CrazyCatLady

I just got home from my surgery with Dr Aceves today (Surgery was on April 16th). Ernesto is not currently driving due to some issues, but Ramon, the driver who has been filling in for him, is equally as wonderful, was pleasant and informative. I drove from Tucson to Calexico, parked at Double AA parking, and was picked up outside the front gate for the ride over to Mexicali. Ramon said that right now, he's doing all the driving for the San Diego patients as well as the Calexico patients, until Ernesto can return to driving. At first this was a bit of let down, but in the end, we had a great experience. Just thought I'd give an update.

Heading back home today after surgery on the 16th. I was amazed how good I feel today in comparison to how terrible I felt yesterday before my drain was removed! I do still have soreness at the Left drain site, but once that drain was removed - hallelujuah!

I got my methelyne blue solution at 830am for my leak test...and I'm still working on it....argh! Never would have though relearning how to sip would be so intense. I took too big of a sip early on and ended up with a horrifically painful gas bubble, had to get meds and walk walk walk before I could return to drinking my blue contrast. Let me just say - heat pad has been indispensable!

Surgery was for me this morning at 9am with Dr Aceves, and it has been a first class experience! I live in AZ, so my husband and I made the 4 hour drive to Calexico yesterday, where we were picked up by the weekend driver Ramon at about 1:15p for the short drive over the border to Mexicali. Hubby was a little tripped out when the border guard opened our suitcase and laptop case to have a look, but nothing happened. After arriving at Hospital Almater, Yolanda met us at the front door - what a woman! God bless her, she truely has a heart for what she does and the people she helps. I was whisked through preop labs, xray, ekg and paperwork with professionalisim and effeciency - wow! As a US RN, I was pleasantly boggled. After tests, we were delivered to the very clean (very swank!) Crowne Plaza Mexicali, where we vegetated and later had supper in the Colorado Room (steak was ...divine!). Hotel driver delivered us back to Hospital Almater at 7am, where we were again treated like celebrities! Met the Internist, Anesthesiologist (Garcia?), Dr Campos and Dr Aceves. Everyone kept appologizing for not meeting me the day before, as we arrived on a Sunday...no problem! In the Surgeon's offices I have worked in, I was lucky to see the doc more than once a day....and I was his nurse! After a shot of Lovenox and a primer on how to use the spirometer, I was off the surgery. Dr Garcia got my hand IV on the first stick - major props to him, never had anyone be able to get a patent hand IV on me before, wooo! Sergio is one of the OR RNs, and he was such a comforting presence. Dr Garcia was having a tough time finding a good place to insert my spinal block while lying on my side, so he gave me some IV Versed and had me sit up with Sergio holding (wow, that man smells good!) They had me lay down and....next thing I knew, I was waking up in recovery with an oxygen mask (oh how I hate those!) And some amazing nurse, who I didn't get her name, stroking my hair.....purrrrrr. After another hour in recovery, they wheeled me back to my room and to my waiting husband....I have never been so happy to see that man my entire life! I havn't had pain per se, but mostly some discomfort and soreness at the drain site on my left upper abdomen. I have 4 lap incisions in total, but it's as if the other 3 don't exist, lol. No nausea, but up until about 15 min ago I still couldn't feel my feet, so I haven't walked yet. Gonna finish this post now so I can "dangle" for a bit, lol. Good luck to everyone! If anyone has questions, PM me and I will answer as I am awake

Bless you, Debly - just what I needed to hear! Leaving early am tomorrow for Mexicali...hoping for the best

I'm having one of those moments of exceptional doubt right now. My surgery is scheduled for April 16th. On April 2nd, I started my pre-op prep diet, which is prescribed as low carbohydrate. I have not had fruit, grains, sodas, juices, sauces, pastas, starchy veggies, coffee, dairy (with exception of ocassional cheese - which is allowed per my MDs outline) since April 2nd. In fact, I have watched others eat them with silent murder in my heart.... And I have not lost even ONE blessed pound. What is going on?!? It's not time for my "monthly visitor", so no bloating, etc. I used to teach bariatric nutrition (ha ha ha, fat nurse teaching bariatric nutrition!), so I am vigilent about those 'hidden' carbs. What is worrying me is - if I'm not losing ANYTHING on low carb now, how is that going to change after surgery? Will I be one of those few unlucky people who go through all the pain and misery, only to lose 50lbs or less? Just so frustrated right now. -Asche, the Crazy Cat Lady

