I survived!

I survived graduation without eating an entire town! I could NEVER have done this before surgery.  I was able to work 50 hours a week, do my clinical internship (20-30 hours), while taking two grad classes post-op.  I love my sleeve!  I know officially have a masters degree, and can sit for licensure.  

It's hard to believe it's almost a year out! I think teeny stomach is settling down, finally.  Harvey (yes, I name my organs) is finally starting to behave, somewhat. I was finally able to eat sashimi and spicy food again. The later is tricky because, no drinking, and such.  However, boy did I miss it.  I eat it in moderation and infrequently, but I find I enjoy it far more now, too.

I can't eat certain things.  Chicken is still like a rock in my stomach.  Beef and lamb, paradoxically, are the easiest to digest.  I can't eat Chinese at all, unless it's steamed.  Even stir-fried without the sauce is horrible.  I'm actually okay with that.  I don't miss it, which surprises me.

I still need a knee replacement.  I have degenerative disk disease (reversible), and I'm not as mobile as I want to be.  I'm alive, however, and able to live my life - and it slowly gets better a day at a time.

I still fight with my binge eating disorder and my food addiction.  I don't always succeed.  However, I get right back on task immediately.  One bite can't turn into one meal because one meal turns into "well I may as well start tomorrow..."  None of that nonsense!  I stay in counseling to manage this because I refuse to waste the gift of surgery.  I refuse to keep anything I can't eat in the house.  Whenever I get food as a gift, out it goes!  Whenever people try to shove it in my face at work, out it goes!

Hopefully in a few years I will be working in bariatrics myself as a counselor after I get experience.  We will see. :)

Congratulations for all you have accomplished this past year! Nothing short of awesome, really! Kudos on the Masters! That is truly wonderful. 

You have done great this year and I applaud you for being so open about and working on coming to terms with your binge eating disorder. That is a monumental task. I love your honesty around the issue, too. It sounds as if you have said goodbye to any shame and understand that binge eating is simply part of who you were, but not part of who you want to be. Big, big stuff you're taking control of! 

Yeah, you rock! 

I try to be open about it because I know how hard it is to go through.  I want to work with food addiction post-graduation, however there is almost no psychological support for it profession-wise, because we don't have a diagnosis for it.  That's a huge shame, since I think it's far more common than is believed.

Thank you for your kind words, kairk!  I've always appreciated your posts and inspiration :)

UC Berkeley offers a certificate in eating disorders. It's done through their extension and some of it (if not all) can be done on line. While it's not a degree, the courses offer a great deal of insight on how to work with patients with eating disorders and identifying different manifestations of eating disorders. 

As far as diagnosis, are you sure about that? On my medical records it clearly states I have had psychological treatment for disordered eating. I was irked about it, too. I went to the psychologist at my PCPs recommendation. I was suffering from depression and that in turn led me to not having a handle on my eating. Vicious cycle. Long story, but the short of it is, I do think it's now a used diagnosis. 

Thanks for that information, I'll check it out for sure!

And yep, there's no official medical diagnosis for "disordered eating" or food addiction at all.  I diagnose people all the time, and so I'm familiar with the criteria.  Having said that, you can be treated for "disordered eating," but I can't bill insurance for disordered eating as a diagnosis.  You would need to ask the provider what the official diagnosis is.  The primary purpose of diagnosis is to determine pathology, but the main reason we use it is because we cannot receive an insurance compensation without a diagnosis.  Then, many doctors (especially older non-psychiatric specialists) will not refer out because they are not "real" diagnoses according to their criteria.  

I was told by three psychologists who do bariatric assessment (some of the best in the country - I live near Chicago) to not bother with post-op bariatrics as a specialty because surgeons won't refer clients to me due to a lack of diagnoses that are appropriate.  I was also told that we bariatric patients are too lazy to want to go.  My response was super colorful, let me tell you!  They said this before they found out I was one myself, heh.

Here's how it works: while there's no official medical diagnosis for "disordered eating" or food addiction at all, at the same time, you can be treated for "disordered eating," but I can't bill insurance for disordered eating as a diagnosis.  You would need to ask the provider what the official diagnosis is.  The primary purpose of diagnosis is to determine pathology, of course, but honestly we are required by insurance to make one.  So that means even if you don't have a mental illness, if I see you in counseling and you want your insurance to pay for it, I have to diagnose you.  It's annoying for us as clinicians because many people can benefit from therapy without diagnoses, because they need the support and assistance, but don't have pure pathology.  I treat people for disordered eating all the time, but it's not their diagnosis.  Most have an eating disorder, or even no eating disorder at all; most clients have major depressive disorder, bipolar disorder, or an adjustment disorder.  I have major depressive disorder myself, and it went untreated for so long long before I was an adult, that by the time I was in my 20s, I had developed an eating disorder from the compensatory behavior (thanks parents).

The problem with not being able to bill disordered eating or food addiction, is that I can't, say, work with a surgical practice as their counselor and bill.  I have to be creative in my diagnostic criteria to some degree.  It also means it's less likely doctors would refer out, since they aren't "real" diagnostic criteria.  It sounds very BS, and it is.  

At any rate, I'd have to see the psychologist's notes to comment in more detail in your case.  I can't diagnose clients with food addiction or disordered eating; insurance won't pay me for that because they are not medical diagnoses in the DSM 5 or ICD-10.  For example, I've always had binge eating disorder, but I was not diagnosed with it until 2013, because before then it didn't exist in medical criteria.

If you're curious, these are what are considered eating disorders that are billable conditions.  As someone with mental health issues myself it's always been frustrating.  Anyway, I don't have my diagnostic manuals here, but off the top of my head the only DSM 5 diagnoses for eating are:

anorexia nervosa
bulimia nervosa
binge eating disorder
eating disorder not otherwise specified
pica
rumination disorder
avoidant/restrictive food intake disorder 
other specified feeding or eating disorder (OSFED) (generally atypical variants of the above, as well as night eating syndrome or a purely purging disorder)
unspecified feeding or eating disorder (UFED)

Thanks for all that info. I will have to ask what my "official" diagnosis is. I bet it's depression of some sort. 

Congratulations on your one year anniversary.  I'm so happy to hear you are doing so well.  And congratulation on your Masters degree.  You are doing great!

Carol

Congrats on your degree and success with Harvey. Here's too a long and happy relationship with Harvey.   What have you named your pancreas? LOL . I think I will name my liver "Merlot" . again, good job.   diane s

Haha, Merlot is the best name ever for a liver!  The pancreas has behaved so it hasn't earned a name yet.  Maybe Horatio?