Speak up those with leaks & infections!

[educationrulz 18]

OMG! Looks like "MidwesternGirl - Wasabubblebutt - aka Michelle Walsh" has been very busy, cutting and pasting and going back through several years of posts!

Sandy,

Are you outing someone by posting her last name on the internet!!?? I hope you don't handle your patients'/clients' personal information in this manner.

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To Nikki,

Reading your story brought tears to my eyes. I can't imagine how bad that must have to be in that position. I have read your posts about your progress and how you are meeting your goals, and your pics look great. You have come through everything so well and you should be proud of yourself for making it through that experience and still coming here to post with a positive attitude. Thank you for sharing your story with us.

Tiffany(IsMajor),

Your post about people thinking you are stupid or too focused on money to take care of yourself is not what we're getting at (at least I think others feel the way I do). I don't think ANYONE here intends to make you or anyone else feel bad about the choices you make. Some of us are more outspoken than others, but I think we all are more focused on getting the word out about concerns with various doctors and clinics as opposed to trying to criticize the patients. Although the money aspect for patients has been mentioned, and maybe it shouldn't be, that's not the heart of the problem.

Please don't feel like this is directed at you because it's not. It's not your fault or any other patient's fault. This is about the medical practitioners and the people who might be covering things up. Regardless of where you go for surgery, the more informed you are the more likely you are to get better care. You now know what to look out for and some ways to handle bad situations that might occur anywhere. Your fellow sleevers are on your side no matter where you go to have surgery.

[Can.sleeved 1]

A great post Mary, and yes I agree with you and believe we are all here to support our fellow sleeves regardless where they go.

There was some real compassion in your e-mail. I know myself and I am very troubled when I think that someone could be at high risk for infection, leaks or worse, it really bothers me. Drives me crazy! I don't think it should be like going to the Casino...

[Oregondaisy 2,021]

Nikki, I am really glad you posted your experience. Everyone keeps saying that only people who have had first hand experience should post their experience, and you did just that!

I can't remember the name of the girl who posted her horrible experience, but her post got deleted.

[Sandy Johnson 15]

Sandy,

Are you outing someone by posting her last name on the internet!!?? I hope you don't handle your patients'/clients' personal information in this manner.

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Michelle Walsh is NOT a patient that I have worked with. She is however someone that posted an entire thread on OH with my first and last name and then proceeded to call me every name in the book! I'm not the only one that has had the honor. She has done it to many other people. Just thought I would clear that up.

I also want to say that I too want everyone with first hand experience to feel free to post THEIR experience. However, far too many have posted information that they do not know as true, is hearsay, unverified and simply just opinion. If someone is posting their opinion, they should just say so. Instead they get mad when someone points out that their "experience" is not actual experience, but opinion instead.

Just as when someone makes a statement such as, "Dr. X does 10 surgeries every day". They will make such a statement even though they have never been there but may have talked to someone that was there having a surgery. Does Dr. X really do 10 surgeries a day? Or did Dr. X have an extra busy schedule that particular day with maybe a couple of unexpected surgeries? Who knows? So in reality, that person only knows how many surgeries were done THAT DAY in which her friend that was there told her about. Make sense?

I would also hope that if I am the coordinator for a particular client and they have a question or concern, they would call me and ask for help so that I can notify the doctor. I want to help in any way that I can!

[LAN2k 18]

Michelle Walsh is NOT a patient that I have worked with. She is however someone that posted an entire thread on OH with my first and last name and then proceeded to call me every name in the book! I'm not the only one that has had the honor. She has done it to many other people. Just thought I would clear that up.

I also want to say that I too want everyone with first hand experience to feel free to post THEIR experience. However, far too many have posted information that they do not know as true, is hearsay, unverified and simply just opinion. If someone is posting their opinion, they should just say so. Instead they get mad when someone points out that their "experience" is not actual experience, but opinion instead.

