Ginger M.

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I haven't been on OH in a while, but I have been checking in regularly on YouTube with the folks there.

I'm still wanting to get the VSG with Dr. Alvarez in Mexico.  Since the last time I posted, I've called his coordinator and got a firm price and got some answers to my questions.  The cost is $9500 *if* my BMI is <48 or $500 more if BMI over 48.  They will take payment in cash or bank draft.  I cannot use my FSA card (which is a MasterCard) because they do not take credit cards/have no way to swipe one.  Sooooo, I have $5000 in my FSA that I have to spend or will lose.  Also, approx. $400 is being taken out each month FOR the FSA.....when that is money I could really use to save towards my surgery.  I will have to pay cash and have to get the money together.  So, it's gonna be a while!

Anyway, since I last posted, I have given up FAST FOOD (the reason I am so fat and my primary binge food all these many years) because I will have to give it up regardless after the surgery.  I have also (miracle of miracles!!!) given up my beloved Pepsi.  I HAVE KICKED PEPSI.  I have also kicked it a few times in the past, but eventually would pick it back up again.  (It only takes one!)  I also know I'd have to give this up as well.  I also wanted to cut these two things from my diet because I knew I'd lose weight (slowly) simply from not having them anymore.  I am having such a hard/painful time walking and I also am freaked out about riding in the plane and not fitting in the seat/skeeving out the person unfortunate enough to have to sit next to me.  :(  I also want to be able to walk through the airport without my cane.

Since around Thanksgiving to now, I have lost approximately 10 pounds.  Even with just 10 pounds lost, I can walk a bit better, so I am encouraged.  I feel confident I will have my BMI under 48 for the surgery.  I think right now it's 50.

I have told a couple of people and, with one in particular, it has gone badly.  Nobody seems to approve.  I have decided I am not going to tell anybody else.  And I'm DEFINITELY not telling them I'm going to Mexico.

I've been mostly looking at YouTube vidz by the WLS community; haven't been coming here so much.

Last week I got a part-time job to pay for my surgery.  Paychecks are being directly deposited into a special account for this.  My goal is to put in at least $1000 per month from this second job.  I have concerns about me still rehabbing my back, knowing that healing comes during sleep and rest.  Pushing too hard, too soon and overcommitting is a pattern of mine.  But no one can say that I'm afraid to take action in order to make my dreams come true.

Today I purchased a scale to track myself.  It also measures body fat.

Next I need to get a digital camera and also a webcam so I can start posting vlogs on YouTube.

Still going with the sleeve by Dr. Alvarez.  I saw a video of him performing the swallow study and interacting with a patient.  It was my first time to actually see him in action (rather than just photos) and to hear his voice.  I was super-impressed.

Still flipping out about flying on a plane at this weight (or close to it).  Really dreading it.

After weeks of mulling this over, I've decided I AM getting the VSG done.  And I'm getting it done in Mexico.

I have decided not to go with Oregon Weight Loss Surgery, despite it being at the very hospital I work at and my insurance covering it.  Here's my carefully thought-out reasoning:  My insurance will pay for me to get 2 procedures (either the banding or the RNY) that I do not wish to have.  I spoke to the coordinator again last week and confirmed -- they will not do the VSG on me, nor will my insurance pay for it.....this, despite the fact that the VSG has far fewer complications than the RNY, is less expensive, has the same weight loss outcomes, and isn't nearly a difficult procedure to perform with no reconfiguring of one's anatomy.  I would have to pay out $6000 (which is 20%) for a surgery *I don't even want, don't even believe in* OR, for $4000 more, I could do what my heart and gut tell me is right.  For a day or two, I did actually considering going with the 80% insurance-paid RNY right down the road, but I ultimately decided that my life and my health and my comfort are worth $4000 extra to me.

I had a day full of preop appointments (nutritionist, psych, etc.) with OWLS scheduled for tomorrow that I've gone ahead and canceled (I actually canceled it last week--so it's not like it's a crazy "the night before" decision based in fear).  I'm going full steam ahead with the VSG, and doing it self-pay.

