My Journey (Finally)

[NursyGirl 1]

Well, today is my one-week surgiversary, and I can?t really justify putting off my report much longer. People have been giving me a hard time on four different forums to share my story, so I?m just going to post it so you all will get off my back.

Feel free to skim to the important bits, or not read at all. I won?t be offended. It is very long because I wanted to write in detail all about the things I wanted to hear when I was making this decision. So here it is: the good, the bad, the ugly, the scary, disappointing, amazing, joyful first step of my weight loss journey.

I chose weight loss surgery after adhering to an extremely expensive diet for several weeks and not losing a pound. I realized that there were no diets left for me to try, and that I was becoming so heavy, and so ill that I could no longer exercise effectively. I was developing diabetes, GERD, hypertension, joint pain, asthma, and Migraines. I saw every hope and dream and goal I had for my future slipping away because I couldn't control my relationship with food.

I made the decision to go to Mexico in general for the convenience (I live in Southern California so it?s a short trip), and of course, for the cost. I am a full-time nursing student who also works hard, and I can hardly support myself. I have debt from school already, which I will be paying off for years to come. I knew that I couldn?t afford $12,000 or more to have it done here in the United States. I thought about waiting a year or two until I have graduated school, but the thought of continuing to feel ill every day, and starting my career feeling tired and sick overwhelmed me with despair. I knew I had to find a way.

The first person I spoke to when I joined VerticalSleeveTalk and ObesityHelp had gone to Dr. Almanza and was pleased with her experience. She has since changed her review of him, but she got the ball rolling for me. I was lucky in that I ignored all of the drama on the Mexico forums, and chose to conduct much of my research on my own, and speak to people through private messages and phone calls instead of on the forum. People told me that their overall experiences were positive, but that there were some problems with the clinic. They felt that there were too many surgeries each day, and that the staff should speak better English. It was also pointed out many times that the surgical center is not a stand-alone hospital with an ICU and blood bank should anything go wrong.

I took these things into account, and asked about them directly through the clinic. I speak Spanish, so that was no impediment. I preferred the idea of recovering in a private home with nurses instead of in a hospital room alone. If there were complications, I would be air-lifted to the hospital. I was also told that the number of surgeries was usually about four per day. I had some apprehension, but made the decision to go to Hospital Jerusalem.

I scrimped and pinched to pay the $500 deposit with my debit card over the phone to my coordinator, who is very busy and business-minded, but also kind, concerned and efficient. I then took out a brand spanking new credit card with 0% APR for 18 months, and then low interest, to pay the balance. I paid through paypal about a week and a half before surgery.

Yaaaaaawn!

I couldn?t sleep the night before, not surprisingly, and only got about an hour?s rest. I got up at what I described as ?the butt-crack of dawn? (3 a.m.) to drive from my home in Thousand Oaks to San Diego. It wasn?t so bad because I was running on adrenaline. I was worried that something would go wrong during the drive, or with the parking, or at the airport, or whatever. I was panicked that something would stop me from getting it done! I made excellent time on my drive, but had I left any later, I would have risked Los Angeles AND San Diego traffic. I got off of the freeway in San Diego, and turned into long-term off-airport parking at the Mission Brewery. The staff there was very helpful and kind, and I was actually able to park in covered parking for less than $10 per day. I took a free shuttle to the San Diego airport, and waited for about an hour near the JetBlue terminal.

At first I thought I wasn?t in the right place because there were no fat people. I mean seriously, it was like a yoga instructors? convention down there! I was finally able to find the other patients who were meeting there, one overweight woman we?ll call S, who was also having a vertical sleeve gastrectomy and her husband. There was also a pretty woman of about forty, P, who was planning a ?mommy makeover? (breast lift and augmentation, Tummy Tuck and liposuction) with Dr.?s Lara and Friday. Her husband had the VSG three weeks prior and she told me that he was doing very well. A large blue passenger van pulled up with ?Hospital Jerusalem? printed on the sides, and we piled in while the driver Tony packed our luggage. Then we were off! The drive was short, comfortable and pleasant, although the driver was on his cellphone quite a bit. It only took a few minutes to cross over the border into Tijuana.

Pre-Operative Testing and Preparation

Once we crossed over the border, we went straight to a clinic where a nurse took a blood sample. As dehydrated as I was, she had to keep trying to stimulate my arm to get a visible vein, ANY vein, but she was excellent. There was hardly any pain and she didn?t dig. She did not wear gloves, but did clean her hands before and after taking my blood.