Just as when someone makes a statement such as, "Dr. X does 10 surgeries every day". They will make such a statement even though they have never been there but may have talked to someone that was there having a surgery. Does Dr. X really do 10 surgeries a day? Or did Dr. X have an extra busy schedule that particular day with maybe a couple of unexpected surgeries? Who knows? So in reality, that person only knows how many surgeries were done THAT DAY in which her friend that was there told her about. Make sense?

I would also hope that if I am the coordinator for a particular client and they have a question or concern, they would call me and ask for help so that I can notify the doctor. I want to help in any way that I can!

I am an outsider with regard to having my VS outside of the US. Considering the nature of this procedure and that there is always a measure of serious risk, researching my surgeon outside of the US (nomatter what country), would be critical, (not to dismiss the need to research any surgeon anywhere). That said, to my knowledge, the people who have had complications on this and OH message boards have been fearful yet humble about their situation, most have been gracious with regard to their surgeons while citing where they felt the conditions were poor. Many have been on these message boards for months before having their surgery. I'm not sure what this ongoing argument is about and perhaps there is some truth to what you are posting, but it seems that by generalizing all reports of complications with labels such as "hearsay", you are insulting those of us that have established communications through this venue but worse you are literally adding insult to injury to those who've suffered from such complications. It's sad that a person who has had a complication due to negligence is then dismissed as being disingenuous or fraudulent.

[BJean 16]

I am an outsider with regard to having my VS outside of the US. Considering the nature of this procedure and that there is always a measure of serious risk, researching my surgeon outside of the US (nomatter what country), would be critical, (not to dismiss the need to research any surgeon anywhere). That said, to my knowledge, the people who have had complications on this and OH message boards have been fearful yet humble about their situation, most have been gracious with regard to their surgeons while citing where they felt the conditions were poor. Many have been on these message boards for months before having their surgery. I'm not sure what this ongoing argument is about and perhaps there is some truth to what you are posting, but it seems that by generalizing all reports of complications with labels such as "hearsay", you are insulting those of us that have established communications through this venue but worse you are literally adding insult to injury to those who've suffered from such complications. It's sad that a person who has had a complication due to negligence is then dismissed as being disingenuous or fraudulent.

That is exactly why I believe someone should come up with the actual statistics of the rate of complications for the doctor and clinic in question.

There was a round about dance that was posted but it didn't actually say anything concrete. It did in fact, if you were paying attention, give the impression that the posters who complained of complications were not made up posts that someone who works for the competition came up with.

And it did wind up sounding like an attempt to have us believe that EVERY doctor and clinic has a similar statistical percentage of complications to those of the doctor who had been accused of providing unsanitary conditions that fostered post-surgical infections.

Posting proof of that would be impressive and certainly quiet the talk, I'd think. Just making the claim that "all doctors have complications" is abritrary and unsubstantiated.

I just keep getting sucked into this debate. I guess because I, for one, really would like to learn that all this is one giant mistake and that the doctor and clinic are being unfairly maligned.

[Sandy Johnson 15]

I'm at a loss. I don't know what else to say. I have NEVER posted that ALL reports of complications are hearsay. What I did say is that MANY are! If you re-read my post you will see that. I also have NEVER accused ANYONE that posted about THEIR OWN experience as being disingenuous or fraudulent. What I did say was that those posting that have had NO FIRST HAND EXPERIENCE is only stating an OPINION! NOT FACT! This is NOT the same as having an EXPERIENCE. Thus it does not have the same merit.

Regarding basic complication rates of bariatric surgery in general, that's easy to find all over the internet. I quickly found the following on the ASMBS site. I will again say that ALL surgeons, not just bariatric surgeons have some complications. ALL surgeries carry risks. I think everyone understands that.

This particular surgeon has an acceptable complication rate. Here is an example of Dr. Almanza's complication rate:

Mortality 0%

Other complications broken down into "Major" and "Minor" and for the sake of space and time are noted in as overall "Major and Minor" and looked at in a 30 day period.

Major: 1.5%

Minor: 3.5%

A basis example of a major complication would be a leak, a blood clot, a cardiac arrest, etc. An example of a minor complication would be an incision site infection, dehydration, diarrhea, etc.

