2b4me

Hi! I'm having surgery on Jan. 23! and would like to know what I'd likely expect at this site, please. Also, would you tell me what it was like at either of the group homes? -- my surgery is with Dr. Almanza. What do I need to pack for Mexico, please? Thanks so much.

You stated you hate the idea of coordinators: However, I hate the idea of coordinators (they remind me of used car salesmen), Yet, in another post you also say you relied on 2 coordinators to get some of your data: Your words: "Because, I even had 2 coordinators verify what I had read about the facility and aftercare procedures of your surgeon". One example of egoism and narcissism: but I did do research on several of the Mexico surgeons, and believe that when I give information, it's just that, information that can be confirmed. Your words: I have done a lot of research, and share the information I've been able to find. I've shared all the links, and told people how to use the search feature here. So, what else am I supposed to do? I guess I could once again contact all of the surgeons and get it in writing again about their procedures and facilities that I based my opinion on. But, even then, it's not firsthand experience since I didn't have to use any of them. In research terms, you have done a lot of secondary research and some primary research. But, you don't have the primary research data, the personal experience with the surgeon and the facility, that others have. Your words: None of the information that I've shared has been incorrect or discredited by any patients. If you or any other patients can state that what I have shared is incorrect, please point me in the right direction. On the detriments of hearsay, chain communication and quality of the research process: The Encyclopedia of Case Study Research: "Storyselling" (2010) -- among other entries. Qualitative Research Methods for the Social Sciences (1998) The Journal of Organizational Change Management: "Coaching can be storyselling" (2007). The Journal of Leadership Development: Understanding the charismatic leader-follower relationship: Promises and perils (1998). Criteria for assessing the trustworthiness of naturalistic inquiries (1984). The Crowd: A study of the popular mind (1974). Principles of Management: "Communication" (2004). -- and pretty well every book on communication using the chain or "party-line" method. There are three things I have argued about your research: 1) your assumption that it is not necessary to have had personal experience before you can fully recommend a surgeon/facility, is not correct and it is not supported by quality research processes; 2) you are not above having to back up your statements, and more than once; 3) the use of daisy-chain communication including but not limited to hearsay, is not effective. The 4th is that everything else you've put into your posts is irrelevant to those 3 statements.

WTH? I hate this...but if you believe you know everything because you have the most posts or because you're the most supportive, you're dead wrong. Let me see -- someone says you are not correct in your assumptions about good research practises and you claim that to be a war? It is terribly egoistic and even narcissistic for you to claim -- Hey everyone on these boards -- it's me. Believe everything I say! I know everything there is to know about everything! I've done all the research. Again, WTH? Using your imagination is not a personal experience; nor is talking to your friends and then repeating what they said. The rules against hearsay are based on this. It would be extremely helpful if through your wide network that you direct the poster to the people who had the surgery with the doctor. I have seen your posts and they are extremely empathetic and supportive, which is great! It seems you've also had a rough go of things so you've had more experience with complications. But, you've not had all the experiences. You are not all things to all people. If you were the wellspring of information, people would not have to post -- they could just pm you so you can tell them what to do. Sorry, but as far as quality research goes for this information request, your arguments do not hold Water. Oh, and the next time you imply that I've started a war, make certain you are correct, and make certain your fight is worth risking your credibility.

Sorry, but anyone providing an opinion needs to back up their statements with some type of experience. If you have first hand experience in regard to the research you did, including all of the data you retrieved from that process, then that can be valid and reliable, providing that research is still current. But to say, "The only person I would go to is Dr so and so" without backup of what you discovered and without the actual experience is not reliable feedback. Too many 'friends' bandwagon making it seem like there are many more positive or negative experiences than what's in reality. Plus, it takes that much more time for the researcher to get the information they need and should use. Who's more important in terms of the risk-taking? The person asking for help or the person answering the post? There is no way someone without that personal experience knows as much as those who have had it.

Hi, Not sure what's up but I just clicked on the link and got to the related post, where the deaths are reported. That poster would be better able to direct you and the original poster of this thread to the right source to read and or ask. If the link still doesn't work for you, the thread/post number is at the end of the link, just after the title of the thread.

