Rager2Sharp

Discouraging Nutritionist?

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Hey guys. So I had another appointment with my nutritionist Monday. My appointment went as usual, until I told him that I wanted to get a full bypass instead of the sleeve. (The office I go to doesn't currently offer Gastric bypass, but they will by the time I am ready for surgery in December)  He then quickly tried to discourage me from that, saying things like  "I wouldn't let my mother get that done to her" and that he told the doctor that if they started offering it to patients that he was gonna quit. 

I wanted the bypass to begin with, but i kind of "settled" for the idea of the sleeve ( not that there's anything wrong with it) because that's what they offered. I was so excited when my surgeon told me bypass was an option. 

Needless to say my nutritionist has kinda freaked me out a little bit. I was just wondering if anyone has had a similar experience. Do you think he gets a kickback or something depending on the procedure the patients choose or does he really think it's that bad of a decision? Maybe he's just drank the koolaid of "gastric sleeve is so superior that's why you shouldn't seek other options else wear"? Whacha think? 

Edited by Rager2Sharp

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My guess is he knows someone or had a patient who had a really bad outcome with a bypass and that has clouded his professional judgement.  BTW, that was not a statement that I would expect from a professional and it probably is best if he does indeed quit!  His role shouldn't be to try and convince you of what type of surgery to have anyway; merely how to manage your nutritional requirements prior, during and after the process.  He has grossly overstepped!

Of course a bad outcome can happen from any surgery, and sometimes when that happens it really does tend to cloud judgement and sway opinion one way or another.  I think I would not see this dietician anymore.  Are you at a Bariatric Center of Excellence?  Seems odd that they haven't been doing bypass.  I would seek a bit more neutral advice and make your decision based on facts not whatever that was.

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Hmmmmm. Interesting. First, I don't think he's getting a kickback. Second, I would guess @msmarymac is right and he knows someone who had something go wrong which clouded his judgement. 

As you can tell from this site, there are lots sleeves and by-passes and it seems to me most of us are super happy with the one we chose. There are benefits to both. Here is my two cents on which to get and why.

If sugar is your thing and you worry about being able to stay away from it post-op, sugar can make a by pass dump which, from what I understand, is a miserable experience and a great deterrent to stay away from sugar. 

If you drink alcohol and don't want to give it up, the sleeve is a better option. Alcohol is processed differently for a by-pass and it will either make people very sick or they get really drunk, really quick. If you drink at all, no matter which surgery you get, I recommend you read through the transfer addiction thread. Several cautionary tales from people who ended up with drinking problems after WLS. 

If you have GERD, by pass is a better option. I have it and I manage it fairly well with meds and make sure I don't eat or drink anything other than water close to bedtime but it still flares up.

Weight loss % and maintaining around goal seems to be about the same for sleeves and bypass. I haven't looked up the data but I think the complication rate is similar for the two surgeries. 

Talk to your dr. about your concerns and don't pay too much attention to what your nutrition said. 

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It is not a Bariatric Center of Excellence as far as i know @msmarymac . To be honest I didn't even know there was such a thing before I joined TTF. I was just trying to pick somewhere that was close enough that i could work appointments around my schedule and that i felt comfortable driving to by myself. 

When I talked to my surgeon he said that none of the surgeons there were certified to perform a bypass, just the sleeve and a few less invasive procedures. They will be getting a NEW surgeon that will be certified in Bypass sometime over the next 6 months. He said if i choose bypass, he would just assist the new surgeon. 

 http://bariatrics.colquittregional.com/

@Stephtay Sugar is my biggest weakness FOR SURE! I don't regularly drink alcohol and would absolutely not be a problem to give it up. (I'm talkin like one wine cooler maaaybe every six months  lol). I have also assumed I have GERD, though i haven't gotten a diagnosis because I just haven't gone to the doctor regularly since i stopped seeing my pediatrician! (That's about to change i guess!) 

 

Edited by Rager2Sharp

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1 hour ago, Rager2Sharp said:

Sugar is my biggest weakness FOR SURE!

A lot of people go into the process assuming they'll dump on sugar if they get a bypass, and seeing that as a good deterrent. I definitely don't dump on sugar. It's going to be all on me to stay away from it. Don't let the possibility of dumping be your reason, as it may not be an effect for you :) 

It does indeed sound like the nutritionist overstepped his bounds. I'd ask to see someone else. 

Also, if the new surgeon is just getting certified now on bypass, he or she will not have a lot under his/her belt by the time you're on the table. Sheer number of previous surgeries does seem, in the literature, to be a good predictor of outcomes - surgeons who've done a lot have fewer complications. Check into this before you decide - ask the clinic and look at the stats. 

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Seconding @Jen581791 - I would make sure his NEW surgeon isn’t also NEWly certified. More than what kind of surgery you have, the experience of your surgeon is what counts toward a positive result. Centers of excellence are key because they have surgeons who have done these surgeries every day for years. You want to know things like:

How many surgeries has he done?

How many complications have his patients had?

Have there been any mortalities among his patients? 

You should also google your surgeon. If you get just his Facebook page and class photo, he may not be very experienced!! Look for reviews from past patients. And ask around here! Someone else might have seen him.

You will do great with either surgery if your surgeon knows what he or she is doing.  That said, I went with bypass because I didn’t want to take PPIs for GERD long term (a possibility) and because I had way more to lose than most people (215# total excess weight when I started ). I’ve had no complications, no hunger but mouth hunger, and no dumping.  All good so far at 9 months. Don’t let your nutritionist scare you off!

 

Edited by Kio

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@Rager2Sharp I would be checking out how many surgeries have been performed by your surgeon like Jen and Kio have suggested.  You don't want to be one of their first ones.

I was  going to have the bypass but I really need to be able to take NSAIDS , so I switched the day I scheduled the surgery. There were 2 other reasons though, a lady I know her friend had RNY and said if she could go back she wouldn't have done it which scarred me since she is a nurse at the same hospital and the surgeon suggested a few times that the sleeve would be a better option in his opinion. Fewer risks ect and he said I could lose the same amount of weight if I stick to the program which I have and I have lost 60% excess already and still plugging away.

Edited by tracyringo

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Respectfully, I’d take the nutritionist’s opinion with a grain of salt. Actually, because I’m me (i.e. a research-aholic who hates it when people spout off opinion as fact), I’d pull up a bunch of the longitudinal studies about the long term success rates of RNY, complication rates, etc and politely ask for citations of the peer-reviewed studies that back up his opinions. And then I’d rip his initial statements apart, mock trial style. But I’m a brat like that.  :D

 

Edited by athenarose

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