Here is the section of the report from the ASMBS regarding complication rates studies of bariatric surgeries covering the past 20 years. ASMBS - Rationale for Surgery

As you can see from this study, Dr. Almanza's complication rate is well below the average as reported by the ASMBS of the overall "Major" complication rate of 3.4% and overall "Minor" complication rate of 9.5%. These numbers pertain to the first 30 days after surgery when the risk of complication is highest.

There is a lot more literature to read out there and complication rates have come down over the years.

I don't know what other "proof" you want and what else I can post. I guess if ALL THE OTHER SURGEONS out there don't have any complications as stated in the studies shown by the ASMBS, and EVERY patient is delighted then they are SUPER SURGEONS and probably not even human. Where do I sign up?

[tennessee1031 0]

I want to hear it ALL FACTS-No hear say- Good, bad, ugly and pretty. Knowing that crap happens here, there etc. I'd like to know where... Just my opinion.

[BJean 16]

Sandy I wish I could say that your post was reassuring. The question isn't really whether the doctor has more or fewer complications than any other doctor. We're talking about specific problems that have been brought up about his practice that may or may not have been corrected since the posts were made. When you say that he does the most surgeries of anyone in Mexico, you're talking about a whole lot of people. Even a small percentage of that constitutes a large number of individuals with complications.

Have they changed the way they provide aftercare for patients at their half way house? Do the attendants wear gloves when touching patients' dressings? Is that facility adequately air conditioned? Is the food and drink from reliable, top notch sources? Can the staff speak English for those patients who can only understand and speak English? Are the attendants well-trained in post operative care? Are they qualified nurses or just people hired to perform very specific tasks?

Is the O.R. thoroughly sterilized and ventilated after every surgery? Do they use the very best quality staples that are manufactured?

Obviously if the good doctor has the lowest prices in Mexico the expenses have to be cut somewhere. Is the patient's health being compromised because of those cuts? Or does the doctor make up for less profit by doing many more surgeries per day?

These questions are totally fair for someone to ask if they are thinking of using any doctor and clinic or hospital. Many of us take these things for granted. We figure that they are basic proper medical practice. But it is up to us to do the research, especially when we are traveling to another country for medical care in a facility that we probably will not be able to see prior to the day of surgery.

Obviously you do not have to take the time to answer my questions. I am not one of the patients who is signed up to come there for surgery at this time. But I believe that if you have good answers to these questions this will give you the opportunity to assure anyone who is currently trying to find a good doctor and clinic. And it will surely go a long way toward putting this discussion to rest.

Edited April 14, 2010 by BJean

[TiffanyIsMajor 1]

Uhh I dont care who you are, IF you go to another country to have a surgery done it is RUDE and arrogant to think for one second that everyone around you should speak your native tongue..That is just a risk you take going somewhere else...I HATE when people complain that someone didn't "understand" them...DUH! you aren't speaking THEIR language...

[BJean 16]

P.S. Btw, thank you for posting the info about general surgical complications, which is what it sounded like I was asking for. While that is very interesting, just comparing all doctors and all surgeries isn't really giving us much specific information about the doctor in question. I was looking for something much more specific and information that goes to the subject of the posts that generated this discussion.

[BJean 16]

So Tiff, if you're suffering from a fever, you think your temperature should be taken but the attendant has no clue what you're talking about and leaves you to fend for yourself, that's not a problem for you? Or do you speak Spanish and for that reason it isn't a problem for you?

I certainly agree that it is encumbent upon any patient who chooses to go to another country for medical treatment to research whether or not there will be people present who can speak their language. I did not make the statement that everyone in the Mexican clinic or after care facility should be required to speak English. I merely asked a question. It is something that I would need to know if I were planning on going there for a medical treatment of any kind. Wouldn't you want to know that?

Uhh I dont care who you are, IF you go to another country to have a surgery done it is RUDE and arrogant to think for one second that everyone around you should speak your native tongue..That is just a risk you take going somewhere else...I HATE when people complain that someone didn't "understand" them...DUH! you aren't speaking THEIR language...

