Re: Totally ticked off!

[Guest guest]

Hey Chey ---

I am sending you some hugs here --((((((((((Chey)))))))) and encouraging you to breathe deeply ... yes ... deep... long inhale .... soft and slow exhale .... and then try and remember something you must have forgotton. THIS IS A GAME! You must play the game on any board chosen by the person who has control over you.

And you know how to play the game too!! I know it ... for instance ... you KNEW the answer to the door knobs question was I love fixing door knobs! And your answers to all the questions are how positive an outlook you have on ALL of life .. how you enjoy going to doctors and helping them in guiding your future ... you just forgot for a moment, Chey ... and thought this guy was here to "help" you .... no sireeeee, he is there to be insurance for the insurance ....and the doctor - in case you freak out later (when you see yourself thin and svelte ... -- hah!!)

My suggestion is to calm down, talk to the psychologist again, agree with anything he suggests ... altho I might ask him to meet me halfway!! LOL! Tell him you were upset with your husband, daughter or the dog - on the day of the test - and it was not the real you ... which is grounded in the reality of your need for this surgery. Good Luck!

Judi in Miss

Waiting for Approval

BMI 59

[Guest guest]

I want to thank everyone for allowing me to vent as I was very upset earlier

today. I also appreciate the support; you guys are really great and it's

nice to know there are some people who can truly understand what I'm feeling.

As for Mr PhD, I'd like to tell him to go screw himself and the lame ignorant

horse he rode in on, but I'm not going to do that...yet. I'm still waiting

for him to return my call (where I CALMLY informed him that I was not pleased

with this situation and I fully expect an explanation.)

I've always had an interest in psychology and actually am working towards

eventually getting a PhD myself, and I know I could have answered the

questions on the test in a way that would ensure a positive report to the

surgeon, but I was actually curious as to how the test would actually turn

out if I answered it honestly. But seriously, the questions on that test

are, for the most part, unanswerable with the choices they allow you. " I

love my mother " Eh....well, yeah, I do, but..... " I like rain. " etc. I

mean come on!

Yes, I have depression and a body image problem. Being morbidly obese

certainly hasn't helped that situation. I've also been at 150 pounds and

felt great about myself! I KNOW what it feels like to be (at least almost)

normal weight. I lost a lot of weight several years ago (basically by

starving myself and overexercising) and I know what it can do for depression

and body image problems. I also know that the sudden freedom from being

overweight can be overwelming for some. It wasn't for me. It was simply

wonderful!

And no, I don't like to follow directions in a lot of instances. If I did, I

would have disregarded the option of having surgery long ago because my

family, friends, and a few doctors did not believe ANYONE should have WLS,

hence it was not something I should even consider. God forgive me for having

a mind of my own and for knowing what is best for me. I have, however,

always been stringent about my medical care, and if things seem out of whack,

you can be sure I'll be at the doctor's office getting the necessary tests

and taking the necessary meds. Whether or not I like to be told what to do

by coworkers (one of the questions on the MMRI test) has nothing to do with

whether or not I will follow the directions of my surgeon postoperatively.

As for Dr. Aslam...you know, I've never even met the guy and he's never met

me, yet he's willing to base the decision of my having WLS on the opinion of

a Psychologist who met me once? Well, there goes my respect for his

abilities. Along with this, he has disregarded the consults of the

Dietician, a Therapist whom I saw for 2 years, my PCP and my Psychiatrist

(the last 2 being MDs) who all told him that I was an excellent candidate for

this surgery.

Maybe this is fate as I've been unable to shake this feeling that he's just

not the right one to be doing this surgery on me. I've been dealing with Dr.

Aslam's office since July and I've yet to meet the man or receive any word

from him that didn't come via his nurse. Yet, I Emailed Dr. Baltasar and

introduced myself, and he PERSONALLY wrote back the next day in a very

thoughtful letter (one I wouldn't expect from a Surgeon) where he explained

his experience, the procedures he offered, the cost, recovery time, etc. And

there was something else he said which kinda floored me. " If you would

decide to have the WLS, I would be happy to take care of you. "

I've worked in the medical field for eight years and deal with doctors

everyday. Right now I transcribe their reports and have NEVER once heard a

surgeon or any type of doctor say " I would be happy to TAKE CARE OF YOU. "

There's the " will admit and do this and that " or " I will accept you as a

patient " or " I will evaluate or operate on you " but never ever " take care of

you. " Dr. Baltasar also gave me his home phone number.

