Newbie with lots of Q's

I appreciate your input. With Dr. Esquerra I would stay there for 4 nights after surgery, so it's not like i'm flying home the next day. I just can't stay somewhere for a few weeks afterward. I guess if I am delayed getting back my ex is just going to have to suck it up and keep the kids. They are old enough (middle school and high school) to stay home alone in the day while he goes to work, if need be.

I am going to try to do the surgery early July if possible since that is when the kids are off on vacation with my ex. He is a jerk and if I asked him to take the kids for a week during the school year he would say no because he would disagree with me getting weight loss surgery. He's naturally skinny and doesn't understand what it's like not to be able to lose and maintain a healthy weight. I could ask different friends to watch my kids if absolutely necessary but really hate imposing on people like that. And it gets complicated during the school year with all the after school activities, getting homework done, etc.

This summer would work out perfectly if I can put the pieces in place! There are a lot of moving parts. But it would be so incredible if I could get this worked out! Imagine, this June I am taking the kids to the beach and it could be my last time in a giant size 24 skirted swimsuit!

you are welcome. I understand about kids, I was in the same boat. That information is NOT true a simple DS is 7 days or less, safety is important, complex RNY to DS are obviously more. either way health journey, the important part is the end

Don't be so closed minded about staying away. Many docs, even in the US want you close for a week or two just in case of complications. My own doc required any patients more than an hour away to stay local for two weeks, and wanted proof of such. She didn't play around. Your family can take care of itself while you take care of you.

Food for thought. I guess I should try to speak to more people that had their DS in Mexico and don't live at all nearby to see their thoughts on it.

I picked my surgeon based on experience. I would not be the first DS a surgeon has done. I haven't been to see my surgeon in 8 years. It's easy enough to get a doctor to run your labs- you just need to bring a list to them. I think most people have the upper endoscopy before the DS.

Thanks, my biggest hesitation is about managing the labs and vitamins. I am willing to fully commit to a lifetime of vitamins and vigilance, but it seems overwhelming to figure out what vitamins, what to test for, how to adjust, etc.

Just from my own experience. I was self pay at the Cleve Clinic in 2013. I haven't had any insurance issue on anything post-op. They did make me take out an extra insurance policy ( built in to the self pay price ) in case there were any immediate issues post-op. I think it was good for the first 4 weeks.

!) I would never have been brave enough to do the Mexico route but in hindsight I applaud those that take the option rather than not do it at all. It seems like you'll do some travel no matter what. Dr. Phillip[ Schauer did my DS and I was impressed with his surgical reputation. He wasn't known much in the DS community and only does a couple of DS's a year but I think skill and experience with the DS were important.

2) Like I said above I think most things like an obstruction that happen after 6 months will not be attributed to the DS. People get obstructions and it isn't only DS people ( and not common with DS people either ).

3) Labwork is an excellent question. I keep in touch with the bariatric program so I can be assured to get a full set of labs once a year. Many people work with their PCP or endocrinologist or whatever to get all their labs in. You may need to PCP shop if your's isn't up to doing the labs for you. Most of the things I worry about now would be fine with my PCP. (D, iron, calcium) but some are less likely (Vitamin A and K) because they are not always listed on the Doc's initial order pad with whatever lab they use.

4) see #3. Not much help to offer on that.

5) It was never required for me to get an upper endoscopy or a colonoscopy for surgery but I had no issues with heart burn or anything that might cause an issue so I think it may depend on your own state of health. From what I've seen not many of the Docs require an upper for doing the DS.

Good luck. The DS has been great for me.

Pete

Thank you Pete. I was originally looking for local doctors and the only one that does the DS has a bad rep so I started thinking of travelling a bit further. When I first heard people raving about Mexicali I thought that was insane, but the more reviews and experiences I read about the more I was swayed. I particularly like that they keep you in the hospital for 4 nights after the surgery, unlike US where a lot of places send you home the next day.

I'll try to answer some of your questions.

Do you have records with your current doctor about dieting? That may be enough to meet your insurance requirements. Worth a try.

Question #1, how to choose a DS doctor if I'm going to have to do some travel? I have read rave reviews for Dr. Esquerra at Mexicali Bariatrics and he seems both extremely experienced and cheaper than US doctors. But are there closer DS doctors people recommend in the south or east coast of the US that I should at least look into?

My surgery was covered by insurance and I went to Hazem Elariny in Fairfax, VA. Brilliant surgeon who does the DS lap.

Question #2, self paying certainly makes getting the WLS quicker and easier. But does this mean that any complication such as a bowel obstruction down the line will not be covered by insurance? Even if I switch to a different insurance company in the future? In other words, is the mere fact that the original surgery wasn't covered by any insurance mean that for the rest of my life, anything that can be considered caused by the surgery won't be covered? I have some money but not enough to cover something catastrophic like a month in the IU.

I don't know the answer about self-pay, but I've changed insurance companies several times since my surgery. Currently there is no such thing as a pre-existing condition, so everything is covered.

Question #3, does self pay and/or using a non-local doctor make it too challenging to get the required labwork for the rest of my life? It seems like most people use their PCP and not their bariatric surgery center for their labwork, at least after the first year?

This is nothing to do with being self-pay or a non-local doctor. I have the list of labs that I got from my surgeon (and I get an updated list periodically) and use my PCP to get the labs done. It took me years to find a PCP willing to work with me.

Question #4, how do you go about finding a PCP with some knowledge about the labwork required, or at least willingness to order the bloodwork you tell them you need? Does anyone have a PCP they would recommend in Charlotte?

Finding a PCP is challenging but doable. You have to educate them and if they're willing they will take you on as a patient.

Question #5, the gastric bypass doctor I saw recommended I get an upper endoscopy. For the past few weeks I have had lots of heartburn. I don't normally, but I finally gave up on my vegan diet and have just been eating whatever for the past few weeks. I've gained 10 pounds in 3 weeks and probably things like cheese and carbs are contributors to the heartburn as well as perhaps the extra weight. Is it recommended to get an upper endoscopy before any WLS or just gastric bypass? Has anyone had the DS surgery without getting an upper endoscopy? My issue is that if I decided to go to Dr. Esquerra he could probably do my WLS before I can even get an upper endoscopy (my initial consultation with the gastroenterologist I was referred to isn't for over 3 weeks, and then who knows how long it would take until I actually could get an endoscopy scheduled). I know it's jumping into things but I am SO ready and I have a golden opportunity this summer with my ex taking my kids on a 10 day vacation, thus I'd be able to go away to get WLS.

Every surgeon has different pre-op testing. For me the Endoscopy was one of the required tests.

Thank you Janet! It sounds like it would be in my best interest to try to line up a willing PCP ahead of time and then I won't have to worry so much! Honestly that's the part I'm fixated on, rightly or wrongly, the vitamins and labwork and knowing how and when to adjust dosages etc.