Psy. evaluation, depression, medication post-op

[Guest guest]

Seeing a " shrink " has nothing to do with being crazy. Being depressed,

having PTSD, being under great stress, and having emotional pain happen to

people during life. Seeing a professional for these can make some sense.

Suggesting that anyone who sees a mental health professional is " crazy " is

a

barbaric notion. I'm sure that you wouldn't intentionally insult the many

people on this list who seek such professional help.

in Seattle

DS 1/5/01 295# BMI 47.6

4/5/01 240# BMI 38

Dr Welker - OHSU

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Does anyone know if current treatment for depression is a disqualification

for WLS? I'm currently taking antidepressants and will most likely need

them post-op too. I wonder how effect the medications will be post op

given the malabsorption effects of the surgery?

jvaszil@...

[Guest guest]

Leonard,

I understand having values that conflict with the requirements that are set

up within the healthcare system. I have made my personal preferences about

the psych evaluation clear. I have also looked at the issue, as best I can,

from the viewpoint of the surgeons. And I have tried to be informed about

the rationale behind the requirement for the exam.

Ultimately each of us must decide what is most important to us. I wanted

to have DS surgery to save my life. In my set of values, my life has a

higher priority than the hoops I must jump through to get there. I've had

the surgery and am in a far better place to look at the process and decide

whether or not I can use my skills and professional training to impact that

within the system. If I die of MO I can do nothing.

I have the highest respect for the surgeons that perform the DS. Although I

disagree with some of the requirements and advice given, I am grateful that

they are there to do this work and give us a new lease on life. This isn't

glamorous work, bariatric surgeons are often disrespected by other surgeons.

The risks are high-- we are the people other surgeons often refuse to

operate on. And DS doctors get sued. That they *shouldn't* is irrelevant.

They do.

So each of us must make a choice. I decided to have the DS surgery. I did

not have to have a psych evaluation. However, I would have done so if that

were required. I was drowning in my morbid obesity. I would not refuse the

lifeline offered to me. You must make your own decision and live with that.

in Seattle

DS 1/5/01 295# BMI 47.6

4/5/01 240# BMI 38

Dr Welker - OHSU

Re: Psy. evaluation, depression, medication

post-op

>

> Dear ,

>

> A further comment on some of the things you said sort

> of in defense of the surgeons like Emma who

> don't have the wisdom to ignore these psychometric and

> psychiatric hoops that the NIH recommends. If you

> think about it, the person that is in the best

> position to make that evaluation in the professional

> community may not be the psychiatrist that the patient

> selects to have a preop interview with but the

> patient's PCP. This is true in the case of potential

> transplant patients, too.

>

> I question the idea that the surgeon is in any way

> responsible if his patient doesn't eat right or take

> the proper supplements. A patient who is noncompliant

> has no business trying to sue the surgeon for trying

> to help him out surgically according to the patient's

> desires to have him do so.

>

> I try to live my life without bullshit and having to

> follow these guidelines is bullshit. They are not

> legal because the federal government has stuck its

> nose where it cannot constitutionally be.

>

> Some surgeons just love to be in a position to play

> god with a patient and reject him if he doesn't quite

> fit the mold. If you talk to , who has

> exposed Dr. Rutledge for his loop bypass, this doctor

> uses these psychological techniques to not just select

> the right kind of patient but create feeling of

> dependence mixed with fear and feeling of inadequacy.

>

> lcp

>

> PS. How many obese people die before they can pass all

> these dubious tests and retests? How many don't get

> the surgery because their shrink or surgeon doesn't

> like them or their attitude?

>

> The use of the MMPI and other psychological tools

> > > for the pre op WLS is pure

> > > nonsense. Except that if the post op patient

> fails

> > > to do what is needed to

> > > stay healthy the surgeon can't be sued for this.

> > > After all, they relied on

> > > another professional for this information. The

> > > professional literature

> > > indicates that there is no relationship between

> the

> > > results of these tests

> > > and WLS outcomes. Reliance on these rather than a

> > > thorough personal

> > > interview with the patient is indicative of how

> > > little most surgeons know

> > > about the mental health profession. Some of the

> > > surgeons ask for a simple

> > > letter from a professional saying that the patient

> > > understand the surgery,

> > > has realistic expectations regarding outcomes, has

> > > no apparent personality

> > > issues that would impair compliance, and is able

> to

> > > make this decision.

> > >

> > > Seeing a " shrink " has nothing to do with being

> > > crazy. Being depressed,

> > > having PTSD, being under great stress, and having

> > > emotional pain happen to

> > > people during life. Seeing a professional for

> these

> > > can make some sense.

> > > Suggesting that anyone who sees a mental health

> > > professional is " crazy " is a

> > > barbaric notion. I'm sure that you wouldn't

> > > intentionally insult the many

> > > people on this list who seek such professional

> help.

>