crosswind

I really thought I had this timed perfectly when I set my surgery date. I'm usually like a swiss watch but I have heavy periods and it was the last thing I wanted to be thinking about when I flew to Mexico. So usually it shows up a couple days after the full moon, the 20th or 21st. Perfect: surgery date on the 29th. All over, no problems and no dealing with that right after surgery. Except it's not coming. Dammit I have even been* talking* to my uterus all day yesterday and today -- " Come ON already...Please. For once do what I expect you to. " But alas. I did just quit smoking and caffeine and SUGAR and I am deeply freaked out about getting on that plane on Monday so I guess I shouldn't be so surprised. Sigh. So I was wondering who all took Aunt Flo into surgery with them and if it was a problem.

Um, I don't do this and I have never EVER done this ever in my whole life. Actually it's not true, I did do it once and from what I recall it itched like I had fireants in my shorts. Am I completely behind the times here? Is a nurse really going to cluck over my chocha while she's inserting my catheter? Do you think they talk in the breakroom about the various foliage they've seen?

You know the only reason I can think of that inlaws would be so obsessed with their son's money is because they think they're going to get their hands on it somehow. I mean it almost sounds like jealousy. Like what they would really expect would be that he handed his paycheck over to them " to manage." I can't even imagine. I'd be so overwhelmed with violation and fury I would probably clean out the bank account and tell my husband to marry his parents. Geeeeeepers.

Thanks for replies, all!

Curious: for that post op fever did you take Tylenol or let it run?

In the states, the original surgeon I was going with had a nice discount package put together with one year of post op followup and BLIS insurance. Going to Mexico is different, you get unlimited phone support and you can come back anytime but you do have to pay ( less than in US) and of course, you have to fly to Mexico.

I was dead set against surgery too. I thought it was self-mutilation. Then I realized I'd been mutilizing myself over this issue for most of my life.

FBG -- it's great to have aftercare. The self-pay surgeon I was looking at here had a package with the hospital, anesthesia, BLIS and I think a year of global aftercare for 20K. I was really going to do that but I did this instead -- I'm almost trying to figure out why after the fact. In the OP I was theorizing about the lack of complications ( as far as I know) with this particular surgeon after so many sleeves. My theory was that rigorous patient monitoring immediately after surgery, and within a longer time frame to let problems develop, might be one reason there are less complications so far with this doctor.

I know but I think those 911 calls are hilarious. http://www.oddee.com/item_96669.aspx

Absolutely what I was trying to say . If the US doesn't have the cheapesst healthcare in the world, it really should have the best given the money and energy that goes into it. And it's amazing about the lap band. When I was looking into surgery it only took a couple of youtube videos -- not even very negative ones -- to decide I did not want that. A port in the stomach? "Fills"?Productive burping? Wha? I am not sure how I happened upon this procedure or actually even what came over me to get me to this point. But I never heard anyone say " I love my lapband" the way I see people loving their sleeves all over the internet. The other interesting thing is what we're articulating. The "system" is so institutionalized that it interferes not only with care but with medical innovation and improving practices. At a certain point we might have to hand over our crown of hightech healthcare to some other country that doesn't try so hard to keep its doctors away from its patients. You can't get better at medicine your real job is filling out forms.

Texas, I know exactly what you mean. You know I had a thought last night. I wonder how many of those celebrity chicks have already had bariatric surgery. Some of these women...I'm thinking...okay how are you still 111 pounds at age 41? What are they eating? Their own hair? Just a thought.

Holy crap! You went there? Man, I thought and thought about getting out there and spending that money. But I just knew what was going to happen. I knew I would buy all new exercise clothes and whatever supplements they were selling and be fat a year later. Oh PLUS I'd be telling everybody, I'm going to the biggest loser camp, yeah, spent fifteen thousand dollars, hm? Oh, well, I gained it back. You know, that kind of program is hard to keep up with on your own...

I haven't been sleeved yet, but I don't think I'll have buyers remorse. I'm not sure, I could feel entirely differently a couple days from now, but I've been dieting since I was eleven and I'm completely neurotic by this time about weight loss. Like I can remember being totally cratered by the stomach flu and getting up the minute I felt well enough to get on the scale. I can see myself being miserable from pains and drains, lying in bed thinking, at least I'm getting thinner...

K. Apparently I'm not sleeping. I'm wondering what all your post op followup visits consist of. I was considering going back to the surgeon in my town for followup but now I'm curious. What's in those visits? Weigh ins? Meds? Exams?

I resurrected a COBRA plan that I was planning not to use. When I first started this process I didn't even know I could be denied for being overweight. I actually am not over 40 bmi but the rep for BCBS said I might be denied anyway because I'm so close. I'm not holding my breath. I think the best thing for people to do when they're not insured and they're self-pay is to try to lock in some kind of basic coverage before they go in if there's no BLIS being offered. If a person is denied because they're a BMI of 39, maybe think about trying to drop just like five pounds to get in the door. If none of that is applicable, well...cowabunga.

