quick update on NUT and surgeon appt. disappointment in NUT

To me that is sad that you dont' have a NUT>  I never would have gotten through my program successfully without mine.  She is excellent and is to me the most vital part of the program.  I saw her preop, at 2 weeks, 5 weeks, 3 months, 6 months, 9 months, 1 year and then every 6 months for life.  She is the one that is responsible for our mealplans, our supplements and our labs.  She has all the training in these areas, not the surgeon or NP.

I'm glad you have such faith and trust in your NUT.  I am VERY happy with my bariatric program, surgeon, NP's and the rest of the staff and find that the entire team is very well versed in what I need to be successful.  I can speak with any one of them and receive the same response to a question because they are all knowledgeable in all aspects of my care.  I have every service imaginable available to me with the program.  Exercise specialists, Bariatric Dieticians, Bariatric NP's(who've all had WLS), and my surgeons pager number that I can use at ANY time as well as a "back on track" program that combines all these services if I or my WLS team feels I need it.

I feel that with or without a NUT my success lies in my own hands.....I can CHOOSE to follow the program and learn from those before me or I can go it alone finding what works best for me knowing that IF I ever NEED the help of my WLS team they are there for me.

First of all a bariatric dietician and NUT are the same thing.  Yes, I do find my NUT or as you put it bariatric dietician.  She is a big part of  my program along with NP and my surgeon.  I choose not to deal with the NP and only with the surgeon and NUT.  My surgeon will gladly answer any questions we have but he feels that the NUT has more training than he does in supplements and nutrition, so he recommends that the detailed questions we deal with the NUT.  Surgeons are trained to cut and know what is going on inside our bodies and I prefer to let them deal with there specialties.

I actually just got a card in the mail from my surgeons office saying it is coming upon my 3 year anniversary and it is time to make a follow up appointment with both the surgeon and NUT.  I like that - they follow up on there patients progress.  Many programs just forget about there patients after there surgery.

However subtle it may be.... There can be a difference between the two...depending on state liscensing laws. Regardless like I posted before I'm glad you like your team...please understand that I like mine as well... So DO NOT feel sorry for me...if I hadn't done well post op with dietary and supplemental needs I would have been asked to see the NUT or the dietician by my surgeon or NP which I have not...and when or if I feel like I'm not on track I'll be picking up the phone and making the calls myself because I have NO PROBLEM being my own advocate... Which as a healthcare worker myself i feel I should practice what I preach!

I vowed to go by the boo****il I'd gotten to regular food stage and the pouch had healed for the most part.  It wasn't so hard to do.   Like Heather, Syntrax Nectar was the only way I was able to get in a decent amount of water and protein in the same day, and even then I had to start slow and increase a little at a time.  (5 shakes is just not possible though... what is your NUT thinkin?)

I've seen my NUT's reports and she has to document that she's doing everything by the book in order to keep her job.  After I was past the 1 month recovery stage, she lightened up and basically said "whatever works", but that was outside of the office that she was able to say that.  So, for her peace of mind and to keep the records straight... I'm extremely compliant on paper.

Just take it slow, be patient, eat what works but keep it within the proper context of the stage you are in.  Get the surgery all healed up first while looking ahead toward the time that you really will be able to eat almost everything you want... in moderation.  You can do this.  :-)

I am sorry but I strictly believe in listening to what we are told to eat for the first month while things are healing.  Our NUTS and surgeons know what is going on in our bodies more than you do and if you push yourself too much, you can do damage to your staple line.  Cottage cheese is not considered liquid or pureed, it has chunks - it is a soft solid and shouldnt' be eaten so soon.  She obviously hasn't progressed you that far.  I agree that requiring you to eat baby food is crazy but requiring you to eat that consistancy is normal.

I was required to be on liquids for 2 weeks -  1 protein shakes per day - 25 grams of protein minimum before anything else.  If I could tolerate a second one, that would be great.  I was allowed creamed soups as long as there were absolutely no pieces.

the fact that you added foods that need to be chewed I think is also what has her upset - it is too soon for that.  Most of us arent' allowed foods that need to be chewed until 4 weeks out.  We were allowed yogurt and puddings at 3 weeks plus tuna, egg or chicken salad provided we put it in a food processor and made it mush with mayo - basically pureeded.  No chewing involved.

At my 1 month follow up, we were given our next stage  menu, which consisted of real foods, adding 2 new foods a day - there were a few different categories ranging from softer foods to harder foods, so by 6 weeks were able to eat anything including meats as long as we chewed them well.

So, I know it sounds tough but it is for your own good.  IF you try to pu**** too fast,  possibly pull on your staple line.

I am sorry but I strictly believe in listening to what we are told to eat for the first month while things are healing.  Our NUTS and surgeons know what is going on in our bodies more than you do and if you push yourself too much, you can do damage to your staple line.

IF the surgeons were all "pushing" the same plan, I would agree with you. HOWEVER, each surgeon has decided to follow their own plan and not the one put out by ASMBS.

My surgeon wanted me on full liquids for an entire MONTH. Had I followed that plan, I would not have gotten out of the bathroom that month as full liquids gave me the runs. My husband's surgeon had him on soft foods the day he left the hospital. He only did full liquids for 2 days. Why such a discrepancy??? Espcially since we both had the same surgery??? All we had differently was surgeons/nuts.

That is why I followed my husband's plan after the first week. One, I had seen that his worked (his surgery was 5 weeks before mine) and I REALLY did not want to spend an entire month sitting on the toilet.

As far as knowing what is going on in our body...well, the surgeon maybe as he did cut on us but the nuts, not so much. Esp when they treat all of us as if we had the same exact surgery.

But I know what is going on with my body far better than any doctor. They have lots of patients, I have just ONE.

Liz

So, my plan was somewhere in the middle.  We couldn't have refried beans for a long time, fiber and not a complete protein was the reason.  Cheese wasn't added until late.  We could have cottage cheese but it had to be pureed.  I thought my cheese soup was under creamed soups, but no, only was suppose to have healthy choice creamed soup due to the sodium and fat.  I did try to follow my plan but also made some errors. My nut didn't want anyone cooking their own stuff to puree or making their own creamed soups.  I do understand that not everyone understand foods and could add way too much fat or whatever and if they say cooking it yourself is ok, they lose control over those things.  I made my own chicken soup to puree but did it responsibly.

In the long run, it is such a short time out of your life that you are limited, if you can eat what they want you to, do.  If you can't, act responsibly and eat what you can.  Soon enough, you will be eating whatever.

So you're saying it's about control and mind games? Not about your nutrition?

--g

Yes, to a point.

With my group, compliance was a big deal.  I thought it was amusing to large extent but I am a rule follower so I wasn't insulted very often with it. 

I think that when you think about the area my group serves, rural, mostly uneducated, having very strict guidelines makes sense to a degree.  They didn't expect anyone to research stuff on line and read other than what they provided and they didn't want you making momma's cheese soup with white flour, lard, etc when you were 10 days out.  I get it. 

Were they always right?  No.  They suggest Optisource vitamins but give all the better options also.  When I asked why, they discussed compliance.  It is easier to get someone to do the 4x a day than all that we have to do.  Is it perfect, no, but better than not taking anything at all.  Did I do it, nope.  And I was honest with my reasons why and they never argued about it.  they were very willing to listen when they thought someone had sense to make good decisions but presented a path for those that were not going to think on their own.