2b4me

Hi! 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; 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, who did an excellent job but this belongs in another forum). 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 :wink0: 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...:confused1: 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 didn't take a Prevacid when I should have and I paid the price. On the headaches, they were from dehydration and the eye surgery and yes, stress. 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. 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 :blushing: -- 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 p.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! :wink0: 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 (Sorry if I've mispoken your 'real' name) and Family Margie (Sorry if I've mispoken your 'real' name) CynCyn and Family Braden, The Rock Star and Family That's what I've experienced so far. I will share a brief conclusion after I get home. Take care for now, Cheryl Emmanuel Jerusalem Clinic Tijuana, Mexico Dr Almanza: VSG Jan 23/10

Hi! Great to hear from you! How are you doing? Are you o.k.? C

Hi Nancy! Lovely to hear from you again! Way to go! on 10 lbs down -- whoo hoo! The two houses are across the lane from one another. All of the houses here are 2 stories (not bungalows) and in a gated community. Yes, the house in which I'm recovering is Dr Betancourt's past home and I'm in in his master bedroom that is up one flight of stairs. This bedroom is the largest and most adorned. My bedroom is very clean as is its bathroom. In this house, there are 2 bedrooms upstairs (each sleeps 2, the second bedroom has two single beds). The third bedroom sleeps 2 and is downstairs. Each room has a TV with SKY cable/satellite. The main floor is also an open-kitchen design, opening onto a dining room and a living room. And I've not seen a scale anywhere in this house!:crying: Just let me know if you have any other questions. Bye for now, Cheryl

I've been on Prevacid for a couple of years pre-surgery. I used to take it every day until my PCP told me that it was only necessary when I needed it -- e.g. if I ate too close to bedtime. I should have taken one as close to surgery as possible, too. Of course, they didn't want me to drink any Water. But, the heartburn right after surgery was so severe, it kept me awake. The painkillers in the IV worked as did the antacid they put in my IV. I'm now 3 days post-surgery and I'm able to take 1 with a couple sips of water every morning. For me, taking Prevacid was/is a lifesaver. Dr Almanza: VSG Jan 23/10 hw /cw /goal weight 235/? /115 height = 5'3"

Bill, that definitely is a classic WLS move! Good for you! :thumbup1: Yes! Asking for consideration on the flight home is a great idea! Janet, 18 hours? You poor thing. No wonder you were exhausted. Did you drive home from Edmonton? I will be up by 3.30 a.m. to get off the Island at 6.00 a.m., getting to SD by noon. I know my surgery will be in the evening so it will be a very long day. On the way back, I'll be at the airport for noon and then I don't get back to the Island until after 11.00 p.m. I hope I am able to do as well as you did, Janet. I'll have Water and clear Protein to put in it. But, no SF popsicles. It would be great if I could find SF Freezies that I could take down and get frozen in the SD hotel. Hmmm, I wonder if I could make SF Freezies? Use the vacuum sealer and its bags, filled with sf ice tea? crystal light? 4 more sleeps....:smile:

Hi! How are things in Fort Mac? I'm a born and raised Albertan! How are you feeling? I hope all is great with you. Thanks very much for the tips. And, yes! the carry-on is a must. It's also so helpful that you spoke of the post surgery experiences to remind me of what can happen after anaesthetic -- yep, I checked that box too! Could you please tell me, how did you feel after you left the recovery house and flying home? How much were you able to walk? Were you very sore? I ask because my plan is to walk and sit through San Diego Seaworld after I leave TJ. What do you think, please? Thanks so much for your post(s)! Cheryl

Hi Nancy, Thanks for your e-mail. I loved the part about 'and some of them wanted to buy a house'! I hope the next time the realtor comes in, it's with people who make a good offer! While I did think about a resort scenario, I thought I would go on a nice holiday after I reached goal. Staying in San Diego for a couple of days and walking Seaworld is my compromise for now. Guilt is a terrible feeling, isn't it? We feel guilty when we eat too much and then we feel guilty when we want to lose weight but can't -- because we're feeling guilty. Kinda masochistic, isn't it? No matter what decision you make, it will be the right one for you. Please keep me posted... Cheryl

