thought that was the plan do the sleeve first then the switch later. Again I told her Juarez said no. So like the 13 my insurance company called me and said I just need to clear up what's actually going on. Juarez's office stated the requested surgery in CA is fraud and probably identity theft. I couldn't believe it.

 

[DianaCox]

I would have reported him to the AZ medical board. You can still do that.