Bipolar and Lap-Band

I am looking into Lap-Band Surgery. I have gained 160 pounds due to medication for Bipolar illness. I have been stable on meds for over three years now. I am afraid that since I am Bipolar that they might not concider me for this procedure. I have made a appointment with my PDoc to discuss this in case the surgen questions this. Has anyone had this procedure that is Bipolar ?

I am not bi-polar but i know there are people on the main message boards that are and are more then willing to give you advice. I hope you keep on plugging along for this sugery, gaining 160 pounds in three years can't be good for your internal organs even if it's from medication. Be Well, ANDI

Hi Debra, Many people who have WLS have depression, OCD, panic disorder, Bipolar Disorder, etc. The key is this: are you stable when medicated properly? If so, I can't see why you would be rejected as a candidate. I myself am (surgery was 9/11/06) am on all sorts of fun meds for issues mentioned above. The only one I had to stop was the time released meds, which for me was Welbutrin XL. I stayed on Paxil and Neurontin. On a positive note, since the surgery, I have been weaned off of the Neurontin! I didn't feel as moody and depressed, plus it made me VERY tired post-op. If you want, email me directly. My own "shrink" reviewed me pre-op and submitted her letter to my surgeon. They then asked her for a bit more info on me and then I was cleared. The point (again) is that on meds, I am very stable and no one would know I suffered from anything. Try not to make your Bipolar disorder the focus of your WLS mission. If your doctor feels it's ok, then try to relax. Just look into any time released meds pre-op; see if they come in a regular release type for crushing post-op. Good luck! -Karen

Debra: Hi! I have done hundreds of preop WLS psych consults. Although each surgeon and psychiatric prescriber may have different screening criteria, what is generally accepted is this. Many people w/ MO have psychological diagnoses, this is not an automatic exclusion to WLS! The purpose of the psychological consultation is to ensure that there is no severe psychological issue that would compromise your chances for success on the program, and to ensure you'll have adequate personalized support as you begin your post-operative life. This psychological service is an important and required portion of your weight loss surgery program. I also discuss: diet history, eating issues & insight into...Knowledge of surgery, risks, complications, outcomes..lifestyle needed for f/up, realistic expectatins etc! http://www.obesityhelp.com/morbidobesity/information/wlsjourney/your+psychiatrist.php What your psychiatrist needs to cover Your psychiatrist needs to include at least the following information: The reason for the evaluation How does the patient think the surgery will benefit him/her How long has obesity been a problem Sources of stress or concerns in present life Personal history (lives where, home situation, family interactions, etc) Medications Tobacco, alcohol, recreational drug use, if ever. (How long since) Family history (include physical abuse, child sexual abuse) Schooling Marital status (history to present) Behavioral observations Test results (validity indicators) Impression Your psychiatrist needs to rule out/look for the following: Drug use Alcohol use Untreated depression Suicidal tendencies Eating disorders Compliance issues Comprehension (Does the patient really understand the surgery and needed lifestyle changes?) Ability to make lifestyle changes Compliance in diet Compliance in exercise Understanding of the need for follow-up no matter how far away the patient lives Reliability Understanding that noncompliance puts them at risk Unrealistic expectations Inadequate support MMPI The psychiatrist (or psychologist) has to touch on all of the above areas of your life. A complete report from your psychiatrist is very important to include when you are asking for preapproval for bariatric surgery. Print out these instructions and send/take to your psychiatrist! *MANY DO NOT SUPPORT A MMPI! JUST FYI! The following is a suggested list of criteria, based on my experience and a review of the literature. http://www.cornellweightlosssurgery.org/pdf/psy_eva_let.pdf this is a link to cornells psych eval req. FYI. http://www.currentpsychiatry.com/pearls.asp Vol. 2, No. 1 / January 2003 Michael Menaster, MD, on Preparing patients for life after bariatric surgery Exclusion Criteria: *JAMIES* 1. Current drug & alcohol dependence/abuse (needs to be in remission >1 year). 2. Untreated and/or unstable mental illnesses: Depression, Bipolar disorder, Anxiety disorder, severe personality disorders or Thought disorders, need to be in treatment with minimal symptoms. 3. A history of near lethal or repetitive suicide attempts may require further evaluation. 4. Eating disorders: anorexia, bulimia, severe compulsive/binge eating with no ability to control intake. 5. Noncompliance issues & concerns (unwillingness to diet, exercise, or follow treatment recommendations). 6. Inability to give informed consent for treatment. 7. Inability to make lifestyle changes (ex. financially, psychosocially). 8. Unwillingness to follow post-surgical care. 9. Unrealistic surgical expectations, ambivalence about surgery or impulsiveness in decision-making regarding surgery. 10. Inadequate family supports or family hostility toward surgery. 11. Presence of unresolved severe situational stress that may interfere with patient's success/compliance: current divorce, job stress, financial issues or family issues. Please realize that the psychological evaluation is an important piece in the multi-disciplinary pre-operative evaluation of the bariatric patient, and I feel that a collaborative approach w/ WLS surgeons to exclusion criteria is imperative for success. It sounds as if for 3 yrs you have had stability w/ Bipolar DO that is a GOOD THING!!! What I'd want to know is that you'd continue to be CLOSELY followed w/ therapist & prescriber because of all the changes over the first few years w/ WLS. Also asking ahead how you will get your meds (some for Bipolar are huge) and w/ the band u may have to find alternative formulations (i.e. Depakote comes in sprinkles and syrup vs the HUGE DR or ER tabs). The tool may help w/ wt loss but some meds you are on may not only effect appetite they may have metabolic effects (i.e. atypical antipsychotics) that the band may/can not correct the underlying endocrine/metabolic changes that they can cause (it can help w/ the lifestyle choices though****reated Bipolar disorder though has to be weighed vs medication s/e risks as it can be even more dangerous (suicide, impulsivity etc). Do lots of research and make an educated and informed decision! Take Care, Jamie Ellis RN MS NPP Lap RNY 10/9/02 Dr. Singh 320/163 5'9'' (lost 45# before surgery) Plastics 6/9/04 & 11/11/2005 Dr. King http://www.obesityhelp.com/morbidobesity/members/profile.php?N=c1132518510 "Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"

After finding the correct medications for me. I have been stable for over three years. Meaning no thoughts of harming myself. Every thing that happened in the few years before seems like a bad dream. I see my PDoc when I am suppose to and really have had no problems at all over the past three years. If a problem comes up where I can't get my meds. Once the drug store couldnt get them. I call my PDoc asap. I know how important my medications are. Thats how I gained 160 pounds over the past eight years. I hate the weight gain and what it has done to me. But the medications are even more important than all of that. I see my PDoc tommorrow night to discuss wether he thinks this would be alright for me. I don't always agree with him but I do trust him and his judgement. I guess I will just have to wait and see what he says. Three years ago I did have a suicide attempt. Thats when they finnally found the right medications for me. I know I would never go there again. It was then I made up my mind to get well. I myself would have to think long and hard about this. Because it is after all a life time commitment. I know that I can stick with commitments because I have come so far mentally. I have done everything I have had to due for my mental health. Now I am hoping I can do the same for my phyisical well being. Wish me luck Huggers, Debra

I'm bipolar and had surgery last november. I was stable on my meds for a year when i was approved for surgery. My doctor did not seem overly concerned as long as i was at the point where i could make sound decisions. That's why there is a pysch evavalutation....that dr is who make the decision is you are "ok" to move forward. In my case my psychiatrist is who suggested the surgery to me GOOD LUCK!!! Aim