Hi and Help!

[kwiklip 0]

I am fairly new to posting and hope to meet some people to offer and give some great support on here. Today, I am the one that needs the support. I am having a tough time navigating through the pre-op stuff. Specifically, I met with my psychologist for the 4th & final time for my pre-op assessment, and he gave me a "yellow light, with the possibility of red" based on the personality tests he gave me. He said that although I do not have anything "diagnosable", the combination between lack of closeness with most of my family and my tendency to be impulsive raised red flags and he won't approve me at this time with out more pre-op stuff on my part. He said I need to attend the pre-op support group at my surgeon's office, as well as a couple of months of sessions with a social worker or psychologist. I want this surgery to work, and I will do what he is asking. But I can't help but feel discouraged by his opinion of me. I have been trying hard to do everything on the checklist he gave me for behavioral change, including my harrowing experience in trying to quit smoking. Today, I feel like I won't ever get there, whether that's realistic or not. The pshychologist also told me that when he hears about people opting for Lap Band versus Roux-en-Y or VBG, he thinks they are not serious about their weight loss and have only "one foot in the door". I don't agree with that opinion, but I have been doubting my decision that I want Lap Band, which actually kind of ticks me off. I have re-confirmed my decision that I dont' want RNY or VBG, and it's not because I am not serious in my efforts, it's because I am terrified of the risks and feel that I will be able to use the Lap Band as a very effective tool in the lifestyle changes I have already started.

Sorry to drone on and whine a bit, but I am at a low point today and really need to know that I am not the first or only person to feel discouraged. Am I?

[VegasGrace 1]

Wow, based on that I would have been denied.

Closeness with family? Impulsive?

That's many Americans now days.

And that's bias...to think those opting for the band are not serious about weightloss.

Sounds like that psychologist shouldn't be a psychologist...in the weightloss area.

[rharriet62 0]

Hi,

Was this a psychologist recommended by your surgeon or did you find him on your own? It sounds like he is not very knowledgeable about weight loss surgery if he said that having the band is "one foot in the door"! I'm a therapist as well and find that interesting that he said that. So, my question about where you found him. Also, how many meetings do you have to attend? My eval was one session with a bunch of tests and an hour-long interview.

Sorry about the stress this causing! Good luck with the no smoking! Good for you! My husband found (when he quit his 20+ yr, 2+ packs a day) that he focused on his goal (skiing AND breathing at the same time) and used the gum in double doses...and said the first 3 days were the hardest. He's been smoke free for over 3 years...but he had also quit several times before that and this time it stuck. GOOD LUCK!

[tonya66 13]

I would ask your surgeon for another physchologist. Get another opinion. Sounds like the psychologist is pushing for RNY.

[wombat712 2]

I agree - the psych person doesn't sound right at all. I didn't have to go through an eval but I think that is because I'm self pay. I too would have failed then on being close to my family (some of them anyway) and being impulsive. What a crock - what has that got to do with being successful with the band?

Good luck to you!! {{hugs}}

[mbanja 1]

I agree with the others on finding a new one!! One doc isn't the end of it. There are millions out there get your doc to send you to a different one. Tell him you want a second opinion and you feel like the current one is not knowledgable enough in the lap band process. Or just tell him you don't fell comfortable with the current one! As for quitting smoking there are some great antidepressants out there especially designed for quitting smoking. I took zyban (sp?) and it really helped me. I think there is a newer one out that works just as good or maybe better. I have read about it on this site and it has gotten rave reviews on here. Search under smoking and read the posts!! There is the shot too, which I don't know much about but I have heard that it works too! Hope all goes well for you! Good luck!

[mbanja 1]

Oh, and on the family issues....it takes more than just you to work out the problems. If the others are not willing it won't work. I think this current doc is full of whoey!! He/She is probably just pushing their "I know more than you, cuz I spent all this money for school" degree!!

[kwiklip 0]

This psychologist was on the list of bariatric psychologists that could do my pre-operative assessment. I happened to choose him because he is close to my home. I had to do four sessions: initial meeting; MMPI II and Quality of Life Inventory (or whatever it's called); another one-on-one; and the last one that I just had, where I had to bring a support person with and we also went over my test results. I brought my neice and when I talked to her about how I was feeling about the whole meeting, she said she could see understand I felt. She thinks he may be a bit burned out and doing everything by rote, rather than addressing me as an individual. Whatever the reason, I am going to let my surgeon's office know about my experience and they can decide if they want to take further action (such as removing him from their list). I also plan on writing to the doctor, because he may not even realize how he was coming across, or how upset I was when I left.

Thanks for all your support!

[kwiklip 0]

High five, that's what I thought!

[kwiklip 0]

I was doing the patch, which wasn't as effective as I need, so I am now on Day 4 of Chantix, which has a good success rate. Thanks for the encouragement!!

[Wheetsin 714]

I'm not a therapist, but I have the degree, and I see several red flags in your story. I can understand where the psychologist is coming from sometimes - in family closeness s/he's likely looking for your support system, but then by your therapist's rationale, someone who's family has died would be a poor surgical candidate, and that certainly doesn't have to be the case.