[BJean 16]

So Tiff, if you're suffering from a fever, you think your temperature should be taken but the attendant has no clue what you're talking about and leaves you to fend for yourself, that's not a problem for you? Or do you speak Spanish and for that reason it isn't a problem for you?

I certainly agree that it is encumbent upon any patient who chooses to go to another country for medical treatment to research whether or not there will be people present who can speak their language. I did not make the statement that everyone in the Mexican clinic or after care facility should be required to speak English. I merely asked a question. It is something that I would need to know if I were planning on going there for a medical treatment of any kind. Wouldn't you want to know that?

Uhh I dont care who you are, IF you go to another country to have a surgery done it is RUDE and arrogant to think for one second that everyone around you should speak your native tongue..That is just a risk you take going somewhere else...I HATE when people complain that someone didn't "understand" them...DUH! you aren't speaking THEIR language...

[LAN2k 18]

Sandy I wish I could say that your post was reassuring. The question isn't really whether the doctor has more or fewer complications than any other doctor. We're talking about specific problems that have been brought up about his practice that may or may not have been corrected since the posts were made. When you say that he does the most surgeries of anyone in Mexico, you're talking about a whole lot of people. Even a small percentage of that constitutes a large number of individuals with complications.

Have they changed the way they provide aftercare for patients at their half way house? Do the attendants wear gloves when touching patients' dressings? Is that facility adequately air conditioned? Is the food and drink from reliable, top notch sources? Can the staff speak English for those patients who can only understand and speak English? Are the attendants well-trained in post operative care? Are they qualified nurses or just people hired to perform very specific tasks?

Is the O.R. thoroughly sterilized and ventilated after every surgery? Do they use the very best quality staples that are manufactured?

Obviously if the good doctor has the lowest prices in Mexico the expenses have to be cut somewhere. Is the patient's health being compromised because of those cuts? Or does the doctor make up for less profit by doing many more surgeries per day?

These questions are totally fair for someone to ask if they are thinking of using any doctor and clinic or hospital. Many of us take these things for granted. We figure that they are basic proper medical practice. But it is up to us to do the research, especially when we are traveling to another country for medical care in a facility that we probably will not be able to see prior to the day of surgery.

Obviously you do not have to take the time to answer my questions. I am not one of the patients who is signed up to come there for surgery at this time. But I believe that if you have good answers to these questions this will give you the opportunity to assure anyone who is currently trying to find a good doctor and clinic. And it will surely go a long way toward putting this discussion to rest.

You nailed down the questions that need to be addressed. For the benefit of those contemplating having their surgery at the facility that she represents, I hope that Sandy will provide answers.

[Sandy Johnson 15]

Sandy I wish I could say that your post was reassuring. The question isn't really whether the doctor has more or fewer complications than any other doctor. We're talking about specific problems that have been brought up about his practice that may or may not have been corrected since the posts were made. When you say that he does the most surgeries of anyone in Mexico, you're talking about a whole lot of people. Even a small percentage of that constitutes a large number of individuals with complications.

Have they changed the way they provide aftercare for patients at their half way house? Do the attendants wear gloves when touching patients' dressings? Is that facility adequately air conditioned? Is the food and drink from reliable, top notch sources? Can the staff speak English for those patients who can only understand and speak English? Are the attendants well-trained in post operative care? Are they qualified nurses or just people hired to perform very specific tasks?

Is the O.R. thoroughly sterilized and ventilated after every surgery? Do they use the very best quality staples that are manufactured?

Obviously if the good doctor has the lowest prices in Mexico the expenses have to be cut somewhere. Is the patient's health being compromised because of those cuts? Or does the doctor make up for less profit by doing many more surgeries per day?

These questions are totally fair for someone to ask if they are thinking of using any doctor and clinic or hospital. Many of us take these things for granted. We figure that they are basic proper medical practice. But it is up to us to do the research, especially when we are traveling to another country for medical care in a facility that we probably will not be able to see prior to the day of surgery.

