Author name withheld for privacy.

YOU CAN’T GET THERE FROM HERE…

There were two things I knew about the state of Georgia, USA - R.E.M hailed from Athens, and the CEC was in Atlanta.  While the music of R.E.M was accessible, travelling to see Dr Ken Sinervo seemed to be out of reach, he did not tour as R.E.M once did! I have known of the CEC, Dr Robert Albee, Dr Ken Sinervo and Heather Guidone for a number of years now and have seen many of my online acquaintances travel there for surgery and regain their quality of life. It was something I considered too far away, out of reach and for women with more complex endometriosis than I had. After 7 previous surgeries for endometriosis, suspected adenomyosis and chronic pelvic pain, I decided to research my options for travel. Excision surgery with a skilled and experienced surgeon gives the best chance of improving quality of life. I had been advised by pain specialists not to proceed with any more pelvic surgeries, yet I knew that endometriosis remained. My symptoms had changed very little in the 30 years since my first period, despite all the ablation surgeries, hormonal treatments and pain medications. I had been through a number of procedures for pain control costing thousands of Euro. All without lasting benefit, some leading to more pain and suffering and long term damage.

I spoke to Heather and Dr Sinervo about my options and submitted my records for review, following a call from Dr Sinervo - a surgical plan was devised - all I needed to do was get there! As a non US citizen, I did not hold insurance and my own insurance would not cover any of the costs outside of the EU. I applied to my bank for a loan (having done this multiple times in the past for surgeries).  They obliged. Beth at the CEC made the paperwork easy and within weeks I was on my way. While I understand this is a large financial commitment, it was one that was worth every cent and in the years since my surgery, it has saved me thousands annually in doctors and prescriptions fees. I will no longer need repeated ineffectual surgeries/treatments which were adding up to €14,000 annually.

Work out your own current outlay, loss of earnings due to sick leave, loss of quality of life, loss of independence and look at the gains - less sick time, less repeated treatments, less medications, less money spent in the longer term. If this was a beloved friend or family member, you would put them forward. You need to consider your own health and well-being as important as those you care for. Surgical and travel costs will vary; discuss your individual case with the CEC team. Give special consideration to your travel partner; you will need to factor in the additional flight cost. It is essential to have someone who can support you, cook, help with shower, pop to shops, be there for the surgery etc. They will need to be with you for the duration of your stay.

I cannot recommend Dr Sinervo, Heather and all the team at the CEC highly enough. Their surgery and care have revolutionised my life. You will read so many glowing reports, and it is only when you experience it first hand will you actually believe. When you enter the CEC offices - there are numerous awards and accolades to Dr Sinervo and the team.  The level of care and attention, the dedication, the experience and the absolute devotion to the better care of patients is down to the passion of Dr Ken Sinervo. The purity of his beliefs and his ego-less approach to surgery is refreshing and reassuring. The staff at the CEC office are professional, caring and comforting. You are put at ease no matter if you travelled 10 miles or 10,000. You will feel at home. You will be cared for and can leave all the decades of pain and suffering at the door - you will not need it for the return flight. The care I received at Northside Hospital was second to none - the staff were helpful, professional and dedicated. It is the cleanest hospital I have ever visited; they have an electronic patient record, which means you can apply for a PDF copy of your whole record after discharge. This will contain all the details of your visit.

So I guess you can get there from here.

It might mean a little bit of planning and some upheaval. You get to explore Target and Walmart for treats and visit the Martin Luther King museum before you come back home. You will experience the “Southern” hospitality and in truth - meet some amazing people who will help change your life.

Tips for travelling from Europe to the CEC
If you are considering a review - have your paperwork ready - order your notes from previous hospitals/surgeons. You will not need every minute detail, but post op reports, surgical pictures and outcomes are essential.

Email the CEC - ask for a review (it is free). Have your questions and concerns ready for Dr Sinervo or Dr Arrington when they call you. Use this time wisely; they are busy surgeons and you want to optimise your time.

After your phone consultation, the CEC will provide you with some costs and practical information about your appointment and surgery.

Begin your in-depth research into flights and accommodation. This will help you come up with a total cost. Use email where possible and  VOIP services to make calls (Skype, Viber, WhatsApp) to save money as they often have preferential international rates.

Look at different times for your surgery (dependent on availability of the surgeon) - take into consideration factors like weather - it gets hot in Atlanta; other times snow can delay flights. Some times of the year are cheaper to travel than others.