My God, am I the only one who thinks US healthcare has gone to the dogs and

these doctors need to take lessons from their foreign counterparts?

Somehow, someway, I'm going to get the money (much less than Dr. Aslam would

be charging me anyway) and I'm going to Spain.

I'm still ticked, but I truly believe that everything happens for a reason,

and though I do not believe this has happened because I'm not meant to have

WLS, I think it just means I'll be better taken care of in a foreign country

rather than my own. (Kinda sad when you think about it).

[Guest guest]

In a message dated 11/3/00 6:38:31 PM, duodenalswitchegroups writes:

<< And no, I don't like to follow directions in a lot of instances. If I

did, I

would have disregarded the option of having surgery long ago because my

family, friends, and a few doctors did not believe ANYONE should have WLS,

hence it was not something I should even consider. God forgive me for having

a mind of my own and for knowing what is best for me. I have, however,

always been stringent about my medical care, and if things seem out of whack,

you can be sure I'll be at the doctor's office getting the necessary tests

and taking the necessary meds. Whether or not I like to be told what to do

by coworkers (one of the questions on the MMRI test) has nothing to do with

whether or not I will follow the directions of my surgeon postoperatively.

>>

But what if one doesn't agree with the doctor

about the necessity of a supplement or something? Or, if one is feeling

great

a couple years post-op

and doesn't think one needs to continue the supplements long term? These are

the

only instances where I think such a question *might* tie in with not liking

to be told

'what to do'????

IF one prefers

group problem solving and discussion, just 'being told what to do' by a

coworker seems

inadequate and simplistic. I think that a better patient/doctor analogy

would be: 'Do you like to

be told what to do by managers/bosses?' This would show that one recognizes

a 'higher authority' (such as a supervisor/manager/doctor)

and will follow through because one recognizes that person's directive.

Then again, I don't think ANYONE choosing this surgery wouldn't realize and

accept that supplementation is an essential lifestyle change and lifelong

aspect of post-op life. Those who chose this surgery generally are well

informed, intelligent and had to pull information like pulling teeth from a

variety of sources! Many people are scared away by the severity of the

nutritional complications post-op upon superficial initial investigation;

Those who remain devoted to the surgery are most certainly devoted to all

that it entails by default, IMHO. :)

I don't necessarily think that all people with BPD/DS are not independent

thinkers...

I don't think 'compliance' necessarily means 'unquestioning obedience.' I

think asking

questions are a good thing and it is easier to comply with orders if one

fully understands

the absolute necessity of them. But, then again, I haven't

taken any psychiatric test yet! ROFL WISH ME LUCK, gUYS! :)

Personally, I think patients should become as informed as possible about their

medical care. Ultimately, it is the physician who is best qualified to make

decisions,

but shouldn't one be responsible for one's body and fully try to understand

what

will happen? I've found that doctors do not necessarily always inform

patients of

issues relating to their condition, etc. or possible treatment options, etc.

I'm not

talking about bariatric surgery in particular (although the experience of

many former

BPD patients may be an indication of how lack of information can lead to

serious

health problems from what I've read), but in general.

I was recently diagnosed with an anal fissure (ouch!) after a colonoscopy.

The doctor

just prescribed a topical treatment and told me to call him if things got

worse. That's

it! No mention of how long before I should expect to see improvement or what

treatment

options there were available. It's been about 3 weeks and I still have

problems. From

what I've read, this is not uncommon (anal fissures can take forever to

heal). But, it sure would have been nice to have known

beforehand what to possibly expect. I also learned upon independent

investigation that there are other treatments

available -- botox injections, stronger topical treatments (with EMLA cream),

treatments

with nitroglycerin --- All viable alternates to surgery. What do I do with

this information?

Just wait things out and, if surgery is suggested, have an active role in

discussing other

options that I might prefer. Am I going to just accept anal surgery (which

carries a risk of post-op fecal incontinence) because it is the 'next' step?

Hell, no! :) Am I going to listen to the doctor's suggestions and

reasoning? Hell, Yes! But, I will not blindly opt for a surgical method

when other options are open to me. I'm not going to just do something unless

I ask questions and understand it first.