April 16th with Dr Aceves

Surgery's coming up for me on Monday, April 16th with Dr Aceves....woo! Seems like life has decided that April should be full of excitement for me. I quit my job so I could go for surgery....and promptly got offered another one that starts the week after surgery, doh! And it's one that I think I'd be a good fit for. The first 4 weeks would be in classroom, so I'm weighing whether or not to say "yes!", even though I'll only be a week postop. I'll have to think on that. I'm a couple days into pre-op diet and I'm craving carbs, hardcore! I almost cried over a Sonic commercial (curse you, chili cheese tots! Curse you, I say!). I can't wrap my head around how things will be different after surgery if I've never been able to stick to carb restriction long term in the past. But I am so very, very lucky - my husband is a 3 year postop RNY, and he says, "I felt that way too, love, but trust me, it will work". He's the best! Keep posting, my April sleeve brothers and sisters! It's so encouraging to remember that we're not alone Best of luck to everyone! ~Asche, the Crazy Cat Lady

Hello April sleevers! Another April 16th here, with Dr Aceves in Mexicali MX. I'd like to say I'm relaxed and ready - instead, I keep hoarding Protein like a neurotic hamster! I'm starting my high-protein preop diet on Sunday, which gives me plenty of time to clean out the cupboards, fridge, etc. So this is a good thing. Two new beginnings: I put in my notice at work so that I could have the time I will need for surgery and recovery, as my work was unable to accomodate my request for time off to take care of myself. On to new horizons! -Asche

I am a fat nurse - and a damn good one at that, if I do say so myself. How many times have I rolled a patient by myself, while my skinnier counterpart was out on her 15th smoke break of the day? I can say that I have suffered discrimination due to my weight, both in hiring and in working. And I have had patients comment about it - even had a patient refuse to allow me to care for her once due to my weight. But you know what? About 25% of my patients in house are obese. And many more than that are overweight - am I permitted to discriminate against them? Absolutely not. In fact, I have used my weight as an encouragement to my overweight patients - we sit and talk about ways to manage diabetes, ways to increase mobility...and I have had more than a few say how much the appreciated receiving teaching from someone that knew exactly where they were coming from, instead of being lectured at by some stick-thin twig who's never had a cheeseburger in her entire life. Once we start discriminating based off of image, where does the slippery slope end?

Howdy folks! My surgery date is April 16th with Dr Aceves in Mexicali MX....because my insurance has total exclusions for bariatric surgery, no exceptions! I was so bummed...but my darling husband (who himself had gastric bypass 3 years ago with fabulous results!) volunteered to pay for it, an anniversary present...awwwwww! I am 5'8 and currently 312lbs - I've been on short term prednisone for the last week and gained 10 lbs!! Just starting to lose it. Hopefully I don't lose my mind in the process. I just want to feel "normal". My goal is around 200lbs...last time I was there, I was a size 14. Good enough. -Asche, the Crazy Cat Lady

Hello again, I was very, very excited to decide on Dr Aceves for my surgery. But it appears my fortunes have changed and I will have to take cost into consideration, which...annoys me, at the minimum. Before I continue: YES - I understand that no price is too much to pay for my health. YES - I agree that I deserve the "best money can buy". NO - I DO NOT have a way to get more money...at all. $6k is my cap and will be as such for a while, for reasons I don't care to discuss on a public forum (why does life hate me this much?!?). YES - Now is the best time in the next 18 months to look at surgery. There will be no better time than the next 2 months to get this done and get on with my life. That being said, I'm looking for some help. I understand that there's been some patient drama regarding Dr Kelly, he no longer has a coordinator, etc etc. I'm not sure if he's on my "short list" or not yet. I can't find much reliable info on him, his facilities and his post-op rate. Dr Garcia is on my "short list" - he operates out of a hospital (not clinic), seems to have good ratings - though not as much experience as others? Dr Almanza is not under consideration at all for me - I had a patient of his pass through my facility this past November, in bad shape due to post-op complications; she ended up on TPN and then with a gtube for nutrition for another 2 months after, plus IV antibiotics - she told quite a story regarding his "recovery house", of people having to sleep on the floor because there wasn't enough beds, no medical staff available, oncall MD being too drunk to be of use, etc. So he's off my list. I am open to other suggestions. My main criteria is that I want surgery in a full-fledged hospital (not a clinic), and a surgeon that will provide decent follow up as needed. Someone I can get ahold of after surgery, who won't drop me like a hot tater!! Comments and suggestions are gladly accepted - thank you in advance! ~Asche, the Crazy Cat Lady

I'm sorry I was gone from a thread I started for so long - I ended up getting really, really sick and spending lots of time in and out of Urgent Care. I still feel pretty cruddy. I keep talking myself in circles over the surgeon thing. I have 3 I really like - Aceves, Alvarez, Rodriguez. Aceves and Alvarez are comparable in price and care. Rodriquez is $2k cheaper, but Juarez and TJ just trip me out. Hello - Juarez was known as the "murder capital of the world" just last year. And I keep hearing that TJ has changed, but all my memories of visiting as a kid growing up in So Cal have scarred me for life, lol! Kinda like how some of us never outgrow a certain fear of the dark....even though we "know" that there are no boogie monsters under the bed My husband backs me up with spending the extra cash for Aceves. Why do we beat ourselves up over a silly thing like price? Maybe it just comes down to the fact that I'd rather die from surgery than get shot by a gang member on the way there or back. Argh. I have to make a decision here, soon. Time is ticking.

