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Pre-Surgical Office Visits and Tests

B

Barbara J.

Member
I've had a complete (and I do mean) complete blood work-up. Everything fell within normal range, thank goodness (check). Also, had a consult with my psychiatrist to make sure he was on board and to get his advice on my meds (check-check). Today, I had my appointments with the nutritionist and psychologist. The nutritionist was really good. In fact, I had a 2-hour office visit with her.

My psychologist, however, was a total nut case. It's a good thing there are no right or wrong answers, because I'm not sure she could even find her way out of a closet. I'm glad I'm only required to see her once; I don't know if I could stand a second visit. She insisted that my husband and I come to her group session next Tuesday. After leaving her office, I noticed on her session sheet that I'd missed the monthly session for "pre-surgery" patients. She wanted my husband and I to go to a session for people who were 18-months or over POST-surgery. The session/s aren't required for my insurance, so my husband and I aren't going. It's over an hour drive to attend one of her sessions. I can go to sessions at a hospital that's about 20 minutes away from our house. I'll take that route. I don't believe I'd get anything out of her sessions, anyway. She said she'd had 24 years of bariatric experience. Has bariatric surgery been around that long? My impression after talking with her is that she couldn't get work anywhere else. The surgeon who's doing my surgery is rated top of the line, but I believe he wants the money too bad to turn me down for surgery because of her. Therefore, I'm not worried about it. One of her questions was "did I consider myself to have a slight or moderate WV accent to my speech". I told her that some people had commented that I had an accent, but I didn't know to what extent. She said she'd record me as having a moderate accent. How in the world would that affect me psychologically??? That's just a mild example of some of the questions and comments she gave me.

I found out today that my surgeon doesn't require a one or two week liquid diet prior to surgery. They also don't require a sleep apnea test. They do, however, require an endoscopy test, blood gas test and a few other tests I haven't heard mentioned in the forum. They also do a test while you're in surgery to assure that there aren't any leaks or problems. I'll have a drain tube in my body for some days after surgery. A medical "group" (for lack of the proper word) will come to my home every day while it's there.

Do my surgical procedures sound like any of yours?

In any case, my case will now be sent to Medicare for approval. The nutritionist said I'd probably have my surgery by the end of October at the latest. I'm ready now. She also told me that as long as I'm not experiencing any problems, I'll probably be given the okay to travel from Florida to WV as long as it's by vehicle versus flying. We'd have to make several stops for me to get out and walk around some. I can handle that. I really don't want to miss Christmas morning seeing the grandkids coming down the stairs to see what Santa brought them.
 
Barbara-I had to laugh when I read your comment about the psychologist, mine was a piece of work too. She was almost 10 minutes late and mentioned my co-pay amount 3 times before she gave me the multiple choice test in exchange for handing over the co-pay, cash only, right then and there *LOL* When I was done she practically ran me over trying to get out the door.

I had to have a test for leaks the day after surgery and also had to wear a drain tube for 4 days. I was lucky that it was removed before I went home but had to tend to one laproscopic incision for 4 days to make sure there was no fluid build up, it was very messy and I wished they had left the drain in instead.

I'm glad to hear things are moving in the right direction for you.
 
The psychologist kept me waiting a full hour after my appointment time, because she was playing with a dog that another patient had brought into the office. She was in full sight of me the entire time. I have to see a psychiatrist every 3 monthss. I had met with my psychiatrist on an extra office visit (a consult) around the bariatric surgery. He went over some things I already knew and others that I didn't know. He also told me that my meds would have to be crushed, etc. After seeing the psychologist, yesterday, she had me sign a release so she could nose around in my psychiatric records. I've never signed that kind of release before and did it with some reluctance. It's quite personal information. She also told me that she was requiring a letter from my psychiatrist stating that he supported me in the surgery, was aware the meds had to be crushed, etc. Keep in mind that I'd signed a release so she could access all the information she was requiring. I called my psychiatrist's office today and found that it will cost $150.00 for the letter. I was livid - not toward my psychiatrist, but at the psychologist. Therefore, I called the office and told them there was a problem. I explained the situation and told them I had no intention of paying for a letter when their psychologist had ready access to my entire records. The nurse practitioner told me she'd contact the coordinator to see if we could come up with a compromise. I then emphasized, again, that I had no intention of "purchasing" a letter. Now I'll just have to wait to see what the "compromise" will be. I'm fully prepared to write a complaint letter to the surgeon PLUS his boss if this situation isn't resolved to my satisfaction. I'm furious!!!!
 
