Psychological exams
I have noticed a trend in all my past blogs; every single one starts with "OK". I will do my best not to submit y'all to that any more. However, immediately after surgery I promise NOTHING!
More than likely I will write down a few things and have David post them in the blog for me. Somehow I just don't see me typing on the old laptop, in the hospital bed, right after surgery! But I did say I would let everyone know what it was like, so i will do my best to at least get something written down.
Anyway...one of the things that I had to do before approval for (not only insurance) surgery, was get a psychological clearance. Now I already knew that I suffered from depression. It had started up during my pregnancy with Seth, and worsened after he was born, but my PCP was treating me medically for it (I think I was on Zoloft at the time) and I had already made an appointment to see a counselor. I had not at that time planned on seeing a psychiatrist, because Dr. Patel was already prescribing anti-depressants for me, I didn't see the need.
So I let the psychologist, Dr. Steven Walfish know about all of this up front. I also had to fill out paperwork for him with medical history, psychological history, weight & diet history. And then we got into the testing. Part of it was a basic IQ test and then the rest was to test for anger, anxiety, depression, coping skills, and then the last part was directly related to eating habits. The written test took about 1 1/2 hours (though they allotted for 2 1/2) then he went over my paperwork while I grabbed a bite to eat and I came back and had an interview with him. Now realize I didn't know what all I was being tested on, and I still don't know which questions tested what emotions.
In talking he seems to jump subjects on me a little bit, I'm assuming he's covering the topics that concerned him the most. The one thing I found amusing was the first thing he said was, "Well, you're very intelligent." The way he put emphasis on the very almost made it seem like he was surprised. I'm not sure if it was because I was a stay-at-home Mom, or because most people don't think fat people are smart, or because I am blonde...but I was just amused that he seemed so taken aback (Of course I found out later how high I scored).
The other thing that came out (not so amusing) was he asked me if I had ever been abused. I had put "no" on the paper, so I'm not sure why he asked again, but I stuttered. I told him I had never been abused or sexually abused, but I had been date-raped in college. He said, "That is sexual abuse." I kept trying to explain to him I meant I had never been abused On-going, and he kept trying to explain to me that it didn't matter, the rape counted. He asked me where I thought I had scored on the anger scale. I said I had a pretty bad temper, I tended to hold stuff in and then BOOM! So I figured I probably scored about 75. He then asked me where I thought I scored on anxiety. I said I thought that was worse, since I had been having panic attacks and such, so probably 80-85. He informed me I scored 95% on the anger scale and 99% on the anxiety/depression scale.
As soon as he said my numbers I knew I wasn't getting my surgery. I was actually pretty sure I wasn't getting it from the moment we started talking about the rape, but I had held out some hope. I was fighting very hard not to cry. I said, "So I guess I don't qualify for the surgery, huh?" he told me not right now, that he wanted me to be under the care of a psychiatrist rather than a primary care doctor. He thought with my level of anxiety/depression that it was very much called for, and would help tremendously. He also said he could re-evaluate me after at least 6 months of therapy with a psychiatrist. I tried to reason with him. I told him that I was trying to get my body healthy so I could start moving better because I thought that would help with my depression. He agreed with me some. He said the problem was, my depression was so severe at that point that the extended recovery time, and the surgery itself would make the depression even worse. Exercising does help with depression, but I wouldn't be ready fr it right away, and I would be down and in pain which would only exacerbate things. The other things that concerned him was that I am an extremely emotional eater. I would binge eat horrible to deal with emotional issues, and he did not believe the surgery alone would be enough to deter me from those eating habits; even with the vomiting and dumping syndrome as a negative reinforcement. He felt I needed the counseling to deal with those emotional eating issues first and then have the surgery.
Although I was not happy at the time, it was a very good move. Dr. Walfish was right on the mark. A few months later I had a very bad breakdown and wound up self-admitting to an inpatient facility that my psychiatrist (yes I got one) worked near. My son (who has Asperger's syndrome) his psychiatrist is the head Dr. there, so I felt totally comfortable going in, and requested my son's Dr. for my own, since he knew me. I was in-patient for 3 days. It gave me time to rest - with no extra stress, meet others who were suffering from severe depression just like me (which was very refreshing - having someone who knew exactly what I was going through. My husband is a wonderful and caring man, but he doesn't suffer from depression and couldn't fully understand what I was feeling. These people I met did. It made me feel less alone). And it also gave me a lot of coping skills. It also gave the Dr.s a chance to look at ALL of my medicines and change some things around. I followed up with a 2 week out-patient program, which was kind of like going to school; 9 in the morning to 2 in the afternoon. That just reinforced the coping skills we had started on in the hospital.
I now attend EA (Emotions Anonymous) meetings once a week. It's sort of like AA, except there is no addiction aspect to it. We follow the same 12 steps, just focusing on dealing with emotional issues instead. After all, most substance abuse generally stems from emotional issues anyway as a form of coping.
Sorry, off topic. But as y'all saw from my first post, I did go back for my re-evaluation and passed. My psychiatrist and my counselor both sent letters to Dr. Walfish letting him know what progress I had made (and yes, we all let him know about the hospitalization.) He seemed very pleased with the fact that I had a plan to cope with the binging urges- which is to DO SOMETHING!
Seriously, the plan is to take my mind off of food AND whatever has caused me to want to binge in the first place. I am now writing for a website, I'm working on some songs, a (possible) book about my depression, and I have developed an interest in a couple of different crafts. If none of those are capable of distracting me, then I get up and leave the house. Sounds simple, but before I had no plan. I just ate...and watched TV or read. I've still got to read though, there is no way I'm giving that up! : )