Guest guest Posted July 11, 2001 Report Share Posted July 11, 2001 Dr. requires that people see psych docs on her team. That way, she knows that they know what to look for. I don't say that method is perfect but it's the best type of method I've seen to date. Ya know..I can understand this to an extent...but if you've been seeing someone for four or five months as you began researching and weren't sure this was it for you, then decided to preceed...how can someone determine what is right and wrong in a one hour session when you are well known to the one you've been seeing? My therapist is well versed in my strengths and weaknesses. I suppose it would be different if I lived in Portland but I found the problem was all the trips I was going to have to make to the area. Maybe its different now, but when I originally went to use her as my surgeon, they had me making at minimum of 4 pre op trips not including the surgery. I was going to do it...Do the test with the Psych, see the dietician, meet the Psych the next day and come home, then back in 2 weeks for the first consult....had all the appts...but when I had to explain to the dietician that Dr. referred me to about the procedure I was having, I decided I would do something different...LOL I could have done the same thing in Bellingham...LOL I'm not saying she's not a great surgeon, I'm sure she is. I just found for me, being a single parent, even if I had gotten my insurance to pay, it would have cost me a fortune for all the trips to Portland and Amber didn't seem to interested in working with me on getting it consolidated into 1 or 2 trips. Oh well....things always seem to work out for a reason.... ~~* AJ *~~ BMI 59 Surgery date 7/24/01 going self pay - Dr Baltasar Spain Check out the Bellingham Support for WLS WWW.lookin2bthin.homestead.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2001 Report Share Posted July 11, 2001 Dr. requires that people see psych docs on her team. That way, she knows that they know what to look for. I don't say that method is perfect but it's the best type of method I've seen to date. Ya know..I can understand this to an extent...but if you've been seeing someone for four or five months as you began researching and weren't sure this was it for you, then decided to preceed...how can someone determine what is right and wrong in a one hour session when you are well known to the one you've been seeing? My therapist is well versed in my strengths and weaknesses. I suppose it would be different if I lived in Portland but I found the problem was all the trips I was going to have to make to the area. Maybe its different now, but when I originally went to use her as my surgeon, they had me making at minimum of 4 pre op trips not including the surgery. I was going to do it...Do the test with the Psych, see the dietician, meet the Psych the next day and come home, then back in 2 weeks for the first consult....had all the appts...but when I had to explain to the dietician that Dr. referred me to about the procedure I was having, I decided I would do something different...LOL I could have done the same thing in Bellingham...LOL I'm not saying she's not a great surgeon, I'm sure she is. I just found for me, being a single parent, even if I had gotten my insurance to pay, it would have cost me a fortune for all the trips to Portland and Amber didn't seem to interested in working with me on getting it consolidated into 1 or 2 trips. Oh well....things always seem to work out for a reason.... ~~* AJ *~~ BMI 59 Surgery date 7/24/01 going self pay - Dr Baltasar Spain Check out the Bellingham Support for WLS WWW.lookin2bthin.homestead.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 12, 2001 Report Share Posted July 12, 2001 Leonard said: Message: 16 Date: Wed, 11 Jul 2001 19:20:14 -0700 (PDT) Subject: Re: Re: What can we learn from ? Dear Psychology Experts, Eliminating people from having WLS because they do not have 'normal' psychosocial backup or support groups is going to eliminate most guys, in my limited experience, from much needed WLS for super and plain old morbid obesity. I was at a WLS meeting the other night, and not one of the humungous guys there had any such backup. So you are projecting your values on the population of all fatties. You cannot, generally speaking, diagnose accurately mental illness by a single trait such as whether or not someone has plenty of support, nor can you predict how someone is going to react to an unknown complex of post-surgical 'challenges'. Life ain't that simple. Preliminary diagnoses using DSMs, which is how the shrinks do it, normally involves a constellation of traits or behaviors; nor are their diagnostics the last word on anything, for that matter. These psychological exams are a can of worms. They are rejecting people because they don't like doctors or have antisocial feelings, etc. They have you believing in their voodoo. There are simply too many variables involved and insufficient data to make realistic predictions as to what could happen post-surgically. This is like trying to predict the weather a month from now. It's all guesswork. The ASBS surgical guidelines, which are the specialty guidelines, do not deny surgery to anyone unless they are obviously psychotic. This means that all of us neurotic, finger-nail-biting fatsos