3 Roadblocks to WLS - BED, Pain Management, and more.

Hi everyone haven't been here in awhile due to being told for 3 reasons I'm a horrible candidate for weight loss surgeries by one clinic. That really frustrated me as I feel I absolutely need this surgery, and most of my doctors agree.. except the clinic I went to *for* WLS. I was wondering if anyone here or x-posted other places online could help give me any ideas ... 

I'm 28 and I feel like I'm dying at my current weight, despite still being fairly young. I'm almost 400 lbs. and 5'6" if I wasn't in a wheelchair since about May 2014. I have about 12 different weight related diseases, some life threatening. I feel this is my last option, and it was just pulled off the table. In a sense I feel like I've been condemned to a slow and painful demise to not be overly dramatic lol but seriously here are some of My Roadblocks... 

Stumbling Blocks Are: 

1) Pain Management - I have intense pain from obesity and spinal fusion from 18 years ago, when at 10 years old I had severe scoliosis and had to have surgery to save my life. This is why at this weight I'm in a wheelchair and have to get steroid shots/take daily high doses of ibuprofen. I could be on narcotics (so there is a way around it) but those are addictive AND if I go on them at this young an age I have no where else to go from there if the pain becomes unbearable say in my 40s. I'd rather not go on narcotics if possible, but it's a possibility. The clinic I went to though said with my pain management now they don't' want me to have the surgery. They want me up and walking but there is the catch 22 - I wont wal****il I can lose the weight. My back doctors stress I need to lose weight quickly if I ever want to walk again. 

2) Binge Eating Disorder / BED - why I got here partially, is because I have been diagnosed with an eating disorder. I was actually in treatment for it in an eating disorder clinic when I lost the ability to walk in May 2014. You can't go to an eating disorder clinic around here unless you can walk. I feel this is another catch 22 - if I didn't have the eating disorder I wouldn't have gotten to be morbidly obese - and since I have BED - I can't have the surgery to really fix the morbid obesity. Help? I don't have the time with my back the way it is to go through the years of counseling that just *might* help me deal with my eating disorder, even that is "iffy". I know it takes a lot of work and I'm willing to do this work of course to save my life and mobility - I'm just afraid I don't have the time to do that right now - if I ever want to walk again. I believe I can overcome it to a point - but eventually I don't think I'll stay on the wagon the rest of my life unfortunately and that scares me - I mean 3 years maybe tops I could do, but I don't know about longer than that. I'm a very honest person and I know this would come up in my psych eval. I don't want to lie but I need to take a gamble on this surgery. 

and finally 3 is something I can't do anything about:

3) Being Emotionally Disabled - I have several psychiatric disorders due to being abused throughout my childhood and genetics. The clinic also sited this as a reason to not give me the surgery. I understand even the most adjusted person can have a psychiatric reaction, but I'm prepared to do what I have to do, if this happens after the surgery. They say it's too big of a risk. I say dying before your 30 is too, and all WLS is to a point a gamble. That and I feel I'm running out of time with all my obesity related diseases, most being barely controlled. 

Although most of my doctors (especially my back doctors) agree the best thing in the world for me would be a WLS, the only doctors who do not are the WLS clinic I went to. I understand WLS is not a cure all by any means, but I'm running out of time and I need answers. I've seen great results from some of my friends through WLS and results that were not so good. Some ended up in hospitals and I've known 2 people who have died from WLS. I personally knew them well. To me though I know this is the only way I might be able to walk again, and not die at a young age of diabetes, or heart disease (both of which I already have, I also have uncontrolled labile high blood pressure with 2 strong high bp medications already...) or several other disorders I have related to obesity.

I have no idea what to do, and like I said, it feels like I'm running out of time to help my mobility, and yes - possibly to stay alive, not to put too fine a point on it... I feel at an impasse - like my last option to live or walk again at least was just yanked away. Should I go to a different clinic for WLS? I know a few that might do the surgery on me anyway - but is that the right thing to do? 

Any supportive ideas are welcomed thank you

I don't have a lot of advice to offer you, but I know about the psychological deferral of surgery. My WLS program I went through required a psych screening before approving me for WLS. My psychologist who I went through said I was only a "fair" candidate for WLS due to my extreme generalized anxiety disorder and depression, and needed more counseling before she'd recommend it. It then turned into a whole big thing where my regular psychologist would kind of dangle it above my head that she didn't really KNOW if I was ready for WLS because of the anxiety I was suffering from her not clearing me for WLS. She finally cleared me, but it was really, REALLY stressful, and I felt it was an unnecessary stumbling block. I view WLS as a life-saving procedure. At 5'10", my heaviest was 477 lbs, and this medical professional thought it would be healthier for her to drag that out as long as possible instead of getting some of the strain off my heart, lungs, spine, knees, and hips. This psychologist acted like WLS was a prize that I had to be worthy of. What if they did that for people who needed a heart bypass, or an appendectomy??? "Sorry, we'd like to take your appendix out before it ruptures, but you are really stressed out about your appendix bursting. Maybe once you learn to cope better, we'll get that out."

