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Psych eval nightmare



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Yesterday I had my psych eval which was the last thing I needed before things got submitted to my insurance company. It took over 3 hours including a super lengthy questionnaire. I had decided that I was going to be 100% honest with the shrink going into this. I just weaned myself off of my ADHD meds and have been struggling with some weight gain and haven't been doing my best when it comes to eating. I expected a tongue lashing over that.

What I wasn't expecting was for this woman to tell me that I have substance abuse problems and I have to be clean and sober for a year before surgery. Apparently very occasionally smoking weed (like, a few times a year) makes me an addict. I had told my surgeon, the nutritionist and my primary care physician that I occasionally partake and was never told that I couldn't smoke. If I had been, I would've quit, no problem.

Then I admitted that my drinking was out of control as a freshman in college. I told her my mom has been concerned with her own drinking. I still drink, but like a normal 24 year old. I might have a glass of wine or beer with dinner if I'm with friends and usually about once a month I go out on the town for a night. I know my limits, I rarely get drunk.

The nutritionist and surgeon both told me that you can't drink for a while before or after surgery. Sure, understandable, no problem. They also said you can occasionally drink after a period of time. I just know that I have to watch myself and limit my alcohol consumption.

This woman says I can't drink ever again. I feel like I'm receiving conflicting information. She says I'm currently not a good candidate for surgery. I obviously can't submit her eval to insurance. What do I do??? Do I take 3 months and get on track with my eating and exercise and then do another eval? I feel like another year is very extreme. Maybe this is the kick in the ass I needed, but it's extremely upsetting and frustrating.

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Yesterday I had my psych eval which was the last thing I needed before things got submitted to my insurance company. It took over 3 hours including a super lengthy questionnaire. I had decided that I was going to be 100% honest with the shrink going into this. I just weaned myself off of my ADHD meds and have been struggling with some weight gain and haven't been doing my best when it comes to eating. I expected a tongue lashing over that.
What I wasn't expecting was for this woman to tell me that I have substance abuse problems and I have to be clean and sober for a year before surgery. Apparently very occasionally smoking weed (like, a few times a year) makes me an addict. I had told my surgeon, the nutritionist and my primary care physician that I occasionally partake and was never told that I couldn't smoke. If I had been, I would've quit, no problem.
Then I admitted that my drinking was out of control as a freshman in college. I told her my mom has been concerned with her own drinking. I still drink, but like a normal 24 year old. I might have a glass of wine or beer with dinner if I'm with friends and usually about once a month I go out on the town for a night. I know my limits, I rarely get drunk.
The nutritionist and surgeon both told me that you can't drink for a while before or after surgery. Sure, understandable, no problem. They also said you can occasionally drink after a period of time. I just know that I have to watch myself and limit my alcohol consumption.
This woman says I can't drink ever again. I feel like I'm receiving conflicting information. She says I'm currently not a good candidate for surgery. I obviously can't submit her eval to insurance. What do I do??? Do I take 3 months and get on track with my eating and exercise and then do another eval? I feel like another year is very extreme. Maybe this is the kick in the ass I needed, but it's extremely upsetting and frustrating.


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Their concern is likely the fear of addiction transfer. A fair amount (I've seen numbers saying around 10%) of people after surgery develop drinking problems. So she's probably looking at if from the standpoint of occasional drug use (even if it's just weed) and a previous phase of uncontrolled drinking. Just remember that they are looking out for your well being.

You can find another pysch to go to for a second opinion, but if you feel you have real issues to address now is the time to do it. Don't simply go looking for somebody to sign off without seriously taking into consideration of what is best for you long term.

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37 minutes ago, powelak10 said:

I had decided that I was going to be 100% honest with the shrink going into this.

That is the absolute right thing to do.

Obviously she found some things that you said or filled out on your questionnaire that caused her concern. There is a small but significant portion of people who go through WLS and turn to alcohol instead of food for comfort, so maybe she thought you were a high risk. Then again, maybe she deals with a bunch of alcoholics and has just applied a one size fits all answer to you, which is really sh*tty, but happens.

What I would do is get the entire report from her, including what the questionnaire indicated. After that be very honest with yourself regarding what it shows. If you truly disagree afterward, go to someone else for an eval, but still be 100% honest. In the end it will only help you out.

Edited by Navigating the Wilderness

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It's very good that you were honest and disclosed your history with substances. That said, just like any other evaluation, if you get a result you are not in 100% agreement it is perfectly reasonable to get a second opinion.

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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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