RNY/Pregnancy Demands

Ok so this week I am going to start interviewing doctors.  One of the best things I've learned on this board is to NOT go with a doctor who is clueless.  When you have a reg. gyn that is one thing but there are special things I need to control.

so I'm compiling a list of questions/conversations to have with the doctors and unless they give the 'right' answer they are so not being my doctor.  I don't ever want to be in the situation where I'm fighting with my doctor.  

Ok here is what I have so far.  Please list others I have not listed here and you would have or did make sure of:


1  How often do you recommend my vitamin levels be checked?  (if they are not that concerned about them.. they are OUT because obviously they are not informed about RNY)

2  I don't want the glucose test:  What alternatives do you have or suggest  (any resistance and saying i have to take a Glucose test is a nix cause that shows they are not concerned about my reactions)

3  I want them to review my current Vitamin regime and compare it to what they normally suggest. 

4  I'm over 40 so I want them to talk about any additional items they may want for me.  (additional ultrasounds or more frequent visits or what ever).  (I AM NOT haveing the Quad screening)

5.  Hospital capabilities in case of delivery or baby issues.

6.  Have you ever worked with RNY Pregnancies (not a deal breaker if they are willing to work with my surgeon and listen to my own knowledge of the surgery)

Hi, I understand your concerns but these are not things an OBGYN should be responsible for if you are a RNY patient. These are things your WLS staff should be on top of. They should be checking your blood regularly and advising you what vitamins to take. OBGYN's know very little about the special nutrition needs of an RNY patient. If you find one who assures you that just one multivite is good...prime example. Run the other direction. As long as you find an obgyn who is open to suggestions and listens to your concerns, then you are good. If you stress that you are worried about growth and development, they may send you for a few extra ultrasounds. But expecting them to be experts on WLS is not fair to anyone. It is up to us to be pro-active and follow up frequently with the WLS staff.
My OBGYN is an absolute doll and I adore her...but she thinks lapband and RNY are the same thing. No biggie, not her field of expertise. She is great at her job but I do not expect her to know much about WLS.
Hope this helps.

Thank you for your feedback!    
I'll try not to be to difficult. in my expectations 

Chelle had some valid comments!  Your OB might not be that aware of weight loss patients, but if they are willing to listen and work with you and your surgeon, that is a good thing!  However, you might get lucky and find one that works with alot of weight loss patients (my OB office does).

Question #1 should be answered from your surgeon and the blood work should be ordered by them (I also had them sent to my OB).  Unlike Chelle, I only take one complete multi-vitamin a day (not 2) along with an extra sublingual B-12, D3, Calcium Citrate and folic acid.  I was taking a daily iron supplement but my iron was high with my last draw (this happened before too), so I was told to take that every other day!  I will have my levels checked at least 2 more times during my pregnancy and make adjustments if needed.

Question #2 is a good question.  You can either do a fasting draw where you go in the morning after fasting and have your blood drawn and then go eat a normal breakfast/lunch and return 2 hours later and have them draw your blood again.  You can also test your sugar levels by *****ing your finger for a certain amount of days/weeks.  I did the 1st option with my last pregnancy and plan to do the same with this one.  As long as your OB isn't insisting on you doing the glucose test and is willing for you to do another option....I think your on the right track!

Question #3 is another one that your surgeon should answer and should be determined by your blood work!  Everyone is different and requires more or less of certain vitamins (as I stated above).

Questions 4, 5 and 6 are all good answers!

Good luck!

Thank you.  yes I'm hoping my diligence will get me just what you have.  Someone who is experienced with WLS Pregnancies and willing to work with me and the WLS staff. 

(one small complication is I was an LGH (Brader Patient) and I'm thinking I may be changing from them due to some changes they made.)  I have researched and found a WLS Program in a sister Hospital to one of my OB choices.  So I'm hoping them being sister hospitals there is more 'cross'training' and collaboration.

I know I am not RNY but I thought I might add my two cents. I do not see my surgeon. I got my surgery in MX. Any follow up is done with your local normal Dr or join a WLS program. Due to losing insurance and only getting it back right as I got pregnant I only had an OB. My OB knows little on RNY and other surgeries but she was very open to listening and added any test I asked for. The first thing she asked was if I could tolerate the glucose test. (I can and did just fine with it) But she was ready to talk alternatives just in case.

So I am saying there is hope that your OB can handle much of what you are requesting. Your surgeon might beable to tell you how many times you need your lvls check and other very RNY specific stuff but your OB may be open enough to follow your suggestions. I just added the extra vit lvls to the standard blood draws they do during preg work ups.

It was my specialist that I saw for the NT test in the late 1st trimester that decided on the extra U/S's for growth. When/If you go for that test try talking to them about your concern and desire for the u/s's.

I hope that helps!

OK since our Dr is well not reachable for the time being I'll be happy to pass along all of the info that I obtained when I was preggo and workign with Dr B and his nutritionists :)

My OB/GYN was slightly familiar with RNY but was totally willing to work with me. I went in armed and prepared with a list of what I wanted done. I supplied her with a full list of the blood tests that Dr B ordered on a yearly basis (let me know if you need a copy), and was tested a few times during the pregnancy. I was routinely tested for the "norms" B12, CBC, thyroid issues etc.

She was quite familiar with the glucose test and the fact that I couldn't do it - we went with the 2 hour post-paradinal (sp?) and she didn't press the issue.

The nutrition info that I was provided was 1800-2000 calories, 90 grams of protein and 100 grams of carbs. I took my 2 prenatals, B12, Folic Acid, calcium.

Good luck hun! Feel free to call/e-mail/text any questions :)

Will so be emailing you.  Thanks Liz!!!

I just got off the phone with someone who is close and was highly recommended.  they have worked with RNY'ers before and I have an appointment in a couple weeks. 

they want to call me back to see what items they would like to see from my Surgeon.  (great sign)

:-)

I was my OB's first RNY patient, and we kinda worked together with my surgeon the first time around. There were things that we did have to overcome and work extra on, but in the end he was GREAT!  I think you should have your questions, (i actually changed drs in the very beginning) but dont be to hard on them, and follow your instincts. If you find one that DOESNT have all the answers remember that just as it was a learning process with you, it is with them.

Good Luck!!