First of all, I care about your health and welfare that includes money you could potentially waste if you listen to the wrong people. I care about you getting the services you feel you need. I do not care that you choose my surgeon or not. I and everyone else on this and other boards have 0 stake in your decision. Congrats! on starting your research process! But, please do the research with people who have had the experience. 1 person = 1 experience. Those who do not have first hand experience project their own fears or fantasies on others. You could be basing your health and your hard earned money on these. No one can determine what doctor is 100% best for you until s/he knows all of your needs -- physical, emotional and mental. If you go to a surgeon/clinic that expects you to be able to take care of yourself, with home-based support for after-care but you cannot or you need more TLC, then find a surgeon/hospital setting. Consequently, it is critical that you complete research that is independent of these and other forums, as well. How do you know if information you get on these forums is reliable? Ask yourself these: Is it based on current reliable research vs. Wikipedia or assumption? Is it based on personal experience vs. gossip or conjecture? Does the poster have a hidden agenda? If any = YES, ask poster for facts AND evidence. Given that you are concentrating on posts from people who have had the actual experience with a Mexican surgeon, this next part is somewhat irrelevant. However, if you insist on taking in non-specific experience, the following becomes more important. On 2 different websites, this is what I found when I was completing my research. If this thread continues, it is likley that 4 main groups of individuals will battle one another to defend their surgeon choices, real or perceived: 1) Pro Mexico; 2) Pro Mexico with the tendency to denigrate other Mexican surgeons; 3) Anti Mexico -- had surgery in Mexico and warn against it; and 4) Anti Mexico -- had surgery in their home country. Group 1 - patients who have first hand knowledge of their Mexican surgeon and her/his demographics Group 2 - patients who have first hand knowledge of their Mexican surgeon, ONLY; and not the actual work or surroundings of any other hospital or clinic Group 3 - patients who have first hand knowledge of their Mexican surgeon and are dissatisfied with some/all of the process Group 4 - patients who have no first hand knowledge of Mexican surgeon. To get the facts, I focused on the posts by patients in Group #1 and Group #3. There are 4-5 Mexican surgeons who seem to be the main players: 1) Aceves; 2) Alvarez; 3) Almanza; and 4) a couple of others whose names you will get from your research (sorry, I've forgotten them). The companies for whom these surgeons work are extremely competitive and even to the extent of using industrial sabotage on this board and others . I believe the sabateurs are referred to as "Trolls". There is also a psychodynamic process called transference that can occur between patient and doctor. The short of it is that his occurs when a patient ends up transferring love and affection to the doctor because the doctor helped positively change that person's life (Carr & Lapp, 2004, 2005, 2006, 2007). To these patients, the doctor can do no wrong -- ever. Please note that Dr. Aceves has had 2 deaths that were reported -- for more information, please go to this link: http://verticalsleevetalk.com/vertical-sleeve-gastrectomy-vsg-surgeons-hospitals/1051-mexico-vs-us-surgery-post38102.html I started out my research by putting in each surgeon's name in the search engine of each website pertaining to VSG. Then I read through all of the threads and had to sort among the good, bad and the ugly of all the comments. Then I narrowed my research to focus on 3 surgeons and their care facilities. I e-mailed each company with questions to get their responses in writing. Then I checked their responses against any bit of industrial data that was formally published (i.e., Certified Board Member, if it matters to you, Number of surgeries completed? How long in practise? Professional credentials, etc.) I did not factor in the cost until AFTER I did all the research (i.e., I've also been to a Tijuana clinic) and determined my needs. Then I chose the sugeon and facility. Whomever you choose, is your decision and only your decision. Your decision will be based on the research you choose to select. A few weeks back, I wrote a lengthy recount of my experience that's now my blog. If/when you do your search (Almanza, Tijuana, Emmanuel Clinic, Jerusalem Clinic). I would rate my experience as 9/10 for the VSG and the recount states why. I wish you the very best of everything! Take care!