Hi Barbara, it sounds like a frustrating time. You need to stand firm on your stance of not paying for a letter from your primary psychologist, when you signed that medical release you gave permission for your primary psychologist to talk to and share "your information" to the requesting psychologist, so if the psychologist wants a letter from your primary she can pay for it, and make sure to follow up with the WLS coordinator they can usually smooth that stuff out. The bariatric psychologist sounds like she needs to seek some counciling of her own, I would also relay, tactfully, your dismay with her as well as her unprofessionalism on you office vist to the Bariatric coordinator. Hope everything goes smoother with the rest of you visits on your journey. :cool: Tom
 
Thanks for your advice. It reaffirms that I'm making the right decision in telling them I'm not paying $150 for a letter when the psychologist has a release. I've seen a total of 3 psychologists in my lifetime. Two of the three were very good. The third was bad but not nearly as bad as the one in the bariatrics office. The out-of-pocket expenses in preparation for the surgery are quite expensive as it is without adding more expense to it. My husband has his heels dug in deep on the subject. I'm hoping I'll hear something from the coordinator today. I truly want to have this surgery badly and am banking on the fact that the surgeon is going to want to make the money. While I was seeing the psychologist, my husband said the "boss - for lack of a better word" in bariatrics in the hospital came into the office and was having a quiet discussion with the surgeon. According to my husband, they were discussing the fact that the surgeries had slacked off. In other words, business isn't too good right now. With the economy being as it is, I'm not surprised. I really don't believe the surgeon or his boss will stand back and allow a psychologist to run customers away. I'll let you and Pat know something when I hear from the coordinator. If I'm not satisfied with the coordinator, I'm definitely going to write a letter to the surgeon and his boss. They need to know what's happening with the psychologist. Even if I am satisfied with the coordinator, I'll still write a letter after the surgery. This woman is supposed to be who I'll see if I run into problems post-op. I'm paying a fee for that, too, so I want a good psychologist.

I'm so glad I joined the forum. You and Pat have given me some real support, and I appreciate it. I was really down-hearted until hearing from the two of you.
 
The office coordinator called me back this morning. I told her point blank that I had no intentions of paying my psychiatrist to compose a $150 letter when I'd signed a release so the psychologist could see my records. The office manager told me not to worry about it. She said she'd see that the psychologist simply calls my psychiatrist. That was a relief.

I'd stewed over this psychologist all weekend and felt that she needed to be reported, so I did just that. I explained to the office coordinator everything that took place while I was in her office. I included the fact that the psychologist had tried to talk me out of having the surgery. The office coordinator was appalled. She's going to anonymously pass the information on to the director. Hopefully, that will either bring about an attitude adjustment with the psychologist, or they'll replace her.
 
darkpoeticangel said:
What co pays
Doesn't my insurance cover it
Click to expand...

There are differences between insurance's. Mine required a co-pay for the psych evaluation. I also had co-pays for most of my tests, specialist visits and of course my hospital stay. To find out what your out of pocket costs will be you should call your insurance carrier. Usually, but not always, your co-pay amounts for a doctor visit, specialist visit and ER visit are printed on the front of your card.
 
The initial office visit with the psychologist isn't covered by my insurance. I had to pay $200 (cash only) for that visit. The psychologist was requiring that I "also" get a letter from my "personal" psychiatrist that consisted of the exact same information that I'd already voluntarily given to her verbally. That letter would have cost an additional $150.00.

One of the most basic building blocks between a psychologist and patient is trust. This psychologist also told me that I'd most likely become an alcoholic after having the surgery. I don't even drink other than a rare glass of wine. There was no basis for her to make that statement. I've had to see 3 psychologists in my lifetime, because I've had some really horrible things happen to me. Two out of the three psychologists were very good. This is the psychologist I'm supposed to see if I run into any psychological problems post surgery. Based on the initial visit, I'll haver my psychiatrist recommend someone.

I couldn't relay everything (on the forum) that took place during the office visit due to it's length. I will say, though, that a normal psychologist doesn't slam her fist onto the desk, repeatedly, or stick a diagram of the surgical procedure in front of your face and pointedly explain exactly what will take place while poking the diagram hard and shaking it the whole time. It was a real fiasco.
 
