Some guiedance needed on Nutritionist vs. Surgeon.

First of all let me say I am so happy with my results, and I am not complaining.  I'm just not sure what my next step would / should be and would like some opinions please.

I had surgery on 9/10/12 and have since lost 85+ pounds (again..extremely happy).  I had to pay for my surgery because my insurance would not cover it.  I did lots of research on who the best doctor in the area was, found him, saved my money, did lots of research on the actual procedure and what to expect after, etc.  When I had the money, I called the surgeon, went in, had a consultation and within 2 months I had the surgery.  At the 3 month checkup, I asked the surgeon what I could do to make sure that this is successful, and that I don't regain the weight, his answer was "just keep seeing me, and you wont regain".  The last appointment was about 20 minutes, he reviewed my levels and said everything was great, and to come back in 3 months. 

So heres my dilemma, Its a 45 minute drive to see him every time I go, and its $150 every time I see him.  Sometimes I wonder if it wouldn't be smarter to look into finding a dietian closer to me, and going to see them every 3 months for $150 (or sooner if they think its necessary).  I'm just wondering was it more beneficial to see the Dietian vs. the surgeon.  It would seem to me, I would only need to see him if I have issues (which i have had none, so great job doctor!!).

Also, how did you go about finding your dietien?  Any thoughts and/or suggestions would be greatly appreciated.

Thank you,

Dina

I've got nothing against my surgeon, and he did a great job for what I hired him for--rerouting my innards. So I went for my one year in September and I am not going back unless I need a surgeon. At this point, I know what I need to do. He can't do it for me, and seeing him doesn't do anything for me.

If I need a dietician, I could throw a stone and hit a dozen of them. My family doctor can order my labs. I take responsibility for tracking my own trends and not accepting that everything is 'normal'. I want hard numbers and a copy.

But all of this is just me.

I agree that you don't need to keep forking out the money to see him again until you are suppose to and not every month.  We should have follow-ups but they should have been outlined-- 3 weeks, 3 months, 6 months and I think at one year.  I wouldn't go more than .. but that's just me.

You have to do what you are comfortable with and if he pushes you not to regain than it may be worth it.

I am surprised that your surgery fee didn't include the follow-up visits with the surgeon.  Also, why do you think you need to see a dietician so often?  Or at all?  Do you have questions about what to eat?  Are you unsure of your doctor's eating plan?  Do you just need to make sure you are "on track?"

I don't have a nutritionist, and my surgeon's office doesn't use them.  He told me, "Listen.  I have been doing this for so many years now (over 20), that I now exactly what works and what doesn't.  With all due respect to nutritionists, most of them have not had the surgery, and don't know the insides of a post-op patient - they don't know what historically works and what doesn't.  The meal program I give you is a tried and true program - I know what works.  If you have questions, or you find information "out there" that is different, give me a call and I will explain to you what is what."  So far, I really haven't found a reason to question him or his plan.  And I haven't found a reason to go in more than the regular follow-ups.

My insurance didn't pay for the nutritionalist so I paid for a few visits just because I had never gotten any proper nutritional guidance after my first WLS and I wanted to know what I was doing.  That was before I was really active on OH so since then I have gotten a lot of advice and support  from the vets here, although in the end it really comes down to education and common sense as far as post op life goes and it's very individualized as far as style of eating goes.  I've never seen a one size fits all.

I see my surgeon yearly for my labs and my PCP for the rest.  I like to keep touch with my surgeon because he is the only one who understands my innards having rearranged them himself so if I do have any issues he is up to date on me.  If going to your surgeon is too costly or inconvenient then you could always find a PCP who is willing to follow you.  They may even be able to get it covered by insurance.

I think if you are really concerned about regaining your lost weight your money may be better spent with a good counselor who understands people with eating issues.  That and a good support group, either here or in real life, should go a long way.  I have observed first hand that the most successful post ops are the ones that have a strong support system and daily contact with other people who understand them.  I know myself that I really got off track after my first WLS when I stopped participating in support groups online and in person.  I had no accountability and it was easy to pretend to myself that I was "normal".