Hi, I've blogged a bit about my experience with Dr Almanza and the clinic in which he works. Perhaps it will help? Also, if you use the search engine that's for VST.com, and put in the search term, "Almanza", you will get a list of threads concerning him. It would also work for the other surgeon. Some of the threads you will see are filled with people who do not have any personal experience with Almanza or the clinic. I would not use these for your research, but instead focus on those who used Almanza (+clinic) and were happy AND those who used Almanza (+clinic) and were not happy. Please also also factor in (alot of) independent research that does not include information from forums. Good luck with your research!:thumbup:

Hi, I've blogged a bit about my experience with Dr Almanza and the clinic in which he works. Perhaps it will help? Also, if you use the search engine that's for VST.com, and put in the search term, "Almanza", you will get a list of threads concerning him. It would also work for the other surgeon. Some of the threads you will see are filled with people who do not have any personal experience with Almanza or the clinic. I would not use these for your research, but instead focus on those who used Almanza (+clinic) and were happy AND those who used Almanza (+clinic) and were not happy. Please also also factor in (alot of) independent research that does not include information from forums. Good luck with your research!:thumbup:

Hi!:thumbup1: Wanted to let you know about my TJ, Mexico experience. Disclaimer a) I have no allegiance to anyone in this company or its representatives and I have not been coerced, cajoled or otherwise persuaded to write this chronology of events; :crying: I write this because I know what it's like to need the surgery but be prevented from having it, for one reason or another. Saturday- Jan. 23: I've not been surprised about the surroundings or the people here. From the airport the driver and I drove directly to the lab to get my bloodwork done, which took about 10 minutes. By 1.00 p.m. we got to the clinic that yes, is among retail stores in a mall-type setting. Across the parking lot is a "Love Boutique". The clinic is on two floors; not one. The top floor is for patients waiting and admin. The bottom has the surgery and recovery rooms. Every hallway and room I was in was clean and cleaning people cleaned all day long. I remember seeing that I was wearing white socks that stayed white. For me, things were a little tough because I had no 'real' water for more than 24 hours. I knew my surgery was to be the last one on the board but wasn't sure what time that would be on what I knew was a very busy surgery day. Because I'm pretty well an "all-in" type of person, I also had my eyes done (Dr. Lara). Sunday - Jan 24, 12.30 a.m.-3.30 a.m.ish: I was in surgery for 3 - 3.5 hours. While coming out of anaesthesia, I remember saying (or perhaps yelling?) "Silencio, por favor...Silencio"! I must have had a headache then...or at least I hope so When I came to, fully, my coordinator and Dr. Betancourt were looking over me and asking me how I was feeling. Yikes? Do you think I was telling them to be quiet? Ah, the things we say when we're partially under... Yes, my coordinator waited for me to get out of surgery to ensure I was doing well. Her name is Melissa Bracker. Yes, she is business minded but she is also a caring person who was there for me. Sunday - Jan 24, 3.31a.m. - to Monday, a.m.: The worst parts -- post-op acid reflux and severe headaches that were so bad I couldn't rest. I really needed to take a Prevacid a few hours before surgery. And I really needed that night nurse to make sure my IV was working properly so I could get acid reflux meds through it. On the headaches, they were from dehydration and the eye surgery and yes, stress. I really wished that night nurse would have remembered that I hadn't had anything to drink for more than 48 hours.:sad0: Monday, Jan 25, - 10-11.00 a.m. I had my blue barium swallow at the clinic. Since I couldn't get down more than that, I used it to get down a Prevacid. This was my "McGyver move" and is not sanctioned by any of the staff. Yep, teeth and lips turned blue from the dye.:biggrin0: The stuff was tricky to get down because it tasted 'metallic'; not because I was necessarily in any pain. Actually, the coolness made my esophagus feel better. Then we headed off to x-ray to make sure there were no leaks. I would have paid not to have to take the next swallow of some clear stuff that I first, had to hold in my mouth until the camera was ready and then gulp. As for taste, it was like, like, oh! like a weak version of