So I guess this works as double duty - an introduction and a (kinda) question.

I am a Registered Nurse...a very fat nurse! And I've been that was (fat, not a nurse ) for almost 13 years. I've done diet after diet. Acupuncture, moxibustion, hypnosis. HCG to the point I got gallstones. And each year, my weight just keeps climbing. I'm ashamed to say that the only significant weight loss I had was after I had met the love of my life, and then lost him...(but later found him...and my lost weight, grrrr!). I have stereotypical PCOS and Metabolic Syndrome (hello, black hairs on chin - I grow an impressive beard!), so that has exacerbated my weight issues.

I started seriously looking into bariatric surgery 6 years ago, but didn't like the available choices of RNY, DS and then LapBand. Over the intervening years, I decided to try to get a LapBand anyways. I had one of those insurance companies that required a 6 month supervised diet, consults, etc...I jumped through all the hoops, found a surgeon I liked...and then he quit! Left private practice to accept a teaching fellowship. I was very bummed. So I figured this was my clue to try dieting again.

So I went back to more failed, frustrating dieting. About this time, I was diagnosed with diabetes, which complicated matters even more. After nearly a year, I decided to go the LapBand route (again!). All my previous tests had expired, so I had to do the 6 months supervised diet and consults again...then got turned down by insurance due to an exclusion...the appealed and won!...set a surgery date and then got very, very ill. The chest xray that was done the week before my surgery showed a shadow in my lungs, so I had to see pulmonary, etc. Turned out to be nothing, but by then my precious "vacation" days from work were wasted and I had to go back. I felt ashamed and defeated, and just gave up on trying to lose weight altogether.

Here it is, 2012, and I can now add hypertension, high cholesterol and tryglycerides and hypothyroid to my medical litany. And finally in January, I said....enough is enough. I'm going to make this happen! I'm 5'8, 310lbs....what would I advise a patient to do in my situation? So I called my insurance and found out that they do not cover bariatric surgery for any reason. ANY. I'm trying to not make any rough comments here, but it's terrible that I am an RN, I devote my life to the health of others, and my company has specifically excluded dietician visits for weight loss, weight loss plans and bariatrics....wtf?? But I digress.

After realizing that I would get no help from insurance, deciding to self-pay was the least difficult choice. My darling husband (the aforementioned lost love who was later found ) had a RNY over 2 years ago with wonderful results, and has been very supportive. I've spent the last month researching my options, and have decided that Dr Aceves is worth my time and money. His track record and reviews have convinced me that Dr Aceves is the best choice for my new sleeve and new life.

And here is where I come to the crossroads. My family is totally unsupportive of bariatrics in general, and Mexico as a whole, so I will not be telling them. The can comment ad-nauseum. I'm still pondering what to tell work - I work in a very tight-knit facility with only a handful of nurses, and my role is such that my absence for even 10 days will be sorely missed (when I fractured my foot in December and I was gone for 2 days, it was mass chaos!). I really, really don't want to tell my boss WHY I need a week and a half off, so I'm trying to figure out how to be creative.

The problem I was NOT anticipating, was needing to find a new primary care physician. When I told my MD what my plans were, she began to tell me how I just needed some willpower, and that she could not support me going to some "back alley hack" in Mexico. She then implied that she would refuse to assist with my follow through care, and that if I did indeed go to Dr Aceves for a sleeve, I would need to find a new PCP.

So I'm stuck on these two things - work and finding a PCP who will be ok with my having weight loss surgery out of country. Argh. I have not set a date for surgery yet...I keep thinking I need to try to get time off first and then try to make a date, but what if one's not open....? I can't afford to lose my job, too many bills! But I need to regain my health. Getting through every day at work is like running the gauntlet, in more ways than one.

Anyways, sorry to ramble. I just want to add what an inspiration it has been to follow along with everyone's progress with their sleeves - I've been reading this forum for quite a while! Thank you so much for your help on my own journey

-Asche, The Crazy Cat Lady

You have to do what is good for you health wise and emotionally. Is your significant other supporting you in this journey? Plan in advance and tell your job you need a much needed vacation for your health and take your days off. Find someone that will support you and help you through this to come with you for moral support. Find a new doctor if they cannot see you after this, that is ridiculous. Your doctor should be worried about your health as well. That is my opinion but you will have to do what works for you and your family. It is ultimatley your decision. I made the choice not to tell anyone but my husband and daughter what I am doing. I feel its a personal decision and I do not want to listen to the negativity from anyone. I have done the research and am comfortable with my decision. Good luck and I hope you have some resolution.

Hi! Your story sounds much like mine! My advice in a nutshell: get your date set with Dr Aceves, then begin calling local Dr's and asking if they will see you. If not, there are walkin clinics that can run labs on you and see you until you find a Dr you like! Good luck to you! Don't put it off sweetie, go with your heart!

I just got back from being sleeved with Dr. Aceves last week. I am sure they will work with you on the date. Can you just tell your work you are having a minor surgery without giving them all of the details? Your PCP sounds a little uninformed. I wouldn't waste my time trying to persuade her about Dr. Aceves' credentials. I recently started going to a new PCP. He was very accepting of my going to Mexico to have the surgery and agreed to follow me afterwards. I am sure you can find someone who is a little more forward-thinking. I was very impressed with Dr. Aceves, his staff and the hospital. Do what you need to do to get healthy!!!

I agree your health is the most important.