All the best,

initial consult with Dr. Gagner, Mt. Sinai/NYC, Nov. 15 -- can't wait! :)

[Guest guest]

>>I have some concerns over how someone who met me once, isn't an MD (how can

his opinion be valued more than MDs who know much more medically, period!) can

think that their opinion should matter more than mine, my PCP, a therapist and

Psychiatrist who have known me for a long time.<<

If you ask me the psychological " profession " has done more damage to the

morbidly obese than everyone else put together. I don't think surgeons

realize just how much they are asking when they require a psyche eval. If I

never see another psychologist as long as I live it will be too soon.

There are little moments of sweet revenge, though. In my undergrad days the

psychology department at my university made a big push to become part of

the College of Science (they were part of the College of Humanities at the

time). The Board of Regents carefully reviewed their request, talked with

some faculty at the College of Science, then unanimously voted not to let

them in! I guess the Board of Regents " had some concerns " about THEIR

candidacy. So back they went to the College of Humanities, where they

remain to this day. Maybe someone could put together a 12-step program for

them. something along the lines of " Facing Rejection From Real Scholars " or

" Dealing with Feelings of Academic Inferiority. "

-

--

Rousey

[Guest guest]

> Maybe someone could put together a 12-step program for

> them. something along the lines of " Facing Rejection From Real

Scholars " or

> " Dealing with Feelings of Academic Inferiority. "

>

> -

>

> --

>

> Rousey

Oh, -- thanks for the great laugh this evening!!! That was

really, really funny. I do think the profession might be able to use

such a 12-step program!

I needed a little cheer and your post did the job!

all the best,

initial consult with Dr. Gagner, Mt sinai, NYC Nov. 15 -- can't wai

[Guest guest]

You gave me chills! BRAVO!