Use a travel agency like TrailFinders for your flights - they take all the stress out of booking - and work out the best route and best price. Let them know it is for surgery and that you will need assistance (both ways if required). Request a seat with extra space or leg room. Ask about any offers on upgrading your flight. I chose the Virgin Atlantic flight Premium class - this allowed for fast track check in, wider seating area etc, but most importantly it allowed the travel agent to choose a seat which allowed me maximum room to stretch out and stand should I need it. This process was seamless, and the connecting flights also had assistance booked. You will be wheeled on and off the plane - so no steps and no rushing. Your travel companion will also be given the same priority. As I needed multiple connecting flights, it was easier to have my luggage checked the whole way through on one ticket. This is especially useful for the return journey. Choose to arrive close to your surgery, so that your time is best spent afterwards for recovery. Do not leave it too close - remember you will need to bowel prep and accommodate any flight delays (and in the time of COVID-19, mandatory pre-surgical coronavirus testing).

Research your accommodation options - look for somewhere with an outdoor seating area, small kitchen area, restaurant on site or close by, supermarket/pharmacy close by. We chose the StayBridge Suites on 4601 Ridgeview Rd, Atlanta, GA 30338. The room was clean, had a small kitchen area and air conditioning. The hotel did not have a restaurant, which was not a deal breaker for us. It did have “social nights” where complimentary food and drink were served and were a welcome treat. The beer taps were installed for liberal use! They have an outdoor seating area, pool and fire pit. It is in a quiet area and surrounded by good footpaths for walks post op. Target and other stores are across the road. The CEC is a very short ride away, Northside Hospital also. Check with your surgeon how long you will need to stay post op. Let the hotel know you will be travelling for surgery and may need assistance or an accessible bathroom etc. 

Book travel insurance. No exceptions. Check what is covered and what is not. If you trip and fall in the days post op are you covered? Will a follow up hospital visit be covered if you develop an infection or bleed? 

Prepare in advance any ridesharing apps you might need - Uber and Lyft work well in Atlanta and we found all our drivers very helpful and they also learned about endometriosis on our journeys. Save the locations you will need in your Google Maps (or similar) now. This will be the CEC, Northside Hospital (check the correct entrance location with CEC), your accommodation, airport etc.

Compile a list of your medications, and have your doctor write a letter confirming doses and items (for flight and also hospital).  Medications are expensive in Atlanta; ask your surgeon what post op medications are needed and if it would be appropriate to have them prescribed at home to take with you. 

Follow the pre op instructions to the letter. This includes the bowel prep. All items required were available in Target across from our accommodation. This was the gentlest (yet effective) bowel prep I have ever taken - and I have had a few!

Prepare some walks and goals for post op recovery, check in with your surgeon.  For me, I was walking outside 48 hours post excision and hysterectomy. The abdominal binder was a great support. I was in significantly less pain and swelling than I was pre op! Walking helped my recovery - the sunshine, fresh air and gentle pace all added up. It was also a lovely distraction to go to Target, Hobby Lobby etc. as time went on. 

Bring some entertainment media with you - TV is full of adverts and news does not cover international events. 

Packing - pack light - you will not need the full luggage capacity - choose nightshirts over pyjamas, leggings and loose tops. Remember the luggage has to be carried - post op you will be reminded not to lift any significant weight. Northside Hospital provides all you need in terms of socks and toiletries. 

Finance - get in touch with the hospital and CEC to discuss your payment options. Get their international bank transfer details early and use a reputable company to transfer your funds. The earlier you plan this, the better. This way you can keep an eye on the exchange rate and get the best value. Be sure to discuss all fees with Northside and have them included on one bill if possible; Northside also has a discounted rate for prepaid visits. Check ahead of travelling that your payment has been received and processed for your arrival. Ask about contingency planning should you need additional nights or services. 

Make note of the CEC address and contact details and likewise for your accommodation - you will need this for the hospital records. 

The hospital will make a phone appointment for your Pre Op assessment. Be sure to have space and time for this call. 

Remove all piercings, jewelry, fake tan, make-up etc prior to your surgery time. It saves time on the day. 

On the day of your surgery, you will attend the CEC where you will be welcomed and given a pre op appointment. The nursing and administration staff will answer all questions and prepare you for your surgery. All forms are signed here, and you will have ample time with Dr Sinervo (or Dr Arrington, as the case may be) to discuss your surgery, have an examination, ultrasound, check etc. Use this time to ask any last minute questions. You will also complete your financial paperwork at this time. The CEC will give you a pack to take to admissions at Northside Hospital.

