Regulations and Dieting (and Surgery)

This is a few thoughts that involve something common in the new year; dieting. Well, tangentially diet related.

Part of the issues I've had cascade down in the past few months...thanks life!...has led to appointments with the rather new bariatric unit at the local hospital unit. They take a whole-in approach of using a team of nutritionists, fitness experts, gastric surgeons, psychologists...the whole nine yards...to create a program with support system for patients.

Part of the intake process meant reviewing your history. This is where I learned something nifty (beyond this machine that weighs you while zapping you with a current that measured all sorts of density information regarding the different kinds of body fat and densities in your body to come up with a profile of good and bad stuff in your body).

They asked about my past history and I told them about the gastric bypass procedure I underwent many years ago...I believe it was around 2009. April. Somewhere in there. My memory is fuzzy.

At the time, the local hospital system didn't really have a bariatric unit. While they very much seemed to support the idea that if you're fat, most of your illnesses and afflictions were weight-based and you needed to lose weight to deserve to be better, they were not well known for their "let's cut parts of the digestive system apart to help lose weight."

There was another hospital, about an hour away from us, that did have a small bariatric surgery unit. They took me into the program, agreed to do the surgery if I lost X amount of weight first, and after reaching that milestone I had the surgery.

Not long after, during the latter phases of physical recovery, I unceremoniously discovered that not only did my surgeon retire, but the hospital killed their bariatric surgery program. There was no notice. There was no letter, no email, no announcement ever reached us. Just...nothing. No more appointments kept.

I soured on the medical system a little more at that point. There was emphasis on how important a support system was...and there is certainly no shortage of continued feeling that when a doctor looks at you, your weight is first a foremost on their mind when figuring out how much a person is worth.

One day I had a consult about something at the local hospital and they mentioned the bariatric surgery, and how I could get followup at the other hospital.

"We can't," I said. "They shut down their bariatric unit."

"They restarted it a little while ago," they said.

Turns out, with little (read: no) fanfare or notification, they revived their bariatric unit. I have no doubt the doctors I worked with are gone; my surgeon had retired, and I can't imagine the younger doctors stuck around once their specialty had been shut down.

This came at a time when fat people were becoming (medically) profitable. Oh, sure, we're still a huge expense in cardiac care (and in this time the local hospital became a leader in cardiac care), but now some of those costs are being recouped through insurance companies through growing sleep apnea care, diabetes drugs and bariatric surgery. What was justification for treating people as sub-human was becoming a PR race to open the best fat-care centers, which before was the market for hucksters and easy diet schemers on television ads.

In other words, upon hearing that the other hospital had re-opened their bariatric unit without any announcement to former patients, I figured it was because it was becoming fashionable and probably profitable to do so. I certainly didn't trust them to give a damn, though. They didn't notify their old patients about it. They expressed no damns about my status. So...screw them.

The annoying thing is that the local hospital decided to focus more and more money into developing a local bariatric/weight loss program. As time went on they moved more staff into specializing on weight care. They repurposed a building just for weight loss. They focused resources on their weight loss center.

But when the topic of weight loss came up with my appointments, the moment my surgery history came up it was suggested I drive another half hour to the other hospital and continue care there.

It was during intake that I finally found out why. During the consult they mentioned something about checking the size of the stomach pouch, as it was obvious I could eat more than I was supposed to be able to. My history came up, and she said something about going to the other hospital.

I recounted my history and my distaste for dealing with a hospital that made it so blatant they didn't give a damn about their patients. She said that she could talk to the surgeon in the local hospital's weight clinic, but she knew what he'd say...no, he wouldn't work with me on it. That was when I learned why.

The government made rules.

See, to make hospitals "accountable" (that's a big buzzword for hospitals now, not just schools!) they were getting evaluated based on patient followup. In this example, I was operated on by hospital A. They had a program they wanted to end, and they did...essentially dumping their patients.

I ended up going to hospital B, my preferred hospital for most medical issues since I only went to A for a procedure B refused to do at the time. But this means that if anything was bariatric-related, B was getting (federally) evaluated for my poor outcome. At some point it seems A was pressured to re-open their bariatric program and make available their resources to old and new patients (although they didn't advertise it...take that as you will.)

That was why I was repeatedly "encouraged" to go to another hospital for some weight treatment followups. It's also why I'm not able to access certain resources at a hospital that in the years following my surgery dumped not insignificant resources into developing a "cutting edge" bariatric unit.

Once again the government is interfering in efforts they don't understand. Or at a minimum lots of hands in the pot have created a system that benefits not the patient, but some other interests, with the net effect of screwing the patient.

In the end I still have to go through their weight clinic, just with some options limited. I get to begin the new year miserably tracking calorie counts and using words like "carbs" and "abs" and "veggies," and dealing with the neuroses that I know will flare up while pursuing the accurate tracking of goals.

Will I be successful? Will I find more reason to distrust and/or outrightly dislike the hospital? Or will I fail miserably? Time will tell. But if you'll excuse me, I have to go prepare a big old egg patty with...egg. Lots of protein. Minimal carbs. Low calorie!

I really miss food.