Bariatrics

So while working in the women's hospital at New Hanover, I've gotten to attend some post-gastric bypass diet eds done by my current dietitian (the bariatric patients, both male and female, recuperate in the women's hospital for complicated reasons not worth getting into). The day after their surgeries, before being discharged at noon (I am still amazed that they're discharged the day after surgery), a dietitian is required to come by and give them a quiz to see how well they know how they're supposed to be eating for the next days and weeks and months. This comes after they've attended a series of diet education classes performed by one of the outpatient dietitians in Wilmington. The quizzes are only 6 or 7 questions, and they're multiple-choice, but of the 6 patients I've seen, none as gotten all the questions correct. One today got half of them wrong. The questions aren't terribly difficult--they're asking about things like daily calcium supplementation requirements, ounces of fluid intake per day, and protein recommendations. Yet the patients don't know all the answers. I find it very disturbing since at this point they've already had the surgery and there's no going back, regardless of whether or not the patients seem capable of handling the major undertaking involved in maintaining their diet regimen. And I have seen (back in the "Tower" part of the main hospital) what happens when gastric bypass patients don't follow their diets (such as the woman who had a serum ferritin of ZERO). Clearly the pre-screening process for gastric bypass could use some work. Although since gastric bypasses are a nice cash cow for hospitals, it seems unlikely. Oh well...