I'm just curious to see what your views were on the homework we have to complete during this process.  Did you like it? Hate it? Didn't care either way?  Did you put your whole heart and soul into it or just answer the questions and do the logs the bare minimum?  Did you do the homework after you had surgery or did you just say screw it ... I got the prize and don't have to jump through their hoops anymore.  

I will start it off by saying I have mixed emotions about the "Homework"
1) I was glad to have something to do other than research the same old things
2) It did make me stop and think about some stuff
3) I kind of felt as if my privacy was being invaded
4) I also felt like "why the hell is this crap mandatory? Who made them so high and mighty to tell me I have to do this?  Do you have to do homework for other types of surgery? NO ... so why this? Yes I can understand wanting the patient to reflect and learn how and what got them to this point but do I really need to sit down and go through this with a social worker?  Not really necessary in my eyes.

These are just my thoughts and I am interested to see the diversity in your answers.  

Thanks,

Hey there,

I have learned alot about myself going through this homework. You are referring to the packet from Orientation? That is what I'll be talking about because I have gotten farther yet. lol

I learned that I'm not as crazy as I thought. lol And where the problems with food lay with me, and it's not way out of balance, like I thought it would be until answering each questions honestly.

The part of the pack that you check off things that you want to do better at and then fill out a work plan for how to accomplish this, is taking me alittle long to fill out because there are many things I want to improve on.

I don't go back to have these reviewed until Jan 18 so I don't know how I will look in their eyes.

I personally didn't find anything to private, we could have different homework too depending where you are going. I'm at TWH.

Thanks for starting this thread.

 Wow, what homework?  I'm in Ottawa and I am wondering what you are referring to.

 Judy

 We have to do Social Work "Homework"
Example questions from my homework are:
Name 6 people who have had a positive or negative influence on your nutrition.
Examine the times in your life when you've gained or lost weight, what were you doing, how were you feeling etc ... 
Examine what you do for everyone else in your life compared to what you do for yourself ... etc ...
These types of questions plus of course food and exercise journal.
I don't mind recording my food ... but the personal questions ... I don't know I just kind of think that it is any of their business what the heck was going on in my life when I gained or lost weight.   Yes they are good questions to present to me to reflect on but answer and share with a social worker ... not my cup of tea!  But I have to do it in order to get the surgery.  

And BTW .. I'm not knocking anyone who liked or was comfortable with the homework ... we are all different ... for  me sharing personal stuff with strangers is just not what I am about ... that's all.

I didn't have those kind of questions.  They did have a sheet that you checked off different diets that you have tried and when and how much did you lose.

But in our kit it said you could pass on anything your didn't want to answer.

Interesting... I had no homework through TWH. I think it should be on an 'as needed' basis. If any of your appointments with any of the professionals raise yellow or red flags then some homework should be assigned and a second appointment made.

I can be a pretty private person, so I understand not wanting to do some of the homework you've described.  From my point of view, however, it is a bit of a red herring to argue that you don't have to do that for other types of surgery.  This process, if it is to be taken full advantage of, is not simply a surgical process.  It is treatment of a condition of which morbid obesity is a symptom and surgery is part of that treatment, but not all of it.  Many of us have underlying emotional aspects to our battle with weight - both in what led to being overweight and the impact that being overweight has had on our sense of self.  The types of questions being asked are not any different than those that would be asked in treating many long term chronic conditions that require a change in lifestyle - be that any addiction, heart condition, physical disability etc.

Sure you can reflect on those questions yourself.  If you don't share the answers however, you may risk missing out on something that could really help you.  If you can do the emotional work yourself without input from the team, then how is that any different from someone saying to you "why don't you just eat less and move more".  If you could do it it alone, wouldn't you have done so already?

The more you are prepared to be in a situation that makes you feel emotionally uncomfortable, then the better chance you have of  being able to withstand the discomfort that comes with developing healthier responses to life's ups and downs that don't revolve around eating.  (there's a reason it is called comfort food).  I say take the risk of getting out of your comfort zone and bear the discomfort of doing your homework.

The only person it is going to benefit is you.  I did not do any of this before surgery - did not look at any of the psychological factors that shaped the fact that I was an obese adult. Never looked at the triggers for my eating, why I eat, my relationship with food at all.  Very little was done to warn me about how difficult many of the psychological aspects of food and my addiction were going to be down the line.  I was given no tools to anaylze this.

Then at 2 years out, I was struggling with food, entered group therapy, and guess what? Did all the stuff that comprises "homework".  My hubby did it during his surgery when he started up in the program and I thought it was great that the program here address the stuff in our head. I'd wish I'd been given more to deal with this aspect. 

Think of it this way, you may come out with more mindfulness and more awareness about you and your eating.  What you want to share is up to you.   You may find some value to it in the long term.  If you need to set some "privacy" limits, then do one version for them, and an honest one for you.  :)   Share what you want to share and it may surprise you in the end with what you learn about you.

Dawn

As far as I know this homework is through the Windsor clinic only. If you look at the bottom of the sheets you will see who created this homework and it is one of the Social workers from Windsor that created it. There is also a sign out in the waiting room wall that says if you do not have your homework completed you will not be seen by the social worker.