who are ready to burst into tears the moment someone looks cross-eyed at us should be able to get surgery. It also means that you are being hassled about your psychic state by surgeons who are a little confused about psychological issues. The NIH guidelines really don't say anything different, though they amount to a plea to use as many disciplines as the surgeons find necessary. This is why the dietitians and the shrinks are getting a piece of the pie. The surgeons are just being generous with the insurance companies or your money. As far as post-operative depression goes, you should be expecting some of those experiencing massive weight loss to have bouts of depression related to their weight loss or to their post-surgical morbidities. There is nothing wrong with having these bouts. There is, however, something wrong in worrying about what might be the etiology of any person's depression. You are playing God. The important thing is to get them treated along with the morbidities attending the surgery. What you ought to be doing, then, is helping to get some help rather than trying to come up with some grand insight. No one, not even the best shrink or the best test, could have predicted how would feel after her surgery, so all of this blathering about who gave her the okay is malarkey, too. Many people are negative about outcomes but positive as hell afterwards. Let's hope that gets some help and eventually gets positive. This shrink business has all the elements of Salem Massachusetts and witch hunting. It is obvious that it is being misused by these surgeons to predict outcomes that are unpredictable, and that they are using these tests to cover their asses when their asses would be better covered by simply giving better followup care of a medical, surgical, or psychiatric type when appropriate. ***************** to a certain extent I agree. I do believe that properly done psych evals might uncover persons who believe they will not succeed, or persons who have no support system. Those persons might be encouraged to identify support groups and to speak to successful post ops to build their " success mentality " before surgery. We all know that a positive mental outlook assists in a positive physical recovery. I think many of the psych evals are poorly thought out and not really effective. However, I've seen some posts from people that have really flipped out over the psych evals and most of them seem to end up not having surgery. I think a psych eval with a doctor who specializes in evaluating bariatric patients, and then possibly 2-3 pre-op visits and say 2-3 post op visits with a transition to a person's own mental health provider would be a good way to go. Dr. requires that people see psych docs on her team. That way, she knows that they know what to look for. I don't say that method is perfect but it's the best type of method I've seen to date. becki ===== Becki, near Portland, OR BMI 50-ish, age 42 pre-op DS. hoping to get approval through Aetna Traditional Choice (fighting 'investigational' denial) Consulted with Dr. on 3-13-01 psych ok, nutrition ok, beckeye_58@... __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 12, 2001 Report Share Posted July 12, 2001 Leonard said: Message: 16 Date: Wed, 11 Jul 2001 19:20:14 -0700 (PDT) Subject: Re: Re: What can we learn from ? Dear Psychology Experts, Eliminating people from having WLS because they do not have 'normal' psychosocial backup or support groups is going to eliminate most guys, in my limited experience, from much needed WLS for super and plain old morbid obesity. I was at a WLS meeting the other night, and not one of the humungous guys there had any such backup. So you are projecting your values on the population of all fatties. You cannot, generally speaking, diagnose accurately mental illness by a single trait such as whether or not someone has plenty of support, nor can you predict how someone is going to react to an unknown complex of post-surgical 'challenges'. Life ain't that simple. Preliminary diagnoses using DSMs, which is how the shrinks do it, normally involves a constellation of traits or behaviors; nor are their diagnostics the last word on anything, for that matter. These psychological exams are a can of worms. They are rejecting people because they don't like doctors or have antisocial feelings, etc. They have you believing in their voodoo. There are simply too many variables involved and insufficient data to make realistic predictions as to what could happen post-surgically. This is like trying to predict the weather a month from now. It's all guesswork. The ASBS surgical guidelines, which are the specialty guidelines, do not deny surgery to anyone unless they are obviously psychotic. This means that all of us neurotic, finger-nail-biting fatsos who are ready to burst into tears the moment someone looks cross-eyed at us should be able to get surgery. It also means that you are being hassled about your psychic state by surgeons who are a little confused about psychological issues. The NIH guidelines really don't say anything different, though they amount to a plea to use as many disciplines as the surgeons find necessary. This is why the dietitians and the shrinks are getting a piece of the pie. The surgeons are just being generous with the insurance companies or