Alot of us have been exactly where you are now! I was sleeved 2 years ago by Dr. Aceves. THE BEST THING I'VE EVER DONE FOR MYSELF!!! I saved my life by making the decision to get my surgery done. I was a self pay as well. I was scared and unsure about everything, but knew I had to do something. I didn't tell anyone what I was doing. I scheduled vacation time for a Mexico trip. That's all anyone needed to know. Just tell work you have the opportunity to go on a Mexico vacation and you are jumping on it. I didn't even tell my Family doc about it until I got back. I figured if she didn't like what I did, I would change docs then, but she was and is totally supportive. You can find another family doc no problem, you can't replace your life. Best wishes to you.

ps: I get so angry when I hear a doc tell someone you just need some will power. How ignorant is that?

Alot of us have been exactly where you are now! I was sleeved 2 years ago by Dr. Aceves. THE BEST THING I'VE EVER DONE FOR MYSELF!!! I saved my life by making the decision to get my surgery done. I was a self pay as well. I was scared and unsure about everything, but knew I had to do something. I didn't tell anyone what I was doing. I scheduled vacation time for a Mexico trip. That's all anyone needed to know. Just tell work you have the opportunity to go on a Mexico vacation and you are jumping on it. I didn't even tell my Family doc about it until I got back. I figured if she didn't like what I did, I would change docs then, but she was and is totally supportive. You can find another family doc no problem, you can't replace your life. Best wishes to you.

ps: I get so angry when I hear a doc tell someone you just need some will power. How ignorant is that?

I agree they are just being stupid or they want you to stay ill so they can make money. I did not tell anyone what I was doing just going on vacation. It is nobody's business and it is what I have to do help myself be healthier. People can say what they want but they are not living in your shoes and cannot make the decision for you.

I'm sorry to hear about the difficulties at work. However, I get the feeling that you are one determined lady & will arrive at a solution one way or another.

As far as your PCP is concerned, look at this as an opportunity to work w/ a more informed (and likely more qualified) PCP; so you're going to be better off continuing down this path - a healthier you!! (both from the surgery & from a better PCP).

On another note, I'm also scheduled w/ Dr. Aceves in March, so I share your excitement about this journey! Take care of yourself!!

How much its it to have surgery with Dr Aceves, and how long do you stay at the hospital, and then do you go to a hotel or a recovery house?

I saw dr aceves it was 8,750 if I recall right. After sugery you stayed at the hospital you had sugery in and was there 3 days before I left to go home. He is awesome I highly recommend him to anybody.

Thank you so much for your thoughts. It's a delicate balance - doing what I need to do for me, while still supporting my family.

Good and bad news: Today, called and scheduled my surgery date for April 20th with Dr Aceves - yay! Bad news - work says they can't spare me for that long without paperwork from the doctor indicating length off work, restrictions, etc. And my boss is so snoopy that she'd look up the surgeon's name and it would be allll over. I didn't even try the 'Vacation' excuse. NO ONE is getting vacations where I work right now, unless you're management (who seems to always be gone!). I will try asking again later in the week maybe. As I said, being irresponsible and quitting is not an option, so I have to make this work somehow.

So I only have told my husband and my two closest friends, which is fine but stressful. I wish I had more support. Sigh.

:/ we are always here to help and support you

I don't know where you work but you cannot be denied your earned vacation, to a certain point. Put in for your vacation time and then schedule your surgery. But regardless, they can't deny you time off. And it's also none of their business where you are going!!! So if it's an issue, reschedule your surgery to fit within some vacation time and tell them you have every right to take time off!!!

I own a business and have employees and I can tell you that it makes me angry when people tell me their company won't let them take their vacation time! Or that they have to give a reason for their time off. It's none of their damned business!

I don't know where you work but you cannot be denied your earned vacation, to a certain point. Put in for your vacation time and then schedule your surgery. But regardless, they can't deny you time off. And it's also none of their business where you are going!!! So if it's an issue, reschedule your surgery to fit within some vacation time and tell them you have every right to take time off!!!

I own a business and have employees and I can tell you that it makes me angry when people tell me their company won't let them take their vacation time! Or that they have to give a reason for their time off. It's none of their damned business!

Amen! It is ridiculous to have to justify why you are taking your vacation time owed to you.

Its your time and you deserve to take it and do anything you want with it.

It is not uncommon for the healthcare industry to dictate to it's nurses when they are and are not allowed to take time off work. Compound that with the fact that the state of Arizona (where I live) is a "Right to Work" state. You can quit at any time and they can fire you at any time, for any reason. Or no reason at all.

Today is a perfect example - I am sick. I have a fever, I am coughing and can't seem to piece a sentence together coherently (you should see how long it took me to type this!). I attempted to call off sick - and was told that there was no one to replace me and I needed to report to work on time or face discipline. Our family attorney tells me that it is not illegal, merely "improper" in the language of the state law, for an employer to make such statements. By noon, I was vomitting. Makes a great impression on patients, let me tell you!.

So I have come down to the point where I am seriously considering quitting my job to complete my surgery. Our insurance covers no part of surgery or aftercare, so I'm not losing out on that aspect. I'm told that I could try to submit a time off request during a "less busy time"..and oddly, this is usually a lul. I have not been at my employer long enough to qualify for FMLA. So that's my thoughts.

I just wanted to say thank you to all of you for thinking of me. Hopefully I'll be more active once I feel better.

-Asche, the Crazy Cat Lady.

Your a nurse so you should be able to find another job pretty easy. Good luck to you. I would put the surgery first.