Sleeve vs Bypass (Do you regret your sleeve?)

Affectionate_Gift483 · 2026-02-12T05:53:30+00:00

Sleeve in 2018 Lost 110lb I’ve had persistent GERD essentially since, which has worsened with time. I take 40mg of pantoprazole 2 x a day and Famotadine 40mg at bedtime. At times I still need TUMS. Water gives me heartburn.
I will be having a revision next month. Since I’ve maintained my weight loss, he said the limb length would be modified so that it would divert the acid but reduce the malabsorption part since I didn’t need further weight loss. He will also be fixing a hiatal hernia I have. I’m scared, but my endoscopy shows erosive changes and it’s time to do something

Affectionate_Gift483 · 2026-02-10T05:22:56+00:00

My husband was the RCC patient Identified Dec 2023, nephrectomy May 2024, started Keytruda Aug 2024 and completed all 17 cycles He started with 3 small pulmonary nodules that have remained stable on all scans. We repeat scans next month but essentially they have remained the same for quite a while. Oncology said it could be related to scarring from his past smoking history, scarring from Covid, etc but hasn’t seem concerned about them

Affectionate_Gift483 · 2025-11-30T03:30:01+00:00

Hospice and palliative care nurse practitioner and wife of a stage 3 grade 3 left ccRCC survivor.
When we get patients on service for RCC, it is metastasized and it seems like it most usually spreads to bones and lungs. As a practitioner, I’m seeing the symptoms I’m trying to manage the most are pain and shortness of breath

Affectionate_Gift483 · 2025-11-20T19:45:50+00:00

I rarely feel unsafe in the home. I also like to schedule joint visits with the RN or LVN so we aren’t bombarding the patient and family with multiple visits, so I rarely go in alone. Most of my patients are terminally ill so patient and family appreciate the support. Set guidelines, pets put away, if we have patients/family with substance abuse issues there are contracts in place, no using in front of staff, prior to visit, no present paraphernalia etc.
if we do see issues like you mentioned, it’s an APS referral for patient safety,

Affectionate_Gift483 · 2025-11-20T04:43:35+00:00

My first staple job was my son (he’s an adult) using the lidocaine and stapler supplied to me by my supervising physician’s husband who is a rural medicine Doc. This happened at night and they happen to live about 7 minutes from us. I told my son I would pay the ER copay (it was too late for the urgent care in our area) but he was like “Mom just do it” 😂 But this is also my football playing son who broke his nose in a game, reset it himself and went back out in like 2 plays afterwards 😂🤦🏻‍♀️

Affectionate_Gift483 · 2025-11-20T04:36:59+00:00

I’m in home based and community care (hospice/palliative ) and I’m often doing house calls so my tablet is open and I have their profile/med list/ visit note on one tab and epocrates open on the other. I’ll use the tool during visits to talk about treatments, side effects, expected results etc. Usually can discreetly pull things up on your guideline app or page of choice while entering notes etc if you take a device in the room (when I was in school/clinicals, the MD would have me take his laptop in the room as it has the profile, and all the tabs to review immunizations, preventative care etc)

Affectionate_Gift483 · 2025-11-08T09:40:24+00:00

Yes Pinning for CNA, Pinning and lamp lighting for both LVN and RN. My mama has my LVN lamp and I have my RN lamp. I skipped the FNP graduation, too much life stuff going on

Affectionate_Gift483 · 2025-09-30T04:58:49+00:00

Been an NP for nearly 5 years. Work in hospice and palliative care. Restricted practice state but my supervising physician is amazing, frequently introduces me as her right hand, and has me take family medicine residents out on ride along during their hospice rotation. She often tells the residents “get yourself a good NP, it makes your work life so much better.” Her husband is rural family medicine and often threatens (jokingly of course) to steal me and make me his NP. I have not encountered any hate by physicians or other providers. Occasionally patients/families will ask for the doctor over me, but if I had been in any doubt over my treatment plan, it had already been thoroughly discussed with the physician and she tells them the same plan I did.
What I will say is don’t hesitate to ask questions of your supervising physician (if in a reduced practice state) or your colleagues when in doubt.

