Question:
I'm Bi Polar...........

is that going to be a major issue during the psych eval?    — [Anonymous] (posted on November 30, 2001)

November 29, 2001
I am bipolar also. I have been seeing a psychiatrist for years, so he did my psych eval. Although my surgeon isn't thrilled about doing this surgery on bipolar people, with a compitent psychiatrist, etc., I haven't had any problems, and you may not either. GOOD LUCK!!!
   — [Anonymous]

November 30, 2001
I had no problem with my psych evaluation. My insurance company (Kaiser) requires a psych evaluation to be approved to even see a bariatric surgeon. My regular psychiatrist was very supportive of me having the surgery and wrote a great letter to my insurance company. Once I was approved for surgery, I had to see a second psychiatrist and internist to be approved for surgery by my surgeon (required for all patients by Pacific Bariatrics in San Diego). I also passed both evaluations with flying colors. I didn't have to take any special tests...the psychiatrist just spent an hour asking me questions about why I wanted surgery, what were my expectations, did I have a support system in place and so on. Prior to surgery I was on Depakote and Prozac. I took both meds right until the day of surgery. The psychiatrist I saw for Pacific Bariatrics said I could restart the meds as soon as the surgeon said it was ok. She also suggested I switch to liquid forms of the meds for a short while until I could handle the pills. Two days after surgery, I tried my meds and my pouch reacted badly. I had the worse stomach pains and heartburn known to mankind. It didn't matter if I took the meds on the empty stomach or on a full stomach, it didn't like the meds. Even taking Prilosec didn't make a difference. On the advice of my regular psychiatrist, I switched back to pill form and split up the dosages. Same effect...a volcano kept erupting in my pouch. After a week of misery, I went off the meds cold turkey with the knowledge of my psychiatrist and surgeon (NEVER GO OFF MEDS COLD TURKEY WITHOUT A DOCTOR'S SUPERVISON--MAY CAUSE PSYCHOTIC EPISODE OR SEIZURES). Neither my surgeon or psychiatrist were happy about taking me off meds, but both feared I would damage my pouch from the heartburn. After a month, I tried the meds again and the same effect happened. So my surgeon and psychiatrist said to stay off the meds until further notice. I had to be closely monitored by my psychiatrist to make sure I didn't slip into a depression or psychotic episode. After six months I was finally able to restart the meds. I was starting to notice my moods swinging and I figured my tummy should be healed. My psychiatrist startd me at low doses and gradually raised the levels to where I was pre-op. This time no problems with tummy upset and my moods stopped swinging after a week. I'm now 11 months post-op and I've stopped taking my Prozac and have reduced my Depakote dosage. The only thing I noticed once I started back on the meds is my weight loss slowed down. My psychiatrist checked and discovered Depakote and sometimes Prozac can cause weight gain. So he adjusted the doses. Since I'm continuing to lose weight, I'm closely monitored by my psychiatrist so he can adjust my meds as necessary until my weight stabilizes. Granted, my experience with taking the meds post-op is rare. Most folks who were diagnosed with depression or bipolar disorder prior to surgery had no problem resuming their meds after surgery. I guess I was one of the unlucky ones. However having bipolar disorder will not exclude you from having surgery as long as you are stable prior to surgery and have a supportive psychiatrist. If you are unstable, are not under a psychiatrist's care or have a past problem with an eating disorder, then you may have problems getting approved. If you are going to see a different psychatrist from your regular one for your evaluation, you may want to ask your psychiatrist for a letter regarding the care you've received under his/her care, their support of the WLS and your current state of health. That will go a long way towards helping a psychiatrist who doesn't know your past make a good evaluation of your fitness for surgery.
   — Cynthia B.