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Help Re: Psych Eval



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Dr Borao wants a psychiatric evaluation done (among other thing) before submitting to my insurance. My plan does not cover this and the Psychologist that he gave me is quite expensive, he did say I can use any licensed or registered Psychologist or Psychiatrist. My husband has a friend who is a licensed Psychologist in NY who after speaking with me has determined I am sane :banana and that I researched the band in depth and I understand the work involved to be successful as well as the risks involved. I believe this is what the insurance company is looking for. The thing is he has never done a pre surgical evaluation before and is not sure what to write or include in the letter. Does any one perhaps have a sample letter or can advise as to how it should be written

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Hi Beth,

Unfortunately, the therapist my surgeon sent me to didn't share her actual letter with me. I just got a sort of pre-printed checklist on which she indicated that I was "cleared for surgery." I don't know what else she might have had to include.

I think the psych eval is more a requirement of the surgeon than the insurance company. Dr. Borao probably just wants the therapist to say that you clearly understand the risks and consequences of banding surgery and that he believes you would be compliant. If he mentions an absence of depression or any compulsive behaviors that would be a good thing too.

It makes sense that it's the surgeon who requires it because it's on his head that he's recommending you for surgery. The insurance company only wants to know that HE is declaring you fit for surgery. So the letter should be written in that vein, to Dr. Borao, about your comprehension and ability to comply.

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Beth, my insurance company required my psych evaluation, not my surgeon. It is not clear to me if your insurance company is the one who requires it. If they do, you then need to ask them what they are looking for. My insurance company wanted to know the following three criteria:

1) Am I an alcoholic?

2) Am I a drug abuser?

3) Do I have any psychological disorders?

If the doctor is the only one that requires it, the only thing he/she wants to know is if you are aware of your decision and understand the ramifications and risks of the surgery. Although the fatality rate of the band is less than .01 to .02 percent, doctors still want to cover their backs.

P.S. An added note: it is my understanding that there is a legal issue in most states of having a friend or acquaintance who is a shrink or psychologist doing your evaluation. One could say that he is writing the letter and knew you had issues and is doing you a favor.I know you want to save money, so the best place to find a psychologist that supports bariatric surgery is on the website for www.obesityhelp.com. THey have a list of bariatric friendly psychologists.

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My husband is going through this right now as well, too, and the surgeon is the one requiring the psych eval (as well as nutritionist eval). His doctor gave us a handout detailing exactly what needed to be addressed in the evaluation. Give your doc a call. I am sure he has a list of questions that need to be addressed.

Tami;)

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I'm still confused because my GP did my psyc eval. She just wrote that I didn't have unrealistic expectations and I wasn't a psycotic (SP?) It was just included with her regular referral letter.

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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
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    • Alisa_S

      On day 4 of the 2 week liquid pre-op diet. Surgery scheduled for June 11th.
      Soooo I am coming to a realization
      of something and I'm not sure what to do about it. For years the only thing I've enjoyed is eating. We rarely do anything or go anywhere and if we do it always includes food. Family comes over? Big family dinner! Go camping? Food! Take a short ride or trip? Food! Holiday? Food! Go out of town for a Dr appointment? Food! When we go to a new town we don't look for any attractions, we look for restaurants we haven't been to. Heck, I look forward to getting off work because that means it's almost supper time. Now that I'm drinking these pre-op shakes for breakfast, lunch, and supper I have nothing to look forward to.  And once I have surgery on June 11th it'll be more of the same shakes. Even after pureed stage, soft food stage, and finally regular food stage, it's going to be a drastic change for the rest of my life. I'm giving up the one thing that really brings me joy. Eating. How do you cope with that? What do you do to fill that void? Wow. Now I'm sad.
      · 1 reply
      1. summerseeker

        Life as a big person had limited my life to what I knew I could manage to do each day. That was eat. I hadn't anything else to look forward to. So my eating choices were the best I could dream up. I planned the cooking in managable lots in my head and filled my day with and around it.

        Now I have a whole new big, bigger, biggest, best days ever. I am out there with those skinny people doing stuff i could never have dreamt of. Food is now an after thought. It doesn't consume my day. I still enjoy the good home cooked food but I eat smaller portions. I leave food on my plate when I am full. I can no longer hear my mother's voice saying eat it all up, ther are starving children in Africa who would want that!

        I still cook for family feasts, I love cooking. I still do holidays but I have changed from the All inclusive drinking and eating everything everyday kind to Self catering accommodation. This gives me the choice of cooking or eating out as I choose. I rarely drink anymore as I usually travel alone now and I feel I need to keep aware of my surroundings.

        I don't know at what point my life expanded, was it when I lost 100 pounds? Was it when I left my walking stick at home ? Was it when I said yes to an outing instead of finding an excuse to stay home ? i look back at my last five years and wonder how loosing weight has made such a difference. Be ready to amaze yourself.

        BTW, the liquid diet sucks, one more day and you are over the worst. You can do it.

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