your money. As far as post-operative depression goes, you should be expecting some of those experiencing massive weight loss to have bouts of depression related to their weight loss or to their post-surgical morbidities. There is nothing wrong with having these bouts. There is, however, something wrong in worrying about what might be the etiology of any person's depression. You are playing God. The important thing is to get them treated along with the morbidities attending the surgery. What you ought to be doing, then, is helping to get some help rather than trying to come up with some grand insight. No one, not even the best shrink or the best test, could have predicted how would feel after her surgery, so all of this blathering about who gave her the okay is malarkey, too. Many people are negative about outcomes but positive as hell afterwards. Let's hope that gets some help and eventually gets positive. This shrink business has all the elements of Salem Massachusetts and witch hunting. It is obvious that it is being misused by these surgeons to predict outcomes that are unpredictable, and that they are using these tests to cover their asses when their asses would be better covered by simply giving better followup care of a medical, surgical, or psychiatric type when appropriate. ***************** to a certain extent I agree. I do believe that properly done psych evals might uncover persons who believe they will not succeed, or persons who have no support system. Those persons might be encouraged to identify support groups and to speak to successful post ops to build their " success mentality " before surgery. We all know that a positive mental outlook assists in a positive physical recovery. I think many of the psych evals are poorly thought out and not really effective. However, I've seen some posts from people that have really flipped out over the psych evals and most of them seem to end up not having surgery. I think a psych eval with a doctor who specializes in evaluating bariatric patients, and then possibly 2-3 pre-op visits and say 2-3 post op visits with a transition to a person's own mental health provider would be a good way to go. Dr. requires that people see psych docs on her team. That way, she knows that they know what to look for. I don't say that method is perfect but it's the best type of method I've seen to date. becki ===== Becki, near Portland, OR BMI 50-ish, age 42 pre-op DS. hoping to get approval through Aetna Traditional Choice (fighting 'investigational' denial) Consulted with Dr. on 3-13-01 psych ok, nutrition ok, beckeye_58@... __________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 12, 2001 Report Share Posted July 12, 2001 At 11:05 PM -0700 7/11/01, becki becki wrote: >... >I think a psych eval with a doctor who specializes in >evaluating bariatric patients, and then possibly 2-3 >pre-op visits and say 2-3 post op visits with a >transition to a person's own mental health provider >would be a good way to go. What're you, CRAZY??? () [meant as a joke...not an attack] There are enough pre-op hoops to jump through to get the surgery as it is. Now you want to add even more obstacles, not to mention expense? I could not disagree more with you. --Steve (..crazy 'bout you, Baby!) -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 12, 2001 Report Share Posted July 12, 2001 At 11:05 PM -0700 7/11/01, becki becki wrote: >... >I think a psych eval with a doctor who specializes in >evaluating bariatric patients, and then possibly 2-3 >pre-op visits and say 2-3 post op visits with a >transition to a person's own mental health provider >would be a good way to go. What're you, CRAZY??? () [meant as a joke...not an attack] There are enough pre-op hoops to jump through to get the surgery as it is. Now you want to add even more obstacles, not to mention expense? I could not disagree more with you. --Steve (..crazy 'bout you, Baby!) -- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 12, 2001 Report Share Posted July 12, 2001 Becki, This psych business is problematic. If you believe in what Dr. Emma is doing in discriminating against fat people by forcing them to take unpredictive, unnecessary, and expensive psych tests is the best way to proceed, then you have faith in her system and no argument or set of facts is going to change your commitment to her and her psychological voodoo. You believe! The MMPI is not predictive as to weight loss outcomes--according to the literature, but at least, using the MMPI, Doc can get rid of all those who do not believe in her and her voodoo. Using psych tests and interviews can be a really nasty and evil way on forcing compliant attitudes in patients. This is exactly the sort of thing that Rutledge of MGB fame engaged in with all of his hoops for prospective patients. He would reject some patients simply in order to create an atmosphere of fear and trembling. The patients getting surgery these days are, by and large, the compliant ones. The bottom line on all this is that we are seeing a lot of morbidly obese people being discriminated against and rejection for real or imagined psychological dearths. This is why those like Dr. , who have embraced a higher psychiatric standard than the ASBS Guidelines are stepping in a cesspool and are, in fact, unwittingly engaged in malpractice while