Doctors Visit from H.... What should I do now?

Friday I had a checkup with my surgeon that didn't go very well and I've been fretting about it all weekend. He first started to tell me that I needed to wean myself off of the protein shakes and that I should now be getting all of my protein from the food that I eat.... he then proceeded to tell me that walking on the treadmill for 45 minutes 3 or 4 times a week is not considered aerobic exercise and is doing me "no good"... when I asked him about my progress he told me that I was loosing too slowly and that most of my weight is "hippy weight" which never really comes off. And that I only had another 7 months to loose the weight or the "window of opportunity" will slam closed and I will be stuck there. At this point, I wasn't sure what I should be saying to the guy or asking him.... it was like he couldn't wait to get me out of the room and on to the next person. When it was clear that he was wrapping things up I asked him about my labs (first set since the surgery)... he goes "you would ask that"... and then said "they look fine". I asked him if I could get a copy of these tests along with the presurgery numbers and he got offended and told me to ask up front for them, he told me that he didn't need to see me until my 1 year anniversary and then left. Well, when I got out to the car to look at the copy of the test results... things did not look fine. My protein levels have dropped, my B12 levels are in the mid 200s which is low for a normie and severely dangerous for a post-op. When I posted my test result numbers to one of the online support groups on yahoo that I belong to, one of the members said that I was within the "brain damage" level of B12 and to run not walk to a doctor who would prescribe weekly shots... How can my surgeon tell me that my numbers are fine? I knew that I wasn't sure about his aftercare when he had me taking Flintstone vitamins and Tums for calcium... I did enough research on my own to figure out that we need calcium citrate and to get that fixed... and even with that my calcium levels dropped. You know, I just don't understand any of this visit. Is it possible to change to another WLS Surgeon in the area for aftercare? How would you guys suggest that I go about finding one??? I really don't want to wait for 7 months before someone checks my labs again. What do you do when your surgeons program is flawed? Do your doctors consider 45 minutes on the treadmill 3 or 4 times per week exercise?? Do other doctors tell patients that if they don't hurry up and lose weight, they will be failures? Sorry for all the questions and the rambling... but I'm obviously still bothered by the events on friday. And to think that I was pretty happy with my 66 lbs weight loss.... and going from a 30/32 to an 18/20 in clothes.

Patty, I would definitely look into another surgeon for your aftercare but in the meantime I would call your primary doctor and show them your lab results. They can prescribe you B12 shots and tell you how to get your results up. I think your weight loss is great and my surgeon says any exercise is better than no exercise. Eventually walking will not be enough but I think you are doing great. I know I have heard people say that the first 18 months (honeymoon period) is when the losing is the easiest but I have read where people 2 and 3 years out are still losing weight. Were you comfortable with your surgeon before? Has he ever acted like this before? Maybe he was having a bad day, but even so he should have never acted this way. If you decide to change surgeons I would report him to your insurance company, they can file a grievance against him for his manners. I hope all works out for you, Kim 286/222/150ish?

Hi Kim... Both my husband and I have noticed an air of arrogance with my doctor before this... but nothing this bad before. I think that you are right, my primary care doctor could probably watch my labs for me and get me whats needed to get my levels back to where they belong. Thanks for the support! Patty in Connecticut 319/253/140

Patty: I'm with Kim. Get yourself to your primary care doctor for medical advice. Ask him to look at your results and then he'll know what you need. Let him know that you have concerns and ask him can he follow up with you in another 3-4 months. Walking is exercise. Eventually, you may switch your exercise program, but if you are losing weight and feeling better, any movement is good. My surgeon says that my 55 lb loss is good and he is very encouraging, even when I am hard on myself. He doesn't believe in the "window of opportunity". He says that weight loss is all about the way you use your pouch. Please try to stay encouraged. Actually, I think you will feel a bit better once you have seen your primary care physician. ((((((((HUGS))))))))))))

Ms Sassy Thank you for the kind words and the hugs... I can use all of them that I can get! I know that eventually my exercise will need to be stepped up, but at this point I feel very priviledged to be able to do the treadmill and also the massage therapy labs that I have 6 hours /week... 5 months ago... this wouldn't be possible. thanks again... hope things are going great for you! Patty