fondly,

Loriann

~~~~~~~~~~~~~~~~

270# BMI 50

to be switched Nov. 17

in Alcoy, Spain

Dr. Aniceto Baltasar

llist@...

Re: Totally ticked off!

I want to thank everyone for allowing me to vent as I was very upset earlier

today. I also appreciate the support; you guys are really great and it's

nice to know there are some people who can truly understand what I'm

feeling.

As for Mr PhD, I'd like to tell him to go screw himself and the lame

ignorant

horse he rode in on, but I'm not going to do that...yet. I'm still waiting

for him to return my call (where I CALMLY informed him that I was not

pleased

with this situation and I fully expect an explanation.)

I've always had an interest in psychology and actually am working towards

eventually getting a PhD myself, and I know I could have answered the

questions on the test in a way that would ensure a positive report to the

surgeon, but I was actually curious as to how the test would actually turn

out if I answered it honestly. But seriously, the questions on that test

are, for the most part, unanswerable with the choices they allow you. " I

love my mother " Eh....well, yeah, I do, but..... " I like rain. " etc. I

mean come on!

Yes, I have depression and a body image problem. Being morbidly obese

certainly hasn't helped that situation. I've also been at 150 pounds and

felt great about myself! I KNOW what it feels like to be (at least almost)

normal weight. I lost a lot of weight several years ago (basically by

starving myself and overexercising) and I know what it can do for depression

and body image problems. I also know that the sudden freedom from being

overweight can be overwelming for some. It wasn't for me. It was simply

wonderful!

And no, I don't like to follow directions in a lot of instances. If I did,

I

would have disregarded the option of having surgery long ago because my

family, friends, and a few doctors did not believe ANYONE should have WLS,

hence it was not something I should even consider. God forgive me for

having

a mind of my own and for knowing what is best for me. I have, however,

always been stringent about my medical care, and if things seem out of

whack,

you can be sure I'll be at the doctor's office getting the necessary tests

and taking the necessary meds. Whether or not I like to be told what to do

by coworkers (one of the questions on the MMRI test) has nothing to do with

whether or not I will follow the directions of my surgeon postoperatively.

As for Dr. Aslam...you know, I've never even met the guy and he's never met

me, yet he's willing to base the decision of my having WLS on the opinion of

a Psychologist who met me once? Well, there goes my respect for his

abilities. Along with this, he has disregarded the consults of the

Dietician, a Therapist whom I saw for 2 years, my PCP and my Psychiatrist

(the last 2 being MDs) who all told him that I was an excellent candidate

for

this surgery.

Maybe this is fate as I've been unable to shake this feeling that he's just

not the right one to be doing this surgery on me. I've been dealing with

Dr.

Aslam's office since July and I've yet to meet the man or receive any word

from him that didn't come via his nurse. Yet, I Emailed Dr. Baltasar and

introduced myself, and he PERSONALLY wrote back the next day in a very

thoughtful letter (one I wouldn't expect from a Surgeon) where he explained

his experience, the procedures he offered, the cost, recovery time, etc. And

there was something else he said which kinda floored me. " If you would

decide to have the WLS, I would be happy to take care of you. "

I've worked in the medical field for eight years and deal with doctors

everyday. Right now I transcribe their reports and have NEVER once heard a

surgeon or any type of doctor say " I would be happy to TAKE CARE OF YOU. "

There's the " will admit and do this and that " or " I will accept you as a

patient " or " I will evaluate or operate on you " but never ever " take care of

you. " Dr. Baltasar also gave me his home phone number.

My God, am I the only one who thinks US healthcare has gone to the dogs and

these doctors need to take lessons from their foreign counterparts?

Somehow, someway, I'm going to get the money (much less than Dr. Aslam would

be charging me anyway) and I'm going to Spain.

I'm still ticked, but I truly believe that everything happens for a reason,

and though I do not believe this has happened because I'm not meant to have

WLS, I think it just means I'll be better taken care of in a foreign country

rather than my own. (Kinda sad when you think about it).

[Guest guest]

> Ultimately, it is the physician who is best qualified to make

> decisions

I respectfully disagree. First of all some physicians are more skilled than

others, some are more knowledgable than others, etc. There are a LOT of

physicians out there who are totally ignorant when it comes to MO patients

(and most, if not all, of us have encountered them personally). I think it

is the responsibility of the patient to:

a) Educate themselves on the available treatments for their disorder and

the pros and cons of each (I would never have found DS if I hadn't done

this).

Listen to the physician, but be a critical thinker. Their experience and

knowledge are valuable, but that DOES NOT mean you have to just take them

at their word. A physician is NOT God. Some physicians aren't even very

good mortals.

Basically, I believe that the patient must bear the ultimate responsibility

for their own treatment decisions. If you have doubts, GET A SECOND OPINION

and GET EDUCATED!

-

[Guest guest]

> > Ultimately, it is the physician who is best qualified to make

> > decisions

>

> I respectfully disagree. First of all some physicians are more

skilled than

> others, some are more knowledgable than others, etc. There are a LOT

of

> physicians out there who are totally ignorant when it comes to MO

patients

> (and most, if not all, of us have encountered them personally). I

think it

> is the responsibility of the patient to:

>

> a) Educate themselves on the available treatments for their disorder

and

> the pros and cons of each (I would never have found DS if I hadn't

done

> this).

> Listen to the physician, but be a critical thinker. Their

experience and

> knowledge are valuable, but that DOES NOT mean you have to just take

them

> at their word. A physician is NOT God. Some physicians aren't even

very

> good mortals.

>

> Basically, I believe that the patient must bear the ultimate

responsibility