Obviously you do not have to take the time to answer my questions. I am not one of the patients who is signed up to come there for surgery at this time. But I believe that if you have good answers to these questions this will give you the opportunity to assure anyone who is currently trying to find a good doctor and clinic. And it will surely go a long way toward putting this discussion to rest.

BJean, I'm very happy to answer all your questions. Up until this point, I've tried to guess exactly what it is that everyone wanted to know. It seemed to be a question of infection rates, etc. But now that you have asked specific questions, this greatly helps!

To be clear about what the "half way house" is. It is a place where patients go after release from the hospital. This is instead of going to a hotel. Many doctors will have patients arrive the day before surgery, stay at a hotel, then check in to the hospital the next day and depending on which surgery they have, patients will stay in the hospital up to 3 days, and then go to a hotel to spend a little extra time, see the doctor again, and perhaps have some testing done before going home. We provide the same, except instead of using a hotel for the "extra days of recovery", patients are sent to the recovery house. All attendants do wear gloves at both of the facilities and there are boxes of gloves on the walls in all the rooms.

There is air conditioning and fans at the facilities. The weather in Tijuana is mild and sometimes they don?t always turn on the air conditioning. They do ask patients if they are comfortable. Sometimes it can be difficult when some people feel hot and others feel cold. That's the reason for the fans. This way those that are hot can use fans without freezing the others out!

The recovery house is stocked with food. They mostly shop at costco. They provide bottled Water as well. Patients are offered liquids such as broth, Jello and juice. There is food for the companions of the patients to eat as well.

Most staff speak at least some English. All staff understand words such as pain, help, etc. They also understand the phrase, "Speak English" and they know to get someone that is fluent in English. There is ALWAYS someone available that speaks English that a staff member can reach in the event of a language barrier. One of the pluses of this Center is that it is owned by the same people that run it. This means that they have control over who works there. When a doctor uses an independent hospital, they have no control over much of the staff so they cannot guarantee that there will always be someone that speaks English. That's not to say that some of them don't have them, but they are not required to have English speaking staff.

The staff is medically trained. There are nurses, medical assistants and doctors at the facilities. All labor is very reasonable in Mexico. That's one of the reasons prices are lower there. There is no need to hire untrained people. Trained people can be hired for very reasonable wages.

The OR is completely cleaned after each procedure. They have a specific staff just for that. All the medical supplies are clean and much of the supplies are disposable, just like in the U.S. The same standards of sterilization used in the U.S. is also used at the facilities.

Other supplies such as staples, bands and other equipment designed for use in bariatric surgeries is of the same quality as in the U.S. and are from U.S manufacturers. All such materials are purchased from the Mexican distributors of the company's manufactures. That is the law in Mexico. For example, you must purchase Allergan bands from the Mexican Allergan distributor. ALL facilities and surgeons MUST do this. It is the same product, however the price is a bit lower in Mexico than in the States. The same Band that sells for $3000 in the U.S. sells for $1800 in Mexico.

There are certain things that are done to help keep costs lower than most. One is that the hospital is owned by the surgeon and administrator so instead of paying a hospital fee of up to $4000 or more per surgery, the surgeon just pays the over head. The other main cost saver is that Bands, Staples and other materials are purchased in very large quantities, which saves a lot in costs. For instance when they purchase staples they purchase at least $300,000 or more in product at a time. In doing so, the cost per item is MUCH less. Bands are also purchased in large quantities, so that $1800 band can be as much as $500 or more less when purchasing hundreds of them instead of just a dozen.

I cannot speak to how most doctors set their profits. I'm sure it's like anything else. Some charge more for their services, some less. Jerusalem does perform a higher volume which allows them to charge a little bit less in per patient profit. There are other small things that save extra money, such as owning their own shuttle vehicles. A Mexican airport shuttle costs about $130 per person to make a run to and from the San Diego Airport.

I have no problem answering any questions anyone may have. In fact I welcome the opportunity to do so. It's much better than all the assumption and guessing that I see. It's also much easier for me because I have been trying to figure out exactly what questions, people want addressed.

I thank you for your questions! Additionally if anyone would like to call me to engage in a back and forth discussion or more questions, I welcome that as well.