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

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

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.

Thank you to everyone who replied! I admit, I was hoping for more sharing from Post-ops - it's very easy to be confident about our choices and then have perceptions changed by reality. Dr Kelly is now off my list. I have communicated with him directly regarding some very pointed questions, and many of them he downplayed or ignored. Questions regarding potential surgical complications should -never- be handled in that fashion. I do not feel comfortable considering him, so I shall leave it at that. I've narrowed my list down to Garcia and Rodriguez. Dr Ponce doesn't quite have the credentials I'm looking for. One of the questions I have asked each office is, "How do you handle complications when they arise, are the treatments and costs included in the quoted price, or are they extra? If they are extra, how is that price determined? And do you offer after-care visits - if so, what do they include and how much do they cost?" If anyone has come across the answers to these questions with Garcia or Rodriguez, I would be interested in hearing your experience. On a side note - I remember not too many years ago, there used to be ads for Dr Joya plastered everywhere! Now you never hear about him. Just one of those random thoughts.

While I am not a coordinator for any of the surgeons, I am a Registered Nurse, and I did my homework as to why there is such a huge price difference. A lot of it comes down to basics. Some of the surgeons operate only out of a fully-equipped hospital (ICU, blood bank, cath lab, etc), and with those surgeons, you spend your entire post-surg time in that hospital. Other surgeons operate out of a smaller, less equipped hospital. Still others use small clinics, similar to what we in the US would consider an outpatient clinic. And out of those, rather than spending post-op time in a hospital, you spend it at a recovery house, which may or may not be staffed by Registered Nurses or other qualified medical staff. If we stay on the hospital subject - some surgeons use only BSN prepared RNs as their care staff - other surgeons are comfortable using CNAs or unlicensed assistive staff to care for their patients post-op. Some surgeons perform multiple leak tests, others only perform one. Or none, other than the one directly related to in-surg close up. Some surgeons provide higher-quality pain medication on a more frequent basis, using PCA pumps and the like; others provide only inexpensive liquid Vicodin, and only ever 6-8 hours. All of these differences combine to create the enormous cost gap between surgeons. You could also factor in things such as the differences in operating costs within certain physical locations, and that contributes as well. This post is not meant to point fingers at surgeons who choose a different standard of care for their patients; it is merely to give an answer to a question. In the end, we all have to make our own choices as to what amenities we feel are negligible and which are not. (As a side note: the above is EXACTLY why I chose Dr Aceves. Do I want to have surgery in an out-patient clinic in a strip mall and then be sent to 'recover' in a hotel, without properly licensed Nursing and/or Medical staff on site at all times? No - I have seen the difference that a quick assessment and treatment can make within my own practice - when it comes to my health, I want nothing less. So I chose a fully equipped hospital with ICU, staffed by BSN-prepared RNs (which many studies have shown have lower mortality rates), and chose a surgeon who performs multiple leak tests, is conservative in his treatment and has been known to turn patients down who he feels are not appropriate surgical candidates. All the things that I would want to see in a surgeon that I work table-side with in my own practice. Just my thoughts.)

I now have my date scheduled with Dr Aceves- April 20th, woooo! But my husband and I are having a bit of a debate. I live near Tucson, AZ - and AAA maps tells me that I can drive from here to Mexicali in 4.5hours. If we decide to fly instead, it's a 60 minute commute to Tucson airport, then around 5 hours to get from Tucson to San Diego (since there always seems to be a layover in LA or PHX or whatever), then another 2 hour drive from San Diego to Mexicali. Same for the way back. So I'm seriously considering just driving. The question is for you post op people - how well did you handle driving at 5 days post op? If needed, we could hang out in Mexicali another day after hospital release (go back to the hotel!). That being said, I would be the driver for the entire distance - my companion doesn't have a driver's license...why is it so many people that live in big cities don't have driver's licenses?!? lol Any thoughts are appreciated. Asche, The Crazy Cat Lady.

Not possible - he's a Canadian foreign national, they have a rather convoluted permit process,and their permits aren't valid for use for driving in the US - we had discussed it in-depth at one point. He's not a resident of the US, he just visits from Canada ocasionally, so that makes the rules complex. I called my car insurance for giggles - they wouldn't cover him to drive my car (with a permit or an actual license, either way) and I would be liable if anything interesting happened. So I guess that means the only option is to fly. Depressing.

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.