at the same time playing God. Any MO patient who is not obviously psychotic regardless of attitude has a right to WLS. We know from patient experience that pre- and post-operative depressions can be treated and that the new size of the stomach and its new personality tend to govern ultimate weight-loss outcomes much more than any psychological test or psychiatric predictions or patient attitude as to outcome. If some of these surgeons took the ASBS Guidelines a little more seriously and their huge egos a little less so, then MOs could get the surgery that they need without having to buy into the egos of their surgeons. The role of the shrink in weight loss surgery is not gate-keeper. This is malpractice, except with respect to the obviously psychotic. The role of the shrink in WLS should be wholly supportive. To use psychology tests and psychiatrists and psychologists as gate-keepers is discriminatory and elitist. It is wrong to deny surgery to someone because they have a lousy attitude about surgical outcomes or the surgeon or even WLS. People often have cynical expectations because those expectations help them deal with future hurt. Low or negative expectations are not, generally speaking, an indication of psychosis or a reason for denial of WLS. Let the ultimate results speak for themselves. --- becki becki wrote: > Leonard said: > Message: 16 > Date: Wed, 11 Jul 2001 19:20:14 -0700 (PDT) > > Subject: Re: Re: What can we learn from ? > > Dear Psychology Experts, > > Eliminating people from having WLS because they do not > have 'normal' > psychosocial backup or > support groups is going to eliminate most guys, in my > limited > experience, from much needed WLS for > super and plain old morbid obesity. I was at a WLS > meeting the other > night, and not one of the > humungous guys there had any such backup. So you are > projecting your > values on the population of > all fatties. You cannot, generally speaking, diagnose > accurately mental > illness by a single trait > such as whether or not someone has plenty of support, > nor can you > predict how someone is going to > react to an unknown complex of post-surgical > 'challenges'. Life ain't > that simple. Preliminary > diagnoses using DSMs, which is how the shrinks do it, > normally involves > a constellation of traits > or behaviors; nor are their diagnostics the last word > on anything, for > that matter. > > These psychological exams are a can of worms. They are > rejecting people > because they don't like > doctors or have antisocial feelings, etc. They have > you believing in > their voodoo. There are > simply too many variables involved and insufficient > data to make > realistic predictions as to what > could happen post-surgically. This is like trying to > predict the > weather a month from now. It's > all guesswork. The ASBS surgical guidelines, which are > the specialty > guidelines, do not deny > surgery to anyone unless they are obviously psychotic. > This means that > all of us neurotic, > finger-nail-biting fatsos who are ready to burst into > tears the moment > someone looks cross-eyed at > us should be able to get surgery. It also means that > you are being > hassled about your psychic > state by surgeons who are a little confused about > psychological issues. > The NIH guidelines really > don't say anything different, though they amount to a > plea to use as > many disciplines as the > surgeons find necessary. This is why the dietitians > and the shrinks are > getting a piece of the > pie. The surgeons are just being generous with the > insurance companies > or your money. > > As far as post-operative depression goes, you should > be expecting some > of those experiencing > massive weight loss to have bouts of depression > related to their weight > loss or to their > post-surgical morbidities. There is nothing wrong with > having these > bouts. There is, however, > something wrong in worrying about what might be the > etiology of any > person's depression. You are > playing God. The important thing is to get them > treated along with the > morbidities attending the > surgery. What you ought to be doing, then, is helping > to get some > help rather than trying to > come up with some grand insight. No one, not even the > best shrink or > the best test, could have > predicted how would feel after her surgery, so > all of this > blathering about who gave her the > okay is malarkey, too. Many people are negative about > outcomes but > positive as hell afterwards. > Let's hope that gets some help and eventually > gets positive. > > This shrink business has all the elements of Salem > Massachusetts and > witch hunting. It is obvious > that it is being misused by these surgeons to predict > outcomes that are > unpredictable, and that > they are using these tests to cover their asses when > their asses would > be better covered by simply > giving better followup care of a medical, surgical, or > psychiatric type > when appropriate. > > ***************** > > to a certain extent I agree. > I do believe that properly done psych evals might > uncover persons who believe they will not succeed, or > persons who have no support system. Those persons > might be encouraged to identify support groups and to > speak to successful post ops to build their " success > mentality " before surgery. We