Bariatric Follow-Up Care

For those of us that choose to have surgery away from our home towns there is an added complexity that needs to be addressed before a surgeon makes that first incision. That complexity is the after care. Who is going to look after you from a medical perspective once you've gone through your surgery?

I made arrangement with my PCP for monthly follow-up sessions. She monitors basics like my blood pressure, my weight loss and my blood work. The blood work is probably the most important given the malabsorptive nature of the Duodenal Switch. She has become my greatest cheerleader and I am very confident in her ability to look out for my best interest.

As part of the care, you may recall from a post a few months ago, she referred me to a new Bariatric Clinic that was established here in Burlington. I continue to see her but she felt, and I agreed at the time, that having someone who specializes in the medicine of obesity on my team could only be a good thing.

I had my second meeting with Dr. W today. I walked away, as I did after my first meeting, very unsure as to where he, and his philosophies, fit into my future care.

The areas of concern

1. He is adamant about meal replacements. He would be happy to see one or two meals replaced by a typical meal replacement shake or bar. I told him that I still consume a whey protein shake daily. That seemed to placate him. I didn't tell him that it's not a replacement, it's in addition to my normal meals.

2. He talked about calories burned and the need to create a deficit between what we consume and what we burn. I found this section to be a little condescending. When I told him I understood he had me explain it to him. He either deals with idiots or the uninformed on a regular basis, or he has no idea how much knowledge the morbidly obese really have about their bodies. We have done it all, read it all, failed it all. Failure does not however equal ignorance or stupidity.

3. When we talked about the amount of calories I should be consuming I questioned the calories from the foods that are malabsorbed. For example. If I consume 100 calories worth of fat, right now, my body uses only 20 of those calories. Do I count the 100 or do I count the 20? (I don't count calories by the way, I'm just using this to illustrate a point) He didn't get it. He was very dismissive saying that has nothing to do with it. Ummm, I'm not a doctor but I beg to differ. Whether he's right or wrong, I clearly have some "faith" issues with him.

4. He wants to see me again in a month. Why? I truly don't know. He didn't seem to have a clear idea of why I was there this time around. I'm getting a sense that this is more about building a practice than it is about my care. Maybe I'm wrong but I'm intuitive and I have come to trust my intuition.

So all up, I'm still very unsure. Others have raved about him. I'm on the fence.

Now the upside - I have lost 13cm around my hips in 8 weeks. I was neglectful in taking measurements before I started so his measurements are useful. That's about it. Not sure if that's a great use of taxpayers dollars in terms of a visit.

Don't get me wrong - you have to have post surgery care. But... it needs to be relevant care...