Kristopia

Hi Wasa - thanks for your PM clarification and for giving me the links to the threads. I appreciate them very much. I don't see where they make Dr. Joya look unethical, though definitely things could have been handled better regarding the nicked liver situation. Her issue wasn't that her liver was nicked (it was enlarged and that can happen) - it was that Natalie didn't tell her until she was preparing to walk out of the hospital that she had to pay the $1200 additional before she could leave. Not a very good administrative decision, and it was stress for her that she didn't need. The hospital should have told her husband immediately while she was in recovery about the additional charges, so he could take care of it before her discharge, and avoided the extra stress. As to the man with the leak - again, very sad situation, but also happens, especially in older patients who have other issues, and I don't see where Dr. Joya was unethical there, either. In fact, the poster actually complimented the Doctor that he tried his best to get rid of all the costs he could, but that he could not get rid of the hospital charges themselves for four extra weeks in the hospital. He stated that Dr. Joya, Natalie, and the hospital staff were all very kind and professional with him in the extra time he had to spend in PV. He said he ended up paying double what he had paid for the initial surgery - that is $10,500 more - for FOUR EXTRA WEEKS in a hospital. My guess is they discounted him pretty heavily to get it down to that. Thing is, these things do happen - anywhere. They happen often in the U.S. Though I'm sure it was scary to have to stay an extra month in a foreign country for surgical complications, that is a chance we take when leaving the country for surgery. The woman who talked to Dr. Joya and he mentioned the RNY said this: Thanks all! I didn't feel he tried to convince me (he was recommending) and didn't feel trapped at all! Also I didn't feel it was money-related. I think he is very skilled with both RNY and sleeve. He is straight-forward and expressed his point of view in my case once I explained my feelings and concerns. At the end of the day, the told me it was MY choice, that it was a big commitment and that I had to go with what I am comfortable with. He seemed so at ease in his recommendation of the bypass for me that I had to question myself....but at the end of the day, I feel I have to stick to what I really wanted, the sleeve (thanks MWG) And thanks to you all, you are a great board!! Again, in this situation, the person said she did not at all feel pressured into getting the RNY, but that he was giving her options. To me, that is just what a surgeon should do - provide options and allow the patient to make the best decision to fit their needs and/or fears. At the end of the day, while these situations were unfortunate, I don't see any unethical practices. I see a really crappy situation where they should have told a client earlier so that she owed more money. In the long term, from what I can gather, it was exactly the two situations - the liver laceration and the leak complication - that caused Dr. Joya's office to set up the complication fund - so that these types of situations would be minimized to the best of their ability. Rotten that they happened, but a good thing came of it and the complication fund was born within two months of the lacerated liver situation and two weeks after the leak complication. I think it is highly ethical to set up a way for this not to happen again. I do think it's great that a few of the other surgeons seem to cover for any complications (Aceves and Alvarez, to name two), but I'm not surprised that it's not across the board. Sometimes the surgeon has no say in what the hospital charges. He might waive HIS fee, but the hospital will charge additional fees that the surgeon often has no control over. Again, thanks for voicing your concerns, though, and for giving me the threads to read over. It's all about being armed with all the information so we can make good choices, and I APPRECIATE being armed :frown1:

Now, see, this is why I'm concerned that this is yet another one of those forums that pushes one doctor while dissing another. I can't seem to find these elusive people you speak of who have problems with Dr. Joya's ethics and have gone to see him. Who are they? Where can I find them to talk to them? Every single person I've spoken to that has gone to Dr. Joya has had nothing but good things to say about him and his staff, OR their ethics. When Gerald, his U.S. based assistant sent me the information, there was a very clear stipulation in the paperwork that talked about the complication insurance, and their policies about complications. No secrets at all there. I've talked to people who have said they went for a bypass, but Dr. Joya talked to them about the sleeve maybe being a better option for them. So is he pushing bypass, or is he simply talking to people about THEIR best options? I talked to a lady today who researched Dr. Joya for almost 10 years before finally deciding to go get a Sleeve surgery from him last year. She said she also heard rumors about the nicked liver (all the way from the patient died to the patient had issues to there was no patient), but never once could find the name of that person or talk to that person about their experience. Every single negative thing I've heard about Dr. Joya (and there hasn't been much) has been very nebulous and has no actual stats attached. Every single positive thing I've heard about Dr. Joya (and there have been many) has contained statistics and names of people. It really concerns me that this might be yet another one of those sites that promotes Dr. Aceves over any other, as if he's a sponsor of this site, and sends out negative information about other doctors, even if there is no real evidence of such happening. Yes, I've heard a couple people talk about having leaks from all of the doctors - docs don't use statistics in their stats of patients who experience issues months later, only those that experience issues early on. Did these people burst their staple lines and get leaks by overeating before they had healed? Did they begin on solids sooner than they should have? Were they anomalies? Or was it really a surgical issue? Nobody can say or give facts. Please, just let me know - I'm not here to cause trouble or whatever, but if this is another site that is going to play the "my surgeon is better than yours" game, I'll just opt out now while it's early. It is good to give people information so they can make informed choices, but only if that information is actually factual. Where is the evidence that Dr. Joya has treated people in an unethical manner? Not rumor - evidence. Thanks

