crosswind

I think there's a method to it though. The stomach is a stress organ. If you're upchucking, exhausted, scared, freaking out -- that has to translate into complications at least sometimes. A blissed out stomach is probably best

. Oh I forgot one more thing: I also mentioned before I left that I had tried to time the surgery so that I would not have my period -- I made a specific effort for this not to happen, so, of course, it did. And I am not a dainty bleeder, let me put it that way. Most people here reassured me it wouldn't make any difference. I almost cancelled because of that but I pressed on. Anyway, it really was kind of a drag. And once you got the blood thinners, well...good thing I was unconscious through most of that. However, within two days I was already out of pads. I figured they would have something in the hospital lying around that served that purpose but it turns out they did not. I asked the nurses, they looked around and in fact started digging in their purses. Then you know what these girls did? They went out to the pharmacy and bought me some, never charged me, never brought it up again. I thought that was impressive. In the US it would have generated a charge for seven hundred dollars on the itemized bill.

I told my brother and my son. Mostly because I realized there was no way I could hide something like that since I was leaving the country. But they are not big talkers and in a way..in that sort of kind way men who are not your husband have...they don't care that much. It's my stomach. I noticed the other day that I joined vst in January of this year. I had no idea it had been that long that I was thinking about doing this. Other than those two I told no one and probably never will. I didn't want to argue for permission from anyone. It was my decision, my stomach, my risk and my life. I was actually carrying on conversations with people in my hotel room about the weather and the news of the day by telephone and *never once* referred to the fact that I was about to have or did just have major surgery. There was something about this I really wanted to be *private*.

No one knows I'm doing this. It's funny, even though I don't qualify for regular insurance and even though I'm clearly obese no one would suspect that I, the quietly growing mushroom in the corner, would one day get on a flight to Mexico to have my stomach cut out. Maybe this is common for wealthy or extremely confident people. I read all the time about movie stars and other sparkly people jetting off to Rome or Cancun -- or what is it these days? Cabo San Lucas with only a bikini and a couple of syringes in a Prada bag but for me this is one gutsy, desperate, expensive, slightly terrifying thing I'm doing. I am not a good flyer. I am a bad flyer. When I get on an airplane I instantly begin to calculate the strength and the agility of the people around me to gauge whether they would be saveable or not if we rocketed into the ocean and it was up to me to get their infirm asses up to the surface and home to their yorkie, Funyons. I usually drink a lot on a flight but this will not be allowed eleven days from now because, as I mentioned, I will be having my stomach cut out the next day. I was just reading an article in the New York Times about the search for an incisionless solution to obesity. They're not having much luck. The fact is that even though twenty percent of people in the US would qualify for surgery, a number that's growing each year, no one's got much more of an answer than to cut your stomach out. I used to think there was some kind of special thing I was not personally doing and once I discovered it I would find myself in an instant size eight, but now I don't think so. I think consumer culture is trying to kill us. The problem is that as food gets cheaper to produce and there are more people on the planet, the quality of it all tanks. There are these places in the US called food deserts where you can't find a leaf of lettuce to save your life but Little Debbie, Hostess and Aunt Jemina are smiling from every shelf like spokesmodels for the apocalypse. I'm five ten and I weigh about 280. Seven years ago I went on the Atkins diet and lost all the weight: I zipped around in teen section jeans from Target and fell in love with a guy who didn't understand what it was taking me, what it had taken me to get to that point. He was a food nazi and a semi-vegetarian and he kept telling me everything I did was "unhealthy". I would work out an hour and a half a day, he told me I wasn't doing enough cardio. He would actually get redfaced over this stuff. His thing was, he was born naturally thin and he really paid very little attention to what he was supposed to be doing or eating, because being naturally thin, he was naturally healthy. I had to work at it. So he would go to work and graze from the Estrogen Bar set out by the office ladies and then come home and want to go out to eat. He loved restaurants.I would have to diet like crazy to keep up with this, and it finally got to the point where I would go off by myself, binge for a couple weeks, then spend the next couple weeks starving myself, and then reappear again, thin as ever. By the time we broke up I weighed about 240, up from a very happy 150 when we first met. During the breakup process, I put on forty more pounds. It was easy, it was instanteous. So for a while I gave up on the whole thing. I mean, how much heartbreak do you need to pack into an issue before you just check out and go for the pasta? I just kept buying bigger and bigger clothes. I didn't care, no one was ever going to love me again and I was now over 40. If I lived in the old country I could put on black robes and a veil and make everybody in the village dumplings every day. And then I realized something kind of odd. The reason we really broke up was because I was too fat for him already, when we met. I wasn't perfect then. I was a blank, doofus of an in-love slate to be improved upon, screamed and tantrummed at and *nothing* in the world would ever make me loveable enough for him. You really have to ask yourself in these moments if you want to live or die, because I had been almost intentionally, systematically destroying myself for a couple of years. But I didn't have the heart for another diet. Atkins wasn't working the way it had for one thing and my life and my body had changed in the past seven years. I had started smoking again. Seven years ago people were saying my god you're so thin how are you doing this you look like a different person just beautiful where is the rest of you? I'm ashamed I'm all the way back where I was then. I don't like to go out where people can see me and compare my old self to my new self. I hate the whole thing. For a while I just decided to be fat. I would walk around asking myself, am I loveable this way? Am I really disqualified from society because of a hundred pounds? It's still a good question, right? Then for a while I tried to do a Geneen Roth thing and "just eat normally". The problem is, for me, eating normally means I gain forty pounds in six months. It would take a year to get back there if I got there at all. I need help, that's just all there is to it. I am not going to count, measure, starve, obsess, and do all that, live on the edge of anxiety all the time worried that I'll somehow destroy my life if i have a piece of cake, only to gain it *all* back anyway in a moment of weakness. There has to be a better way. I really hope this is the way. I'm so sick of this now. It's enough already.