Hi Nancy, It's good to hear from you. Yes, I will post as soon as and as much as I can so I don't forget anything and so you and everyone else who is interested will get up to date information. How are things going for you? Cheryl

Hi Everyone, I've been reading the boards and Holy Smokes! another round of bashing regarding the clinic I'm going to. Yes, it is still Dr Almanza for me as I could not find anything negative about his surgical skills. On the remainder of the service, etc. -- I'm very self reliant so I'm not worried about having to change bandages or getting up and around on my own. Although I hope it's my last, this surgery certainly won't be the first time (actually 4th or 5th) that I've had an IV buddy to wheel around. As long as everyone keeps their promises, I can't see why I wouldn't report back as having a great surgery. I can't wait to be "skinny" for me!

Hi! First, thanks to all for sharing your experiences that are extremely helpful because for me, they provide a range of activities and issues. After being sleeved, who feels like they are "starving" (regardless of stage of weight-loss)? What was your solution? What was the impact on weight loss? Thanks very much for your help.

Hi, From what I can see, the extremes of not being hungry to hungry alot, still prevail with the sleeve. Yet, with the sleeve, one cannot eat as much volume as before the sleeve. Is this what you would say, Judy?

Hi and Thanks very much for your post. I'm glad to know you as well as CynCyn will be there and I really look forward to meeting you. What do you think about yesterday's posts about Jerusalem?

Hi and Thanks very much for your post. I'm glad to know you as well as CynCyn will be there and I really look forward to meeting you. What do you think about yesterday's posts about Jerusalem?

Hi Everyone! Thanks very much for your replies. I'm very happy to hear that you've had good experiences and I do appreciate your good wishes. My wish is that everyone achieves everything they've ever dreamed. :thumbup:

Hi! I hope you're doing great! Thanks very much for your help. All of these are great things to put on my list. I'm taking only a small suitcase and a backpack for my lap top, so I hope I'll be o.k. for entertainment. All the best!

Hi! I'm heading to Mexico for surgery January 23! and would appreciate your views on what is important to pack to perk up comfort levels. Someone was kind enough to provide her list but I can't locate the thread now -- please help. Thank you very much.

Hi Nancy, I'm so sorry to hear about your predicament and of course, about the stroke. I wish there was some way you could have all your problems solved. Would your sister be willing to check out this forum to read about how many people, who have been to Mexico, are doing so well? Perhaps this could be a way to get her, happily, on your side? I wonder if creating a balanced report on best case and worst case situations (from this website or others) and presenting it to your doctor for his approval might help get your family's full support? I'm doing this all on my own. I did tell one girlfriend who works in a Dr's office and she was ecstatic for me. She knows the struggles I've had with weight issues and she's very supportive about me doing whatever I need to do to help myself. While my entire family is overweight, none would consider doing this. They would say, "go on a diet". So, on the one hand, I'll be alone for the whole thing. On the other, I'll not have to worry about judgements regardless of how well (or not) the process has gone. This is not the time to have negativity around me -- this is the time for celebration and new beginnings! :smile1: I'll try to post as many times as I can before and after the surgery so you can get a good idea of what Dr Almanza's environment is like. If you think there is anything else I can do to help you, please let me know and if I can, I would be more than happy to do so. Until then, keep your fingers crossed for me! My plan is to take a bit of a walk around San Diego Seaworld before I return! xo Cheryl

Thanks very much for your replies! I've learned alot about what I should have to maximize comfort levels: 1. pre-op diet to detoxify, clean out digestive system and reduce glycogen in liver 2. heat source: heat pad and microwaveable heat wrap 3. gas-X 4. appropriate Spanish to ask for pain meds (Necesito la medicaci?n de dolor por favor) 5. warm, loose clothing 6. slippers 7. antiseptic spray and Purell-similar stuff 8. something to read or similar I'm going alone so it will be great to meet up with CynCyn! And, I have to stay in San Diego for 2 nights before I can get back to the Island. I think I'll be all right on my own for that time. Good luck to us that are going to have the surgery. And, I hope everyone has a joyful recovery.

