Marley Update

This is the Veterinary Specialty Hospital, where we got the first quote for Marley's surgery... Yes, it's gorgeous... but, do I really want to pay just for the right of having her surgery there? I mean, we could even put her through Doggie College with that kind of money!!!

Este es el Hospital de Especialidades Veterinarias donde nos dieron el primer presupuesto para la cirugia de Marley... Si, esta preciosos... pero, realmente queremos pagar simplemente por el derecho de que la operen ahi? Diglo, hasta la podriamos mandar a la Universidad para perros por esa cantidad!!!

I already ordered this harness for when she gets out of surgery.

Ya ordene este arnes para cuando salga de la cirugia.

This past week was a bit stressful and full of "what should we do???" moments... Even a couple of friends got involved...

I actually talked to my friend Eloina during the week and she recommended me to ask her vet (to which I had also taken Mia when we lived in Tijuana); so I did... I call and she immediately KNEW what was wrong and said she could perform the surgery... Not for $3300, not for $2800, not $1000, not even for $500... she said she does it for $80-$100!!!

That's not even a quarter of the price!!! It's 3% of it!!! (SD $6600 total both knees "worse case". TJ $200 both knees!!!). Even if it doesn't turn out right the first time I can afford to have 31 more surgeries on BOTH of her knees and STILL pay less money!!! (that would be a total of 32 surgeries... 33 surgeries would make the cost equal).

I think that if I was a bit more "intrepid" I WOULD operate on her!!! J/K LOL I mean, I know how to put a catheter on, I know how to give stitches to somebody (draw blod, etc)... How hard can it be to cut the cartlidge and make it shorter and then stich it??? LOL Maybe if I got drunk I would have the "courage" to do it. (I actually think the hardest part would be the cutting of the bone, knowing what angle is better, the technique, dept, etc... but $6600... really???).

So I sent this email to John, because he said something like "well, imagine how many corners they have to cut to be able to offer the surgery for that little":

Good morning,

I just scaned this to send it to Eloina so she could drop it off by the vet tonight (I emailed her a copy where I covered the prices, just so that the won't get any ideas )... And she replies with (even before seing the prices): "and if you need to leave her there she only charges 5 bucks per day!"... Yeah... BIG difference...

I already emailed you a bit about this... BUT I was looking at the quote again... And now disecting the bill:

1) The Nova Critical Care: STAT panel is a freaking monitor!!! They're charging us (or think they are) $84 for the use of a fucking monitor!!! Are we taking it with us after she leaves?!?!?!

2) Radiology interpretation $45... REALLY???? (I know what they say, it's not what is wrong, it's KNOWING what IS wrong... but any way $45 x2...).

3) Catheterization $94... So they're charging us almost 100 JUST for the catheter!?!?!? I've bought catheters in TJ (when I was in HS science club)... They're NOT that expensive... I'm sure Marley (specially after 4 doses of anesthesia) doesn't need a super specialized type of catheter.

4) Epidural $82, isoflurane anesthesia $112 (first 15 minutes) and $160-240 after; surgical anesthesia $280... REALLY?!?!?! $714 in 4 types of anesthesia?!?!?! Hmmm... I mean... if a woman can give birth just with an epidural, don't you think that would be enough for a freaking knee surgery... specially for a dog... Just make me think...

5) Surgeons fee $915 to $963... Surgeons fee in TJ... probably $20...

6) Nursing care $ 126... Nursing care TJ: free.

7) Surgery room use $108... surgery room use in TJ: $5?

8) The only one that I would pay without question (I think) is the surgical implant and that's "only" $96... And the epidural ($82)...

Bottom line it's about $2134 in blown up prices and/or non essentials!!!

I just think that it IS possible to have the surgery for that much cheaper in TJ, with pretty much the same result... And, I promise, if Marley has a problem after the surgery I'll pay for her to get fix up here myself!!!

