TSB

From what I have read, folks have has a wide variety of experiences w/ the psych testing. Here is a link to my post after I went for my psych eval. http://www.lapbandtalk.com/f84/psych-test-94988/

My PCP favors GB more, but only because she had that surgery herself. The surgeon I see seems to me to also favor GB. With him, I think it has more to do with the rapid weight loss that tends to occur in the 1st 6-12months afterward. In the end, though, they both advised that it was my decision. I decided on the LB :thumbup: and am still going through my pre-op phase. I hope that with my last two appointments coming up, that by the end of June I will find out for sure whether I am approved and get a date.

You are experiencing both caffiene and sugar withdrawl (if you are not drinking diet Mt. Dew.) I am still pre-op, but kicking soda has been one of my pre-op requirements, in addition to caffienated coffee and cigarettes. I had a really rough week when I gave up soda & coffee. The withdrawl symptoms do pass. I wish you luck, you have had such impressive weight loss.

Had my psych test today. It was not at all what I expected from what I have read of others experiences here. I had no pen & paper diagnostic testing at all. Just spent about a half hour w/ a psychiatric nurse practioner. She asked me to explain my understanding of the surgical procedure and the frequency and sort of follow up required. She asked me why I wanted to have this surgery, if I had ever been able to lose weight on my own. Asked about family psychiatric history, if I ever thought of suicide,if I ever thought of killing anyone, if I ever hallucinated, asked whether I had a history of eating disorders, and if I had a history of drug/alcohol abuse. Then she did some simple, verbal evaluations of my cognitive functioning. This consisted of asking me my name, where I was, and what sort of surgery I was pursuing. Then she said three words and asked me to repeat them back to her. Told me she would ask me again later, and in the meantime would distract me with other questions. She asked me to spell a word forward and backward and had me do some simple arithmatic in my head and then asked me if I remembered and could repeat back the 3 words she had given me earlier. In the end, she said I did fine and that she thought I was a good candidate, psychologically speaking, for the surgery. YAY! That was my last pre-op test! Now I just have a follow up appt. with the pulmonoligist to get the results of my sleep study and I have to await the nutritionist's stamp of approval. :smile:

LOL, no not nuts or retarded. I did ask if I could get some kind of certificate stating I was perfectly sane that I could post at both work and home. She laughed and said all she could attest to was that I was not psychotic:huh2: and that I understood how WLS will impact my life. I was a little nervous about the psych eval, too. I had read about the written tests that a lot of WLS candidates have to take and I was worried about checking off the wrong box or something. Of all the pre-op testing I have been through over the last few months, this was by far the easiest.

I have not had the lab band surgery yet. However, when I had an abdominal hysterctomy in 2005 I had an issue w/ the incision not healing properly (doc went in through the scar from 3 c-sections). I can't imagine having to clean & pack it myself. Have you looked into whether your insurance covers any kind of home health care? I was lucky, as that was part of my coverage. I had a home health care nurse visiting me daily for 2 to 3 weeks until my incision healed properly. I hope you feel better soon!

As someone who is still pre-op, and relatively new to this site: I have a great appreciation of your posting style, monkey. I find that you dispense sound advice in a manner that is not judgmental or condescending. I've learned a lot from your posts :thumbup:

LOL, Steve, great post!

I toyed with the idea for 2 or 3 years but never pursued it because my BMI was not at 40, and until this year, I didn't really have any health issues. I now have high cholesterol. My PCP actually asked me if I had ever considered WLS at my physical in January. I told her I had, but did not think that I would qualify. She suggested making a referral and thought that I had a good chance of qualifying.

When I went they did an arterial blood gas (ABG) test, asked me a bunch of questions about my sleep, did a cursory physical exam of my throat, ears, & nose, and then I did several different types of breathing tests. After that I was scheduled for my overnight sleep study. I don't know if it is standard or not for all WLS patients. At my initial consult I was asked if anyone ever told me I snored loudly, my response was yes, so they scheduled me for the appt. as a part of my pre-op work up.

I went to my PCP 1st. She made a referral to the surgeon. The surgeon's office set me up for all of my pre-op evaluations w/ providers that they use regularly, including my upcoming psych eval. It will be a psychiatric nurse practitioner that does my psych eval as well.

I've not had a huge problem with this. I've had a couple of providers that my surgeon referred me to for pre-op testing comment that I was smaller than most people referred to them for the purpose of WLS. One co-worker mentioned that she didn't think I was "big enough." It didn't feel like these statements were judgmental and I didn't take offense to them. But that may just be my personality type, I am not easily offended. It is surreal to me, to think that I am not "fat enough" to pursue this surgery. I have been obese ALL of my life and have on occasion crossed that line on the BMI chart into the morbidly obese category. I currently have high cholesterol and a strong family history of diabetes and heart disease. In short, there is much more to being a good candidate for this surgery than the # on the scale or where you fall on some chart! And quite frankly, I don't think any of us should have to "justify" our choice to anyone other than our surgeon & our insurance company!

