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

Asche, that sucks! But even so they can't deny you vacation for a whole year! That is a crime! CA is an at-will state too but people fight it all of the time and win. So don't lose hope...

(and remember I say this as a business owner with employees!!)

Asche I am sorry to hear about all of your troubles getting your surgery. I am a medical student and my insurance completely excludes WLS and such, thankfully we have a student health clinic and is the policy that they have to see me. I am surprised of how much difficulties your job is giving you about time off, here in Texas we have such a huge nurse shortage that you would find a job in no time! You are right is ridiculous that working in the health care field they don't want to take care of us, its all business. I have only told two of my classmates about my surgery (mine is May 10th w/ Dr. Kelly) and I only told them because one is a nutritionist (well now a medical student) and the other is a close friend. But in all honestly I am with everyone in that is noones business and I don't want to have to splain myself and deal with the stress. My husband is highly supportive, and that makes all of the difference for me. Him and my daugther are very loving and supporting and other than them and my mom noone else knows. I am seeing my doctor next week and will see what she has to say, if she refuses to see me that is against policy but I would still not be comfortable with someone who is judgemental and would find someone else (but so far from past experiences I don't think she will be). I am glad you made your appointment and are getting ready for a new life, I understand the stress of the thought of loosing your job, but that does not seem like one I would like to have anyway. You went to school too long to deal with that kind of treatment, honestly if you were my nurse and were that sick I would not want you anywhere near me LOL... a couple of weeks ago I had the flu, I skipped a class in which we had popquiz, well we does not allow make up quizzes so I got my first Zero ever in med school! (the good news is that it did not have a lot of weight but I could had come and spread the virus to everyone) so I understand your frustration. Does your state has workers compensation? here in texas they do and if they fire you specially when you have a medical note (you should consider bringing it in even if the nosy lady looks up the doctor) the place of employment has to pay part of your unemployment check (the good news is that it will give you more time to recover while getting a little bit of money and while you find a better job). Check with your lawyer and your state laws. Good luck!

sorry for all of my typos, was typing with my ipad and just realized how horrible I did LOL

So, as soon as I go back to work on monday (still off sick, spent quality time yesterday in the ER for some IV Levaquin and fluids), I am putting in my 2 week notice. I should have clarified - the time off I requested would have been without pay - we only get 5 days of vacation/sick/personal (it's all one lump pot) a year, and I've already used mine. It was a bad year, broke my foot, got hit by a drunk driver...my paid time off days are done for a while. I think I have maybe 1 whole day worth of accrued time at this point.

Honestly, it won't be terribly "easy" to get a new job, as I am a specialty (wound care), so I generally can't get any old floor nurse job. The politics of nursing jobs is odd that way. But I digress.

My health is worth more than continuing to work at a place that I wake up at 4am every morning before work with a knot in the pit of my stomach. They say change comes through inspiration or desperation, and I guess I've hit the desperate part. My plan will have to be that I just get back into fighting form as soon as possible after surgery and start looking for another job, or maybe go back to home care. Not sure.

-Asche, the Crazy Cat Lady

note: this was typed after consuming two tablespoons of cough syrup with codeine - typer is not liable for not making sense or rampant spelling errors