all know that a positive > mental outlook assists in a positive physical > recovery. > > I think many of the psych evals are poorly thought out > and not really effective. However, I've seen some > posts from people that have really flipped out over > the psych evals and most of them seem to end up not > having surgery. > > I think a psych eval with a doctor who specializes in > evaluating bariatric patients, and then possibly 2-3 > pre-op visits and say 2-3 post op visits with a > transition to a person's own mental health provider > would be a good way to go. > > Dr. requires that people see psych docs on > her team. That way, she knows that they know what to > look for. I don't say that method is perfect but it's > the best type of method I've seen to date. > > becki > > > ===== > Becki, near Portland, OR > BMI 50-ish, age 42 > pre-op DS. hoping to get approval > through Aetna Traditional Choice > (fighting 'investigational' denial) > Consulted with Dr. on 3-13-01 > psych ok, nutrition ok, beckeye_58@... > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 12, 2001 Report Share Posted July 12, 2001 Becki, This psych business is problematic. If you believe in what Dr. Emma is doing in discriminating against fat people by forcing them to take unpredictive, unnecessary, and expensive psych tests is the best way to proceed, then you have faith in her system and no argument or set of facts is going to change your commitment to her and her psychological voodoo. You believe! The MMPI is not predictive as to weight loss outcomes--according to the literature, but at least, using the MMPI, Doc can get rid of all those who do not believe in her and her voodoo. Using psych tests and interviews can be a really nasty and evil way on forcing compliant attitudes in patients. This is exactly the sort of thing that Rutledge of MGB fame engaged in with all of his hoops for prospective patients. He would reject some patients simply in order to create an atmosphere of fear and trembling. The patients getting surgery these days are, by and large, the compliant ones. The bottom line on all this is that we are seeing a lot of morbidly obese people being discriminated against and rejection for real or imagined psychological dearths. This is why those like Dr. , who have embraced a higher psychiatric standard than the ASBS Guidelines are stepping in a cesspool and are, in fact, unwittingly engaged in malpractice while at the same time playing God. Any MO patient who is not obviously psychotic regardless of attitude has a right to WLS. We know from patient experience that pre- and post-operative depressions can be treated and that the new size of the stomach and its new personality tend to govern ultimate weight-loss outcomes much more than any psychological test or psychiatric predictions or patient attitude as to outcome. If some of these surgeons took the ASBS Guidelines a little more seriously and their huge egos a little less so, then MOs could get the surgery that they need without having to buy into the egos of their surgeons. The role of the shrink in weight loss surgery is not gate-keeper. This is malpractice, except with respect to the obviously psychotic. The role of the shrink in WLS should be wholly supportive. To use psychology tests and psychiatrists and psychologists as gate-keepers is discriminatory and elitist. It is wrong to deny surgery to someone because they have a lousy attitude about surgical outcomes or the surgeon or even WLS. People often have cynical expectations because those expectations help them deal with future hurt. Low or negative expectations are not, generally speaking, an indication of psychosis or a reason for denial of WLS. Let the ultimate results speak for themselves. --- becki becki wrote: > Leonard said: > Message: 16 > Date: Wed, 11 Jul 2001 19:20:14 -0700 (PDT) > > Subject: Re: Re: What can we learn from ? > > Dear Psychology Experts, > > Eliminating people from having WLS because they do not > have 'normal' > psychosocial backup or > support groups is going to eliminate most guys, in my > limited > experience, from much needed WLS for > super and plain old morbid obesity. I was at a WLS > meeting the other > night, and not one of the > humungous guys there had any such backup. So you are > projecting your > values on the population of > all fatties. You cannot, generally speaking, diagnose > accurately mental > illness by a single trait > such as whether or not someone has plenty of support, > nor can you > predict how someone is going to > react to an unknown complex of post-surgical > 'challenges'. Life ain't > that simple. Preliminary > diagnoses using DSMs, which is how the shrinks do it, > normally involves > a constellation of traits > or behaviors; nor are their diagnostics the last word > on anything, for > that matter. > > These psychological exams are a can of worms. They are > rejecting people > because they don't like > doctors or have antisocial feelings, etc. They have > you believing in > their voodoo. There are > simply too many variables involved and insufficient > data to make > realistic predictions as to what > could happen post-surgically. This is like trying to > predict the > weather a month from now. It's > all guesswork. The ASBS surgical guidelines, which are > the specialty > guidelines, do not