Comparing St V's instructions to Clarian

After having some conversations with Ken, who had surgery at Clarian right after I did at St. V's, I have found there are some really big differences in our instructions... and quite frankly, I like his better! lol! I am just curious if anyone had ever noticed this and had any ideas on why there are such differences in the full liquid diet portion between the two hospitals? I just checked out Clarian's sheets on WLSindy and was so surprised! A few examples of things Clarian allows that St. V's doesn't... PB liver sausages scrambled eggs tomato-based products saltine crackers I am NOT being critical of St V's at all, I just thought this was interesting and wanted to know if anyone had any thoughts? Belle

Belle, Hmmmm....you might want to think twice about liking Clarian's better. Peanut Butter...great protein but high in fat Scrambled eggs...the eggs have a tendency to get caught on the stoma. Hurts like heck when this happens. Once upon a time, they were allowed right away (they were 9/04) but so many people had problems to where 6 months later, they were off the yellow sheets. Tomato-based products...can and will cause ulcers when you are early out. The acid just tears you up/ Liver sausages...not sure what these are but any meat is harder to digest than cheese, soups, etc. Sausage typically also contains fats. Crackers...these were allowed 4/03..but if they are trying to get people to hold off, I can understand that. I had become a cracker addict after my revision. Crackers are pure carbs with no protein. Don't waste your space on them. If you want crackers, make some: mound ~1-2" of shredded low-fat cheese onto parchment paper. Space apart ~1-2". Bake at 350 for 15 minutes. I think all the things on the St. V's yellow sheets are kept up to date as much as they can be. If patients have problems with a certain food, they have every newbie to hold off so that they can try to keep them from having problems as well. And trust me, I would not wish an ulcer, a stricture, a perforation, a revision, or a hernia on anyone. Congrats on being on the other side and having a great start to your journey. Sherri

Belle, as I understand it, each doctor may do the surgery a little differently. So one guess is that some things that one doctor may find to be okay may not be with a different doctor? At anyrate, I would want to err on the side of caution. Linda Vicory

Hi Belle. I think that both programs offer good service. I also think that a grain of salt needs to be taken with ANY instructions you get that haven't been custom made just for your case. People like us haven't really been known for our common sense with food so therefore "those in charge" set out very specific black and white guidelines to help us. (or in st. V's case black and yellow) As we grow, hopefully we become the ones who make those decisions and then we realize that we were the ones in charge all along, we just needed a little help not to damage our new equiptment. Not to get too far off the subject...but it has been slowly dawning on me that this surgery really does VERY little for us in the long run except give us some room at the beginning to change our habits. It gives us an excuse to say no. It takes actual hunger out of the picture for awhile....but come on...actual stomach hunger was rarely the reason I ate anything. You? It's the internal spirit/mind work that is the eventual true ticket out of obesity, I think, and not the internal tinkering with the pipes. I think that Dr. Gupta and Dr. Mattar probably have similar styles, as you know, she would have been my choice had Dr. Mattar not been on my insurance plan. Still, there may be reasons for why her instructions differ....or there may not be. Sometimes it's just part of the program to go with the flow. Otherwise you get LABELED. lol. For example, I know that Dr. Mattar is known for creating a VERY small, tight pouch and that he generally bypasses about 90cm of bowel. Therefore, he is very protective of his pouches during the first week, and that's why his patients have to have "Cup to Cup" pourability of their pureed foods for at least the first week. As you can see, I basically stuck with his plan, but liberalized just a little with the (very well chewed, low fat) saltines because I knew it was going to be allowed very soon anyway. (that's the RDs instructions, but it's not the sheet and her suggestion is NO MORE THAN FOUR PER DAY...EVER). I have been known to be a go getter like that, sometimes to my detriment! I may pay a price for that eventually, but I'm trying to use a little common sense. There are some things on the list that I just don't want to do, but may be helpful to others in this boat, like Peanut Butter. I know it is on the list, but I just don't like the high sugar/ high fat aspect and I don't want to get any habits started. Yes it's protein, but personally for me it's a little too high a price to pay in fat. Actually...that's the only thing I don't do except liver sausage. And god...who on earth eats liver sausage!? Just kidding. I used to as a kid. It's called braunschweiger. Again...for me it's not a big attraction because of the taste/fat content, but i have been eating a a lot of pureed tuna salad. Honestly, as the week goes on I'm floating more toward SOFT and less toward pureed and I need to watch that. I have taken their statement: "consistency like small curd cottage cheese, baby food or applesauce" and used that as a starting point. It looks like St. V gives really specific foods "allowed" while Clarian gives "guidelines". For some, one way probably works better, for others, the other. For me guidelines work, just because I begin to have trouble with being told what to do after a while. I'm a rebel, I guess! On the total opposite of the spectrum, there are those in the Clarain system with the same surgeon who have done no damage to their pouch eating just plain old soft food from the beginning and skipping pureed, but I'm not comfortable with that either. I think it is all individual. It appears that St. Vincent goes to much greater length / is much more strict as far as their guidelines go. In some ways I like that a lot. They seem to be really trying to ingrain habits in people NOW so that in a few short months when the hunger comes back and the pouch has stretched a bit they won't get into trouble. I think Clarian does it in a less formal way with 1:1 teaching instead of on paper. Either way, they both work but have to be tailored to fit the person wearing them. Just my $.02 We're both going to do GREAT anyway if we follow the rules of watching the fat, carbs and not drinking with meals or sabotaging the tool!! What a long, rambling, and atrociously arrogant post! I could be wrong about all that, but thanks for being on the ride with me anyway. Ken

I in no way meant to impune either program. I simply wondered if it was just philosophical differences, differences in surgeons, or differences in the ACTUAL surgery (pouch size, stoma size, etc.) I know people who have had WLS personally and one was via Clarian and one St. V's. They both have had great success. I am assuming that St. V's is a little cautious and perhaps revises their guidelines quicker. I just have to decide what I can live with and what I cannot over the next three weeks, I guess. I am trying to stay as close to the program as possible, but I am going to discuss some variety and texture with my dietician today. I appreciate your responses!

I have had a consult with Dr. Samual Matar. He is one of the best in Indiana. I went for a revision. I do know his surgery is completely.....different than St. Vincents and so is his followup nutritionist. I had a distal problem.My pouch and opening were both so tiny that he recommended no surgery. I still think I need surgery but what surgeon wants to correct another surgeons dangerous mistakes. If you think their diet is great I do know that with Carmel St. vincents after so many months u can have diet soda and Dr. Mattar absolutely does not agree with that. They have a table of food they are allowed to have compared to our what six page sheet for week by week. I followed it to the tea and believe me my stomach pouch and opening is still tiny as Dr. Mattar had said. ..I am looking else where for the distal problem. I dont think anyone could go wrong with Clarion North they are like a family and they take care of you like family. I do appreciate their honesty and if I find no doctor to follow up with my distal problem I will go back and join clarion for follow up care.They are wonderful. Also the wait is not half the wait that u have at St. vincents.golden starr

St. V's doctors do not want you to ever drink soda...because of the carbonation..it is not on there list of things allowed ever.....