the bitter apple you'd spray on something you didn't want your puppy to chew. I haven't figured out what that was yet, but we all had it, we all had various stages of nausea afterward, we all lived. Oh yes, if I wanted to, I could have paid $10.00 for the x-ray photo of my new tummy on a t-shirt....c'mon! I'm just kidding -- There is no such thing...But, I claim patent on the process and copyright on the idea! Then we were taken to one of two recovery houses. Everyone had their own bedroom but perhaps, not their own bath. This is unless you were able to negotiate the Master bedroom in your package, as I did. In my house, there was one cook and 1-2 caregivers every day from 5.30 - 5.00 p.m. Every night, 5.00 p.m. to 6.00 a.m. there is also a caregiver for you, who will also heat up food for your companions. Dr Betancourt saw me Monday afternoon, checked out my stitches and drain, told me I had a reaction to the tape, changed my dressings and made sure I was o.k. He offered to have my hair dried and/or to have my feet rubbed. Dr. Lara saw me and replaced tape with glue -- yep, glue -- on my upper and lower eyelids. Yesterday, Tuesday, Jan 26th: One of the caregivers removed my drain -- after the Dr found out if the reaction had stabilized, etc.-- and in moments, it was out. How does that feel? Well, I liken it to putting your thumb in very firm Jello and then pulling it out slowly. The feeling was one of suction rather than any pain. The caregiver then bandaged the 3/4" wound (no adhesive tape for me). Today, Wednesday, Jan 27th- Before I had a shower this morning, I removed the bandage, showered and then left everything to breathe. After about 5 hours, I saw a 'dime's diameter' of leakage, sprayed no-alcohol antiseptic on the wound and rebandaged. It feels fine but the incision needs cleaning and less of me sitting-up and walking 14 stairs, 10-12 times a day. Dr Lara saw me in a happenstance way and said my eyes were healing as they were supposed to. Dr Betancourt showed up and looked at my incisions again. Then he asked the caregiver to give the drain incision a 'good' rub with antiseptic. I've been ordered to do the same as many times in the day as I can. Improvements I would like to see a) Since I've been here, I've met only one person who was somewhat unmotivated and perhaps over her/his head. But s/he was not in a critical care giving position. However, s/he did work in the clinic. I am not giving out the name because I don't want to have her/him discharged. I have however, given the name to my coordinator so the person can get more training? more sleep? both? as I believe s/he is still a good asset to the team, who could become better. I talked to both my coordinator and Dr Betancourt about the situation. They listened attentively, and promised to address issues with that team member. Best Ofs a) one-hit IV excellent coordinator (Melissa Bracker) - she and Dr. Betancourt kept their promises c) the care in the recovery house, 24hrs/day d) the warming saltiness of chicken broth e) Actually, it's Dr Betancourt who sells the t-shirts across the street from x-ray! Suggestions a) do your research about the country and culture in which your surgery will take place - If you want to have done full research about having surgery done in Mexico, go to where you'll be having surgery, meet the people and understand the culture of the service industry, then find a coordinator who has the same understanding. Then make your decision. negotiate your package c) In all cases, Mexicans' first language is Spanish -- learn some Spanish or be patient with the various levels of English d) if you really want something you're not getting, then ask for it e) do not be afraid to leave tips Thankyous to Other Patients and their Families Because I came here alone, I thought I would be alone. This was very far from the truth. I would like to say a public thank you to those other Posters/patients and their families (I will not post their names) for checking in on me, for buying me sunglasses, for giving me a couple strips of gas-X and for being so very caring: Tyrza and Family Brett and Family Margie Cynthia and Family Kerri and Family Braden, The Rock Star Take care for now, Cheryl Emmanuel Jerusalem Clinic Tijuana, Mexico Dr Almanza: VSG Jan 24/10

I think this is a great post because it speaks from personal experience, it tells the user to think critically about using forum posts as research. I also think that it was a professional response to the previous poster (excellent post as well) that was also indicative of high emotional intelligence that often-times is missing in threads about Mexico and its WLS surgeons.