deny > surgery to anyone unless they are obviously psychotic. > This means that > all of us neurotic, > finger-nail-biting fatsos who are ready to burst into > tears the moment > someone looks cross-eyed at > us should be able to get surgery. It also means that > you are being > hassled about your psychic > state by surgeons who are a little confused about > psychological issues. > The NIH guidelines really > don't say anything different, though they amount to a > plea to use as > many disciplines as the > surgeons find necessary. This is why the dietitians > and the shrinks are > getting a piece of the > pie. The surgeons are just being generous with the > insurance companies > or your money. > > As far as post-operative depression goes, you should > be expecting some > of those experiencing > massive weight loss to have bouts of depression > related to their weight > loss or to their > post-surgical morbidities. There is nothing wrong with > having these > bouts. There is, however, > something wrong in worrying about what might be the > etiology of any > person's depression. You are > playing God. The important thing is to get them > treated along with the > morbidities attending the > surgery. What you ought to be doing, then, is helping > to get some > help rather than trying to > come up with some grand insight. No one, not even the > best shrink or > the best test, could have > predicted how would feel after her surgery, so > all of this > blathering about who gave her the > okay is malarkey, too. Many people are negative about > outcomes but > positive as hell afterwards. > Let's hope that gets some help and eventually > gets positive. > > This shrink business has all the elements of Salem > Massachusetts and > witch hunting. It is obvious > that it is being misused by these surgeons to predict > outcomes that are > unpredictable, and that > they are using these tests to cover their asses when > their asses would > be better covered by simply > giving better followup care of a medical, surgical, or > psychiatric type > when appropriate. > > ***************** > > to a certain extent I agree. > I do believe that properly done psych evals might > uncover persons who believe they will not succeed, or > persons who have no support system. Those persons > might be encouraged to identify support groups and to > speak to successful post ops to build their " success > mentality " before surgery. We all know that a positive > mental outlook assists in a positive physical > recovery. > > I think many of the psych evals are poorly thought out > and not really effective. However, I've seen some > posts from people that have really flipped out over > the psych evals and most of them seem to end up not > having surgery. > > I think a psych eval with a doctor who specializes in > evaluating bariatric patients, and then possibly 2-3 > pre-op visits and say 2-3 post op visits with a > transition to a person's own mental health provider > would be a good way to go. > > Dr. requires that people see psych docs on > her team. That way, she knows that they know what to > look for. I don't say that method is perfect but it's > the best type of method I've seen to date. > > becki > > > ===== > Becki, near Portland, OR > BMI 50-ish, age 42 > pre-op DS. hoping to get approval > through Aetna Traditional Choice > (fighting 'investigational' denial) > Consulted with Dr. on 3-13-01 > psych ok, nutrition ok, beckeye_58@... > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 12, 2001 Report Share Posted July 12, 2001 Garguy...(sorry, don't know your name), I question to you then would be - were you the surgeon, with consults being scheduled out 3 to 4 months in advance, seeing 5 new patients a day, taking your time to carefully acquaint yourself with your patients physical concerns primarily - would you be able to readily identify those who were " obviously psychotic. " I've worked in the mental health field and I'll tell you some of the most wacked out people come across as the most " normal " and " well-adjusted " of individuals - sometimes for months at a time - and then there's a " snap " and you can't imagine them to even be the same person. Sorry you have such a poor regard for Dr. . I hope you have met with her face to face and had enough interaction with her to draw your conclusions so - well - conclusively! I for one did quite a bit of research on her, sought the opinion of her peers, and above all - my very honored and trusted PCP feels that she is an outstanding surgeon and would choose her for herself if she were in need of this surgery. Dina in Aloha, OR Age 37/BMI 61 Waiting for my consult with Dr. Hoping my new insurance will cover it all.... Re: Re: What can we learn from ? > > Dear Psychology Experts, > > Eliminating people from having WLS because they do not > have 'normal' > psychosocial backup or > support groups is going to eliminate most guys, in my > limited > experience, from much needed WLS for > super and plain old morbid obesity. I was at a WLS > meeting the other > night, and not one of the > humungous guys there had any such backup. So you are > projecting your > values on the population of > all fatties. You cannot, generally speaking, diagnose > accurately mental > illness by a single trait > such as whether or not someone has plenty of