New Doctor...New Questions
Prior to surgery I had made arrangements with my family doctor (PCP) for my follow-up care. She's the one that's helped deal with the gas issues, she kept an eye on the incision as it healed and she weighs me monthly so I have my weight on record.
About a month ago she mentioned that there was a new doctor setting up a Bariatric Clinic in town. He specializes in bariatric medicine and maybe he would be a good person to have on my team. Ok. Makes sense to me.
So on Thursday I went to see the excitable Dr W.
The session started off with him explaining why I was fat. He told me that it wasn't my fault. The basic philosophy is that our bodies are pre programmed for survival in a world that doesn't need that survival instinct anymore. That in the minds of the obese there is a missing receptor which controls our need to conserve for future famine. Or something like that. The point is it's not my fault. Ok... I can live with that I guess.
He acknowledge (without prompting from me) that the DS surgery was the best surgery that you can have. That was a huge relief for me - the DS is often not well understood in a world that is more RNY and lapband oriented in terms of weight loss surgery. I think he was quite excited to have me as a patient because I am a great case study. I am relatively early into the process which means that he can watch me lose during the natural weight loss window period and then more importantly to him, see how I manage weight maintenance in the long run.
The meeting got weird at the point where we started talking about the long term. His perspective is that the thing that made us fat (the reason we became obese) has not gone away. We are still programmed the way we were before surgery... we simply now have a tool that will help with the weight loss. (makes sense on an intellectual basis)
His belief is that in the long term we still need to count calories, we may need to be on meal replacements for the rest of our lives (his recommendation is 1 or 2 meal replacements and 1 balanced meal a day) and we may need to look to medication like Meredia which acts as the missing receptor to tell us that we are full. It was at this point that I had a "WTF" moment.
When I signed up for surgery I accepted that I would need to make life long changes to the way I eat, to what I eat and to the supplements I would need to take to ensure a healthy life. I did not however sign up for meal replacements and medication. On some level what he says has some underlying logic but another part of me, whether caused by denial or otherwise, tells me that it makes less sense. The DS is programmed to malabsorb much of the caloric content so therefore what I eat (no simple carbs) is much more important that how much of it. As long as my net calories end up at around 1200 - 1500 I'm doing more than ok...right...????
So the net result is that he has me confused. I will continue to see him a couple of times just because it's an interesting opportunity but I will be connecting with Dr L to see how much of this fits in with his philosophy. My goal is to have this tool work for me and while I'm in the weight loss free for all early stages to learn the habits that I need to be successful in the long term. I don't want to face a future of meal replacements and medication...that is not what I signed up for. That is simply too much of a reminder of a miserable past.
About a month ago she mentioned that there was a new doctor setting up a Bariatric Clinic in town. He specializes in bariatric medicine and maybe he would be a good person to have on my team. Ok. Makes sense to me.
So on Thursday I went to see the excitable Dr W.
The session started off with him explaining why I was fat. He told me that it wasn't my fault. The basic philosophy is that our bodies are pre programmed for survival in a world that doesn't need that survival instinct anymore. That in the minds of the obese there is a missing receptor which controls our need to conserve for future famine. Or something like that. The point is it's not my fault. Ok... I can live with that I guess.
He acknowledge (without prompting from me) that the DS surgery was the best surgery that you can have. That was a huge relief for me - the DS is often not well understood in a world that is more RNY and lapband oriented in terms of weight loss surgery. I think he was quite excited to have me as a patient because I am a great case study. I am relatively early into the process which means that he can watch me lose during the natural weight loss window period and then more importantly to him, see how I manage weight maintenance in the long run.
The meeting got weird at the point where we started talking about the long term. His perspective is that the thing that made us fat (the reason we became obese) has not gone away. We are still programmed the way we were before surgery... we simply now have a tool that will help with the weight loss. (makes sense on an intellectual basis)
His belief is that in the long term we still need to count calories, we may need to be on meal replacements for the rest of our lives (his recommendation is 1 or 2 meal replacements and 1 balanced meal a day) and we may need to look to medication like Meredia which acts as the missing receptor to tell us that we are full. It was at this point that I had a "WTF" moment.
When I signed up for surgery I accepted that I would need to make life long changes to the way I eat, to what I eat and to the supplements I would need to take to ensure a healthy life. I did not however sign up for meal replacements and medication. On some level what he says has some underlying logic but another part of me, whether caused by denial or otherwise, tells me that it makes less sense. The DS is programmed to malabsorb much of the caloric content so therefore what I eat (no simple carbs) is much more important that how much of it. As long as my net calories end up at around 1200 - 1500 I'm doing more than ok...right...????
So the net result is that he has me confused. I will continue to see him a couple of times just because it's an interesting opportunity but I will be connecting with Dr L to see how much of this fits in with his philosophy. My goal is to have this tool work for me and while I'm in the weight loss free for all early stages to learn the habits that I need to be successful in the long term. I don't want to face a future of meal replacements and medication...that is not what I signed up for. That is simply too much of a reminder of a miserable past.
posted by Aussieabroad at
12:57 PM
1 Comments:
Hmm. Hard to know what to think. As you say, at least the doctor was open-minded, to a point, and is eager to learn.
My inkling is, you'll end up teaching *him,* simply through your own experience.
I'm only 13.5 months out. I can imagine that an awareness of calories, per se, may play a role in some DS patients' lives (Marybeth of ATTRAVERSIAMO talks about this now and then).
The meal replacement bars, one meal a day, and medication? Not so much.
For the record, I don't count calories, as such, yet. But I can definitely eat normal portions now, and I am beginning to consider restricting my fat intake a little more than I did at the start (nothing major -- but in fact our intestines do start processing it more efficiently over time; it's just that no one can say by how much).
I eat more carbs than I did initially. I'm about 163 and 5'6" right now, and you know, that works for me. Would I like to see my personal goal of 154? I would -- but perhaps not to the point of actually "dieting" to get there. Eating responsibly, okay. Dieting, no (but that's just me -- it rings my old bells).
Good post!
By
Anonymous, At
2:50 PM
Post a Comment
Subscribe to Post Comments [Atom]
<< Home