One of the other things I considered is that the sleeve, before it became popular as a stand alone WLS, was the first step in a DS. My thinking is that if something should happen that the sleeve and I don't get along in the long term, then I'd still have the option of the DS. OH.com also has a very active DS group that had quite a time of it on the board, yesterday. Look for a post by Rockne -- part of the Topic line is: "why do you keep doing this to yourself" or something similar. I believe every type of surgery was represented on that thread. Below, I've posted a link to get you started on some independent research. Duodenal Switch I guess the other thing I'm trying to say is that it is a good idea to learn about all types of WLS so you know all of your options as well as their benefits and limitations. It's also a very good idea to do research that is independent of forums so that you can get to medical studies and other articles that speak to the long term factors of each WLS. Good luck with your research! :001_unsure:

I'd go for the 70% or greater chocolate, chocolate!:001_unsure: It has antioxidants and a little goes a very long way in terms of flavour (keep it from becoming a slider food). Plus, if you still have a craving, it could tell you you're really wanting sugar. In sf pudding, the first ingredient is cornstarch, which is not great. To your body, it's like eating something with the first ingredient being sugar. Plus, sf pudding is a slider food.

One of my downfalls pre-op was to eat, a lot, right before I went to sleep. Sometimes I would also get up around 2.00 a.m. and eat again. And, these eats were carbohydrate laden. 6 weeks post-op, some nights, I find I still do this out of habit and because I saw that other VSG'ers were having late night dinners and Snacks so it seemed o.k. At first, I would have a bit of Jello or sf/ff yoghurt. Then, it seemed like I needed more and more. Now, I've stopped all that type of eating, completely. To better prepare for this, I should have practised not having anything to eat after 7.00 p.m. for at least 2 weeks, pre-op, regardless of what other VSGers were doing or feeling. Know yourself to battle habit hunger. One of the things that is troublesome about the very low carbohydrate "diet" is that one could be ingesting very much more artificial sweetener. Unfortunately, and depending on how much one has, or is not used to, these can also trigger cravings for sweets. Regardless of whether or not it's true hunger or habit hunger, it can persist after surgery. But...the idea is to research, research, research so that one is armed with as much information as possible so as to learn about this and other aspects of WLS -- find medical articles and interview professionals, do not just rely on websites. Why? because the benefits from this surgery can be tremendous!:001_unsure: Good luck with your research!

Sorry Pumpkin...the post wasn't supposed to end up where it did...

I'll be a full 6 weeks out, tomorrow. And, I still do not feel 100%. Mostly, I get tired very easily and so cannot focus for a long period of time. I'm on soft foods with my carbohydrates coming mainly from my Vitamin supplements (they sure do have a lot of carbs) so I suppose the low energy level is not surprising. I have so many "half way done projects" that I don't want to start other work that also needs doing and soon (taxes! :tongue_smilie:) Finally, I'm not thrilled with the taste of food I am making. I don't feel good about throwing away so much food.:thumbdown: Come to think of it, weeks 5-6 didn't make me feel very good at all.:frown1: But, tomorrow is the start of a new week and hopefully, things will get better :thumbup:

Sorry -- replied to incorrect part of thread, incorrectly The article is long because it provides 2 contrary points of view, plus a summary by the reporter -- one doc is pro exercise and the other is not and they say why. Pro- Exercise: - exercise is beneficial and needed to maintain overall health - exercise helps in weight loss because exercise decreases one's appetite for a time - athletes can burn 5,000 calories in a day Con-Exercise: - exercise does not help weightloss as much as cutting calories - people who exercised over estimate calories burned by an average of 4X - people who ate the number of calories they believed they just burned, over-ate by 440 calories I used to exercise 6-7 days a week, up to 2.5 hours a day (cardio every day + weights) for 3 years. In the first year I lost 65 pounds out of the 80 I had to lose and could only maintain it for about 2 months. The rest of the time, I was between 155-160 pounds (no, muscle does not weigh more than fat -- 1 lb = 1lb; muscle takes less and different space). After I started researching and writing, after exercising I sat at a computer for 12-14 hours a day. I never did reach my goal weight because I could not exercise enough and keep down my hunger at the same time. To burn as many calories as an athlete, one must train like an athlete and I could not. It was less than a year before I gained all the weight back plus another 40 pounds. I needed the sleeve because I could not keep myself from eating. Here's what I learned about me: Exercising kept me away from the pantry and the refrigerator for the time I was exercising! :crying: Exercising made me feel great because it made me smaller but not lighter and because it made me look more like other people expect un-fat people to look. I could never exercise the amount I needed to, to reach goal weight. I was always too hungry to do so. The older I got, the more exercise I needed to maintain some shape and decrease my weight.