. Thanks for replies. I'll keep updating. I type a lot when I'm nervous...

You know, I was thinking this might be part of the secret to the low complication rate. In the states no insurance is going to pay for hospital stays that are longer than absolutely necessary. That's where the money really adds up here, and people are sent stumbling off into the world far too early. If you have a four day recovery time - your fluids are monitored, your pain is monitored, your nutritional intake is monitored, etc. You are not suddenly called in to work by your boss, your dog is being fed by someone else, your sheets are sterile...well, on and on. It seems to me that might make a difference in how well a person would recover anywhere.

otfm, I'm not trying to convince anybody to fly to mexico. If I had insurance I was reasonably sure would cover this *without* a lot of paperwork and driving to different offices and waiting for stuff in the mail and convincing people I was worthy -- I would absolutely do that. Everybody has their priorities. Above all mine is, I am 46 years old, uninsured, and I am out of time to screw around. " The needlework alone could last for years." Did you ever see that movie? Yours are different and it's your surgery. It's hard to argue that it's a bad idea to "stay home* and *pay less*. You're right, a lot of people don't have that money -- some people finance it - but here's my thing about the money: I am going to spend it trying to lose weight anyway. I am going to buy a diet, ten more diet books, the new craze, pill, injection, miracle juice - - not to mention I am going to spend a whole lot of money on medication if none of that stuff works, which it won't. Ten thousand dollars is chump change against what most women, at least, spend on getting thin in their lifetimes; and if they fail they end up paying a doctor anyway.

I quit smoking. I stopped drinking caffeine. I am blowing up these silly little balloons every day. I have a passport. I bought a round trip ticket, first class. I checked as reasonably as I could into insurance options when I got home. I am doing the pre-op lowcarb diet. Saturday I'm going to purchase a money order since I couldn't get my credit card limit raised since I just moved. I made a plan to stay with my family for the first ten days after I get home just so somebody would be around. I bought slippers and some slouchy pants to walk around the hospital with, GasX strips, and ordered Protein drinks and a pitcher from Amazon. I still need Jello and broth. I have a ride to the airport. I have a ride home from the airport. I think I'm actually doing this! I might be a little optimistic about how miserable I'll feel afterwards. Also I specifically *planned* for this to happen after my TOM and wouldn't you know it, the darn thing hasn't come yet. Neither of these things is enough to make me chicken out. Plus I've never flown first class before -- the trip is about 4.5 hours. I'm looking forward to the happy pills, lol. Mostly I'm just stunned at my audacity. In the past two years I've looked into all kinds of weight loss options. Fat camps. Did you know there's a place in Utah that will put you on the HCG diet if you stay a month and give them twenty thousand dollars? Also The Biggest Loser camp in utah -- 15,000. You can go to a spa in California where some guy will feed you tuna and crackers every three hours and "reshape your body": 25,000 dollars. Hiking, touchy-feely camp in Vermont: 18,000. We Care spa, where Mariah Carey went once: 20k to live in a desert cabin and make your own vegetable juice, all other services extra. Raw food retreat -- 5,000 a week. The Raj Ayurveda Panchakarma spa: 700 a night. Nutrisystem: 400 a month times a year is 5k, if you stay on it. Medifast is about the same no matter what they say. Jenny Craig, oh my lord. Initiation fee of 500 dollars plus about 150 a week. I am just tired of this, you know? At the supermarket every women's magazine is really a diet magazine touting a "miracle breakthrough." I was in the deli section and there was a book caarousel there with a book on it called " The TEA Diet." So think about this. Think about all that money, all that time, all that reading, all that measuring, taping, weighing, the "consultations", the "meetings", the late night infomercials, the exercise tapes, the before and afters, all that time, years and years of life wrapped up in this obsession that NEVER gets solved. I mean look I can love my body and allow myself to be loved and adore my ankles and all that but this will not make me a thin girl. I found one thing that really will and it will cost me eleven thousand dollars, an enormous amount of anxiety, some literal pain and after that? all that, up there? Gone. FOREVER. And I am really doing it.

Awesome! Congrats!

Actually I think the real true reaason for the pre-op diet is because if I wasn't on it I would do what any normal fat or thin person would do if you told them they would not be able to eat for a month and then very very carefully forever thereafter. I would go insane trying to stuff everything in my mouth I would tell myself I would never taste again. If you want to make an obsessive overeater out of anyone, just tell them the world will be all out of food next week...

