"Cheer Up Duckie"
Why isn’t there counselling as part of the package of care with lap-band surgery? This is a question I have been asking myself since yesterday, provoked by a post in a forum. Within my remit as a therapist, in the service I work in, everybody gets pre-diagnostic counselling before they even see the consultant for the barrage of tests. In my experience with the lap-band, I saw the consultant first to talk me through all the physical aspects and then the dietician to go through the pre-op and post-op diets. Neither of them has been physically banded themselves. This is the most radical things that I have done to my body. Why isn’t the emotional aspect to it addressed?
I am aware of the local support groups but, only from the forums. The forums that, incidentally, I was already a member of prior to my initial consultation. I have yet to go to a support group as the February one in my area was 36 hours after my operation :( but I am definitely going to the March one. However, if it wasn’t for the forums I wouldn’t have known what to expect post-operatively.
Here’s an example. I have had several days this week when I have woken up totally depressed. Not just depressed but irrationally and uncharacteristically irritable. This morning was the worst; I completely lost the plot over nothing. It was literally like a red mist had descended on me and I found myself screaming at Jack Spratt over, wait for it, me having a sharper tone with him than normal. Yes, I can be occasionally highly strung, but, very occasionally. The normal me is happy, laid back but easily excitable in a fun way (these are Jack’s words – not mine :) But, this morning I ended up chucking the saucepan into the sink so hard that I chipped the sink, thankfully Jack was upstairs at the time. I was so upset, I was sobbing uncontrollably into the onions as I cooked them. I am so ashamed at myself for the way I ‘lost it’. I scared myself and I certainly shocked Jack. I had warned him that I was barely holding it together this morning so to cut me some slack. I think it’s fair to say that he will believe me next time. I have NEVER screamed and shouted like a ‘fishwife’ before. In my job I have to be so tolerant of behaviours and things that would, frankly, test the patience of a saint at times. Tolerance is my normal state. But this morning, this was like the devil coming out of me. The whole ‘thing’ must have only lasted a couple of minutes, with me having about 10 minutes of sobbingly ‘cooling down’ time. Jack was so lovely; he just cuddled me and cuddled me, whilst I sobbed and snottered on his jumper. I know that he loves me and perhaps understands that this isn’t as easy as I made out. But, still, I am so sorry and utterly ashamed of myself.
The reason I’m saying all of this is that I kind of knew that it might happen. I have read posts about people feeling totally down, without any reason, shortly after post-op and that increased irritation may be a side-effect of both the surgery and the radical change in eating patterns. But what if I wasn’t computer savvy? Many people don’t have regular access to a PC or, if they do, are not confident in using it. So what I’m trying to say is that, in my opinion, I think that everybody should have at least 1 pre-operative counselling session. Something that could help them plan strategies and to inform them of what to expect, emotionally, after the operation.
Then I think that there should be access to a short set of either the choice of, one to one support and education sessions, or, perhaps a structured support and education group comprising of 4 weekly sessions in the first month post-operatively. Then you should be encouraged to attend the normal, informal support groups. The key to it should, in my opinion, be that the sessions are led by somebody who has actually had the lap band themselves, not by some skinny Lizzy who wouldn’t know a calorie if it bit her on the bony arse. Sorry, I am ranting somewhat but, I really think it’s verging on neglectful not to offer this as part of a package. Perhaps it’s because I am a therapist, I’m not sure. But to be, at least, offered the option of something. I know this would be trickier for the Belgium peeps but, even so, if there was a rolling, standardised, group programme across the UK that both the NHS and private people were able to use, then the Belgium package could negotiate to be linked into it.
I just know that I would have really benefited from something like that. That’s just my thinking today.
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