The article is long because it provides 2 contrary points of view -- one doc is pro exercise and the other is not and they say why. Pro- Exercise: - exercise is beneficial and needed to maintain overall health - exercise helps in weight loss because exercise decreases one's appetite for a time - athletes can burn 5,000 calories in a day Con-Exercise: - exercise does not help weightloss as much as cutting calories - people who exercised over estimate calories burned by an average of 4X - people who ate the number of calories they believed they just burned, over-ate by 440 calories I used to exercise 6-7 days a week, up to 2.5 hours a day (cardio every day + weights) for 3 years. In the first year I lost 65 pounds out of the 80 I had to lose and could only maintain it for about 2 months. The rest of the time, I was between 155-160 pounds (no, muscle does not weight more than fat -- 1 lb = 1lb; muscle takes less space). After I started researching and writing, after exercising I sat at a computer for 12-14 hours a day. I never did reach my goal weight because I could not exercise enough and keep down my hunger at the same time. To burn as many calories as an athlete, one must train like an athlete and I could not. It was less than a year before I gained all the weight back plus another 40 pounds. I needed the sleeve because I could not keep myself from eating. Exercising kept me away from the pantry and the refrigerator for the time I was exercising! :crying: Exercising made me feel great because it made me smaller but not lighter. I could never exercise the amount I needed to, to reach goal weight

A while back, another poster provided this link that takes you to a Sleeve Diet Guide. I use it as a guideline and it has helped answer many of my questions. Perhaps it will help you too... IABS - Diet Guides

Hello all, Today is my 1 month surgiversary. From the start, I was doing very well getting in my Protein. However, now that I'm adding bits of real meat (less than 1 oz.) to my diet, I find that my stomach is really sore. So much so, that even after I get a decent night's rest then have a Protein shake for Breakfast, I'm still feeling unwell or even worse. Now I'm back on clears as these seem to be all right. Has this happened to anyone? If so, how long does it last? Has anyone ever developed a protein intolerance (I don't mean disliking protein shakes)? Thank you...

Thanks very much for the information. I thought it could be the meats themselves and/or whatever I mixed them with. Yet, I'm still becoming ill even though I tried meat alone -- and now have stopped eating it entirely. At any rate, I've gone back to basics and Clear liquids and will keep this up until my 6th week starts. Then I'll try again. I don't want to hurt so that I can't even drink liquids because I've always been lucky enough to be able to have 1-2oz at a time and stay very hydrated. It sounds like it's a phase that will bear itself out. Thanks again.

PS. Sorry, I should have added that I'm talking about pureed hamburger and fish (canned tuna, shrimp); and not steak. Thanks again...

Hi Sarah! I think you've done very well so far! Your body is still in shock and of course, all its energy is going toward healing. So, it's not surprising that it requires extra, extra TLC. Just remember that sometimes, slower is faster. I stayed on Clear Liquids for an extra week because I just wasn't ready for the next step. I'm also more than a week late for mushies but I really don't mind. Because I didn't force anything, I'm now able to get in all of my Protein and liquids without any problem. And, I enjoy the Protein shakes. Anytime you'd like to talk, just let me know! Rest, Rest, Rest! You're going to do great! in no time! Cheryl

Congratulations Tiffany! You've done extremely well!

Hi Tracy, Thanks for the tip. It would be great to be able to have pork rinds again. I haven't checked any labels for a very long time but I hope I can find some that have the same nutritional count (high Protein + low fat).