I can also see his comment about one foot in. This procedure is widely viewed as the "reversible" procedure, meaning that it doesn't require the full committment that something like a permanent change/removal of your organs would. However, there are many, many extraordinarily valid reasons someone could opt for the band over a "permanent" solution, that s/he is either unaware of, or failing to acknowledge with you.

[mrsjiggles 4]

Just my experiance- I am self-pay and still had to undergo a psych. eval. It was compromised of one session. He talked to me for about an hour regarding my support system, my history of abuse, drug addiction and so on. He gave me a symptoms test and a 650 some odd question personality test. He approved me. I even told him I was an emotional eater. He said that I seemed like I made my mind up about the surgery and that I understood the changes that were going to take place. I think you should strongly consider a different Dr. to do your evaluation. It's not his job to talk you into what procedure to have. It's his job to make sure you know what your getting yourself into and that you'll be able to handle it without having a nervous breakdown. Unless you have some diagnosable personality disorder, I don't see why several sessions are required to get what other Dr. can do in a matter of a few hours. Just my 2-cents. Good luck with everything!

[PATCHELTON 0]

This psychologist was on the list of bariatric psychologists that could do my pre-operative assessment. I happened to choose him because he is close to my home. I had to do four sessions: initial meeting; MMPI II and Quality of Life Inventory (or whatever it's called); another one-on-one; and the last one that I just had, where I had to bring a support person with and we also went over my test results. I brought my neice and when I talked to her about how I was feeling about the whole meeting, she said she could see understand I felt. She thinks he may be a bit burned out and doing everything by rote, rather than addressing me as an individual. Whatever the reason, I am going to let my surgeon's office know about my experience and they can decide if they want to take further action (such as removing him from their list). I also plan on writing to the doctor, because he may not even realize how he was coming across, or how upset I was when I left.

I am pre-op for the lapband, and going through the screening appointments like everyone else. However my psych eval was one session consisting of about an hour. I was given no tests, but I was asked if my sister (who had RNY about a year ago) influenced my decision. I had listened as she talked about her journey, but when the idea for me to have surgery came up, I did some research and decided the lapband was a better choice for me, and it was totally my decision. First of all, I didn't gain the weight overnight, so losing more slowly wasn't an issue. What attracted me more was that lapband is a restrictive procedure, not malabsorptive, so I would not have the Vitamin issues that RNY presents, even though they recommend Vitamins (and I take Calcium now anyway). I liked also the fact that it is adjustable. I don't believe for a minute that my resolve is any less than my sister who had RNY. And, I have another sister I haven't even told about this because she is the "all you have to do is eat less" type, and didn't understand the RNY sister's decision, so I haven't included her in my plans. My parents are deceased, so my support group is really small. I have friends suggesting I put my food on a smaller plate to trick my brain or stomach. Well meaning but misguided; I live alone, and there is no one to stop me from returning to the stove with my smaller plate and filling it a second or third time. I need help with Portion Control, and that is why I am doing this. I will get out of it what I put into it. It is possible to undo both lapband and RNY if you decide to eat the wrong stuff. Based on your psych eval I would have been turned down too. I have one more week of "documented" weight loss attempt, then paperwork for my PCP to sign off, and then it all goes to insurance for approval. My BMI is about 38-39, but I am about 100 pounds overweight, with sleep apnea, high blood pressure, high cholesterol, knee arthritis, esophageal reflux (i.e., enough co-morbidities for 3 people) so I don't expect to be turned down. My coworker got approved with BMI 40, 100 pounds overweight, borderline sleep apnea, and borderline high blood pressure. She even did her 6 month diet attempt as two 3 month diets, at the same time (diet classes and Weight Watchers online) and she is 2 weeks postop. Get yourself a new therapist, even if it is out of pocket (mine was out of network, so she was out of pocket, but one visit only, $150). This person doesn't understand the lapband and should NOT being seeing pre-op patients who are going for it. Good luck on your journey.:ranger:

[kwiklip 0]

Wow, you are moving right along. Your surgery is coming up quick!

Thanks for the feedback. I agree with you on everything. The 600+ test is the MN Multiphasic II, which is the one that he said I had 'borderline' readings with impulsiveness and family support. I wish I had your Dr.!

Best of luck!

[kwiklip 0]

I'm not a therapist, but I have the degree, and I see several red flags in your story. I can understand where the psychologist is coming from sometimes - in family closeness s/he's likely looking for your support system, but then by your therapist's rationale, someone who's family has died would be a poor surgical candidate, and that certainly doesn't have to be the case.

I can also see his comment about one foot in. This procedure is widely viewed as the "reversible" procedure, meaning that it doesn't require the full committment that something like a permanent change/removal of your organs would. However, there are many, many extraordinarily valid reasons someone could opt for the band over a "permanent" solution, that s/he is either unaware of, or failing to acknowledge with you.

Thanks for your response. I see all of your points, and they are valid. The thing was, the last appointment I had, I had to bring a family support person to the appointment. I brought my neice, who is like a sister to me (and also a nurse). Even after I acknowledged that I can't rely on most of my family for a lot of support post-surgically, I told him and showed him a good support person, and to me that should have been enough. It wasn't, and I already have an appointment with another psychologist. This one is more closely connected to my surgeon, so hopefully I will get past this bump. I can't wait to start my new life!