Kaiser: First meeting with the Nutritionist

Hello all. Over a year and some months, I have been reading all of your posts and information about the good and the bad things about your surgery and or appeals to have the surgery. I have just recieved my first visit to the nutritionist at Kaiser and found out the will be many more and i have to lose 5% of my body fat. My first question is, are there any Kaiser recipients here? To let me know what is next? My second question is, " Does everyone who gets the surgery, required to take supplements for the rest of their lives?

Yvette, I'm not a Kaiser recipient (actually, my health insurance plan denied coverage altogether, and I was self-pay). However, my surgeon, Dr. Barry Greene (who does not participate w/Kaiser), does have a pre-op weight loss requirement. He does not set a percentage amount, but it's got to be more than 5-10#s. His rationale is that he does his RNY WLS surgery laparascopically. Losing weight pre-op reduces the body fat, a lot of which is usually enveloping the liver. The liver lies in front of the stomach and intestinal area where the surgeon works. If you can shrink the liver size by reducing the surrounding fatty tissue, the liver becomes more pliable and easier to work around when the doctor is going inside with the smaller instruments. As for your second question: Abolutely!!!! When you go into having weight loss surgery, at least any of the surgery styles that result in malabsorption, such as the Roux-N-Y or Duodenal Switch, the requirement to take vitamin and mineral supplements for the rest of your life is to insure that you have a rest of your life. These types of surgeries result in the body malabsorbing many of the essential vitamins and minerals; most of the absorption of these vitamins and minerals take place in the portion of the body that's immediately at the bottom end of the stomach, which is an area that's bypassed. As a result, the amount of vitamins and minerals you do take have to be greater than the daily minimal requirements you see on labels, because you're absorbing smaller amounts per dosage. If this is what your nutritionist told you, he/she is right on point. If you're hearing something else, find another nutritionist. Best of luck on your journey. Leesa

Thanks a lot for your comment. What was the main part about the surgery that you would want to tell a soon to be recipient?

A couple of thoughts come to mind, and not in any particular order. Always remember that everyone's progress will be different. Some lose like there's no tomorrow, and others (like myself) may still lose slowly. Be patient, because you will plateau, but if you're compliant with your doctor's instructions, you will lose. You didn't indicate if you'd been assigned to any Kaiser surgeon yet. Dr. Brian Cantor worked with Dr. Greene for a while, and I know he (Dr. Cantor) is w/Kaiser now. If you get to work with him, he's a real sweetheart, and really knows his stuff. Either way, listen to YOUR doctor. There are a lot of people posting on this message board, most (if not all) have had great experiences with their respective surgeons, and we are lucky that there are so many good ones in the Washington/Baltimore area. However, there are differences between the instructions that different surgeons give their patients. It doesn't make one right, and the others wrong -- they're just different. Drink your water in between your protein, and keep very well hydrated. It seems WLS patients can, and often do, get dehydrated more easily. Keep sipping your water (or Crystal Lite, herbal tea, or whatever works for you). Start exercising now. Even if you can't do much, try to do something, and keep doing it. It's one thing I didn't do enough of before the surgery, and started late after the surgery. It's helped, but it could have helped me do even better. Keep asking questions. No question is too silly or too dumb. As many say, the only dumb question is the one that's not asked. When in doubt, or when encountering a problem, start with your doctor's office first. Find a support group, and keep coming, both pre- and post-op. If you want to try Dr. Greene's group (all are welcome, regardless of your surgeon, check his web site: www.AdvancedWLS.com, for the schedule which are the 2nd Monday and 4th Sunday of each month in the Rockville area). Make your support group your second family. Most of all, keep educating yourself along the way. There's no such thing as learning too much about this surgery, and your post-op life. I'm sure others will post with their suggestions. Best of luck to you! Leesa

THANKS. I am just getting started so we only know of three doctors working with kaiser, and Dr. Cantor is one of them, but your info is very much needed, thanks again.

I used to be with KP. I started the 6 month diet and missed one month and could not get another appt. I would call and call but she was booked up and had not opened her appt for the next month. Also as I was going thru this I decided I rather have lap band which I was told they would not cover. Being a fed emp I got tried of the games this co played so I changes to a PPO that will cover the lab band. My advice if if you want RNY do not miss any of your appts. BYT I did find some people who went thru this one profile you can check out is http://www.obesityhelp.com/morbidobesity/members/profile.php?N=B1022288060 And Good Luck

Thanks for the comments. I am on my hubby's insurance and I missed open season, so if I don't have the surgery before December, I might change. I do like that they offer this info but six months of it is too harsh.

Yvette, Leesa really did provide you some great info.... The only addition and I didn't do this enough... because you will hit plateau's (sp?), measuring yourself can be motivating for those times the scale isn't moving. You will find you are losing inches. I also have a pre-op, six month, and 9 month post op pics. I still look back when I need to inspiration. It helps to see how far ou have come... Start exercising today. Like Leesa indicated... it will help more than any other one thing you can do. I started exercising post-op right away but not pre-op. It is huge. And, agreed, pre-, and post- op success lie in support. Studies do indicate longer term success to those who attend a post-op program. Best wishes on your journey. Lisa

Thanks. I planned to start exercising but beings though I have a severe sleeping problem I a so tired and can't do nothing. I barely have the enegry to clean the house, but longs as I stay on here, I will get the movitation I need. Thanks again.

Yvette, If you have a sleeping problem, see whether Kaiser will cover your having a sleep study. Many who are morbidly obese have some degree of sleep apnea, which can be diagnosed by a sleep study. What is happening with sleep apnea is that you may be waking very frequently during the night (even though you're not fully conscious of it), and never fully reaching a deep REM sleep stage to provide your body with the rest it needs. If the sleep study determines that you have a sufficiently severe case of sleep apnea, using a CPAP machine at night when you sleep may help provide your body with the oxygen it is being deprived of -- which could be contributing to your poor sleep. If you need, and start using the CPAP machine consistently prior to your WLS, it also will help you with the pulmonary risks inherent with the WLS surgery and subsequent recovery. Leesa