Saturday, June 29, 2013

My First Dietitian Consultation (#1 of 4 ) & Accountability

I have been on various diets and fitness programs my entire adult life.  To be honest, I feel like I know in my brain what is healthy and what is not.  So when my doctor ordered private consultations with a dietitian, I immediately had visions of those consults with diet pill doctors & Jenny Craig's "consultants" (they were just skinny women wearing white coats).  Don't get me wrong...some of the ladies I had during my Jenny Craig days were very nice, but they were not educated professionals.

When I arrived for my appointment with Melissa, my Dietitian.  I was sitting there rolling my eyes, waiting to be judged by some super thin model type with judgmental expressions.  I am glad to report I was wrong.  Melissa is a gem!  She is friendly, super busy and really loves her job.  When she is not consulting clients, she is head of food service at the small surgery center where her office is located.  The surgery center handles a great deal of WLS patients so she is experienced with our unique issues,  as well as those who are dieting alone.

This first visit lasted an hour, we talked about my failed weigh loss long I followed it, how much weight did I lose, how long was I able to maintain and why I think I stopped.  Then we talked about my band and all the complications I have had.   She asked me to describe what my typical day of eating was like, how often we eat out and where.  No judgments, just encouraging smiles from Melissa.

She told me I was already doing some of the basic things like food journaling & increasing my water intake.  But the thing that stood out the most was my lack of protein.  I have been eating too much carbs (not a surprise) and not nearly enough protein.  Ok, I should know to eat my protein first, it was pounded into my brain when I was banded, but I had fallen into my old eating habits. So it's back to basics for me.

She suggested a 1300-1500 calorie/high fiber/Diabetic Cardiac meal plan (due to family history)

I need to keep my protein in the 50-70g range and she wants me to include protein in every meal including snacks.  She also asked me to replace the carbs with whole wheat alternatives, which I already do at home, except for pasta.  The challenge for me is making whole wheat choices when eating out....I lack the willpower :-/

We then discussed protein supplements.  I did protein shakes in the beginning when I was banded, but had gradually stopped.  She told me about some new choices on the market.  There was no sales pitch with any particular products, she just talked about likes/dislikes from her other clients.  A couple of them didn't sound half bad, so I plan to give them a try.  Now that I have no fluid in my band, I hope to eat enough protein so supplements won't be required.  Once I am sleeved, I don't know if it will be possible to eat that much food...hence I need to start experimenting with supplements again.

We also talked about exercise briefly.  Mostly, the increased risk of bone/muscle loss in WLS patients.  She wants me to add at least one strength training session per week.

Bottom line:  My doctor ordered 4 consults, I'm not sure if that's all insurance will pay for...or if he will order more when I'm done.  I am very glad that I went, I already knew much of the things we talked about.  But, I think I needed the reinforcement.  Melissa asked that I print out a report of my foodlog from fitnesspal so we can review it during my second appointment.  Say What?? My brain screamed ACCOUNTABILITY !  Everything that goes into my mouth will be scrutinized, I hoping for some positive feedback on my next appointment.  I think it's going to be very nice to have someone to discuss my nutrition choices with!

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