Okay, this thing is tomorrow. I am sitting here blowing up balloons. Wouldn't you know it I got my period TODAY and I lost my cellphone yesterday. And tomorrow I am going to Mexico to get my stomach cut out. I am sitting here thinking...maybe I can just go on another diet. Maybe this is a bad idea. Maybe I'll get to Mexicali, get on that table, and there will be a huge earthquake while I am under anesthesia and I will wake up in the rubble with no painkillers. Maybe I'm not ready. Maybe I should go on a huge diet and lose fifty pounds and eat wheatgrass and Water before I do this so I'm like really REALLY healthy before I go. Maybe this is all a internet scam and what's down in Mexicali is a tin shack and some upsetting looking types who are in the kidney business... Help help help get me off my ass and packing please....

Is there anything i can buy at the supermarket that would work as a clear Protein drink? Is milk okay?

. hey all. I'm in the hospital. Hospital Almater in Mexicali Mexico, and of course because it's me everything happened this morning was random. The shuttle was supposed to pick up all the fat people at the hotel at 7 AM ( I keep thinking about this vanful of overweight americans on their way to get weight loss surgery and I wonder how we're described every once in a while, privately, in spanish. Hey, got another busload of fat white people from the airport, where do you want me to put them?) but I was not among them because I asked for a wakeup call at six and slept right through it. I told them to leave without me and so for about half an hour I was floundering outside the system with the recurring thought that I could just leave. I missed the bus! Missed the bus, couldnt make it to have my stomach cut out, sorry. The problem was that I had not slept at all the night before. I was so tired by time they released us to the hotel last night I was crosseyed. They told us we could have anything we wanted to eat and drink - I could barely even make it downstairs so I sort of used exhaustion as momentum to propel myself to the restaurant bar. " Okay listen," I told the lady behind it. " I haven't slept in 24 hours and I haven't eaten all day. I've got no juice to even order off this menu so could you just feed me? " So she did. In minutes I had these awesome quesadillas and a cheese plate and bread and some kind of chiles in front of me, plus a nice hefty glass of cabernet of which I had two. It was green and manicured and pretty outside the plate glass of the restaurant, and some of the other people from the group, couples, were eating too, far in the distance in a place my legs would not take me to even to say hi. When I was done I weaved attractively back upstairs to my room and turned on the tv. It was seven oclock. I remembered to put everything in my bag, call for a wakeup call, charge my phone and take my two mgs of ativan and then friends I remember no more. The Crowne Plaza is okay. I'm not a fan of big industrial hotels. They have a kind of signature darkness to them. There is a cavernous marble entryway that seems way too big for the furniture in it, or maybe they sold off the stuff they used to have. There are two restaurants, also cavernous - one was closed and one was empty. However the grounds were well watered and cheerful and the pool glittered blue and sterile. It smelled clean. All the staff would approach you in Spanish but when you answered in English they'd answer back perfectly as if they were from Manhattan Kansas. The walls and decor on the residential floors were a dusty pink, probably the same color they painted then in 1982 when the place was built. Rooms were huge, also dark, lots of dark wood everywhere. But like I said: Clean. And I didn't care, anyway, I was drunk with exhaustion with the whole time I was there. Anyway so back to this morning. I was lying there on a bed at the Crowne Plaza hotel in Mexicali Mexico. The sun was clear and bright outside the window and I thought, you know....this is a pretty nice place...I could use a beer....I could just stay here for a day or two and then get someone to drive me back to san diego, hang out there for a couple days and catch a plane home....yes that's what I'll do, I missed the bus, I've been left behind...oh well, I'll call them and get my money back, they can have the deposit... Then the phone rang. It was Yolanda. She said -- WHAT are you still doing at the hotel??? I said...um... She said, well you need to get here AS SOON AS POSSIBLE, the internist is going to be here before eight. So that was that. No shower. I swished some Water in my mouth, brushed my teeth and went down to the lobby. The front desk receptionist told he'd be there in a few minutes so I took the side door past the man who was cleaning the walk and my foot slid way way past where I expected it to go and I fell right on my face into the parking lot. The guy who was cleaning the walk studied me with scientific interest. And then the shuttle came. I walked in, asked the front desk for Dr. Aceves' and got Dr. Campos who handed me off to the nurse, who got me x-rayed and settled in my room. We had our 45 minute speech from Dr. Aceves and it was decided that one woman would go first. She's already gone. So here I sit on my hospital bed, locked into my fate. I called my brother and told him I had made it here. He said, what are your thoughts? I said, I am trying not to have any thoughts. So far none of this stuff has been the least bit uncomfortable. I had a blood test, an x-ray, a conference with the anesthesiologist and a nice drive through san diego. If I hadn't been so exhausted and freaked out, not to mention menstrual, it actually would have been kind of fun. So far.

Thanks so much you guys. Okay, I'm halfway packed, and I'm about to go digging around for a heating pad. Thanks for that suggestion. I also bought a gophone. And checked to make sure they work in Mexico. Dammit, I can't believe how much money I spend on phones. One thing I did was I asked my brother to drive me to the airport. He's a GREAT brother and he'll always help me out if he can, but the thing is he has to take off work to drive me there. Soooo...if he gets me in that car and I change my mind it's kind of a huge waste for him and that will pretty much get me on the plane. The fact that it's first class will stop me from freaking out and making them turn around because I want to get off. Plus, you know, who wants to be out that much money AND go to jail? So that gets me to San Diego. Solution for San Diego to Mexicali? Ativan.

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.

Oh, man. Good to know!

Yeah there is that.

I know, it's just going to make the whole thing suck that much more...

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!

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?

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!

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.