Nutrition Group meeting (Dietitans) Kings college Hospital

[TiaLi]

Just wanted to say hi, I'm under King's as well. My surgery is booked in for mid-March with Dr Patel (bypass). My wait was longer than 11 months, but I've had a bit of a special journey so isn't really comparable. The waiting list is rather long though, they will tell you "18 weeks" once you are actually put on the list after your meeting with the surgeon, but that is simply the NHS targets, in reality it is much longer. Like paulam says though, it can vary quite a bit depending on what surgeon you have (and I think Dr Patel's is the longest list).

@paulam - What happens at the pre-op assessment at King's? I have mine in ten days. I'm not a big fan of hospitals etc and generally find that I can cope better if I know what to expect. Is it just bloods, blood pressure and ECG? Do they get the results from the blood tests then and there (ie do you find out straight away if anything is wrong and needs adjusting prior to surgery)? Also, and this might be a silly question but - do you need to remove your bra for the ECG?

 

[Jadine Hayles]

Hi @TiaLi thank you for you msg. That does help alot. I just had my group nutrition seminar on Tuesday and Dietitan told me waiting list is 6-12 months. Which is annoying I just want it done asap. How long did you wait to see the surgeon after your last dietitians appointment and mdt meeting?. And one last question do you have anything like pcos diabetes etc?

Regards to the preop people I know have had the camera down their mouth but I haven't heard anyone saying kings have done this so I'm. Confused. And ecg you do have to be top less .
Good luck with your op it's so soon I'm excited for u. And do you have instagram? X

 

[TiaLi]

@Jadine Hayles I actually saw the surgeon before the group nutrition seminar. It does seem like the order in which all the meetings and appointments come differ a bit from patient to patient at King's. I remember there were several people at that group meeting who hadn't yet seen the surgeon, but also some who (like me) already knew which surgery and surgeon they were having. For me, the order has been:

* Nurse (first appt)
* Sleep apnea and lung function test
* Dietitian individual meetings
* Surgeon
* Group nutrition seminar

...and now to be followed by pre-op and then surgery. My last individual session with the dietitian was in March 2016 I think, then met with Dr Patel in June 2016 (which is when I finally went on the actual waiting list), and then the group meeting shortly after. Surgery due mid-March.

I don't think they do an endoscopy unless you have a history of ulcers or something else they need to investigate. I did one a couple of years back though, and it's fine as long as you choose the sedation. Don't be a hero and opt for just the numbing spray...it's not painful but very unpleasant if you are awake.

The nurses and my gp kept telling me my glucose was fine and that I didn't have diabetes, but according to my surgeon they have now changed the guidelines in terms of what glucose reading constitutes diabetes, so I am now right on the border apparently. They took some new bloods back in June when I saw Dr Patel but I haven't heard anything from them since so I assume the bloods were fine.

I did test positive for sleep apnea though. No pcos. And I don't really use Instagram I'm afraid!

I went to see my GP today and while I was there I asked her to check my blood pressure (I'm getting paranoid about something coming up during the pre-op assessment that will make them cancel the surgery!). It's high, but she said it wasn't so high that she wanted to start messing around with medication at this point. Once the weight starts to drop the blood pressure will hopefully drop down too.

So hopefully I am good to go!

 

[Jadine Hayles]

Hey, thanks so much this helps alot.
I've noticed people's journeys are totally different for real.

I've had consultation, lung function test, sleep apnea test, bloods, Dietitan (1 appointment then discharged), group nutrition seminar and now booked to meet the surgeons next month. But I'm confused when calling during the week the co-ordinator said my surgeon appointment was 21st April but I got my letter yesterday saying 24th March.
Did you see surgeons twice?

Yes I'd be paranoid too making sure nothing cancels this surgery. At least you have Dr Patel. I've been given a new surgeon. But no reviews online at all about him.

@Jadine Hayles I actually saw the surgeon before the group nutrition seminar. It does seem like the order in which all the meetings and appointments come differ a bit from patient to patient at King's. I remember there were several people at that group meeting who hadn't yet seen the surgeon, but also some who (like me) already knew which surgery and surgeon they were having. For me, the order has been:

* Nurse (first appt)
* Sleep apnea and lung function test
* Dietitian individual meetings
* Surgeon
* Group nutrition seminar

...and now to be followed by pre-op and then surgery. My last individual session with the dietitian was in March 2016 I think, then met with Dr Patel in June 2016 (which is when I finally went on the actual waiting list), and then the group meeting shortly after. Surgery due mid-March.

I don't think they do an endoscopy unless you have a history of ulcers or something else they need to investigate. I did one a couple of years back though, and it's fine as long as you choose the sedation. Don't be a hero and opt for just the numbing spray...it's not painful but very unpleasant if you are awake.

The nurses and my gp kept telling me my glucose was fine and that I didn't have diabetes, but according to my surgeon they have now changed the guidelines in terms of what glucose reading constitutes diabetes, so I am now right on the border apparently. They took some new bloods back in June when I saw Dr Patel but I haven't heard anything from them since so I assume the bloods were fine.

I did test positive for sleep apnea though. No pcos. And I don't really use Instagram I'm afraid!

I went to see my GP today and while I was there I asked her to check my blood pressure (I'm getting paranoid about something coming up during the pre-op assessment that will make them cancel the surgery!). It's high, but she said it wasn't so high that she wanted to start messing around with medication at this point. Once the weight starts to drop the blood pressure will hopefully drop down too.

So hopefully I am good to go!