I'm paying the $500 for possible complication issues, for sure. Do you have the info on the people who had any issues, so I can talk to them? I heard about the liver, but I had also seen his stats on other sites (including OH) that showed much lower complication rates than my U.S. surgeon.

thanks Efura - I'd seen on another post that Dr. Aceves was running a July special. A problem with that is that I probably won't get my passport until the end of July, as I just ordered it last week and it's taking 6 to 8 weeks right now, according to the passport website *sigh* So I can't schedule a surgery in July until I know when I'm getting my passport. ah well - and yeah, it's a great bargain - but hey, I'll get a few vacation days in a beautiful town before my surgery in PV, so it evens out

Steve - well, self-pay here would be lots more than my co-pays. But self-pay in Mexico is 1/3 the cost of self-pay here in the U.S. - at least apparently in my area - and yeah, they do know what they're doing - unfortunately, sometimes it doesn't seem all that ethical. MacM - yep; it is pretty messed up. To me, just having a little regulation would help immensely.

Thanks Ruthi and Elizabeth - it's been a long battle, and has caused a lot of stress and some depression, all the fighting for the surgery - but now I have something to get excited about! :lol0:

Yes, it IS ridiculous - the variations AND costs - one reason I'm definitely supportive of regulating our health care industry. My U.S. surgeon's fee alone would have been $12,500 - without hospital fees. I have a very close friend that got her VSG last July - same surgeon, same hospital I would have used - $36,000 total. That's for two nights in hospital and the surgery. It is horrific that they'd charge that much for two days, but there you have it. Even if my insurance HAD covered at 70% (which is what the surgeon's office told me), that would still be over $10,000 out of my pocket in the end. More than it is costing me to go to Puerto Vallarta and have it. Craziness!