support, > nor can you > predict how someone is going to > react to an unknown complex of post-surgical > 'challenges'. Life ain't > that simple. Preliminary > diagnoses using DSMs, which is how the shrinks do it, > normally involves > a constellation of traits > or behaviors; nor are their diagnostics the last word > on anything, for > that matter. > > These psychological exams are a can of worms. They are > rejecting people > because they don't like > doctors or have antisocial feelings, etc. They have > you believing in > their voodoo. There are > simply too many variables involved and insufficient > data to make > realistic predictions as to what > could happen post-surgically. This is like trying to > predict the > weather a month from now. It's > all guesswork. The ASBS surgical guidelines, which are > the specialty > guidelines, do not deny > surgery to anyone unless they are obviously psychotic. > This means that > all of us neurotic, > finger-nail-biting fatsos who are ready to burst into > tears the moment > someone looks cross-eyed at > us should be able to get surgery. It also means that > you are being > hassled about your psychic > state by surgeons who are a little confused about > psychological issues. > The NIH guidelines really > don't say anything different, though they amount to a > plea to use as > many disciplines as the > surgeons find necessary. This is why the dietitians > and the shrinks are > getting a piece of the > pie. The surgeons are just being generous with the > insurance companies > or your money. > > As far as post-operative depression goes, you should > be expecting some > of those experiencing > massive weight loss to have bouts of depression > related to their weight > loss or to their > post-surgical morbidities. There is nothing wrong with > having these > bouts. There is, however, > something wrong in worrying about what might be the > etiology of any > person's depression. You are > playing God. The important thing is to get them > treated along with the > morbidities attending the > surgery. What you ought to be doing, then, is helping > to get some > help rather than trying to > come up with some grand insight. No one, not even the > best shrink or > the best test, could have > predicted how would feel after her surgery, so > all of this > blathering about who gave her the > okay is malarkey, too. Many people are negative about > outcomes but > positive as hell afterwards. > Let's hope that gets some help and eventually > gets positive. > > This shrink business has all the elements of Salem > Massachusetts and > witch hunting. It is obvious > that it is being misused by these surgeons to predict > outcomes that are > unpredictable, and that > they are using these tests to cover their asses when > their asses would > be better covered by simply > giving better followup care of a medical, surgical, or > psychiatric type > when appropriate. > > ***************** > > to a certain extent I agree. > I do believe that properly done psych evals might > uncover persons who believe they will not succeed, or > persons who have no support system. Those persons > might be encouraged to identify support groups and to > speak to successful post ops to build their " success > mentality " before surgery. We all know that a positive > mental outlook assists in a positive physical > recovery. > > I think many of the psych evals are poorly thought out > and not really effective. However, I've seen some > posts from people that have really flipped out over > the psych evals and most of them seem to end up not > having surgery. > > I think a psych eval with a doctor who specializes in > evaluating bariatric patients, and then possibly 2-3 > pre-op visits and say 2-3 post op visits with a > transition to a person's own mental health provider > would be a good way to go. > > Dr. requires that people see psych docs on > her team. That way, she knows that they know what to > look for. I don't say that method is perfect but it's > the best type of method I've seen to date. > > becki > > > ===== > Becki, near Portland, OR > BMI 50-ish, age 42 > pre-op DS. hoping to get approval > through Aetna Traditional Choice > (fighting 'investigational' denial) > Consulted with Dr. on 3-13-01 > psych ok, nutrition ok, beckeye_58@... > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 12, 2001 Report Share Posted July 12, 2001 Garguy...(sorry, don't know your name), I question to you then would be - were you the surgeon, with consults being scheduled out 3 to 4 months in advance, seeing 5 new patients a day, taking your time to carefully acquaint yourself with your patients physical concerns primarily - would you be able to readily identify those who were " obviously psychotic. " I've worked in the mental health field and I'll tell you some of the most wacked out people come across as the most " normal " and " well-adjusted " of individuals - sometimes for months at a time - and then there's a " snap " and you can't imagine them to even be the same person. Sorry you have such a poor regard for Dr. . I hope you have met with her face to face and had enough interaction with her to draw your conclusions so - well - conclusively! I for one did quite a bit of research on her, sought the opinion of her peers, and above all - my very honored and