I've checked into Medical Tourism, which has a number of excellent hospitals throughout the world (Costa Rica, several in Mexico, India, and Belgium).  I got prices for all of these.  I'm not sure why (because they're all part of the same outfit), but the prices vary quite a bit.  And it's not just an exchange rate thing, because the European hospital was cheaper than the Mexican hospital, which is way counterintuitive.  Statistical information on the surgeons performing the VSG laparoscopically is less readily available (although I must admit I have not requested such data from them).

The fact is I keep coming back to Dr. Guillermo Alvarez out of Piedras Negras, Mexico (just across the border from Eagle Pass, Texas....sort of close-ish to San Antonio).  My main concern is that the surgeon be excellent.  I don't really care if I'm staying in a fancy medical resort if I end up dead on the table because the surgeon is a hack.  I have read nothing but good things about Dr. Alvarez, although I understand the hospital is old and spartan (but extremely clean).  His surgery statistics (with complication rates) are posted online.  There are pages and pages of glowing reviews about him here on this site, including quite a few by patients who also happen to be nurses.  I think I finally stopped reading at about page 8.  I keep coming back to something about his body language (I'm really into body language....it NEVER lies) in his many photos with patients who seem pretty freakin' satisfied to me:  In every picture, he is always turned into his patient so that he is heart-to-heart with them.  This is the best possible body language there is (it means, "I'm completely focused on you"), and, to me, it speaks volumes.  Turns out, he's one of the best VSG surgeons in the world.  He's the one that cleans up what other surgeons have botched -- he's known worldwide for this.  He's the man for me.

My best friend, Mark, said he will come with me.  But he doesn't want to go to Mexico.  He is afraid it will be dirty and I will acquire an infection.  He would rather go to Costa Rica, which he has been to before and absolutely loved.  Ordinarily I am not afraid to do things alone -- I've moved across country (twice!) all by my lonesone and drove from Texas to South Carolina by myself for college when I was 17 -- but I am very concerned to be alone while having this and to be alone in a Mexican hospital.

My insurance will not pay for this.  I am going to save money (the cost is $10,000) like crazy.  I have set aside $5000 for 2009 in my flexible spending account for healthcare at work, so I need to scramble together $5000 plus travel expenses.  I HOPE that they (PayFlex, FSA administrator) will approve the credit card transaction when it goes through, otherwise I'm screwed.  I have double-checked on this, but will need to talk to Dr. A's coordinator to be sure.  I am also freaked out about flying on a plane when I am this heavy (274, 5 feet 0 inches, BMI 54.5).  I won't fit in the seat (or will spill over into my neighbors' space) and will need a seatbelt extension.  How horrible.  I simply must lose weight so that at least my neighbors on the plane are not dreading having to sit by me.  :(

I've been watching a whole lot of WLS YouTube videos.  I found one woman in particular -- Massage Goddess -- who has really struck a chord in me and who is very inspiring to me.  She was about the size I am now when she had her surgery a year ago.  Last night I even had a dream about it.

Now I'm going through so much indecision about WHICH type of surgery to have.  I've been reading/watching everything.  I have ruled out the gastric band.  I continue to be so drawn to the vertical sleeve gastrectomy, but the coordinator at OWLS said insurance won't pay and that there isn't even a CPT code (used for billing purposes) given to it yet....however, I see people on this board who've had the VSG and sometimes insurance will pay for it.  So how are they doing it?  Also considering the mini gastric bypass and, the old standby, the Roux-en-Y.  I truly do feel that the VSG is the superior procedure and that, 5 years from now, the RNY will be considered "old technology."  Time and time again, I balk at the rewiring of the guts thing.  Been checking out medical tourism -- going overseas to have the VSG done.  There is a surgeon in Costa Rica I'm looking at and a bunch of people here swear by a couple of docs in Mexico.  Decisions, decisions.

Going later this week to have my preop blood work done.  Next week, I have my full day of appointments with psych, nutrition, etc.

