Since the time I started learning nutrition, I have understood that diet and counseling go hand in hand. As much as your content matters, how you present it to your patient, how you motivate them, how you coax them into following your advice is equally important. Without their compliance, you cannot measure your success as a “Nutritionist”! What’s more post surgery diet is an intrinsic part of Bariatric Surgery and following instructions post surgery is absolutely critical to avoid both complications and also ensure complete weight loss.
However, sometimes you are forced to stop and wonder at the sheer “innocence” of some patients who in spite of repeated counseling fail to adhere to your instructions. Specifically, when it comes to bariatric nutrition where you need not counsel the patient to eat less, but to eat more often. You can’t stop but smile at these funny occurrences.
The ones I still laugh at in the last few years of my experience fit into largely four categories
THE URGENT MISSIVE PATIENT:
4 days post-surgery patient repeatedly calls at 10.30 pm to ask if they can have tomato soup! And they also claim that it’s URGENT! Talk about hunger pangs in the middle of the night.
(Just so you know: Post surgery, tomato soup is allowed)
THE RUNAWAY PATIENT:
One of our 27 year old patient who got admitted pre surgery but couldn’t control her hunger, so she stole rotis from the hospital, ran away to the canteen and had sabudana wada. Post-surgery, on her liquid diet, on the 5th day, she had small bites of vada pav, ice-cream etc. On counseling that it can be dangerous, she says “Relax guys, I just had like 1 small bite”.
THE ACCIDENTAL EATER:
The 1st day post-surgery, one of the patients started crying on phone. I understood her situation, given the pain she was going through because of the acidity (which is expected in some patients). I counseled her for 15 minutes, spoke to the husband and was in touch with her for 3-4 days, just to ensure she was comfortable!
On the 13th day, I receive a call at the office saying that this patient wants to speak to you URGENTLY
She: “I am dying of acidity and just can’t bear the pain.”
Me: “What did you eat?”
She: “Err…Actually, I just had a few peppered cashewnuts last night!!!”
Me: Speechless! (In the first 15 days post surgery, patients are strictly supposed to be on liquid diet)
ONE MORE QUESTION PLEASE TYPE:
One of our male patients asked me to speak to her daughter-in-law for dietary guidance post the surgery. Since he was on the soft diet phase, I explained to her our recommendation of moving from clear liquids to the full liquid diet to finally the soft diet stage.
“Ma’am, your booklet mentions dal-rice? So, can I give him these foods?”
“Ma’am, can he eat khichdi?”
The piece de resistance was when she asked me, “Ma’am, your book says home-made paneer. Do I need to make it at home?”
I was tongue-tied at the rhetorical questions!
So if you don’t want to fit into any of these type of patients, my tips:
- Listen first. Then ask.
- When calling up a professional, it’s polite to ask if it’s a good time to talk rather than just starting with your story.
- If some reading material is given to you, it’s better to go through it thoroughly and then pose questions.