Arriving at Northside Hospital - ensure you have the right entrance - it is easy to find - the admissions team are helpful and while there may be some additional questions around the international address/payment/phone numbers the process is straightforward.

You will then proceed to the surgical floor - your partner/friend/family member will be called to the desk to complete some paperwork and will be given a buzzer that works on the hospital campus. This allows them to walk about while waiting for you. 

The Pre Op nursing team will show you how to prepare - wipe down with disinfecting wipes - gown on - socks on - hair cap on and into a very warm and cosy bed. Blood is taken for labs and also to prepare your platelet rich plasma (for use during your surgery).  The anaesthetist will come and speak with you. Your surgeon will also call in just prior to moving you to the theatre as will the lead scrub nurse. Your partner/family member/friend will be allowed in pre op once the initial assessment is completed. You will receive a hydrating drip and also your pre meds in this area. Your surgeon will  reassure you at this point, and double checks all you have discussed. 

Off to theatre - it is a wonderfully welcoming team - everyone is here to ensure your surgery is going to be successful. You are settled on the table and the anaesthetic is administered. 

During your surgery, your surgeon will call your nominated person and give them an update on your progress and what they have found so far. 

Post op, you will be moved to recovery and made comfortable. Your nominated person will meet your surgeon and discuss (with your permission) the surgery, photos, findings etc. Your surgeon will give the option of this conversation to be recorded. Take this opportunity. 

When you are moved back to the ward, you will be settled in by the nursing team for post op care. You will be asked your pain score and your pain score goal. You will also be assisted in standing, toileting etc. You will be asked to get up and walk at least twice in the night to help with your recovery. This is the most wonderful walk - up and around the corridor, as slow as you wish, knowing it gets the circulation going and the healing to begin. Be sure to also perform the respiratory exercises as often as prescribed.

Your travel partner may have the option of staying with you - this is at the discretion of the nursing manager - and they will advise. They provide a duvet and pillow with a recliner chair. 

When it is suitable for you to consume food and drink, the hospital will provide both. Your travel partner can eat at the hospital canteen - the food is well prepared and sufficient choices for even the most complex requests. 

Your surgeon will visit you in the morning to check on your recovery; you may also see some of the surgical team. 

When it is time for discharge, you can book a ride/taxi. The hospital portering staff or volunteer will take you to the door and ensure you are safely in the car. Use the pillow provided to help cushion your abdomen from the seatbelt.

When you are back at your accommodation, rest - but be sure to move gently to stimulate circulation and healing. Set your phone alarm for medications and follow all post op instructions from your surgeon. Make sure you have the CEC On Call number saved in your phone and that of your travel partner (+770-913-0001). 

Prepare for and attend your post op appointment at the CEC - this may even be a week or 10 days post op. Have any questions or concerns written down so you do not forget. Your surgeon will discuss your recovery, the pathology report (which is essential), your future needs and expectations. You will get a chance to thank everyone. 

Prepare for your return flight - make sure you have a letter from your surgeon stating you are cleared to fly. Most airlines will want this sent at least 48 hours in advance. Pre book your ride to the airport in plenty of time. This is when all the preparation pays off! The assistance at the airport (priority check in, wheelchair, straight through security, priority boarding) is essential at this time. 

On the flight - ensure that you move when you can - at minimum - do your leg and arm stretches. Ask staff for assistance as required. Follow any recommendations from your surgeon. 

When home, continue your recovery. Life will change, stairs that were once mountains become achievable, showers that wiped you out will become moments of relaxation and the pain medication schedule will change almost daily. Enjoy this time, keep in touch with the CEC as needed.

When you are cleared by your surgeon - book a pelvic physiotherapy appointment if indicated and return to exercise and work. 

Please give feedback and thanks to both the CEC and Northside Hospital about your visit. This is important, it helps forms policies and procedures for other patients. It is seen as a quality improvement, but it is also nice to say thank you!

Keep every receipt! You can claim medical expenses (including travel, subsistence, accommodation) on your tax return (in many countries). For me, it was a return of 20% of my total costs. 

Complete any follow up paperwork and give honest feedback on your symptoms - this allows the surgeon to track outcomes and to help share collective experiences with other patients. Your outcome and long term health is important.

You are always a member of the CEC family.  Enjoy the experience!