Thanks for your reply. There were some other data implying that doctors used to use the pre-op diet to determine whether the patient would be a good candidate for WLS. If s/he could do the pre-op, then s/he would have a better chance of later on. I think this has pretty much been debunked by now. I wish everyone the very best with their pre-op diets. You're right! It's tough to do. But just think of how squeaky clean everything will be for surgery and recovery! Keep up the great work! All the very best to all

I'm a little confused about the pre-op diet. Everything I've read says that liver fat from non-alcoholic means (NASH) can and should only be reduced by losing weight very slowly, such as 1-2 pounds/week or 5-10% of body weight over a period of months and so as not to hurt the liver. If the pre-op is meant to empty the intestines and bowel, then I can see more of a relationship between the diet and ease of surgery. I'd really appreciate it if someone could tell me where I can find studies on how rapid weight loss is positively correlated with a decrease in liver size for bariatric or any type of surgery. Thanks very much. I know there must be another side of the story but I can't find the data. Thanks again!

FONT="Georgia"]Hi, I go for VSG on January 23. I and my family and friends, for the most part, are "you need to pick yourself up by the bootstraps" people. So I did. The problem is that I have to do it so many times over. I have gained and lost more than 400 lbs in my life. When I thought I was at a good weight and especially a great physical fitness level (could squat 500 lbs + had no health issues), my doc said I was still obese. I could not do it alone. Since then, I've gained more than 100 pounds. My concern is about regaining the weight after surgery: "We know that 5 percent or maybe even more of these patients over time can regain weight," said Dr. Daniel Jones, director of the bariatric program at Beth Israel Deaconess Medical Center in Boston. "A large part of that has to do with the fact that the factors that caused them to be overweight to begin with are still out there." (ABC News, 2008). There is much more information out there now. For instance, we now know that ghrelin is a great anti-maintenance culprit (i.e. see medical studies by googling "ghrelin and bariatric surgery". Even though most of the ghrelin producing part of the stomach is removed during VSG, some of the hormone producing cells still exist in my body. If I am not aware of these issues, I can't do much to change anything, which is one reason for my yo-yoing. So, although I don't know everything there is to know about VSG before the surgery, I do know that without VSG, I will most certainly be successful at only short-term diets. Now and after surgery, it is my goal to eat less and "do" less for ghrelin production. VSG itself, is one of those things. So for me, bariatric surgery is part of the "pull up your socks" belief -- I am doing everything I think I can to be so much better than I was and than I am now as far as my weight and its affect on my health and well being are concerned. On my other 'flaws', well, there ain't no surgery for them! Vive la difference![/font]

Hi, I go for VSG on January 23. I and my family and friends, for the most part, are "you need to pick yourself up by the bootstraps" people. So I did. The problem is that I have to do it so many times over. I have gained and lost more than 400 lbs in my life. When I thought I was at a good weight and especially a great physical fitness level (could squat 500 lbs + had no health issues), my doc said I was still obese. I could not do it alone. Since then, I've gained more than 100 pounds. My concern is about regaining the weight after surgery: "We know that 5 percent or maybe even more of these patients over time can regain weight," said Dr. Daniel Jones, director of the bariatric program at Beth Israel Deaconess Medical Center in Boston. "A large part of that has to do with the fact that the factors that caused them to be overweight to begin with are still out there." (ABC News, 2008). There is much more information out there now. For instance, we now know that ghrelin is a great anti-maintenance culprit (i.e. see medical studies by googling "ghrelin and bariatric surgery". Even though most of the ghrelin producing part of the stomach is removed during VSG, some of the hormone producing cells still exist in my body. If I am not aware of these issues, I can't do much to change anything, which is one reason for my yo-yoing. So, although I don't know everything there is to know about VSG before the surgery, I do know that without VSG, I will most certainly be successful at only short-term diets. Now and after surgery, it is my goal to eat less and "do" less for ghrelin production. VSG itself, is one of those things. So for me, bariatric surgery is part of the "pull up your socks" belief -- I am doing everything I think I can to be so much better than I was and than I am now as far as my weight and its affect on my health and well being are concerned. On my other 'flaws', well, there ain't no surgery for them! Vive la difference!