 

[TiaLi]

@Jadine Hayles Hmm, might be that your date has been postponed and that she could see that in their systems but that you haven't received a letter yet? Or maybe she just read it wrong. I'd double-check if I were you.

I'm not sure if the "new" surgeon my dietitian spoke about is the same as you are now having, or if they now have another new guy as well - but when I met with the dietitian towards end of 2015/early 2016 she told me that they had three surgeons: Dr Patel, Dr Chang and a "new guy" (whose name I unfortunately do not remember). According to her the new guy was lovely and very good - and his waiting list was a lot shorter than the others since he didn't have as many patients. Dr Patel and Dr Chang are well known so those are the surgeons people tend to refer to, whereas the "new surgeon" had yet to build up the same reputation.

So, if the two are in fact the same person, the good news is that you are likely to face a shorter wait (and he is supposedly lovely and very good as well).

 

[Jadine Hayles]

@Jadine Hayles Hmm, might be that your date has been postponed and that she could see that in their systems but that you haven't received a letter yet? Or maybe she just read it wrong. I'd double-check if I were you.

I'm not sure if the "new" surgeon my dietitian spoke about is the same as you are now having, or if they now have another new guy as well - but when I met with the dietitian towards end of 2015/early 2016 she told me that they had three surgeons: Dr Patel, Dr Chang and a "new guy" (whose name I unfortunately do not remember). According to her the new guy was lovely and very good - and his waiting list was a lot shorter than the others since he didn't have as many patients. Dr Patel and Dr Chang are well known so those are the surgeons people tend to refer to, whereas the "new surgeon" had yet to build up the same reputation.

So, if the two are in fact the same person, the good news is that you are likely to face a shorter wait (and he is supposedly lovely and very good as well).

I called them like last Thursday and was told 21st April then my letter came Saturday and said 24th March. So I'm thinking so I see him twice or something.

Ok there was two new surgeons but this one I've got I haven't seen nothing about him but he's been at King's since 2015.
I don't mind having him and if his waiting list is much shorter which it must be. I'm very happy bunny.
I understand why everyone would want Dr Patel and Ms Chang though as they do have a good reputation.
But I'm sure this surgeon would be good too or he wouldn't be there doing the surgery.
I'm just counting down till I meet him, I hope I get put on the waiting list then and there.

 

[paulam]

Hi @TiaLi and @Jadine Hayles sorry I have taken so long to come back on here I have been busy with appointments for my son and getting back on track at home. @TiaLi Dont worry too much about the pre-op it is fairly straightforward they will weigh you and do their usual checks then the primary task is to give you the LRD (liver reducing diet). Depending on what your surgeon has requested, the will tell you 1-3 weeks on the milk or low calorie diet. (I am not clued up on the latter because I did the milk diet.) They will also tell you about what to expect on the day of surgery and what time to come in etc. Do you have a surgery date yet?

 

[TiaLi]

@paulam Thank you! Yes, my surgery is booked in for 14 March. I have Dr Patel, and from what I hear he does not want his patients to do the LRD actually. I know Dr Chang does though. In terms of the checks, is it just bloods, blood pressure and ECG, or did you have any other tests as well?

 

[paulam]

I had all those done before pre-op. I had sleep apnea test 18 months prior to bariatric surgery when I had my gallbladder removed and ecg was requested by a and e due to continuous palpitations. If I remember rightly I had bloods done twice which may have been because the first set had been taken more than three months prior to surgery. I did not know that Mr Patel did not like patients to do LRD most surgeons prefer it because it reduces the size of the liver and makes the stomach more accessible. I do have to say that he is a brilliant surgeon and is well experienced in his field. I did have Ms Chang. I chose her because she did my gallbladder removal and I was very impressed with her work. She is very thorough. Good luck for March 14th.

 

[TiaLi]

@paulam Thank you, that's really helpful! Yeah I think that's still his position at least - I know from reading accounts from previous patients that he did not want them to do the LRD, and my dietitian did say that whether or not you have to do it will depend on which surgeon you get. So I assume she was referring to Dr Patel given that that's what I've heard from others as well. I'm not entirely sure why that is (as you say, most surgeons seem to prefer it) but I read on another thread somewhere something about him wanting you to be as strong as possible when you go into surgery, and therefore doesn't like patients to do such a drastic diet right beforehand.

Before I read that I was planning on still doing the LRD even if I don't have to, thinking that "at least it can't hurt, better to be on the safe side". But if this is a case of him not WANTING you to do it (rather than simply not REQUIRING you to do it) then I will listen to what he says. He's the one doing the cutting so after all so I want to stick to whatever his preferences are. I'll see what they say at the pre-op.

Congrats on your loss so far - hope to soon join you on the losers' bench!

 

[paulam]

Hi @TiaLi . Thank you as I said it is going very slow in comparison to others but I am happy to go at a snails pace for now. I would not diet if that is the case but try and eat as healthily as possible, making sure you get enough calories in. I would also look at vitamins as you have a month before surgery that may be something worth looking at.

 

[TiaLi]

I think you're being too hard on yourself @paulam - you've lost over a stone a month! I'd hardly call that snail's pace

 

[Jadine Hayles]

@TiaLi @paulam wow sorry for the big delay. I see you ladies have been in big discussion. Yes Dr Patel can work without the liver shrink diet but I'm the same as you TiaLi I'd be like are you sure as I don't want no complications. But he's an expert.
I'm finally meeting my surgeon in April was supposed to be next month but kings moved me a whole month .... and I have a new surgeon so I don't know what to expect with him.