Hi Barbara, that psychologist sounds like a real nut case and very unproffessional, the good news is once you have had your consult with her and had you your surgery you will never have to see her again, since you are paying out of pocket you can see who ever you would like, if the need arises, including the psychologist you have seen in the past:D I highly doubt that you will become an alchoholic after the surgery, studies have shown that men are more likely to develop alcholism within 2 years of surgery than women, however it would be worth monitoring, but not worth worring about. My drinking got way out of hand about 9 months after surgery and led me down a dark path for a while but I rebounded ok, I call it my bump in the road, my WLS coordinator warned me about the alcohol and mot the psychologist, so I was able to regofnize it and get help before I damaged myself:eek: that was a real scary time for me. I hope everything slse goes well. :cool: Tom
 
Yeah!!! Hurdle Has Been Crossed

I just got word from the bariatric coordinator that the psychologist spoke with my psychiatrist yesterday - no extra $150 charge. She said the office will be getting in touch with me in a week or so to schedule my surgery date. There still are a few tests and endoscopy that have to be done. Everything is done thru the hospital where my surgeon operates. Apparently, they have everything down to a fine art, because things are going to start hopping once I get that phone call.

Lord - please let be doing the right thing. It's going to be such a HUGE life style change. Now I've got the jitters. I just keep thinking about all the activities I'll be able to do once the weight's off. Plus - the biggee is the fact that in all probability the surgery will either drastically lessen by back pain or eliminate it altogether. I'm having to wear a "Tens" unit all day, now, to mask my back pain.

Pat, I've already set my notebook up. The notebook has a clear sleeve on the front. I typed a coversheet titled "Bariatrics" - Not a Diet; A New Way of Life" and slipped in into the sleeve. The notebook has labels, sub-labels, etc. I've even typed up my own personal daily food schedule that includes all my medicines using their food schedule as a guide.

I'm excited, but nervous at the same time.
 
Barbara J. said:
...One of the most basic building blocks between a psychologist and patient is trust. This psychologist also told me that I'd most likely become an alcoholic after having the surgery. I don't even drink other than a rare glass of wine. There was no basis for her to make that statement...
Click to expand...

There is evidence that this is actually true with a percentage of gastric bypass patients. Sometimes the food addiction turns into an alcohol addiction after surgery. There are people on this forum that have been told the same thing. If you do an Internet search you will find related information to verify this.
 
I realize there is a small chance I could turn to alcohol. While I was waiting in their office on my last visit a lady came in, and we began chatting while we waited. She told me that she had become an alcoholic after the surgery. She ended up having to go to rehabilitation for 2 years as a result of it.

The problem I'm having is being able to establish a good psychologist/patient relationship with their psychologist. We definitely started off on the wrong foot. I've decided the next time I have an appointment with her, I'm going to be upfront with her (in a nice way). If we're ever going to have a good relationship, I've got to be able to resolve a few issues I have with her. I'm the kind of person who doesn't just sit back with my mouth closed when someone has offended me. I believe in being open and to the point. I've found that, in most cases, if you discuss a problem you have with someone, the problem usually resolves itself.

Did you have all kinds of emotions hit you prior to your surgery? I know I'm doing what needs to be done and am on board with those reasons, but it's like I'm on a roller coaster right now. My back pain will either lessen dramatically once the weight is off or go away altogether, I'll have better self esteem, I'll once again be able to wear clothes that don't look like they could be used as a pup tent, etc.. I've got a high pain tolerance, but I hate hospitals, so I'm dreading that part of the journey. I could use some encouragement from someone who's been thru the surgery. Would you mind giving me a hand?
 
It is an emotional rollercoaster ride for sure! You are not alone in that feeling, most of us have been there. After surgery I didn't have any problems with pain, they gave me a pain pump for the first 24 hours then a liquid pain med for a week or so, the only pain I remember was when I laughed, sneezed or rolled over in bed and gettiung up from a chair, but that went away soon enough too, it wasn't a sharp pain that lasted just one that I felt doing that activity, I am a whimp when it comes to pain so will do fine. By the way I am one of those who has developed alcoholism, it may be due to the surgery but it is also due to genetics, not everyone becomes an alcoholic. Hang in there. :cool: Tom
 
I'm in the middle of volunteering (I'm a Team Leader and Recruiter) in the Presidential campaign - wasn't realistically thinking my surgery would be scheduled until some time in November even though they initially said Pumpkin season. I received a call from the office girl who does the scheduling this afternoon. My surgery is scheduled for October 22 - first surgery of the day. There are so many various doctor visits and tests required prior to surgery I thought it would be impossible to get all of them in prior to that date. I immediately began making calls as soon as I got off the phone. I think I've got all of them scheduled - Whew - talk about doing some scrambling!!! Now, I just have a couple of questions answered, and I think I'll be set. Between the campaign, physical therapy, smoking cessation classes, and doctor visits, I hope the time flys by. I was surprised to find out that Medicare has to approve me, because I'm having the surgery done in a "hospital of excellence". Go figure... Based on the date of the surgery, I'll be able to travel from Florida where I live, now, back to WV to see the grandkids for Christmas as long as we don't run into any complications.
 
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