Question:
I am being delayed because of my psych eval, please read. (LONG)

This is my problem. I went to my psych eval not too long ago. I was nervous, but not too bad. I went in there being confident and honest. I know I had a lot of problems in the past, but that was the past not now. So I was an open book. I answered everything honestly. Well to make a long story short I had a lot of messed up things happen to me (which I know we all do) and I had suffered from depression in the past and had a lot of food issues. Well this woman focused so much on my past I think anything now didn't matter. She didn't ask me enough questions about the present. The ones she did ask I was honest about and thought were good answeres. Example Q: when do you eat? A: when I am hungry. Next Q: do you have less stress in your life? A: No but I handle it better. Q: What do you know about the surgery. A: I gave a very detailied explaintion that I am sure you would have all been proud of. Well that is basically all the questions that pertained to the present. At the end I felt she rushed through and simply told me, keep a journal and I will see you in a month, I can't tell in one visit if someone will be able to follow the after care diet. Well that upset me enough, but I was okay with it. Well I come to find out from my surgeon's office that she recommended a six month evaluation and therapy before even making a decision. My financee called and asked if we could get a second opinion or anything, being concerned that I would have to wait 6 months and what a hard time I have. She told him, no second opinion but I could prove myself to this other woman and maybe I would't have to wait six months. I don't konw what to do. My knees are so bad I can hardly walk anymore. I am going to see my PCP the 18th and talk to him and see if he can do anything. Any advice? I am willing to keep seeing someone afterwards, but to wait for 6 months, I am afraid of what will happen to my body in the mean time. I am happier now than I have ever been. I am more stable, the only thing keeping me down is my weight and my health. what can i do? I am so scared. I am 26 years old 6ft and 410 pounds. I can barely do anything by myself anymore. I only leave the house for doctor appts. What can I do???? Thank you in advance. Is it fair that I be punished that things that have happened in the past???    — Female C. (posted on September 10, 2002)


September 10, 2002
I really suggest that you get a second opinion. Go to another psych and see what they have to say. If it is anything different from what this one has to say then have them write up a referral and submit that one to either your surgeon or insurance company. By the way, how are you supposed to prove yourself to her?
   — Teekay80

September 10, 2002
hiya hmmmm....was this shrink recommended by your surgeon? or did you pick her or were you referred to her by your insurance? i'm not sure but i think (at least with hmo's) you can request a 2nd opinion. i'd be very curious to see if you can get a copy of the shrink's evaluation and find out what she based her decision/recommendation on. don't give up whatever you do! there's got to be something you can do! hang in there, {hugs} kate feel free to email me anytime. [email protected] open rny 6-14-01 pre op: 268lbs goal weight: 135lbs current: 130lbs
   — jkb

September 10, 2002
is your doc office or your insurance requireing the eval? most doc office are content with a mmp test being adminatered and thats all the want? clarify who is asking for the eval and what exactly they want?!!! my eval was a simple mmp test.and was not required by the insurance but my surgeon... YOU ARE entitled to a second opion who said you were not? your surgeon? swich surgeons!!! (if so)
   — bekka K.

September 10, 2002
Hi this is the poster of the question. Thanks for your support. I wanted to say that the surgeon's secretary told my financee that people go and get second opinions and he doesn't take them into consideration, strictly goes by what this woman says. Second this is the only surgeon I can go to. Thank you so much for your support and ideas so far. I don't know what to do or think.
   — Female C.

September 10, 2002
I'd add my voice to the chorus of "get a second opinion." I can't imagine developing a good therapeutic relationship with somebody who's sitting there waiting for me to "prove myself" to them. Huh? Like the previous posters said, "prove what," exactly? Or, if the second opinion thing doesn't work for some reason, maybe you can strike a compromise and promise to attend therapy as part of your follow-up to surgery. What the heck, it might help, but why postpone surgery for that?? Lots of us have "issues" and past depression. I think the therapist has to be a lot less vague with you about what she expects to achieve in six months (!) before she's earned *YOUR* trust as a patient. Just my 2c!
   — Suzy C.

