Nutrition and Dr. Srikanth

i've heard it said that Dr. Srikanth's nutrition guidelines are not as good as other's when it comes to being pro-active.  and i wanted to offer my take on this.  i'm pre-op (4 months into my supervised diet), and my experience with Dr. Srikanth is that he is indeed pro-active, requiring bloodwork and (tons of) supplements and protein all well before surgery...  and correcting any existing deficiencies beforehand, etc... 

i also asked him about this and he said quite clearly that he tries to avoid deficiencies rather than correct them later...  sounds pro-active to me.

just my experience.

Wow, who told you he wasn't pro-active?

It seems to me that he is one of the "toughest" surgeons out there in terms of pre-op diets and supplement requirements.

Dr. Srikanth's nutrition guidlines are tougher than other Doc's! I'm very impressed with his knowledge and primarily his pro-active views on nutrition.  This was one of the main reasons I chose him and not Dr. Oh.

Hi, I listened to his bariatric surgery seminar on the hospital's website, and found him to be very thorough.  I have to get approval from Group Health Cooperative (which I'm waiting for right now), and I don't know who they go through to perform lap band surgeries, but I'm glad you're happy with Dr. Srikanth.  He would be my first choice :)  Thanks, Katie

I just got banded by dr. srikanth.  I find him to be very strict compared to many doctors. but by far the best with bedside manner.  He is one of the best in the area. and it tool me about 4 years to decide to get this done.   I do feel a little left in the wind now that i am banded, but you do have to help yourself  they can't do it all for you.  I have been given a strict list of supplements and vitamins to take, i had to create a chart there's so much i have to grind up and shove down my throat.  the iron is the worst part.....eat your leafy veggies is all i got to say and lots of them. up until your pre-op diets and you cant anymore.....i have to have infusions and pills they are not fun.  i feel so stuffed with supplements..... my dentists was very impressed with my gums improvement and i gotta say, i think its all the vitamins and stuff.

good luck to you all, and enjoy srikanth the other two doctors seem stuffy.

I also have found Dr. S. to be very thorough.  I think he's very proactive on nutrition.  I also think he has one of the strictest programs nutritional programs I've seen.  The only thing that I would say is that it appears that one size fits all.  In other words, the band eating program is the same as the bypass, sleeve etc.  However, with regard to vitamins it is all adjusted as your bloodwork dictates and it seems to me they are very thorough.  I just went in for my third blood letting this weekend.

Hum, I just got my preop labs done. I was lucky because I'm under 45 and only a BMI of 41 - so they only took 10 tubes, one UA and one 24hour urine. So he's very proactive about identifying and treating individual nutritional deficiencies.

However, the copied, one size fits all handout about diet is not so great. Haven't been to the nutrition class yet, so I don't know enough to speak about that.

the nutrition class is a bit geared toward bands and rnyers (not DS)...  but once you speak to the nut herself, it gets more tailored, imo... 

I would certainly like to know where you may have heard that Dr. Srikanth's dietary guidelines are not as good as other when it comes to being pro-active.  Here's the information from his own 33 page Patient Handbook for Weight Loss Surgery that is given to all of his patients regardless of procedure (some supplements may be increased if bypass performed):

Pre-Op: 10 day clear liquid diet plus 3 30 gram protein shakes daily plus 4 children's' chewable mulit-vitamins, 1500 mg chewable calcium citrate, 30 mg Prevacid Solutab plus any additional nutritional supplements based on extensive lab work tailored to a individual's needs (i.e. additional OTC and/or vitamin/mineral supplements like A, D, B-12, and iron).  At the final pre-op appointment he also goes over any additional maintenance medications you may have (e.g. OTC pain relievers, Rx pain relievers, Metformin, Crestor, Atenolol, etc.)

