Psych Eval Importance?

Today I got my copy of the psych eval; I meet with Dr. Rawlins again on April 18th for the 2nd time and hope to show him I am a good candidate. At the first appointment he was very discouraging, probably because I am a past VBG patient who failed the surgery. He ordered more tests for physical questions (EGD, Upper GI) which I have already completed as well as the first nutritional consult and now the psych eval. There are several inaccuracies in the psych eval report that I will go over w/Dr. Rawlins but what concerns me is the overall tone. Wondering if it is going to negatively influence him. ? What do you think of these excerpts: "She is likely at a mild level of a dysthymic condition (this means mild depression) which can exacerbate to a moderate level of severity. At this level of severity, there could be limitations in self-management of her follow through requirements." And also this: "She is likely to be seen as good patient, but will make struggle to comply with her treatment regimen. This is likely related to her tendency to minimize emotional distress and treat these symptoms as physical complaints. There is some concern that her psychological features ocould complicate recovery." Does this sound bad or am I just worrying needlessly? The bit about physical complaints sounds wrong, when a person is under stress a lot of times it manifests itself in physical conditions...this is commonly known. Tension headache, for example. Any opinions? Thanks in advance. Molly

Hey Molly, I think if I was you, I wouldn't worry until I spoke with the surgeon. He may not see these remarks as a reason to NOT do surgery. I think that alot of your emotional problems are from being overweight and from failing the first surgery. Why did you fail the first time? And tell him that you are completely dedicated to make this surgery work this time. I mean, if you fail something once and are given a second chance to try again, you most likely will NOT fail the second time around! I am rooting for ya darlin. I hope that things work out for you. Lori

Thank you, Lori. I will try hard not to worry. Have wanted revision surgery for 5 years now and to be so close to it and then meet with what seems to be discouragement is tough. I think that I failed the VBG and in some way it failed me too. Dr. Schrock did it and didn't have any follow-up care beyond the basic visits and a support group would have been so helpful if he'd been part of it. We had one at Fairchild AFB for awhile but when I began having hunger and then stomach pain problems the weight loss stopped and everybody else was losing like crazy so i got discouraged. Then the group disbanded and I was pretty much on my own trying to figure out how to live with it. Over the years the weight just crept back. Dr. after Dr. would tell me to keep food on my stomach and I got into the habit of being a grazer in order to stave off the pain. And this wasn't hunger pain. (Even though I'm hungry about 30 minutes after I eat.) This is a bend-you-over, radiating pain that creeps up into my neck and back, I break out in a cold sweat and get short of breath because it hurts to breathe deeply. My heart checks out completely fine except for a childhood murmur. Two EGD's, two Upper GI's , ulcer test and a stomach biopsy show nothing. BUT...Dr. Rawlins and my latest PCM (in the military they change all the time) have me on Carafate syrup now in addition to my twice-daily prilosec and I am able to control the pain much better now and reduce the really severe attacks. I hope that I can convince Dr. Rawlins that like you said...one failure has made me so much more determined to be successful this time. At the psych eval, the Dr. said that studies show you have a much higher success percentage when you are part of a support group so that is now a very important factor for me. And if the once a month Rockwood clinic meeting isn't enough, apparently there are several more around town. All I have left to complete before seeing Dr. again is a yucky stool test. I am severely anemic for the first time in my life and the PCM is looking for hidden bleeding. My bloodwork is coming up bad (have even had my kidneys checked out recently) and we have to get to the bottom of it or I'm afraid that will be another roadblock to surgery. Well, not that I'd be so stupid as to expect to have surgery with an unknown physical problem. Thanks for listening, sorry to be so long winded. Molly

Hey Molly, I wouldn't worry too much about the dysthymic stuff. I actually have dysthymic disorder (chronic low-grade depression) along with Generalized Anxiety Disorder, and I'm good to go for the surgery. Part of the purpose of the eval is to show what you will need help with to be successful, so they may recommend seeing a counselor or something so you don't get sad and start emotional eating. The non-compliance stuff about your emotions=pain thing ticks me off though. That sounds like he didn't believe you about your pain level. I hate doctors that don't trust you to know your own body. I remember taking Mik (my husband) to the ER three times in 48 hours because they kept dismissing some weird pain he was having... They said it was part of his medical condition at the time. Turns out he had an infection. Anyways, let me know how it goes. I still haven't received my eval in the mail.

(in case you can access the web on your tdy)...Thanks, Karli. Did you get your copy of the eval yet? Hope you do soon. Can't believe you had to take your husband to the ER three times before he got an accurate diagnosis. That must be why they call it 'practicing' medicine. haha, old joke Talk about compliance, this week I am finally following the dietary restrictions for the last of my PCM tests (the stool shmear sample...ick). With one thing or another I just wasn't able to do it any earlier than this. Hope to have results back on it before I see Dr. Rawlins, but am cutting it close time-wise. For some reason I'm really anemic so I guess they are looking for an answer there. See you later this week. BTW, I am working this weekend too. Molly