Let me know what you think.
Love ya,
Pilar

He replied with a "That's ridiculous"... And agreed to have her evaluated in TJ... So there we go... I made an appointment for her on Saturday at 11:00 AM.

We got there and the vet asked me to walk her around to see her (the Dr. in SD didn't do this), then she told me Marley is overweight (must run in the family :-( ), so it'll be better if she looses about 10 Lbs. and she'll most probably improve even before the surgery (yeah, that makes sense... and the vet here didn't told us that either), she told me that usually smaller breeds are the ones that develop this and that there are different levels of the Patella Luxation and Marley seems to have Level 1 right now. She also said that she has performed the surgery before in smaller dogs but that she can guarantee that the knee will be functional and pain free, but she can't guarantee the alignment of the knee/leg (esthetically the same or straight)... Therefore I thought it was probably out of the question for John and I didn't ask much more... But I REALLY appreciated her honesty AND she didn't even charge me anything after assessing Marley for 45 minutes!!! (Compare to $98 for less than 20 minutes).

The other good thing is that she told me about another Mexican vet she knows that works in Lakeside and could give me a better price knowing I'm from TJ...

I got home and talked to John... He asked me some questions that I didn't ask (like I said, I thought that because of the "no aligment guarantee" it would be out of the queston for him), but now I think (from what he said) that he's willing to have that risk... For one, I kind of screwed up because I thought (or assumed since it was so damn expensive) that the surgery here was performed with a laser, but John clarified that it's with a saw (or something mechanic) which is the same as the vet in TJ... So at this point... I'm going to call her again tomorrow, ask a couple of questions (about how to get the medicine, when can she perform it, etc)... And, as of today... Marley's on a diet!!!

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Esta semana pasada fue estresante y llena de momentos en que pensamos "que vamos a hacer?"... Y hasta algunas amigas se involucraron...

Durante la semana hable con mi amiga Eloina y me recomendo que hablara con su veterinaria (con quien llevaba a Mia cuando viviamos alla); asi que le llame y ella supo INMEDIATAMENTE que tenia y dijo que podia hacerle la operacion, no por $3300, no por $2800, no por $100, ni siquiera por $500, sino por $80-100!!!

Eso no es ni un cuarto del precio!!! Es el 3%!!! ($6600 en San Diego por las 2 piernas en el "peor" de los casos, contra $200 en Tijuana). No manches, aunque tuviera que hacerle la operacion otra vez de ser necesario, podriamos operarla 31 veces las 2 piernas pagando menos que en San Diego!!! (32 veces en total con la operacion inicial, 33 operaciones costarian igual que en SD).

Creo que si yo fuera un poco mas "intrepida" yo misma la operaria, digo, se poner cateteres, suturar y sacar sangre gracias al Club de Ciencias en la prepa... Que tan dificil puede ser cortar el cartilago para acortarlo, volverlo a coser y luego rebanar el hueso un poco para hacer el camino mas profundo para la rotula... Jajaja... Solo estoy bromeando... Pero igual y nada mas tengo que ponerme hasta las chanclas para "armarme de valor" (creo que lo mas complicado es cortar el hueso, darle el angulo adecuado y todo eso, pero $6600, neta???).

Asi que le mande este email a John porque me dice "imaginate cuantas cosas 'recortan' para poder ofrecer la cirugia tan barata"...

Buenos dias,

Acabo de escanear esto (el presupuesto) para mandarselo a Eloina para ver si puede pasar a dejarselo a la veterinaria (cubriendo los precios para que nadie se haga ideas)... Y me dice (aun antes de ver los precios): "pues si la necesitaras dejar un dia en el hospital solo te cobran $5"... Sip... Una GRAN diferencia...

Ya te habia escrito respecto a esto hace un ratito.. pero estaba viendo el presupuesto otra vez... Y lo empece a analizar:

1) El Nova Critical Care: STAT Panel es un pinche monitor!!! Nos estan cobrando (o creen que nos van a cobrar) $84 por usarlo!!! Nos lo vamos a llevar cuando Marley salga del hospital??? (Ver foto arriba).