Pre-Op 2 Days Before Surgery: 4 packets Neutra-Phos-K (nutritional supplement with electrolytes) is added to the above

Post-Op Week 1: Clear liquids plus 4 mulit-vitamins, 3500 mg calcium citrate, 60 mg Prevacid Solutab plus the additional supplements listed above (Neutra-Phos-K is only taken 2 days post-op)

Post-Op Weeks 2-4: Clear liquids, 3 30 gram protein shakes daily, and 4 mulit-vitamins, 3500 mg calcium citrate, 60 mg Prevacid Solutab plus the additional supplements listed above (Neutra-Phos-K is only taken 2 days post-op)

Post-Op Weeks 5-6: Add "mushy" (consistency of baby food) to above, adding only one new food item a day.  Do not drink any liquids 30 minutes before meals or 60 minutes after eating.

Post-Op Weeks 7-8: Add soft foods to above

Post-Op Week 9: Introduce regular solid foods as tolerated.

It is because of his strict dietary guidelines that he can boast the best excess weight loss percentage of any surgeon in WA. 

To give whomever told you his dietary guidelines weren't as good as some unknown other's and that he's not proactive with them, I could only guess that they meant that Dr. Srikanth gives you a tool with WLS, tells you in-detail how to work with it most effectively, expects compliance (and checks on it through monthly follow-ups for the first year and then regularly scheduled for life) but doesn't bend when it comes to eating things that will sabotage general health and maximum weight loss. 

I am including my personal lists of the pre-op labs/exams/consults that Dr. Srikanth required as well as my list of my surgery specific medication that he requires as evidence that he is very thorough and that his requirements are tailor-made to an individual's needs, both to decrease surgical risk and ensure a successful outcome:

 

Labs: Comprehensive Metabolic Profile, Uric Acid, Phosphorous-Inorganic, LDH, ALT (SGPT), GGT, Magnesium, Lipid Profile, Iron-TIBC, CBC Differential with Platelet Count, TSH, HGB A1C, B12, Serum Folate, Vitamin A, Vitamin D (25 Hydroxy), Zinc (Serum), Serum Impact PTH, 24 Hour Urine Calcium, Serum Feritin, Urine N Peptide, Serum Osteocalcin, Urinalysis, Prothrombin Time, Partial Thrombone Time.

 

Exams: Abdominal Ultrasound, Pelvic Ultrasound, Chest X-Ray, Upper GI Swallow, Bone Densitometry, EKG, Sprirometry, EDG, Myocardial Perfusion Scan, Pulmonary

Function Tests

 

Consults: Cardiologist, Pulmonologist, Psychologist, Internist, Nutritionist

 

Children’s Chewable Multi-Vitamin (OTC)	1 x 4 daily
Calcium Citrate (OTC)	1500 mg Pre-Op (Will increase to 3500 mg daily post-op)
Vitamin D (OTC)	2000 iu daily for deficiency
Prevacid Solutab (RX)	30 mg x 1 day Pre-op for gastritis/hiatal hernia - will increase to 2 x day post-op)
Vitamin D (RX)	5000 iu x 3 weekly for deficiency
Cyancobal Inj (B-12) (RX)	1000 mg x 1 weekly for deficiency
Multigen Plus (Iron) (RX)	5000 iu x day for anemia
Neutra-Phos-K (Nutrition/Electrolyte Balance) (RX)	4 x day two days pre-op and post-op
Lortab Elx (RX)	7.5/500/15 as needed for pain post-op
Zofran Solutab (RX)	8 mg as needed for nausea and vomiting post-op due to narcotics sensitivity
Phenergan Sup	50 mg as needed for nausea and vomiting post-op
Intravenous Venofur Solution (Iron) (RX)	20 mg/ml IV to start with surgery and 4 scheduled post-op for anemia

 

 

I hope that this helps to dispel any myth that Dr. Srikanth is anything but lackadaisical when it comes to all aspect of his patients' health and long term weight loss success.  I am having VSG with Dr. Srikanth on 11/19/2008.  I chose him because he’s the best in WA…period.  The Center for Weight Loss Surgery, which he was instrumental in establishing, has been recognized by more surgical organizations and insurance companies than any other in the state.

Amy

I am really impressed with Dr Srikanth also.  I think the packet they hand out is a very good general ... but the info you get one on one and with the nut./ ma is great also. 

Anyways I think he's great.  I've been to two of the Nut class.  Two different people teaching it, two different outlooks.  So I think I benefitted greatly from that.