I had major issues with the homework, I hated it and it stressed me out and I actually said so in the work i submitted. I think its perhaps a good idea but at the same time it is a LOT to do, when you add it to your food journal, which by the way I think was an AWESOME thing to do. I did 20 days not just the one week they asked for.

the first part of the homework you got in your orientation package is nothing compared to the homework you get at your first appt with the social worker.

as for your privacy being invaded you need to look past this. This homework is only a tool for them to understand more easily what your triggers are, and how they can be changed. I dont really see it as invading your privacy. they are just asking about times in your life when you gained weight, how much you share and dont sahre is up to you.

I called the social worker and talked to her about the problems I was having with the homework and I was basically told to just do it and get it done, no real support there. In truth a lot of it was repetitive and a lot of it was pure bull****

As for the homework I was given to hand in at my 7 month post surgery follow up, I highly doubt I will be doing it. I jumped through their hoops so I can get surgery, so I am done hoop jumping.

heres 2 entries I wrote for the self talk homework you get after your first appt with the social worker.

May 8^th

Keep thinking about this homework and how I Fear that it wont be completed the way it is supposed to be and therefore having my surgery pushed back or even denied. I have worked damn hard to get where I am today, no smoking, no junk food, no candy, no fast food, and thru all this I have lost 33 pounds. I don’t do well with stress and this is really stressing me out.

All I can do is write what I think I should and hope its satisfactory.

June 30^th

I am honestly having serious issues with this homework. I feel the surgery I desperately need hinges on this homework. I am finding it near impossible to write daily about my feelings and negative thinking. I dont have negative thoughts about eating. I made the decision last year to change my lifestyle and I did, and I have stuck to it. I am now completely stressed out from this homework you gave me. This homework being mandatory has me thinking I have to have negative thoughts, so now I think there is something wrong with me because I dont.

and my last entry:

July 13^th

Last entry in this part of my homework and I am off to bed early as I am heading to Windsor tomorrow. I am scared and excited at the same time. Part of me thinks that what I have done in these 2 exercises will not be enough to convince you that I am ready for the surgery. I can assure you I am ready. I have had lots of time to think about my choices in life including this surgery. I have come so far from where I was just 9 months ago. 9 months ago I went out of my way to put crap into my body. I did not care what I ate or how much I ate. Today I think about everything that goes into my mouth. The way I used to eat is in the past. My portions are smaller, they are healthier choices for the most part and I feel a lot better than I did just 9 months ago. Stairs dont hurt nearly as much as they used to.

FYI: They read EVERY page you write

Jake

When I did my homework and was asked about my relationship with food the SW said I spoke about food too much.. I just about lost it.... As for the homework for 9 months post op... That sheet is long gone.

Plus I didn't get along with my SW. She made me feel like garbage about myself. I never once left there on a positive note.

Jake, I found your notes interesting, concerning homework for SW, from Windsor Bariatric Centre. I too went through Windsor Bariatric Centre, started with them March 2010 and had my surgery at TWH March 2,2011.
I did not find the SW staffmember at Windsor to be helpful. I found she was seriously lacking in personality, and did not seem open to hearing comments that veered from what she expected to hear. So, I quickly adapted and told her what she wanted to hear.

I did not have homework postop with the SW dept at Windsor Bariatric. I only had to attend a group meeting for my 9 month postop date. I attended that meeting just a few days ago, and frankly, to me it was just another hoop to jump through, as they took attendance(which I expected) and the subject matter was rushed, and more or less just seemed like a bunch of fluff to me.. the theme was.. take care of yourself, don't be afraid to make time for yourself and put yourself first sometimes.
There were two SW staff in attendance.. one did all the talking, the other operated the display screen.. Mind you the SW who did the speaking was very animated and pleasant, but frankly
the meeting to me did not really offer me anything new to learn. They were very good at
reinforcing the fact that they could be contacted if we need to talk with them about any struggles we are having, but frankly the meeting to me was sort of a waste of time.

I guess the SW program varies from bariatric centre to bariatric centre and is only as helpful
as the SW presenting the facts. Some SW staff are great with people, others are not so great.
Before surgery, my two appointments I had with the SW were not very satisfactory. I felt that they wanted to hear certain things from the client and if you told them what they expected to hear you got a passing grade. So I played their game and got the passing grade but did not feel they were of help to me. I continue to work out my issues with help from friends, family, and OH members who are always willing to listen and offer help when asked.

suzyq0052

I had the benefit of having different SW's at both of my appointments. The first one I did not like at all, and all my anger and frustration was from her. The second appt when I met the other SW, went much better. She was much better. I actually enjoyed talking with her. aside from the mistake she made at the very beginning of the appt mistaking my girlfriend for my mother.(gf is 13 years older than me and I apparently have a baby face, lol)

I am really hoping that my 7 month followup will not be with the first one as I really have nothing nice to say about her.