Keep positive and know that you are right! You need to change doctors asap! The aftercare is equally as important as the beforecare and surgery. I have a surgeon who copies all lab results to my GP, so if there is any question, there are more than one set of eyes on the test results. Walking on a treadmill can be great exercise, just keep it up and increase the frequency as soon as you can. Also, if you can increase the difficulty level once it becomes routine, it will benefit you greatly. Keep up the great work! 66 pounds is nothing to sneeze at! As for your vitamins, try Centrum Adult Chewables twice a day and Chewable calcium (our local store has their brand which is even sugar free!). I also take a sublingual B-12 and Biotin twice a day as well. These have kept my levels good, even when I had trouble getting all of the protien that I needed. Keep up the good work and remember, there are a lot of us out here that support you, even if that surgeon doesn't! Cheri

Cheri Thank you for the kind words... I know that I am doing things right and that I will succeed at this.... I just can't believe that someone could deflate a person so easily without even a second thought. I am using bariatric advantage multi vits and calcium citrate... will be adding magnesium, iron and an additional b12 per day as soon as my next paycheck arrives. I know that at least for the immediate future I will continue using protein shakes to supplement my protein levels... its obviouse from the dip in numbers that although I am eating around 80 grams of protein/day I am not absorbing very well... I have increased my shakes to 2/day and may even go to three.... I do believe that changing doctors is my best option at this point... just not sure how to go about doing that... there are some definate criteria that I will be looking for in a postop program. Hope things are going well for you Patty

I'd just love to know who your surgeon was... I can tell you that mine sees folks regularly and monitors labs..has been nothing but supportive and has never treated me ANYTHING like the way you describe. I suspect you are seeing one of the "famous" WLS in CT who have vast numbers of patients and are shuffling them in and out like cattle... My surgeon DOES discourage reliance on shakes due to high calorie content and does stress getting as much as possible from food...I have taken it on myself to take b12 supplements as I learned about it from this site...surgeons are NOT nutritionists...and I really believe that after they get us through the surgery and off the table and flying right...that much of what they say is very subjective in terms of diet and vitamins..or depends on the nutritionist they consulted to set up their programs guidelines. However..there is NO EXCUSE for any Doctor we have paid for a SERVICE to be rude, insulting or demeaning. As for exercise..I am supposed to get in a solid hour every day...and my Doc thinks walking is fine....he thinks the duration is more important than the mileage....just wants me to get the heart in the target zone. Many surgeon's programs are flawed in one area or the other....mine has us all taking tums and never mentioned b12 or iron supplements...but I have taken care of that myself... also has us all on chewable vitamins...I found Centrum Chewables for myself and a couple of other brands...as well as B12 sublinguals... My surgeon got me through the operation and off the table in one piece...that was his main job....IMO....the rest I have taken a good bit of responsibility for...when I go have labs, I always write my name and address in the space that says "mail carbon copy to:"..I get the results as fast as he does...and can draw my own conclusions. The surgeon agreed to monitor labs pertinent to the surgery, and my PCP monitors the rest the way he always did. One thing I can say...my surgeon has never been demeaning about my weight loss..and warned me that it would slow down due to my age and metabolic factors. I think you are doing a GREAT job with the loss....JMHO. Sher' 272/216/???

Yep...I THOUGHT so.... You went to "God" for surgery....I rebelled against going to this man just because I was leery about what you are describing....he just about has his own cult...and a heads up...95% of the CT board went to him as well...so saying anything negative about "God " there is like sacrilege. I went with the Hartford Hospital program and Dr. Tishler....and I am glad I did. The "Middletown Guru" is way over booked...and has been famous for arrogance from the git....he is due for a big swift kick in the pants...I hope none of his patients has to suffer as a result. He only does open because more surgeries can be done in a day that way...that's the bottom line. Sorry you had this crappy experience...I peeked at your profile. Hang in there! Sher'

Sher Thanks for the kind words.... I had never noticed that we were from the same area.... wish I had decided to go in another direction when I first encountered the God's attitude... but I had already been through two years of waiting with another program and thought that I could deal with a little arrogance... guess I was wrong. I have a girlfriend here at work that is having surgery with Dr. Tishler... she is very happy with him. email me if you want to talk sometime.... Have a great day Patty