September 10, 2002
Ok, at the end of your session, the therapist said she would see you in one month. Keep the journal like she asked so that she can see you are able to follow directions! When you go back to her at the one month session, with the journal she requested, ask her to confirm that she recommended to your surgeon's office that you wait six months. If that truly is what she recommended, talk to her about how you feel about having to wait for six months. Perhaps if she hears how much you want this to happen and you will do whatever it takes to make this work, perhaps she will give you the authorization you need to proceed. If she tries to direct the focus of her questions about your past, try to bring her back to the present and how well you are doing NOW, not how poorly you did back THEN. I know you want to walk on eggshells so the therapist will give you the ok for surgery but I think it's good to get clear on what she recommended. It's a shame that the surgeon you really want would not consider a second opinion of a therapist. I find that questionable. Good luck to you at your one month appointment!
   — Jennifer A.

September 10, 2002
I just wanted to say I feel for you. I almost missed my WLS date because of a bad psych evaluation, but I scrambled at the last minute and found one recommended by my WLS doc. I am surprised that your WLS insists on only taking this doc's evaluation - I would think that they kind of work "hand in hand" if you know what I mean, and that unless you are writhing around on the floor crazy, a psych recommended by your WLS doc would approve you. It seems as if you're stuck between a rock and a hard place if you can't change WLS docs or psychs. Good luck!
   — rebeccamayhew

September 10, 2002
Find a new doctor to do the psych evaluation, and changes surgeons if need be. A psychological evaluation is performed ONLY to ensure 2 things: (1) that you know the risks associated with the procedure and are therefore able to give informed consent, and (2) that you are mentally competent enough to pursue your follow-up care (i.e., not severely mentally ill or mentally incapacitated in any significant way). Tell this to the psychologist/psychiatrist and and them WHY your evaluation had to go beyond these 2 simple tasks.
   — Patricia E.

September 10, 2002
When you go back to see the psychologist, tell her that you want to talk with her about the last session. Tell her how you felt about her focusing so much on the past. Point out what you have done to address past issues and how you deal with stress now. Speak confidently (as much as you can), and repectfully but firmly. She may see how good you are at handling your feeling appropriately (ie assertively). I am a therapist, but I work from a strength-based, solution focused model. While it is important to know what your past was like, it's more important to know what you do now to handle your feelings, and what supports you have in place. Let her know that if difficulites arise for you post-op, you will seek help. Good luck!
   — [Deactivated Member]

September 10, 2002
Hey our psych doc who approves ALL my surgeons patients dont put us thru what you did. E mail me and see Dr Paul Friday in Pittsburgh. He is a great doc and you should get approved on his first visit. Reasons for denials from him. Active alcohol or drug abuse, Not alert to understand what your going to put yourself thru and a very few with multi personality disorders like hannibal lecture. I have repaierd machimes in westlake, its a long but easily doable drive from pittsburgh. Me and Jen could have dinner with you before you return home.
   — bob-haller

September 11, 2002
Please get a second opinion. The psychiatrist that I went to said that in order to "fail" the exam, or merit a postponement such as the one you experienced you have display extremely severe behavior (which does not seem to be your case). In my doctor's exact words you have to be "very much out there; ie: you believe that by you having WLS, the population of China would be better off". The eval is not to see if you need therapy, but to verify that you are capable of making decisions and following through with their consequences. While counseling can be a good thing (I know it helps me), that's not the purpose of the evaluation. Very best luck with this. Hang in there!
   — Rebekah B.

September 11, 2002
Trixy you know my thoughts on this already, It suck's big time. I think you have got some good advice here though for when you go back to see her. I think and hope that you will be able to get through to her. You just need to know exactly what her concerns are so that you can confidently address them. If you can't get through to her on the second visit I'd try to have a talk with your surgeon directly about getting a second opinion. You and I have been chatting awhile and I know you are definitly ready for this surgery and it is so mean of her to make you wait. Carrie
   — Carrie D.

September 12, 2002
This is the poster of the question. I just want to thank you all for your posts. I really appreciate it and it helps a lot. You all gave me some great advice and I will use it. Thanks again for caring and understanding. :)
   — Female C.




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