My doc says no caffeine ever pre-op/post-op. The # 1 reason I have been given is that it can contribute to ulcers. Other reasons I have been given is that it functions as a diuretic and after WLS it is very important to stay hydrated. I have also been told that caffiene can stimulate the appetite. I was a heavy coffee drinker -- 1st cup at 5:30 am and drank straight through unil about 3:00 pm daily. Probably had about 10 cups a day on most days. I started to wean myself off by setting a # of cups of regular coffee. I allowed myself 3-4 cups a day. I did that for a week or so. Then for a couple of weeks I drank 1/2 caf. Finally, I move to straight decaf. It was rough, that's for sure. I had headaches for about the 1st week after I went totally decaf.

Congratulations, Thinner & Mel, on getting approved!

Will keep my fingers crossed for you, MZ!

Another Mainah here. I am still pre-op, though, and am going to Dr. Loggins. He is with CMMC in Lewiston.

Overall, it has been a positive experience. His staff is very thorough and helpful. Early on, I had a feeling that by-pass was being "pushed" vs. the band. Now I look at it as being given all the info upon which to base MY decision. Wish the process could move faster, but appreciate the efforts in ensuring that my health and well-being comes first!

My nutritionist's rule on protein shakes is no more than 10 calories per gram of protein.

Sorry for those of you having to wait a long time w/ Kaiser. I have to say, though, I grew up in Contra Costa County in CA (age 4 to age 24) and I kind of miss Kaiser. It seems as if it was so much more user friendly and cost effective than the insurance I have here in Maine (Anthem BC/BS.) But I suppose there is no perfect insurance. I just found out this week that my insurance has made some changes to its policy on bariatric surgery. If you have it done at a center of excellence, everything is covered. If you don't have surgery at a center of excellence, then there are deductibles and co-pays you have to pay out of pocket. There are only two hospitals in Maine that qualify as such, and neither of them are the one I am going through:sad: But, I spoke w/ my clinic coordinator and she tells me they are waiting on their provisional certification as a center of excellence. So, keeping my fingers crossed on that one. I will not go to the two places in Maine that count as centers of excellence. One of them is 2 hours from where I live and the other an hour. As opposed to CMMC, which is 15 min from where I live.

Had my sleep study last night. I am a little bummed that the technician did not have to come in during the study to put me on a cpap. I am taking that to mean I have no apnea. Odd to wish for a health problem, but I was kind of counting on apnea to be my qualifying co-morbidity so that I would qualify under my insurance. The technician said there are all kinds of things in the study that the doc will look at. So maybe something will still come of it, but I am not feeling too posistive about it :smile:

Hey all. Just chiming in w/ my hopes of being a lower bmi bandster in 2009! I am almost done w/ all of the pre-op stuff and then the doc will submit to the insurance company. Haven't had any negative experiences with anyone saying I am not "fat enough" for the surgery. Though a few of the pre-op providers that my surgeon has referred me to have commented that I was smaller than most of the patients my surgeon refers to them. Family and friends all seem to be on board :cursing: which is all that really matters.

If your BMI is above 35 and below 40 and you have co-morbidities, you can often times qualify for the surgery. At the rate I am going on my pre-op, I may be down to a BMI of 35 or less. I have high cholesterol. I am hoping that will count as a comorbidity and I will be approved by the insurance company. Also, from what I have researched, the qualification process is typically based on your BMI on your first weigh in w/ the surgeon, not your weight on surgery day.

No it has not. I have been overweight since I was a child. The first time I joined weight watchers I was 12 years old. I lost 25 pounds. I have had repeated "success" at losing weight all of my life. A few years ago, I even managed to drop 60 pounds (from 215 to 155) in a period of about 6 months. As you can see, I gained it all back. The reason I am getting the band is that 1) I hope to get down to a healthy BMI & 2) I hope to use the band as tool to STAY at a healthy BMI.

:laugh: WOOHOO! Just got a call from the sleep study center, someone cancelled for tonight, so I get to have my sleep study done tonight. This means my follow up appointment, originally scheduled for mid-july, will also be moved up I am one happy camper right now!

Diets vary from surgeon to surgeon and insurance company to insurance company. My insurance company does not require a "diet." However, part of the pre-op requirements w/ my surgeon include losing 10% of my starting weight and being nutritionally cleared by the nutritionists he has on staff. The philosophy is that I need to show my commitment and my ability to make the neccessary life-style changes given that the band is merely a tool. At first, I was really put off by the nutritionists, but as I get further into the process I have realized two things 1) they are a great resource in this process and 2) they are also in a sense "gatekeepers" in that it does not matter if I pass every single medical/psych test given me --- if they are not satisfied that I "get" the nutritional part of all of this, I will not have surgery. Therefore, even though I am not perfect in following their nutrtional recommendations (i.e., I had two margaritas and a big old plate of enchiladas for my 40th birthday) I am being as compliant as possible in following their recommedations. For me, the recommendations are consume no more than 1200-1400 cal per day, eat 60-80 grams of protein a day & consume 48-64 oz of low calorie/non-caffienated fluid a day.