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Persuading my Psychiatrist



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Thank you.

Yes, even though I’m going to a psych recommended by the surgeon, I know I will need to partner closely with my psych. I’ve asked each surgeon I’ve met with about the risks for BP patients and med absorption. The only one who took it at all seriously recommended the sleeve and said I would probably need to decrease dosages after losing weight. That said the literature I’ve seen suggests greater risks than that. I’d honestly rather be obese than have a relapse. It isn’t something I play with.

I’m meeting with my private psych in a couple of weeks to discuss this in particular. She has seen me through some rough Patches so I trust her. I just don’t think she understands obesity and weight loss terribly well. She seems to think diet, exercise and appetite suppressants will do the trick. Perhaps for some, but not for me. I track calories religiously, and I can only lose at 900-1000 and I gain at 1300. Appetite isn’t my issue.

Anyway- could you tell me more about the challenges that you faced Post-surgery?

thanks again.

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On 2/2/2018 at 11:56 PM, ElseeG said:

James,

Congrats on hitting the five year mark! What have been some of the greatest challenges post-op? What has been most difficult?

Thanks.

Right after surgery, the complexity of meeting all the daily requirements were mind boggling. It seemed like there were not enough hours in the day. But as I progressed, I developed a very systematic approach that made the process easier. [For example, putting all my Calcium tablets in a small finger bowl in the morning and then taking them periodically over the day helped. And if I was up and about, putting them into a zip lock bag and carrying them along with me helped.]

The other challenge was adapting to the changing requirements post-op. There are many transitions such as going from full liquids, to pureed foods, to solid foods that one passes through. Some of these can present difficulties. This is an ever changing road. Every time that you think you have it, there is another curve ahead. Realizing that there were two phases, the Weight Loss phase and the Maintenance phase, and each one had a different approach was important.

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Are you getting your terms mixed up? I've been seeing a psychologist for talk therapy since the summer of 2015 and a psychiatrist has administered my meds for ADD and, later, insomnia. My psychologist was supportive of the surgery after I talked about why I was doing it at several sessions. The only reason I mentioned it to my psychiatrist was because I wanted to make sure there weren't any psych meds I was on that I couldn't take after surgery, or that would require dosage adjustments.

The psych eval for surgery was completed by a licensed therapist with a practice that specialized in eating disorders and other food issues. I passed that exam easily, but I don't know if I was honest about my food addiction (or if I even knew how bad it was until after the surgery).

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Hi. My psychiatrist is also a psychotherapist, so therapy is part of the relationship. i seperately have to pass the psych evaluation with the bariatric psych recommended by the clinic.

My question is whether the bariatric psych would require my psychiatrist’s sign off.

Thanks!

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I don't think so, no. Mine didn't.

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31 minutes ago, ElseeG said:

Hi. My psychiatrist is also a psychotherapist, so therapy is part of the relationship. i seperately have to pass the psych evaluation with the bariatric psych recommended by the clinic.

My question is whether the bariatric psych would require my psychiatrist’s sign off.

Thanks!

Mine did. But my therapist was very supportive. She's more of a life coach at this point in my life, and she thought surgery was a great idea. A lot of what we spoke about were the goals I wanted to reach, and how my weight was prohibiting them. She also knows the stuggles that I faced trying to lose the weight after the birth of my child. I would dedicate myself to diet after diet, hours in the gym, with little to no results.

Does your psychologist know THE WHY behind the surgery for you? Does she know other things you've tried, the struggles you have had, etc. You maybe should ask her what she knows about bariatric surgery. And if she has an unfavorable opinion, might be a good idea to remind her that projecting her assumptions on you are kind of against the rules of her job. Maybe bring some research with you? Good luck!

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Just saw my psychiatrist this morning. He never asked me about surgery next week. He had no clue and I left it that way. I don’t think my psych evaluation made it past the hospital walls.


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