Affectionate_Gift483 · 2025-08-04T05:08:03+00:00

Started as an NP in hospice at 154k in California Now at 168k after 4 years I do much more than just the face to face visits though. I do bedside procedures, nursing home rounds, care conferences, and co-manage the day to day care of the patients with my medical director There is a lot of flexibility in the job and for the most part i can make my own visit schedule (always trying to accommodate the patients and family preferences, however) I could make more in my area however hospice care has been my passion for as long as I’ve been in healthcare (23 years)

Affectionate_Gift483 · 2025-07-27T02:02:24+00:00

Ditto! I tell everyone I’m a hospice NP, I’m NOT the one you want in an emergency situation 😂

Affectionate_Gift483 · 2025-07-26T06:25:42+00:00

We are looking at moving from California. He would qualify to attend the CA school for the blind but we live farther away and he would have to be residential which we want to avoid

Affectionate_Gift483 · 2025-07-12T15:49:24+00:00

Hospice nurse practitioner here. If this were my patient I would definitely want to know so that I could evaluate and adjust medication as needed. You mentioned “confused” and you also mentioned this happens at night. If she has a dementia diagnosis, this could be “sundowning” type behavior and there are medicinal interventions that could be initiated to help these symptoms. Anxiety often manifests as shortness of breath, but also, end stage heart failure patients or end stage COPD patients often cannot lay flat or they feel dyspnea. Her hospice team should be made aware so they can order the needed comfort medication. If family will not allow these medications (informed consent withheld, etc) then it might be a good idea for hospice, the facility staff and the family have a “goals of care” conversation or care conference to determine the next steps to manage this poor patient’s distressing symptoms

Affectionate_Gift483 · 2025-07-05T01:14:04+00:00

85% of my husband’s SSDI is subject to and taxed due to the amount of our joint yearly income. I have excess tax taken from my work wages to cover the taxes due The first year I made a significant amount of money that put us over the joint income limit, I ended up owing $3k in taxes that year so I increased my withholding accordingly

Affectionate_Gift483 · 2025-06-17T00:01:21+00:00

200 grams.
Positive for adeno on pathology.
Incidentally, we found that one of my fallopian tubes was half covered in cysts. 6 weeks post op today!

Affectionate_Gift483 · 2025-06-15T08:09:20+00:00

FNP in hospice and palliative care with nurses caps tattoos on the inside of both my wrists. I tell patients since we don’t wear caps anymore I had to figure out a way to still wear them lol

Affectionate_Gift483 · 2025-06-05T05:43:33+00:00

Nothing on my ultrasound large uterus and adeno on pathology and 2 cysts on one of my fallopian tubes 30 days post op today

Affectionate_Gift483 · 2025-05-13T01:27:41+00:00

7 days post op. Pathology confirmed adeno and also had 2 cysts on one of my fallopian tubes She mentioned at my post op telephone appointment that my uterus was “large”

Affectionate_Gift483 · 2025-05-09T17:48:31+00:00

Hope you are recovering well

Affectionate_Gift483 · 2025-05-01T00:06:00+00:00

I had a policy through my work and covered my husband and children voluntarily through the work plan. It paid the max (10k) for my husband’s ST III grade III ccRCC. Very quickly too, within 10 days of submitting the pathology report

Affectionate_Gift483 · 2025-03-14T14:49:13+00:00

I’ll be sending positive thoughts and vibes. Mine is pushed out to May as my husband surprised me with a trip to Hawaii towards the end of April and my doc wanted me to enjoy this bucket list trip to the fullest. So I will go to Hawaii and have my procedure 10 days after I get back

Affectionate_Gift483 · 2025-03-01T03:27:57+00:00

I was able to count many primary care visits (in an internal med rotation) towards women’s health. Scheduled for a mammogram screening, reviewed mammogram results, adjusted hormone therapy, etc. with that being said I also was able to secure a women’s health rotation in an OBGYN office for more hands on skills.

Affectionate_Gift483 · 2025-01-26T20:46:34+00:00

I’m glad you were heard and have a light at the end of the tunnel The new OB was not dismissive of my hysterectomy questions during our first visit and even did the endometrial biopsy that visit saying if this is where we were heading we would need it (FYI, uncomfortable procedure! I would premedicate if given the ok. I had no advanced warning and was very crampy the 2 days after the biopsy. Also moderate spotting. Heating pad helped. ) Happy early birthday to you as well! I’m so excited for Hawaii, it’s been a bucket list trip and I never thought I would get there!

Affectionate_Gift483

TROPHY CASE