> for their own treatment decisions. If you have doubts, GET A SECOND

OPINION

> and GET EDUCATED!

>

> -

ERIC: I wholeheartedly agree that not all physicians are created

equal. And, yes - many of them do NOT know the specifics of MO and

don't treat the MO patient accurately. I'm sure EVERYONE here has

suffered from that! I don't think in any way I said that people

should blindly follow any doctor's opinion without doing independent

research or being prepared beforehand.

IN FACT, MOST of my post described how having knowledge is essential

to good self-care and questioning treatment is a positive (and perhaps

even life-saving) activity. I joked about how the psych may not

consider ME an 'ideal candidate for BPD/DS' because I do 'question

authority' and MUST understand instructions totally before taking

actions that are given to me.

However, all this being said, I meant by the sentence above that I

ultimately respect MY CHOSEN doctor's (i.e. - THE DOCTOR) opinions

and experience. I don't just trust any doctor's word, but when I DO

find one that I can trust (and trust is a basic tenant to the

doctor/patient relationship, IMHO) and have discussed options, etc.

with that person -- then, I will and do, at some point, need to concur

that this person *may* know more than I do.

I firmly believe that healthcare IS a cooperative experience, but in

the end, all things considered, I can do all the research in the world

and still not necessarily be able to know *absolutely* what is best in

every decision. I may have preconceived notions that are not totally

accurate; I may have not taken into consideration various factors; I

may not have access to the most recent studies available. My doctor

could have gone to a conference recently and have information that I

would not be able to access and this information may have me thinking

of NEW options, etc.

I would never say that doctors are GODS nor do I think having an MD

behind one's last name indicates that a person knows everything about

medicine. If something doesn't 'feel right' to me or a doctor does

not adequately address my questions, needs or fears -- then I have no

hesitation looking elsewhere. I have done this before!

But, once I find someone with whom I can have a comfortable exchange

of ideas; Someone who can respect my intelligence and desire to be an

active participant in my healthcare decisions; I feel that I WILL

ultimately be putting my life into that person's hands. Why? Because

that person WILL ultimately be making decisions on my behalf when I am

not able to do so (ie. during surgery while I am under anethesia).

I expect that doctor to respect my wishes and opinions but I also

think that there will be instances in my life when my chosen doctor

(and, I will have taken the time and effort to have chosen that person

WELL) will need to take actions, guided by my input, but ultimately

these actions may have to be made based on his/her expertise.

all the best,

initial consult with Dr. Ga

[Guest guest]

From: http://www.asbs.org/html/ration.html#PREOPERATIVE

PREOPERATIVE PSYCHOLOGICAL TESTING:

There are two possible reasons for pre-operative psychological testing prior

to bariatric surgery. One is to weed out those with significant

psychopathology in whom surgery would be contra-indicated, the other to

pre-select those in whom the surgery is likely to be a success.

Unfortunately psychologic evaluation has proven of limited value in both

these situations.

(there is more there to read)

=================

I am concerned about the inappropriate use of testing for this surgery. I

think it comes partly out of recognition that a person needs to have the

cognitive understanding and the willingness to follow the post op directions

to prevent serious deficits.

Second, I suspect that the surgeons share some of the bias that is also

mentioned in the report above:

" Lack of respect for the morbidly obese is an issue of concern. A survey of

morbidly obese individuals found that nearly eighty percent reported being

treated disrespectfully by the medical profession.(30, 31) There are

widespread negative attitudes that the morbidly obese adult is weak-willed,

ugly, awkward, self-indulgent and immoral. This intense prejudice cuts

across age, sex, religion, race, and socioeconomic status. Numerous studies

have documented the stigmatization of obese persons in most areas of social

functioning. This can promote psychological distress and increase the risk

of developing a psychological disorder. The morbidly obese patient is at

risk for affective, anxiety and substance abuse disorders. The obese often

consider their condition as a greater handicap than deafness, dyslexia or

blindness.(32, 33) "

in Seattle

----- Original Message -----

> I cannot believe this!

>

> After a year of researching WLS, after driving hundreds of miles to meet

with

> doctors and have the preliminary tests done, I'm now being thwarted by

some

> schmuck psychologist who met me for 30 minutes!

>

> I suffer from depression, not major just dysthymic, and because of this

and a

> low self esteem, I saw a therapist for over 2 years. When she moved out

of

> state, I began seeing the Psychiatrist who manages my meds for therapy as

> well. Both believed, after having known me for quite a while, that I was

an

> excellent candidate for WLS and that it would not be detrimental to my

mental

> state. Both expressed their opinions to Dr. Aslam, yet he would not

accept

> their opinions because they did not know all there was to know about the

DS

> procedure.

[Guest guest]

> After telling me he was going to get his (positive) consultation

>done that night and send it out to Dr. Aslam asap, and after actually

>sending an unsolicited copy to my Psychiatrist, he had a change of

>heart after " grading " my test and decided I was " not a good candidate

>behaviorally

Sheesh! I can imagine you are ticked off, sounds like a very

frustrating situation. I just took similar tests for my psych

evaluation and agree that they seem pretty simplistic. In my

appointment they scored it while I was in the office which only seems

fair instead of telling you that you'd passed. It would be very

interesting to see what changed his mind. Maybe he could do a phone

consult with you? I'm sorry it's such a pain and I hope it gets

resolved well for you.....

=====

H

Dr. Keshishian/surgery 11-21-2000

San Francisco Bay Area

mailto: hillsmith2000@...

__________________________________________________