Why am I leaving the US for Surgery? Here are my reasons: 1. My United Health Care insurance refuses to pay for ANY type of WLS surgery - they won't even pay for a doctor supervised weight loss program, period. Ridiculous. 2. I live in "medicine city" - Durham, NC. We have Duke Medical Center, not to mention huge amounts of other hospitals, specialists, pharmaceutical companies, labs, etc. Even so, I found two surgeons that were even slightly experienced in VSG - I was going to get RNY (because to me, a tool is a tool, except I didn't want a lapband, for all the reasons cited on this board), because insurance would never cover VSG - not this insurance in this state. 3. I saw my surgeon twice - once back in January at the seminar, and once at an initial consultation for 10 minutes. He was nice - but damn, 10 minutes? His office staff were coldly polite, and the insurance girl was a pain in the butt - she never called me back when she said she would, and she told my my insurance would cover - I jumped through ALL the hoops, and got ALL the pre-surgical testing. All of it. I have spent well over $1000 out of pocket for all of the pre-surgical testing. More to come, I'm sure, as I'm not done getting all the bills yet that insurance wants me to copay, etc. In the end, nothing. 4. My surgeon, while experienced with RNY and lapband, has only done about 30 VSG surgeries. And even with RNY and lapband, he doesn't measure up to the experience my chosen Mexican surgeon has....OR his track record. 5. In the US, my surgery would cost a total of $35,000, including surgeon's fees and hospital fees (that's only two nights in hospital) if I pay out of pocket. Seriously?? Yep, seriously. So, I researched surgeons in Mexico, and researched, and researched, and I've chosen my surgeon. I've chosen Dr. Armando Joya in Puerto Vallarta, Mexico. I know Dr. Asceves seems to be the popular choice here, and I'm certain he's a great surgeon (they were both tied until recently), but here are the reasons I have chosen Dr. Joya for myself (and we all must make a personal choice of surgeon we are most comfortable with). 1. Dr. Joya has well over 500 VSG surgeries under his belt, as well as thousands of other surgeries including metabolic, etc. He is a gastroenterologist, which I'm glad about. He seems to me to run pretty much even with Dr. Aceves. So it came down to cost and location, really. 2. Covered in that cost is three nights in the resort, two nights in hospital, cabs, yadda yadda yadda. Everything but flight - and complication insurance. It's a little higher than Aceves, but I'm willing to pay the extra for my comfort level. 3. Private small lovely hospital. 4. Flight goes straight in to Puerto Vallarta airport, where you are met with a sign with your name on it, then transported to the resort, which is only 10 minutes away from the airport. You are met by Natalie, Dr. Joya's coordinator/assistant. The hospital is from 5 to 10 minutes from the hotel. All of the transport is taken care of (though I'll carry money for tips for the drivers). 5. After surgery, like Dr. Aceves, there are leak tests performed. 6. I will not have any drives over borders or for longer periods after surgery - I'll have the very short drive to the Puerto Vallarta airport, and then a 20 minute trip from my airport here in NC to my apartment. The flight itself, with one stop in either Dallas or Houston, is in two sections, both under 2 1/2 hours. The layover is short, so enough time to walk a bit in the stopover spot, but not enough time to be uncomfortable or overtired. 7. the location. I have always gone to the ocean to heal, whether it be emotional healing or physical. there is just something about Water that I need. And, a very close friend is going with me - we decided also that since both doctors were equal in my estimation, it was worth a little extra to go to Puerto Vallarta, which is beautiful. I'll spend two days extra vacationing (except for food, I'll be stuck with clear juices and broths and water) before surgery, and a couple extra after I leave the hospital as well. 8. Dr. Joya actually comes to visit his patients in the resort. Can't get that in the United States :thumbup: I seriously doubt the surgeon here would make house calls. I believe I have made the best choice for me and my comfort level. Several docs in Mexico are highly reputable, but Dr. Joya is my choice for the reasons above and many others, but this e-mail is too long already I'm going to send my deposit within the next few days (either tomorrow or Monday), and hopefully will get my passport soon so I can schedule the surgery for end of July or early August.

I take Bariatric fusion Vitamins at present (chewables) - I haven't had my surgery yet, but I pre-ordered them back when I thought insurance would only pay for RNY. They're really good for incorporating everything in there, including zinc and Biotin, but I'm not a fan of the taste - taste like fruit flavored tums to me. Anyway, it calls for chewing 4 per day, but I'm only taking two, as I'm pre-op and I don't want to overload on Iron. I do think it is incredibly important for those of us who have weight loss surgery, even VSG without the malabsorption, to get good vitamins in. But I might not get the bariatric fusion again - bleh!

LOL - fun word, and one I like a lot - but yeah, might get me in trouble at work to say I'm "working my cock" instead of "working my tool" **snicker**

LOL MacMadame - I'm totally going to think of that now every time I hear "tool"

I find them in most grocery stores, but certainly at Super Target or Wal Mart. Dove chocolate has a bag of individually wrapped darks. Hershey's kisses does a back of dark kisses (I think they're purple wrapped, but can't remember), and Hersheys has them too in their "signature" chocolates. I like Dove myself - creamier tasting. I also like to get sugar free Chocolate pudding (or vanilla, for that matter), and freeze them in their individual cups. It really helps when I have a craving for ice cream or gellato.

You do know you can by a whole bag of just dark chocolate minis, dontcha? :biggrin0: I LOVED that invention, because the darks are what I eat, too, and one satisfies a craving, even now without the sleeve.

Exactly! :biggrin0: I think, after talking to so many people and looking at the research, the word "tool" is a very important one. Those people who consider WLS just a tool to assist them in reaching their goals, along with healthy diet and exercise, stand to have more success in the long run than those who expect it to be the end all and be all without the diet and exercise. I can have this tool and still not lose weight - by drinking high calorie shakes that pass right through, or continuing in bad habits of eating pastries or candy, or drinking drinks that are high sugar. VSG is a fabulous tool - and I can't wait to get it - but it is a TOOL that we combine with the things we already know, but struggle with doing because it can be discouraging. I'm SO looking forward to the help