1100? All the better! Don't me wrong, I'm not bragging personally about Dr. Aceves - I haven't met him yet. I was really just using him as an example of the difference in techniques and requirements among successful surgeons. From some of the posts I've read all over the place, some of these guys have their patients sweating bullets for months when the real issue is whether the surgery was a success, and whether post-op compliance was met. It seems...extraneous.

See, now, I would totally go with that guy because he's done eleven hundred of the things. In my home state I asked about that and they told me that surgeon had done five hundred bariatric procedures, and when I asked how many sleeves two nurses at that office said they "weren't sure." And I agree about the malpractice.

Hey. Believe it or not there are some studies that show that older patients do better with major surgery than younger people do. I can't quite remember all the studies but one thing they pointed to was a less urgent response to stress. Stress is actually an immune response -- older peoples' immune systems aren't always worse but often different -- more flexible and acclimatory. One thing older people have learned how to do is adjust -- that seems to help with health challenges, including surgery.

On another topic I was posting my brilliant musings about surgeons and pre-op diets and I wanted to say this because sometimes I'll answer a post and it will sound like I'm stating some authoritative opinion when I'm really thinking out loud. I've been watching these boards for a couple of months and looked into getting surgery in my home state but it was very expensive. I knew it was going to be but then I realized the other thing I really did not want to deal with was six months of "pre-op" nonsense. I realized this when I contacted Dr. Aceves' office a second time and spoke to his patient coordinator, who was very direct but also very clear about what was truly necessary and what was not. In their practice. My pre-op is a week long lowcarb diet. I had to quit smoking ten days beforehand and start blowing up balloons. She told me about many other patients, their concerns, what could possibly come up, and why they needed me to do what they needed me to do. Dr. Aceves has performed over 600 sleeves with very few complications as far as I can tell. I know of one rumored leak and then another phantom guy who came on here and said he almost died and that translates to a .03 serious complication rate for his sleeves. Yet his pre-ops are pretty lenient. I can use NRT. I did not need a psych evaluation. I put down my deposit, bought a plane ticket and was scheduled two weeks from that date. If Dr. Aceves were this lenient and he was sending people home half-dead, I would be suspicious. But he does appear to know what he's doing and there is a strong track record behind his methods so I'm happy to do what he tells me to do. One other thing I noticed is that less people come around, online, on youtube, on boards like this and describe serious early or late complications of any kind if they've come from Dr. Aceves. Now either he is paying off his broken patients off or he is rolling the dead ones up in rugs and driving them into the desert for the coyotes -- OR more people are coming away pretty much whole when he is done with them. Which leads me to my suspicion about a number of surgeons in the US who are approveable by insurance: some of these people -- not all, I haven't done any data mining in this regard -- but unscientifically it seems some of these surgeons just have not done many sleeves and so they have to learn the hard way -- on us. One way to mitigate potential disaster in that case is to make the patient's pre-op extremely rigorous. For example, a surgeon might say he can't operate on you until you lose ten percent of your body weight -- why is that? Because the literature and the insurance actuarial studies have said that this lessens risk by some margin, and it's possible that without certain patient requirements the hospital or the doctor will not be paid the insurance portion of the procedure. Also - surgeons work how they need to work - if he has learned to do the surgery using a 48 bougie on patients with very tiny livers who are under 45 BMI, these are the only people he is going to operate on. I am not faulting a surgeon who has only done a couple surgeries for doing another one -- he'll do what he needs to do to be reasonably sure his patient is going to live through it. But as of 2008, three years ago, a local news story on the sleeve said that " only a few surgeons in the country" knew how to do this procedure. Anyway my suspicion is that your pre-op diet reflects what reassures the surgeon according to certain criteria and what will appease your insurance company. Whether it is specifically *necessary* to do the operation is another thing. It's the only logical conclusion I can come to based on what I've been reading. Why would a person need to lose ten percent of his body weight *before* surgery? It makes no sense -- but it might make sense according to some JAMA study the insurance companies like. The other thing I've noticed is that while Dr. Aceves' pre-op is not the most rigorous in the world -- his POST-OP is incredibly strict. Why? Because complications don't occur before surgery. They occur afterwards. That's why his patients ( and some others I'm sure) leave the hospital on Clear liquids for ten days, not three. Or more actually. It seems like the majority of post-op complications come from patient noncompliance some time after surgery, like the person who goes to a barbecue three days out and attempts chili. It seems more important that you don't do that than *anything* you do beforehand within reason. So what it comes down to is this -- at this point this surgery is unique to the surgeon. His experience, whatever pressures there are from the money or the hospital, and his specific expertise in punching you open and refashioning your internal organs. And this is why I say the American system is fuqed. It would all be so much easier if some of those pressures were lessened, and insurance didn't put so many roadblocks in the way -- not just for patients but for the whole procedure. Thats what I think!