Has anyone had there surgery pushed back b/c of there psychiatric illness

shellbell4955
on 4/23/11 5:45 am - GA
I went to my dr's first seminar last night and the only hitch between me and surgery is my pschiatric illness,bi-polar panic disorder, he wants me to have like 24 months od a stabilized run of life before surgery has anyone had problems with this if so what happened how did u get through??
Shelley Belly

sjbob
on 4/23/11 6:54 pm - Willingboro, NJ
 Nope!  My doctor listed my manic-depression as a comorbidity which I thought was simply stupid due to its genetic nature.  Anyway, it actually helped.  Depending on the severity of your moods, I can also understand why a surgeon or the ins co would be reluctant to approve some people.  I've actually only seen actual denials due to bi-polar or simple depression with people who had been suicidal or who had thought about committing suicide a lot.  What's the sense of having the WLS if you plan on killing yourself?  WLS is not a magic bullet as far as weight loss is concerned and it is definitely not the solution to a chronic mental conditiion.  Acceptance of the mental condition along with proper treatment go hand in hand with being able to being able to cope with the negative mood changes that often follow surgery.  The negative effects go away fairly, but someone who is having major problems may not be able to cope.

We must understand that each person is an individual and general statements about mental conditions and how they affect WLS are basically useless.  You must trust your primary, your surgeon, and your shrink.  Considering that the surgeon is the new link in your treatment team, I'd consider getting a different surgeon's opinion if both your primary and your shrink think you are ready for surgery and the surgeon does not.  In my case, I've had the same primary for several years and have changed shrinks over the years due to changes in insurers ( plus, many shrinks just don't like staying with a particular HMO ).  I had my original shrink for about 6 years and my primary for 14 years prior to my original RNY ( i needed a revision a few years later due to a staple line disruption).  

I don't know what 24 months of a stabilized run on life from bi-polar panic disorder would look like.  I suggest that you discuss that with your shrink.  You may already have most of that requirement in--why go crazy worrying about the requirement if you've alrad had something like 20 monts duration?  However, if it's only been a few months from a major incident, then you should definitely discuss that with your shrink also.

I was super morbidly obese when I had my RNY and weighed over 570 lbs.  I would have been dead about 8 or 9 years ago if I hadn't had it.  Some people may   question my quality of life, but at least I am living.  I have my good and bad days but I tend to live life on an even keel.  I know that my shrinks through the years have been disappointed tha I only felt like I was feeling OK.  In my case, feeling Good is an indication that I'm becoming slightly manic.  It's takeen me years to be able to realize that.  So, I'm fine being OK.  You should know by now what your "normal" is and be able to communicate that to your shrink.  Then, you may have to find out how to communicate it to the surgeon.  The letter or questionaire that your shrink writes may go a long way in deciding whether you get the WLS soon.  A long letter ffrom my shrink describing the medical advantages of having the surgery went a long way in helping me get approval.

Try to be patien--my worst ability.  I know it's hard waiting aroung when you are looking forward to something that may really help you.  I have no idea how obese you are nor what your co-morbidities are.  It wouldn't matter because I'm not qualified to remark on that.  However, some people who are now trying to get WLS are barely morbidly obese.  I had tried everything out there before I decided on WLS.  Remember that it is major surgery.  I was considered a high-risk patient simply because of my weight and some minor complications.  If there is no other way to lose necessary weight, then fight for the WLS.  
shellbell4955
on 4/24/11 12:00 am - GA
Thank you sjbob on for your help. I know wls is not a magic bullet just a tool to help me this is something I have been researching and thinking about for 6 years now I HAVE HAD A ROUGH GO OF PSYCHIATRIC INCIDENTS THOUGH so my surgeon will probably deny me but he said he will work with me to go ahead and get the ball rolling and we will go from there so mabye he will see improvment and it wont be such a long wait, but again I enjoy and want any feedback from u guys I welcome it

Shelley Belley
Patricia R.
on 4/26/11 11:34 am - Perry, MI
Bipolar disorder is a comorbidity with any other illness when doctors write patients' diagnoses.  It just means an accompanying illness.  Like, when I had my surgery, my comorbidities included arthritis, high cholesterol, prediabetes, and acid reflux, along with my bipolar disorder and alcoholism.  Genetic or not, it is considered a comorbidity, meaning an illness you have along with the need for surgery. 

Doctors have to make sure they document all of the comorbidities to cover their anatomy if the state agencies inspect the records.  Better to have all your diagnoses on the paperwork, than miss one and not be accountable for it.

Seek always to do some good, somewhere. Every man has to seek in his own way to realize his true worth. You must give some time to your fellow man. For remember, you don't live in a world all your own. Your brothers are here too.
Albert Schweitzer
96179

sjbob
on 4/24/11 11:55 am - Willingboro, NJ
 I don't know mushc about most types of WLS, but I do have a friend who had one of the band surgeries and he occasionally goes in for "fills."  That may be a less intrusive form of WLS.  Maybe you should discuss that with your primary and your shrink.  It would probably involve dealing with a different surgeon.   I really don't know.  I would like to give you some hope regarding your chances for WLS.  
sjbob
on 4/25/11 12:46 am - Willingboro, NJ
 I just want to add that I read apost on another forum this morning that stated that the lap band requires a lot more work on the patient's part.  I know that I would have a hard time with that.  You and your doctor(s) can evaluate all of the WLS options that are out there.
shellbell4955
on 4/26/11 6:58 am - GA
I wanted the rny but I think with the malaportion probs im gonna have to go with the band b/c im iron, B-12, and potassium defficiant and my psych meds will not be absorbed right, did any of ya'll ahve trouble with psych meds not being absorbed?
sylvan
on 4/25/11 11:59 am
Find out his definition of stable.  It might just be staying on your meds and out of the hospital.  If that's what he's looking for, that's reasonable.  If he is looking for 24 months with no mood issues then that's going to be harder.  Actually, that may be impossible.  Do you have a good pdoc?  Could you get your pdoc to write a convincing letter documenting your stability?  That's what I did.  So far, so good.  I'm waiting for them to turn everything in to insurance later this week.
NIXMOMMIE
on 4/26/11 5:42 am - NC
i did have a surgeon deny me based on my diagnosis of bi-polar. the shrink I had my psych eval with said I had missed 2 dr appointments the previous yr. He said that showed me not being consistent. He told me to come back in a year. I sought another surgeon. I was approved and had surgery in record time. I do have to say I am quite the miserable puppy these days. Everyone says its it natural but I am feeling pretty depressed these days, and I do not have my food buddy to console me.
                    
shellbell4955
on 4/26/11 6:53 am - GA
Nixmommie why do u feel so miserable? Is it the wls or not having the food or just your bi-polar flaring up?? I will be praying for u
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