Hi Nancy, Thanks for your reply. Actually, I've not thought about getting WLS as I thought I would "fail" with it as well. You see, this 5'3" frame has gained and lost more than 400 pounds in only 46 years. Also, I've had liposuctiion and a tummy tuck when I thought I was at my 'ideal' weight only to have gained back a 100 pounds. I'm now at almost the heaviest I've ever been and with borderline health issues. So, although my track record with cosmetic surgery and dieting with mega exercise is not great, I'm hoping to improve my record with VSG. The bottom line is that I love eating too much and I always eat until I am very full, regardless of how many calories I'm burning. Between September 2004 and April 2005, I lost 65 pounds by exercising (cardio + weights) 1 hour every morning, 5 days a week + dieting. And I was still 20 pounds overweight. From April 2005 to May 2006, I upped my exercise regimen to almost 2 hours, 6 days a week (at the time, I could squat more than 500 pounds, do 5-7 minutes of ab exercises, etc.). I was extremely proud of myself -- so much so that I wore bikinis in the Caribbean and Hawaii the spring of 2006. However, when I went in for my semi-annual physical, my BMI was measured and it was 29.5. My doc said I should think about getting more exercise and going on a diet. I was devastated. But, I wore my bikinis in the south of France and Italy that summer, anyway. Then, the person I was with said, "You are a great person! You just don't care...you wear what you want anyway"...I died a little more that day too. When I returned from Europe, I went back to the gym but became physically ill. My stomach was sore and I became nauseated. After 5 minutes, I left. I tried again a couple days later but with the same outcome. Finally, I stopped going all together. It made me sick to know that no matter how much I exercised and dieted, I'd never reach my ideal weight and I'd never be that little person who -- since she was 5 years old, was told she was fat (nickname: Cheryl the Barrel) -- has been dying to get out of that body. Now I am sick because I'm at the heaviest I've ever been and without having built up any muscle (if I wore a bikini now, it would look like two rubber bands on an egg! Even though I am very frightened of failing after the surgery, I am scared to death of not continuing to try. I believe the VSG will help me get where I want to go and keep me there! Is this false hope? Is the surgery a crutch, like so many non-supporters say? I don't know and I won't know until I've done it. Why am I taking the risk? I have to be re-motivated to be able to re-learn to take good care of myself so I don't overeat in both the short term and long term. Again, I believe VSG will help me do this. I chose Dr. Almanza because he was lowest cost without a waiting list. Yep! There it is -- I said it out loud. In my opinion, the old economic rule of the price:quality association in medicine no longer applies, 100% (see studies on laser eye surgery). You do not necessarily get better products or services just because they are priced higher. These days, too many businesses are too well practised in marketing and so, they perpetuate old beliefs. Yes, younger docs like Almanza have less experience than someone doing the surgery for 20 years. On the other hand, Almanza is building and building his reputation and if I'm right, he will not take short cuts that will jeopardize his career and earning potential so early on. Of course, this is a justification for my choice. If I find out differently, I will let you and others know. I'm on a self-imposed pre-op diet to ready my body for the surgery -- detoxifying with lots of greens. For the past 5 years, I have always had a Zone Perfect protein/nutrient bar for Breakfast along with coffee that has Silk (soy coffee whitener). Protein keeps me feeling full. In my years of dieting, I always seem to forget this when my carb cravings kick in. The sugar is mightier than the sword! So, I've also had apple crisp, too. But! I've been eating grapefruit and oranges as well. Will all this help? I don't know. Will it hurt? I don't think so. I'm worried about taking my meds post-op as the capsules are quite large. I've had the unfortunate experience of tasting the contents and well, I can say I never go for seconds of that! So, emptying the capsules and taking the stuff with Jello or juice will, in my head, be only a little bit of an improvement. So far, I've practised by taking one capsule at a time and 'soaking' it by swishing a little liquid in my mouth before swallowing. So far, so good. Well Nancy, that's my story. I hope I haven't bored you too much. Bestest, Cheryl

Thanks very much! And yes! having another option in addition to a heating pad is prudent -- I didn't think of the electrical so thanks! again. And yes, the new Jerusalem hospital as well as the new recovery house will have very little data but I was hoping I might find someone who could tell me more about them. All the best to you!