Gastric Sleeve

Start getting involved

Today, I’m supposed to see one of my congressmen at MYA.  While I appreciate the attempt to make it easier for a non-political person such as myself to see our representatives I think it’s less likely to see dramatic changes when I’m going with the idea of three bullet points.  Not one has specific actions.  Not one has to do with the key function that opens the door to the full practice and autonomy that full billing rights does.   

I say this quite possibly out of naivety.  My idea is that if we can bill independently at 100% for all of our services then the right to work autonomously would be a natural progression.  

I see the ASA involved in so many layers of government and see our CRNAs in so few places.  Honestly,  the MYA was much more expensive than I expected and less well attended than I expected.  

I went to the Region 2 update and was impressed to hear about our reactivity to each of the bills in each state.  I heard of 1-5 bills presenting legislation in each state that would better AA, ASA or decrease CRNA practice.  IN EACH STATE!!! I didn’t hear that we presented bills, we sat on these committees and task force set-up by.   I heard the AANA did a first ever state leadership retreat to Vegas though.  Several were happy about this.   

I see that the Cultural Assessment is in full swing and I know people cried for this but the membership slid down a few more points this year.  I guess I don’t understand the cultural piece as this is a business and professional organization that should be fighting for CRNAs based not on culture, ideals, or in an unbiased opinion.  I think the political piece is a large part of what should be our organization but we don’t even raise 3 providers income among 50,000 CRNAs in any given year to work with.   

I offered to put a link on the page that would say to support the PAC and was told that it was illegal to do so.  I learned something new.   

I don’t know what is in our future but am quite aware that we need to do better as a professional organization and we all need to be more involved than we are.  Billing rights and autonomy of practice will be paramount principles for independent practice and advancing our profession.  As a locum that enjoys nearly all practice environments I think that this focus and becoming more involved in each states organization can only help us.  But, involvement means action, knowledge, and fricking membership for those that aren’t even a member of our professional organization.   

You have seen my financial information and I’m still a member of our AANA, donate to the PAC monthly, and despite my poor political affiliations I am here trying to learn and grow just to maintain or improve our profession in the future.  I am starting to get some of the knowledge beyond just being a provider, or clinical educator in the OR. 

Please take some time to go to the state meetings or national meetings and start getting involved in what we need to do for ourselves.  Consider a contribution to either the AANA which is tax deductible or to the PAC which is not.  Both advance us as a professional organization just in different ways.   

Just my 2 cents.  


Taking time

One of the things I truly forget about is... myself.  Taking care of myself, taking time for myself, and just taking time with family.  

I get so involved in the number of hours, case types, and thinking ahead to length of assignment/finances/bills/investments that I lose sight of self.  I forget the 70 hours of work and 40 hours of sleep is 110 hours in 5 days 5x24 120 doesn't leave a lot of time when you drive an hour a day.  Most weekends I am off which helps but notice I say most because I offer myself up to any days.   

So, as I mentioned I'm planning our family vacation to Hawaii to see my brother and sister-in-law.  This takes financial and self awareness.  You'll recall I'm 1099 which means paid vacation does not exist.  I have to make sure all standard bills will be paid while gone and that $$$ exist for hotel/AirBNB, tours, and the like.  

This week long vacay may only be a week but I've decided to do something that 50% of people say horrible things to me about and the other half... support.  I'm going to get my gastric sleeve.  Not because I can't just go on a diet and lose some weight.  It's because I can't get myself to completely change my habits.   Why?  When I diet I can rationalize that this workout or diet for three days means I can go with friends to X restaurant have drinks and dinner and enjoy... then the next day I just skip the workout because I'm tired and have a beer with dinner because man I worked so hard.  The wagon is broken.  I'm changing the ability to rationalize by saying my body has been altered and despite all things and what people say .. I'm limited in ability to fall.  Yes in 3 years if I want to screw things up... I can.  Have you changed everything for three years and decided to return to a life you didn't like?  My hope and goal is to do this drastic thing to myself to force a change in habit.  Right or wrong I'm doing this so I am around for this family.  I feel like if I don't I'll be that 40 year old in the ER with a heart attack.  I'm hoping at 37 this will allow me to physically change and reverse the negative effects on my health before they are permanent.   No it's not because I don't want to exercise.  In fact, I walked 6 miles today with elizabeth.  It's not because I hate healthy food.  I love it... too much.  It's portion re-training:  yup, I'll have to break the Diet Coke addiction too.  

That's two things I'm doing for me... but that's in November.  You can't just take a week every 3-6 months and feel fulfilled.  I think at least every couple weekends you need a little just for you or just for family time so you see the fruit of the labor.   

What do you do? 


I am so happy it's the weekend!  I went for a four mile walk with Elizabeth.  Sent Francisco to the Urgent Care office for bronchitis and may send EE but she seems to be improving.  

I can always tell when I start getting paychecks again.... I start planning what it's going towards.  So, we are just planning our trip to go see family in Hawaii for Thanksgiving and I'm also thinking that just after I will be considering the Gastric Sleeve.  Lots of things would have to come together to make this possible but I can see the possibility. 

It's amazing how opinionated everyone is on the subject.  It's not an easy thing to come to the decision of "there is no way this will happen and be lasting if I continue to do the diets, exercise, and all the things I have done over and over again"  They have morally bashed me saying it's just you and you can do on your own, you have to be an example for your kid, and you need to just be a better you.  You don't think I know this... you know I walk a couple miles multiple times per week, you know that I know what I should eat, you know I know the portions and then what the stomach and brain say totally contradict the rest.  It doesn't matter how much I know... it's the habit and ability to truly change the body and mind.  Yes, I can totally screw this up... I can do everything and lose the weight and 4 years later over-eat so much that it stretches the stomach and I gain all back and more.  The idea is to completely overhaul the brain and break the habits that one goes to when a diet fails or missed exercise days become months.  

So, I'm still looking into options. 

Work is work and we are busy.  I love good days but I'm so not used to having multiple people in the room "helping".  I am not used to a hospital where the room nurse and CRNA don't go get the patient together.  I'm not used to the differences at this hospital than the ones I've been to in multiple states so I'm having a harder time not saying "this isn't right and needs to be fixed".  Generally, I try to stay out of politics and policy.  I have told several that this is going to cause errors and they have even said that it already has caused them.  In which case I don't understand why the process hasn't been changed?  

Maybe it's not my soapbox to get on.  Philadelphia is a very different city to me.  I know we'll be here for a while so I better start embracing it a bit more :)  time to work on the websites, plans, 401K and so much more.  

I hope your journey is amazing!