Hi

I had my surgery 9 months ago at TWH, and did my appointments 12 to 14 months ago, so I may be out of date and to be honest I don't remember those questions specifically; but I would like to try to respond to the "sharing personal information with the social workers" side of your post. 

In my case, while having the surgery itself seemed to be the important decision at the time; it was the mental preparation required to clear the psychological profile that has made the real difference to me and my success post surgery.  I decided to be honest with myself and those around me with respect to what I was going to need to do in order to change and be successful long term.  I also took this chance to address what I would need THEM to change as I moved forward.  And if I am truthful, we have all had to make adjustments and not all of them were easy. 

For example - I no longer do grocery shopping.  I don't cook very much, and I rarely eat what everyone else is eating.  Going out now means finding a place where I can eat too.  Some foods are no longer in the house.  I've had to replace my whole wardrobe.... underwear, shoes, pj's, day clothes and dress clothes, and that has eaten into the $ available for other things. 

Most of the discussions on all this took place because of the social work sessions.  I'm glad it did (and my husband and daughter both came to that appointment), because we cleared the air before I went forward.  This gave me confidence about their support, and helped them to realize this wasn't just another diet.

How you handle this aspect of the process will be a personal decision, of course; but I do believe the social workers are there to help, and they come armed with insights about what has worked and not worked for others.  I'm really glad I took as much advantage of what they had to offer as I could, and I value the on-going support sessions they run. 

This is the hard stuff, because the surgery makes the initial loosing of the pounds much easier than it ever was before.  The better prepared you are for the OTHER aspects required to "work the RNY tool the best you can" the easier it will be for you as you go along, at least in my opinion .

Claire
9 months post surgery
HW 348
CW 182
Loss 166 lbs

let me just add that even though I hated doing the homework, I am glad I did, as it did open my eyes to some things in my life that needed to be addressed.

Failure to follow through with post-surgical expectations can be fatal - I don't think they are being "high and mighty"....but rather they are truly trying to help save lives - that is the purpose of the surgery - although your overall appearance is a fantastic side effect of the surgery - the bottom line is that with this surgery that are trying to extend your longevity, reduce and eliminate co-morbidities, and truthfully reduce the impact that obesity has on the medical system.

I would consider it a foolish decision on the Canadian governments part for them NOT to have the psycho-social aspects of the approval process - it is absolutely essential for people to understand and be able to cooperate with post-operative life.

I hesitate to compare this surgery to any other surgery - when I had my appendix out - nothing in my life was altered at all. When I had a cyst removed or even my c-sections.....there was very minimal impact on my life - we are talking about a major upheaval here. I recently had a situation with a person who was being considered for surgery with whom it became painfully obvious that the person had some mental health stuff that needed to be sorted out before they could have this surgery.

When I was starting out at TWH they made me answer a series of psycho-social assessment questionnaires  - they were hard for me to do because we use such assessments to evaluate our clients at my place of employment - I knew why they were asking and what they were looking for in the answers but I still did it because I understand the importance of really making sure people are able to take responsibility for what needs to be accounted for and to make sure people are in a good status of mental health prior to being approved.

Definately different "homework" than the forms I had to fill out for TWH. I had a 30 page evaluation and you chose on what level the questions applied to you. not at all - slightly - sometimes -most days - always. That kind of thing.
And then 3 day food journal. And the other that I said in my other posts.

I didn't have that homework specifically but I was asked to attend a new program St. Joe's (Hamilton) was setting up.  It was basically cognitive behaviour therapy for emotional eating and we used this workbook...

http://www.chapters.indigo.ca/books/Cognitive-Behavioral-Workbook-Weight-Management-Laliberte-McCabe-Taylor/9781572246256-item.html?ikwid=9781572246256&ikwsec=Home

It was a group session and there were 4 or 5 of us most sessions (8 weeks) and it was led by Laura the social worker and Carmen the psychologist (she is on mat leave right now).  It was very helpful but if I wasn't part of it, I would've had my surgery in the summer and now I'm still waiting.  Ah well, all in good time.

I look at it as a part of learning more about myself. This is not the same as having your appendix out. Have surgery ,recover and you are just the same.
If we cant identify and have the skills to deal with the changes our bodies are going thru it make success that much more difficult. Dont forget that our participation makes this surgery covered not only for us but those who follow. They need to sho that it is necessary and successful. Without the research it is not necessary. I gues if you want to pay for it yourself then you dont need to follow the process.

I had surgery about 2 years ago at Humber River Regional in Toronto.  At that time they didn't have this type of "homework".  I think it's a great idea and I think it should be put in place at all the centers in Ontario.

I will never forget about 5 years back when I saw an American friend of mine who had gained back ALL of the substantial amount of weight she had lost after an RNY.  My heart just broke for her when I saw that.  When I asked her what she thought had happened, this was her answer:   "They make a surgical change in your body but they don't change what's in your head.  After two years or so you can eat around the surgery and gain all your weight back.  All of the reasons you became morbidly obese in the first place are still there. If you don't deal with what's in your head, you will likely regain your weight back."

This "homework" will serve you well if you use it as the ADDITIONAL TOOL that it is.

I wish you all the best,
Cheryl