trusted PCP feels that she is an outstanding surgeon and would choose her for herself if she were in need of this surgery. Dina in Aloha, OR Age 37/BMI 61 Waiting for my consult with Dr. Hoping my new insurance will cover it all.... Re: Re: What can we learn from ? > > Dear Psychology Experts, > > Eliminating people from having WLS because they do not > have 'normal' > psychosocial backup or > support groups is going to eliminate most guys, in my > limited > experience, from much needed WLS for > super and plain old morbid obesity. I was at a WLS > meeting the other > night, and not one of the > humungous guys there had any such backup. So you are > projecting your > values on the population of > all fatties. You cannot, generally speaking, diagnose > accurately mental > illness by a single trait > such as whether or not someone has plenty of support, > nor can you > predict how someone is going to > react to an unknown complex of post-surgical > 'challenges'. Life ain't > that simple. Preliminary > diagnoses using DSMs, which is how the shrinks do it, > normally involves > a constellation of traits > or behaviors; nor are their diagnostics the last word > on anything, for > that matter. > > These psychological exams are a can of worms. They are > rejecting people > because they don't like > doctors or have antisocial feelings, etc. They have > you believing in > their voodoo. There are > simply too many variables involved and insufficient > data to make > realistic predictions as to what > could happen post-surgically. This is like trying to > predict the > weather a month from now. It's > all guesswork. The ASBS surgical guidelines, which are > the specialty > guidelines, do not deny > surgery to anyone unless they are obviously psychotic. > This means that > all of us neurotic, > finger-nail-biting fatsos who are ready to burst into > tears the moment > someone looks cross-eyed at > us should be able to get surgery. It also means that > you are being > hassled about your psychic > state by surgeons who are a little confused about > psychological issues. > The NIH guidelines really > don't say anything different, though they amount to a > plea to use as > many disciplines as the > surgeons find necessary. This is why the dietitians > and the shrinks are > getting a piece of the > pie. The surgeons are just being generous with the > insurance companies > or your money. > > As far as post-operative depression goes, you should > be expecting some > of those experiencing > massive weight loss to have bouts of depression > related to their weight > loss or to their > post-surgical morbidities. There is nothing wrong with > having these > bouts. There is, however, > something wrong in worrying about what might be the > etiology of any > person's depression. You are > playing God. The important thing is to get them > treated along with the > morbidities attending the > surgery. What you ought to be doing, then, is helping > to get some > help rather than trying to > come up with some grand insight. No one, not even the > best shrink or > the best test, could have > predicted how would feel after her surgery, so > all of this > blathering about who gave her the > okay is malarkey, too. Many people are negative about > outcomes but > positive as hell afterwards. > Let's hope that gets some help and eventually > gets positive. > > This shrink business has all the elements of Salem > Massachusetts and > witch hunting. It is obvious > that it is being misused by these surgeons to predict > outcomes that are > unpredictable, and that > they are using these tests to cover their asses when > their asses would > be better covered by simply > giving better followup care of a medical, surgical, or > psychiatric type > when appropriate. > > ***************** > > to a certain extent I agree. > I do believe that properly done psych evals might > uncover persons who believe they will not succeed, or > persons who have no support system. Those persons > might be encouraged to identify support groups and to > speak to successful post ops to build their " success > mentality " before surgery. We all know that a positive > mental outlook assists in a positive physical > recovery. > > I think many of the psych evals are poorly thought out > and not really effective. However, I've seen some > posts from people that have really flipped out over > the psych evals and most of them seem to end up not > having surgery. > > I think a psych eval with a doctor who specializes in > evaluating bariatric patients, and then possibly 2-3 > pre-op visits and say 2-3 post op visits with a > transition to a person's own mental health provider > would be a good way to go. > > Dr. requires that people see psych docs on > her team. That way, she knows that they know what to > look for. I don't say that method is perfect but it's > the best type of method I've seen to date. > > becki > > > ===== > Becki, near Portland, OR > BMI 50-ish, age 42 > pre-op DS. hoping to get approval > through Aetna Traditional Choice > (fighting 'investigational' denial) > Consulted with Dr. on 3-13-01 > psych ok, nutrition ok, beckeye_58@... > > __________________________________________________ > Quote Link to comment Share on other sites More sharing options...
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