Could use some advice on finding aftercare in the U.S

-when you call to find a new PCP, do you ask the lady on the phone that you want to know if the PCP will support after care for WLS? that was performed in MX? (i'm not comfortable telling a stranger this)

-has anyone arranged for a WLS surgeon in the U.S. to provide after care? How do you tell them where you got your surgery?

-my PCP made me feel like, because my surgery is in MX, that no one will help me here because of that fact.

-so now I have a complex about how to tell and find a new M.D.

I would like to have all my ducks in a row, before the big day. Thanks for any guidance/insight you can provide.

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It's unfortunate that doctors in the US feel like they can turn away a patient if the operation was performed elsewhere. I mean, don't people ever travel and get into accidents? Or move from one state to another? One of my friends was travelling in Asia in the spring and had a burst appendix repaired in Singapore. I can't imagine a doctor here saying "I refuse to treat you because you had surgery in Singapore." WTF? As a future physician, I'm extremely bothered by this notion. In fact, I think if a doctor here was to do something like that, they'd be up for disciplinary review. I could tell my physician was NOT happy when I told her about my surgery (she was perfectly professional, but I could gather it by her body language), but she agreed to do follow-ups with me - she did ask that Dr. Aceves specify the required bloodwork and the like, as she has no experience with bariatric patients.

Now, back to your concern....you don't need a WLS surgeon for follow-up. Like I mentioned earlier, a primary care physician can do the basic follow-up, such as bloodwork and making sure your incisions are not infected. Just request the details from your Mexican surgeon to ensure that your PCP knows what she's doing.

Any general surgeon is qualified to repair a ruptured sleeve or complications such as strictures in case something happens (partial gastrectomy is a fairly widespread procedure). Gastroenterologists can also do a lot of the repairs for complications, as they can perform ablations and other invasive procedures without actually cutting you open. So any complications that may arise (knock on wood) can be treated by other specialists.

The only required follow-up besides bloodwork will be an upper GI (barium scan), which can be performed at any facility and also doesn't require a WLS surgeon. You can always request a copy of your scan and send it to your Mexican surgeon for review (I plan to do this in addition to having it read by the radiologist here in Canada).

I would approach this very matter-of-factly. Don't start your interaction with the physician by announcing you are looking for a doc to take care of your sleeve. I understand it's very litigious in the US and doctors may be tempted to turn away any patient who's potentially risky. Establish a relationship with the doctor first and then casually mention the surgery. I didn't have any sort of big discussion with my doc about how she feels about my sleeve. I simply walked in there, dropped the bomb, and gave her a list of all my meds and the paperwork from the surgery, and then informed her that I will need bloodwork and an uppper GI in 3 months. You are paying them for their services and they've all taken a Hippocratic oath, so don't feel like you owe them something. You could've gotten the surgery here and then moved to another state or your surgeon passed away unexpectedly and was no longer available for consults, or whatever.

Also, explore your rights as a patient. Like I said, I'm pretty sure here in Canada a doctor couldn't legally refuse to treat a patient like you. In countries founded on immigration, it's ridiculous to hear doctors say they won't take care of work performed in other countries.

BBJ,

Thanks so much for this. I am going to save this post for future reference. My PCP did tell me she would order any tests I needed afterwards, but because she didn't know anything about this procedure, really made it sound like if anything was wrong she wouldn't be able to help.

So if anything dire happens I know I can go to the ER for help. And if, for my 3-month check-up, my PCP is clueless (which I doubt, she 'can' read lab results), I will then begin my search for a new PCP. I sort of want to stick with her, just to prove to her that this will be successful for me, and her negativity was misplaced. And I'm hoping after I told her, she went and did her own research on the subject (and maybe changed her attitude)

Thanks again!

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