I don't know you or your situation that well, but I know the feeling of having to keep reaching for a dangling carrot to get your life back. I'm sorry you're in that situation, and I hope things dramatically improve very soon!

Thank you for sharing your own struggle. It does seem that way sometimes, they basically said because of anxiety etc. I need to work on my emotional health for years probably before I can get the surgery. I don't have years, I'm fairly sure and so are my back doctors. If my back rods break that could very well be game over, and I can already feel them creaking in my back every single day. Talk about anxiety... it just goes to show - I don't have the time time to wait for this psychological deferral. Can I just promise to do all the work after the surgery? I just want to get it so I can walk, and probably so I can live. 

I also have uncontrolled issues (or well - barely controlled) diabetes, heart disease, and pulmonary issues. And several other join issues. I just wish I could live a normal life, and I wish I could get there without all this stress. I know what I need to do but it's like I can't find the help or people to help me get the surgery without jumping through ***Soooooo***** many hoops. Thank you for the well wishes, hopefully things do improve. 

I don't know if it's the right thing to do.  I definitely see the points that the WLS clinic makes.  Regardless of surgery type, we're not supposed to take NSAIDs long term.  Is it possible that you could use narcotics post-op just for a year or so until you lose enough weight that you're not in so much pain?  (I had to take a low dose of tramadol for about a year and didn't experience any addiction issues when I wanted to stop it.)  

Are you seeing a mental therapist now?  Surgery won't change the binge eating disorder - it's possible to eat around any surgery.  But therapy can help and that might encourage a center to work with you.  

I think that your thoughts here are also valid - it does seem like surgery could help.  So, in your shoes, I'd probably work on getting second opinions.  Is self-pay in Mexico an option at all?  

I just want a second opinion, although yes under regular cir****tances I do see the points of the first bariatric center. Some bariatric centers are more "picky" than others about who they feel is a candidate - this one is known to be very difficult but good. I'm thinking if I go to a more laid back clinic (and one that's closer to home) I might have a better outcome. I'm already on tramadol low dose and it barely touches the pain (also on high dose ibuprofen and gabapentin for nerve pain - still barely standing due to the pain of spinal stenosis or strangulation of the spinal cord). They want to possibly put me on methadone, which scares me but it's an option I guess. 

Yes I've seen therapists my entire life and I see one now. That doesn't specialize in eating disorders, nor does anyone in this area that takes my insurance. I've never in my life passed a psych eval so I don't know why it would change now. I have several serious genetic and PTSD related illnesses that will never go away - or at least take years to cope with my past trauma. I don't have that unfortunately. I don't know, I've never thought of Mexico (I live near Canada, about 50 miles away in upstate New York). I guess anything is possible. Thank you for your suggestions. 

Hey a fellow upstater here. I was just wondering which hospital did you go to? I went to Highland in Rochester. They take medicaid I believe. They were awesome. I just wasn't sure which way you were in NY. Also medical pot is going through legislation but it will be really well regulated and take a lot of work to get approved for it if lovely Cuomo has his way.

Hey - I'm up near Plattsburgh NY near Canada & Vermont, I've gone to Albany Med in Albany NY (3 hours away) and they were the ones that were EXTREMELY picky. I'm thinking of going to Dr. Hill in Saranac Lake for a 2nd opinion. I'm too far away from Rochester really I think for surgery (8 hours). I think you're right about Cuomo lol (our governor here in NY). My other alternatives are a) Saratoga Hospital, b) Burlington Fletcher Allen or c) trying to think really outside the box and go with someone near my parents ... God forbid... like Graber in Utica / someone in Syracuse, but I'm using that, because of our relationship dynamics, as a complete last option

Dr. Graber was my surgeon here in Syracuse at St. Joe's.  The process was incredibly smooth and he was fab; the whole office staff has been great from day one.  Something to think about...

Thank you for the recommendation. Since I'm on medicaid I've been on his waiting list since last May and haven't heard anything yet (usually takes over 9 months they said back in May if you are on Medicaid). It might be something to consider yes, when I hear back - hopefully soon.