I just pulled the trigger.  I confirmed that I could pay for my portion owing of the surgery (in part, at least) with my flexible spending account at work.  It is open enrollment, the time each year when you sign up for your insurances and what not for next year, and the big deadline is Oct. 31.  It's one thing to SAY you're gonna do this, but putting the money down is FOR REAL.  Oh, I forgot to mention with the FSA that if you don't use it, you lose it.  I just signed up and put the maximum, $5000, in the account for 2009.  So, each time I am paid in 2009, an equal portion will come out of my check.  It works out to $209 taken out per check, I think....something like that.  SO, HERE WE GO.  METAL TO THE PEDAL.

I spent hours yesterday looking at YouTube vlogs.  There were 2 women in particular (massagegoddess and divataunia) that I found very helpful and inspiring.

HERE WE GO!

Last Thursday I got "the call" I'd been waiting for since submitting my paperwork.  She answered my questions about insurance and how much of this I will have to pay out of pocket (approx. $7000 for the RNY, possibly less because I work at the hospital and so some of the tests and services are free for me).  All the preop appointments (psychiatric evaluation, nutritionist, etc., etc.) are scheduled back-to-back on one day, in one building.  (I'll just go from room to room.)  That date is November 12th (Wednesday).  The lady at OWLS (Oregon Weight Loss Surgery) said it would "look better" to the insurance company if I got a letter from my PCP saying she recommended this for me.  They also need a copy of my medical records from my PCP's office for the last year.

So, this last Wednesday, I made an appointment with my PCP to get all this stuff.  They weighed me -- 276 -- not quite as much as I thought (I was thinking I weighed 300).  They also checked my height.  Since the accident, I have shrunk 1-1/2 inches.  I knew something had to have happened because my pantlegs have been dragging on the ground.  I am now exactly 5 feet tall.

Anyway, my PCP was not very keen on the RNY, but was more willing to go for the banding.  Her concerns were what mine are -- that it's a major rewiring of my system and its irrevocable.  I would greatly prefer to have a gastric sleeve (which doesn't require rewiring my guts), but it's still experimental and my insurance company is definitely not going to pay for it, although I feel it's a superior procedure with better results.  The coordinator from OWLS said there isn't even a CPT code assigned to the gastric sleeve yet.  Long story short, I have been contemplating just having the banding done and THEN if I still haven't managed to keep the weight off, then I could have the RNY OR by then the sleeve will have been approved and insurance will pay for it.  BUT a coworker has had the band and has actually managed to gain weight.  I look at pictures on here, and it seems that almost all the folks with the great before and after photos have all had the RNY.  A friend of mine told me that nobody she knows who has had the banding has lost weight.  :(

I am concerned about how I am going to pay for this.  I was planning on putting the maximum $5000 on my flexible spending account for 2009 (it's open enrollment right now, so now is the time to do it).  Now I am freaking out about if the flexible spending account will approve this as an eligible expense (even though it's MY money!  Argh.  Don't get me started on that FSA thing...)  I also am concerned about taking time off from work, since I have accrued very little time following the accident.

Spending a whole lot of time thinking about what to do....and I feel like the clock is tick-tick-ticking because the end of open enrollment is coming up very soon and I have to make a decision.

last week of September, 2008 - Been crying every single day.  Had a cool dream about moving into a new apartment and everything was old and dirty and brown.  But then I started cleaning and, to my surprise, I discovered that everything was actually sparkly, shiny, and new underneath! Took this as a good sign.  Went to Wal-Mart and looked at clothes and dared to think I could fit into a size 5 for the first time in my life.  Spent about 8 hours on Saturday here at this site, reading as much as I could.

September 28, 2008 - Stopped eating fast food.  I was appalled to realize, after filling out my questionnaire, that pretty much all I ever eat is fast food.  This is why I am so fat.  This has gotta go, esp. if I'm going to have this surgery.

September 24, 2008 - Went to 2-hour info session.  Been crying a lot about this whole thing.  Came home and immediately filled out all my paperwork, knowing that if I didn't do it immediately another 6 months would go by while I procrastinated.  Mailed out packet the very next morning.  The doc I want is one of the best in the country.  I feel lucky.  I work at the hospital, and I know my insurance pays for this.  Not completely sure I want to do this, but I figure I will go through the process, knowing that I can opt out at any point.