2) Interpretacion de la radiografia (si ya se, el chiste no es arreglar lo que esta mal, es SABER lo que esta mal, pero, en serio $45 x 2!!!)...

3) Cateterizacion $94... Asi que nos estan cobrando casi $100 por ponerle el cateter??? Yo he comprado cateteres en Tijuana (cuando estaba en el club de ciencias) y no cuestan tan caros!!! Y luego, Marley no va a ocupar un cateter super especializado, sobre todo despues de estar knockeada con tanta anestesia!!!

4) Epidural $82, anestesia isoflurane $112 (los primeros 15 minutos!!!) y $160-240 despues de eso!!! Anestesia quirurgica $280... NETA?!?!?!!? $740 en 4 tipos de anestesia??? Digo... una mujer puede dar a luz tan solo con la epidural, no aguantaria un perro una mugre operacion de rodilla... es lo que te hace pensar....

5) Cirujano ortopedico $915 a $963... en Tijuana mmm... tal vez $20?

6) Cuidado de las enfermeras $126... cuidado en Tijuana: gratis.

7) Uso del cuarto de operaciones $108... uso del cuarto de operaciones en Tijuana $5?

8) Lo unico que (yo creo) pagaria sin hacer preguntas en el implante quirurgico ($96) y un tipo de anestesia ($86)....

En sintesis, son $2134 dolares de gastos inflados y no necesarios!!! Creo que si es posible que le hagan la cirugia por menos dinero y con basicamente el mismo resultado en Tijuana!!! Y es mas, si no queda bien con la primera operacion yo pago por que la arreglen!!!

Dime que te parece.

Te amo,

Pilar

El me mando un email que decia "es ridiculo" y me "autorizo" para llevar a Marley a evaluar a Tijuana... Asi que ahi vamos el sabado a las 11:00 de la manana...

Llegamos y lo primero que me dijo la veterinaria es que hiciera caminar a Marley de un lado para otro para que la viera (el Dr. en San Diego no hizo esto), luego me dijo que Marley tiene como 10 libras de sobrepeso (ha de ser de familia :-( ) y que si pierde esas 10 libras va a mejorar aun antes de la cirugia (eso tiene sentido... y tampoco nos lo dijo el Dr. aca), me dijo que usualmente son las razas mas chicas que desarrollan este problema y que hay varios niveles, pero Marley parece estar en el Nivel 1... Tambien me dijo que ella ha operado a perros mas chicos, y que puede garantizar la funcionalidad de la pierna y que Marley no tenga dolor pero no la alineacion (o sea, que le quede derecha la pata)... Asi que pense que John no iba a aceptar y ya ni pregunte mucho... Pero REALMENTE aprecie su honestidad y que me haya dedicado 45 minutos para evaluar a Marley sin cobrarme NADA!!! (comparado con $98 por 20 minutos o menos aca).

La otra buena noticia es que me recomendo a otro veterinario mexicano que trabaja en Lakeside que me podria dar la operacion mas barata sabiendo que soy de Tijuana...

Llegue a la casa y hable con John... el me hizo algunas preguntas que no pude contestar (ya ven que pense que no iba a aceptar despues de saber lo de la alineacion), pero ahora creo (por lo que dijo) que esta dispuesto a correr el riesgo... Para empezar, yo crei (porque por "algo" ha de salir tan cara aca) que la cirugia seria con laser, pero dice John que no, que aca tambien es con sierra (o un instrumento mecanico) igual que en Tijuana... Asi que... manana le voy a llamar para preguntarle algunas cosas (como, donde conseguir la medicina despues de la cirugia, y cuando la podriamos agendar, etc)... Y, desde hoy, Marley esta a dieta!!!