Klumzyfule66

Hey all, my wife is looking into the gastric sleeve surgery, of course I am the one with all the questions about it. Hoping maybe someone could help with any anecdotal evidence at least. I'm trying to reduce the "I wish we knew x before doing this" ... Anyway, for obvious reasons we are looking at Mexico. The first one she sent me was Elias Ortiz out of Tijuana. So I looked into him more, and read about some very poor (in my opinion) things about him, I think mostly when he was with ALM (or whatever it's called). Of course the first surgeon we look at giving me the eebie geebies is not a great start. He's not officially out of running, but we have looked into the following now. Odd that there didn't seem to be lists of them. Haven't looking into everything equally, our spoken to the coordinator on prices or anything, but these are probably in order of what we like. Endobariatric in Piedras Negras with Guillermo Alvarez LIMARC in Tijuana with Liza María Pompa González Obesity Control Center in Tijuana with Ariel Ortiz Elias Ortiz & Co in Tijuana VIDA Bariatrics in Tijuana with Gabriela Rodriguez Ruiz So I guess the questions are the following. If anyone could answer whatever question you may be able to add to, that would be great. Thanks!! 1) After deciding on Mexico, what was the overriding determinant in picking a surgeon, was it only price? 2 Did you get to pick the bougie size? I read a study (odd that I only found one) about bougie sizes - apparently 32 fr and 40 fr are the 2 commonest sizes? Anyway the study said that there was no materially significant weight loss difference between the two sizes, but there were less complications with the 40 fr size. Also in her situation, she's 5'10", and her general body type is such that her most healthy weight is going to be more than others her height, so I fear something too restrictive could come with problems of their own. 3 I've read about issues where people's Drs don't support post op care for out of country surgeries. This was old info though. Have people found this to still be the case? Is it only for the primary doctors, or only bariatric doctors? Or both, or is that not really a thing anymore? 4 What about complications during surgery. I have to imagine they send you to an ER in the states. I understand at that point our insurance will cover the emergency internationally, but not sure the MX hospital would be adequately staffed, and may have to send us to a place in the US. Any issues with transportation delays having to cross border? 5 Complications after you return home... I assume no, but are there any that, if we are about to make it back out, would fix the problem for like no cost or reduced fee? 6 Post op care. Like weeks/months/years... Is there a type of support you wish you had but was not provided? Nutritionist, or type of PT or psychologist/psychotherapist that focuses on mental issues that may arise after the big life change, to avoid body dysmorphia from moving to a different body part... I know the OCC place mentioned 5 years worth of support. Not sure if that is worth it, or if it's just something out there for fluff because it seems like something that would be useful for patients, but actually patients after the fact realize it's not helpful. 7 anything you know now, but would've been really helpful to know beforehand? Whether generally, or issues that would be specific to MX vs going to a place in US? 8 wondering the success of people with situation like her... In my opinion her problem isn't with overeating/the size of her stomach. She doesn't eat because she's hungry, so I'm not sure the impact this has on ghrelin will be a huge help. She invites an environment where she keeps low metabolism, skips meals, snacks on crap, drinks artificial sweeteners, takes medication that has been shown to lower metabolism. I tell her she needs to eat more protein, fiber, and 'eat like a diabetic' and when she works out (which she doesn't even do anymore), it's more of a benefit to go shorter sessions, but with more intensity, as that is best for your metabolism ... She says "Believe it or not, I actually learned this in college (for her nursing degree) and I know what I need to do" but yet does not do at all what she needs to do - and yet also simultaneously complains that she's tried everything to lose weight, even though that's not the case, particularly in last few years when she's out on anywhere from 20-40 pounds (guess). Looking at all the pre and post op diets, it looks like there's a focus on protein (as one would expect). So she's like, addicted to the dopamine I guess that she gets. She eats because she knows it's there. So while I am sure she will lose a bunch of weight offer the first 6-12 months, I tell her I'm more worried about being back where she is now 5 years after the fact, due to her behaviors that have put us in this situation in the beginning. There have been a handful of things that she's done (each successive thing being more expensive), where she's like "if I get x then it will force me to do y" and that's basically her 'argument' here. 9 related to above, how does one stay hydrated while exercising, esp in heat? Or even being sick? Is it recommended to drink warm water, due to the quicker absorption than cold?