Good Morning. Best kept secrets

Do you use the "smile and nod" method with your NUT/dietitian or do you spill the beans?

I saw my surgeon's old dietitian twice, I think, but I've been going to a local support group since a year post-op. The local support group dietitian is quite dictatorial and you do a lot of smiling and nodding. My surgeon's new dietitian is quite open, however, and I feel better about opening up and being honest with her. Maybe because I'm further out and have met goal...I dunno. I don't envy the new dietitian, she has 4 surgery types to understand and a very experienced surgeon who has learned a little something about successful diets, exercise and vitamins over the years. His ideas and her training are not always in sync. lol  Anyway, I thought I'd ask how you work with your NUT this morning.

Y'all have a good one!

--gina


  

Both my surgeon and my NUT are really good.  Their approach is moderate....fluids for 10 days, then soft foods for a week, then soft foods and slow progression to new textures.  They want you ready for the tougher stuff (salads, etc...) around 6 months.  They don't push calories...Protein, Protein, Protein and exercise.

I have a very extensively trained bariatric surgeon, not just a surgeon who does/decided to do bariatrics.  His practice is comprehensive and he really trains his team.  There is only one thing I ignore.  They aren't very discriminating in the protein drinks that are recommended.  I concentrate on whey isolate protein.

Overall though, my NUT is really good.  Lucky me!

My dietitian is really sweet. She pushed the protein, etc. during the losing phase. She wants everyone to get all their protein from food and not shakes, but she doesn't push me because she knows I don't like to and won't eat in the morning, but I will drink a shake. Right now however, she is pushing me to up my calories to 1200 or more. I have a hard time with that, but she keeps telling me that I will end up hurting myself staying below 1200. I feel like I eat all the time as it is and am usually in the mid 800's right now, but I am afraid to up them any higher because I think I will gain.

Hi Shannon, you have done so WELL!!  I don't think you will gain eating 1200 cal a day, but you could increase to 1000 and see, and then up to 1200.  With the amt. of exercise you do, I am surprised you are still not loosing at the same rate.   Those are my  two cents anyway.  You will do what is right for you/your body over time....I know it. 

I can understand the fear of gaining, but somehow I don't think you would let that happen, you are/have been so MOTIVATED.  Not like me, I have been more nonchilant about it, 900-1200 cal a day and exercise 2-3 times a week, but have still lost 70 lbs in 5 months.  And now thinking I have lost just about as much as I want to loose, maybe another 10 or so lbs.  So I too have been trying to think how many calories it will take to maintain, and can't see eating anymore than I do now.  Oh well, I really don't have to worry about it for another 10-12 lbs.

Jane

Thanks! I'm about to post a discussion topic about this because it is really weighing on my mind. You will do fine, just keep up the good work!

I haven't seen my NUT for a really long time.  I could if I wanted to, but I really don't have any reason to talk to her.

My Surgeon moved to Alaska after I had surgery so I see the PA now.  She is a tiny little thing and very sweet.  I was worried about eating small meals and snacking and she said that's how she has always eaten.  I told her I use Protein drinks as my first source for getting in my Protein Totals and she seemed really pleased.

It seems odd to me that you would talk to the PA about what you are eating - proteins, small meals, snacking etc - that is what you should be talking to the NUT about.  I would never think about talking to the PA or surgeon about those things.  To me the NUT is the most important part of my program and I will continue to see her every 6 months for life.  She is the one trained in nutrition and supplementation.

I have only seen my NUT once post-op (@6wk out).  I will see her again at 6 months out...in about 3 wks.  I think I will be honest, even if I'm not doing what she wants.  I'm gonna try and keep an open mind.  She will be new to me, regular NUT out on maturnity leave.  So we will see.  I am hoping she will agree with me that I should stop loosing wt. before I reach my normal BMI weight, 154.  I am at 170-173 now, wearing size 8 and look slinder and fabulous.  I am thinking now I don't want to weigh any less than 160.  I am curious about what she and the NP will say to that, I see them both on the same day.  As you know I have been really conflicted about my weight goal.  Originally wt. goal 130, then 140, then 154...as I have lost wt., I realize I don't really want to be a size 2,4, or 6.  I think at 160 I will still be able to wear size 8s.  Any thoughts would be appreciated.

Jane

I haven't seen nor spoken to a NUT since 4 weeks after my surgery.  I also found out that my "fee" I paid for the NUT was only good for 6 months. 

Oh well... I've never really felt like I needed to contact her much after that point anyway.  It would be nice to hear what they think I should be handling maintenance, but I'm not going to pay another fee to find out.

Gina,
I like my NUT, but don't necessary like the one plan fits all thoughts.  She is not a fan of protein drinks and we discuss it everytime I go.  I listen to her and see some of her reasoning. 
I know what works for me and I am the one that has to live with this for the rest of my life so I think if my plan is working, I'm satisified and my labs are all good what difference does it make if I get my protein from drinks or food.

I will only see her each year now, unless I want to email her with a question or concern I have.
Anytime I email her she is always very quick to respond, but I ask most of my questions here now because we live it...

I hope you are feeling ok.

Linda