I call "bullsh*t" on RNY program nutritionists.

My surgical program provides good information regarding post-op nutrition.  Unfortunately, the lead nutritionist isn't the most patient person and I've seen her practically dismiss people who just can't quite grasp the info.  In my pre-op NUT class, there was one gentleman, in particular, who clearly had some sort of learning/comprehension disability (he reminded me a lot of my son who is special needs).  Rather than take the time to break the info down into terms he could understand, she glossed over it and kind of brushed him to the side.  I was livid!  Needless to say, she did not get a favorable evaluation from me.

I 100% agree!!!

For the past 2 months in the support group meetings held at my bariatric center the staff MD has been the presenter.  He's a bariatrician, member of the ASMBS and ASBP and has dedicated his practice to the care of WLS patients.  His knowledge is amazing (even if he does get side tracked easily and can go on hour-long tangents).  BUT --- his information is way off the mark of what I learn from my own research and what science and biology is telling me.  After last months' meeting I went on a bit of a rant in my blog about his presentation ("No need to worry about calcium, just make sure your vitamin D is fine."  Gimme a break!!) http://pamtremble.blogspot.com/2009/02/bad-advice-from-exper ts.html

I'm putting together a presentation of my own for the next meeting of the "informal" support group (mostly the same members of the official clinic group, but led by a patient in a peer-to-peer based group).  Everyone comes to me with questions about vitamins (even the group leader) and what they should take and in what order and how to fix deficiencies.... so I'm putting together a packet of info so they at least have the basics that they are missing from the center's [lack of] information.

The nutritionist?!  Give me a break.  They are useless and what they tell me goes in one ear and out the other.  I see them because it's part of my program, but it's usually a waste of my time.    Their recommendations don't even align with the basic vitamin recommendations put out by the ASMBS. 

My last round of labs showed a dramatic drop in my iron levels (by 30 points) but since I was still in the "normal range" there was no need for me to supplement.  My zinc levels were 4 points away from being deficient and I was showing signs of it already being a deficiency, but again, no need for extra supplements.  Of course I took action on my own and the signs of deficiency are gone - we'll see what my labs look like. 

So yeah.  I agree with you.  I would feel more comfortable with a nutritionist who actually had RNY and understands the life we lead, what we need, what we struggle with (mentally and physically) and applies her own life experiences to her advice.  But until such a time that I find the perfect nutritionist.... I'll continue to do my own research and shape my journey the best way I know how on my own.

Pam

Interesting post.  However, I am glad to know that at least my group is one of the better informed.  They told me up front about the chewable multivitamin.  Said it could be 1 adult centrum or 2 childrens.  They explained about the calcium, how much and when it can be taken (not after iron) and about the sublinguinal B-12.  The only "failure" they had was I was already low on D (and they had the bloodwork) and never mention I needed to continue.  However, went to PCP about 1 month post op,  she did blood work and said my D was worse than before.  So other than that.. I assume I was pretty well informed.

Actually you need TWO adult multi-vitamins per day after RNY.  And it seems you're missing a b-50 or b-100 complex. 

Isn't that funny.  Called my NUT, said only 1 multi was needed and b-12 was enough.   I take biotin as well, but only because I'm worried about hair loss.  Every group is sooo different!

The ASMBS has a published bariatric nutrition recommendation --- it lists what the basic vitamin supplements are for post-op folks based on their surgery type.  I'd more readily accept their recommendations than anyone else.....

Check out the chart that starts on page 7
http://ullberg.us/Andrea/SOARD_Bariatric_Nutrition.pdf

pam....can you post what you take and when...

I always seem to have a problem breaking up the pills into when I should take them...and I wanted to compare what I take versus others..

My vitamin routine is going to be different than someone just starting out because I've had to adjust based on lab results.  Here's the schedule I followed for the first year post-op. 

7am -- protein shake -- Calcium +D
10am -- breakfast -- multi-vitamin and other supplements and meds
1pm -- lunch -- calcium +D
4:30 pm -- snack -- calcium +D
8pm -- dinner -- calcium +D
11pm -- tiny snack -- multi-vitamin, supplements, meds

Vitamins tend to absorb better when taken with food, so I scheduled my vitamins around meal and snack times.  The only exception would be iron which likes an empty acid tummy, so take it along with vitamin C.  I didn't start iron until my 1 year mark (I'm not menstrating), but if I had to find a place for it in the above schedule, I'd do it around 10pm.

Right now I'm on an "every 2 hours" schedule since I've had to add some extra stuff and needed an extra dosage time during the day.  I use www.MyMedSchedule.com - -it's a free service where you can enter all your vitamins and meds into your account, assign it a dosage time and frequency... then set up text messages to come to your phone or email reminders.  So about every 2 hours I have a text message come through that reminds me to pop a pill. 

I believe there's more details about my vitamins in my profile if you want to read about my boring life.  LOL

Pam

My doc office is great; the nut support was and is great.  But they are all people and people will tell you what they learn themselves. 

They provided all info needed - over and over again:  meeting supports we had to attend before surgery, after surgery, individual support, etc.  On top of that - they are available for extra one-on-one meetings as needed.  
I can not imagine a better group.   They charge an upfront fee, but with all they offer - I think it was (and is) a deal of a lifetime.

But - I can not say that I did not learn some on my own, and with the help of OH people. 
As individual as we are - our nutritional needs need to tailored to our bodies... I do not think that without my personal research I would have been as successful as I am. 

I completely agree about the lack of education regarding supplements!  Thank GOSH for all of you on this board that share your knowledge!  I had to undergo 12 weeks of nutritional therapy before our bariatric program would even CONSIDER doing surgery on me!  Then another 6 weeks behavioral change.  Not once did we discuss the supplements needed post surgery.  It was all "bull" diet info. basically telling us why we got fat!  It all cost me after insurance (what portion was covered) a whopping $1100 PLUS the 2 nutritionist visits and all the gas for these 18 weeks for a 200 mile round trip.  Now I find myself scrambing on this site for all the info I can get!  CRAZY to say the least!!!  Thanks to all of you!!!!