crosswind

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

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.

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...

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.

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.

Susanne, I haven't been sleeved yet. And I think what I was trying to express wasn't whether the "surgeon was right or wrong" -- really how would I know? I'm not a surgeon. What I am trying to say is that it seems like the American healthcare system is really fuqed. And when I say that I mean the whole attitude we've become accustomed to -- wait six months for this evaluation. Wait another four weeks for that approval. The doctor makes his pronouncements about these things and as consumers we really aren't free to argue; even though I have to tell you in that situation I might. The way I came to my decision about whether I would have surgery in the country ( knowing I sure as Christmas was not going to get covered for this even if I waited til Hell froze over) or out of the country finally had to do with how long I was going to have to wait and how much crap I have to put up with just to get to the freakin *point*. In my *opinion* making people dance on the head of a pin to prove to a doctor they deserve surgery is pointless since the *actual surgery* and post-op is such a massive pain. I truly doubt anyone considering this surgery does not know that their lives are riding on that fork. If you are suicidal or stupid, you are going to go home from the hospital and order a pizza. Otherwise there has to be a clue included somewhere in the fact that your stomach is gone. What I've gleaned from my research is that the huge variation in pre-op instructions has to do entirely with what is comfortable for the surgeon. There seem to be unique instructions and methods with every guy. If there was an industry or medical standard regarding these things, both you and I would know about it. So what I was trying to say -- respectfully, Susanne -- was that it's possible to separate these issues out without feeling like you ruined your life by eating a cookie. *After* the surgery that might be true for a while. But forever before, with surgeons who insist people have to lose fifty pounds before they can even * get* to the "pre-op diet", and insurance companies denying these procedures at the last minute for some "actuarial" reason -- the way all this goes it seems like you might just die of natural causes or *stress* before you lose pound one. That's all, just my 2

. Hi Susanne: Not being able to keep our hands out of the cookie jar is the reason everyone here is shelling out ten to twenty to thirty times that to get their stomachs permanently altered. If it were that simple, no one would need this surgery at all. At the hospital I'll be getting a chest x-ray and I'll also be put under life-threatening anesthesia, endure the risk of severe pain and complication, need Vitamin supplements and carry scars for the rest of my life not to mention figure out a way to do without any food at all for ten plus days. All because of that cookie jar. That said, there are some really excellent reasons to comply with a lowcarb diet prior to surgery. Lowcarb not only depletes the liver of glycogen, it also depletes the rest of your tissues making it far less likely that lymph-related complications will arise. Less Water means less pressure on your heart and circulation which is a good thing when you're undergoing anesthesia. Also people who are carb-laden are in "sugar-burning" mode -- in a surgery like this a ketotic state is optimal since blood sugar is less likely to undergo life-threatening drops. Once you get into a ketotic state, you get anorectic because you don't have insulin and blood sugar driving you to eat. When a person comes out of surgery with most of their stomach removed, it's pretty likely that without that they'll come out starving and weak since fat metabolism hasn't kicked in. But...again...another way to check to see if a person is in ketosis for surgery is to ask them to pee in a cup.

My sleeve is scheduled in Mexicali with Dr. Aceves and I'm starting to er, rethink this. Am I crazy? It's so much money. What if something happens? I have no insurance. I have a little insurance but...oh boy oh boy what a huge step to take.... For a while I was retreating back to the lap band but there seem to be a lot of long term complications with it there aren't with the sleeve. I have tried every diet and gained all the weight back, gotten depressed and gotten back on the trail again to lose over a hundred pounds twice, but it never lasts. I'm just under 40 BMI now....I don't think I can ever in any scenario see a time when insurance would ever cover this for me. I don't even like food very much. I just want to be normal. Go to work, eat what I want, stop when I've had enough and not be fat. I feel like I'm at the end of the trail, it's this or nothing, Now or never. I just hope it works out.

Wonderful. I hope I feel the same way.

I just got off the phone with the patient coordinator at Dr. Aceves office where I have my surgery scheduled for Monday. I was worried because I haven't really been checked out thoroughly by a doctor in a couple years. She told me not to worry -- she said, look, you're in a hospital, if there's anything wrong we'll work on it so you can have a safe surgery. It seems like in the states the whole system really wants to make all this is as hard as possible. It's one of the reasons I decided to go to Mexico despite the risks. I had second thoughts a couple days ago and called the surgeon I was going to originally go with, and asked them if I decided to go with them and their BLIS insurance how long it would take before I actually ended up on the table. She said three months to a year. I thought, that's three to 12 months of my life gone for some piece of paper to get somewhere else, for me to answer correctly on all the forms, for me to drive to the office and 'consult" with yet another bariatric professional, and for me to get all kinds of lectures about how I live my life. Now I don't know for absolute sure if I've made the right decision but I do know that if I were you I would not be ashamed, I would be annoyed. It's not *you* who's got the problem, it's them, and I'll tell you what it is - your surgeon is afraid to do that surgery unless he is absolutely certain your liver is perfect. But one way to find that out, since you're actually *in the building* -- would be to order a catscan or an ultrasound to see how big it really is. It would take 45 minutes, tops. Your liver and it's rumored massiveness was sitting *right there* on the chair, in the hospital. There are actually much more scientific ways to find out if a liver is enlarged besides asking the patient if they ate a cracker that week. You need to lose that weight and stick to your lowcarb diet to get the doctor to actually operate on you. It's his concern about his own skills that are up for review here, not your worthiness. So just do it so he feels better and you can actually get your sleeve. But don't feel bad about it -- you're actually making allowances for his insecurity. If my doctor told me he would feel better if I walked around wearing a pink hat and purchased a parrot before surgery, I'd do it.

Thanks Becca. I was wondering, do you feel -- can you tell your stomach is smaller now? Do you feel that it's smaller inside your body or does it just feel like a normal stomach after a while?

. Hi Rosie: Yeah I've got my eye out for you guys. My mother died of pancreatic cancer when she was 79. She was diagnosed when she was 75 and there was a conversation at some point whether surgery was "worth it" since she was over some number, seventy I think. My mother said excuse me? It's worth it.

I was running a scan over on pubmed and found this abstract of a study comparing bariatric surgery outcomes in people over 65 compared to younger people. Turns out some of the variables were even better. http://www.ncbi.nlm.nih.gov/pubmed/20870182

http://www.ncbi.nlm.nih.gov/pubmed/21298508

This is another study on pubmed from JAMA, comparing bariatric surgery procedures and their complication rates to get a handle on what made things go wrong, if they did. Total complication rate for all surgeries was 1.6 percent. Sleeve surgeries alone had a serious complication rate of 2.2 %; mortality rate for sleeve surgeries was exactly zero. The study said that complications were inversely proportional to how many surgeries the hospital handled, and how many surgeries the surgeon had performed. COE status was irrelevant. http://www.ncbi.nlm....pubmed/20664044