We then drove to Hospital Jerusalem, which is a far cry from what people in the U.S. are used to. They call it a ?hospital? but it is just a surgery center, and yes it is across from a ?love boutique? and near a Home Depot. It freaked out one of the other patients, as it is part of a strip mall, but the interior, though cramped, is clean and modern like any other surgical suite.

We went upstairs and waited a few minutes to go into the consultation room where Juan assisted us in filling out paperwork. He is bilingual and will fill the paperwork out for the patients, as it is in Spanish. I had paid in advance using PayPal, so a couple of signatures and I was on my way! Lupita, a petite nurse who only knew a couple of words of English took me downstairs next for an EKG. The cardiologist is an older man, absolutely adorable, and he was so excited to have a patient with whom he could actually converse! I was wearing a dress so Lupita draped my lower half and pulled the dress up to expose my belly for a 12-lead EKG. She also poked my breast and asked ?implants?? When I told her no, she said ?oh, que suerte!? (how lucky!). I was trying not to laugh, and the cardiologist was definitely blushing. He did the EKG and came to show me the results, which he explained, but I already understood from my background in healthcare. He also told me to try and relax as my pulse at rest was 104; it usually is high, but I tried to calm down.

Lupita took me straight to the room next-door, a teeny recovery room with two beds separated by about a foot and a half. She had me change into a hospital gown, which had no tie, which was annoying, and she gave me the remote control for the television and told me to relax. She brought in sterile supplies, and put on gloves to start an IV in the vein on the side of my wrist. Lupita is a skilled IV nurse. I had little pain, despite the large gauge of the needle. She then wrapped my lower legs tightly in bandages (their version of compression stockings), put on booties, and stuffed my hair into a hairnet. ?Sexy!? I told her. She giggled and left to go get the next patient.

I was glad to see P, the woman I had bonded with on the drive over. She was changed and prepared for surgery the same as I was, and I handed her the remote control and we settled in to wait. I expected to wait a long time, as I had been told that many patients have to wait until late at night for surgery. I just figured I?d suffer through it, and it was part of what I paid for. To pass the time, I took out my camera, and told Pat we should take pictures to share with people thinking of visiting the clinica. But no sooner had I reached into my purse for my camera than the surgeon came to talk to me.

Because I had never had surgery before and was in a foreign country, I didn?t really know how much attention I would or would not receive from my doctor when I arrived, but I was and still am very pleased with my surgeon Dr. Almanza. He spent a lot of time with me, talking all about the surgery?s procedure step-by-step, its risks and benefits, and what to expect afterward. He also spent time getting to know me personally which I never would have expected. He was curious about why I chose the VSG when everywhere throughout southern California are billboards advertising lapband surgery. We talked about my personal life, and why the surgery was important to me. I was impressed that my surgeon took the time to put a life and a personality behind the piece of meat he was about to fillet on the operating table.

Once Dr. Almanza left, I settled back in to wait. P was all of a flutter over Dr. Almanza, and definitely had a little crush. I was expecting to be second because the other patient had been doing her consultation, EKG and everything else before me, but it had only been about a minute when I heard Lupita ask Dr. Almanza who was first, and he said I was! I was excited to go first and get it over with. Dr. Almanza poked his head in to tell me that the OR would be prepped in about ten minutes. It was more like four minutes before Lupita came to take me back. It was noon at the latest.

Surgery Time!

I walked into the anteroom to the operating room, and was taken aback. The entire surgical team was lined up all around the room standing against the wall, smiling at me. ?Uuuuhhh? hay una fiesta?? I joked awkwardly, giving a dorky little wave, and everyone laughed. Lupita led me into the OR and to the smallest operating table I have ever seen, which I climbed onto. I have no idea why a surgical center that specializes in bariatric surgeries would have a child-sized operating table. I?m one of the smallest people I?ve met to have this surgery, and I felt like I was spilling over everywhere! A nurse in a white uniform came to my side, and I tried not to stare. She was made up like a clown, literally, with eyes and lips over-drawn to the point of comical. I remember thinking, ?Oh God, please don?t let this be the last thing I see before they put me under!?

Then I heard the most beautiful, smooth, heavily-accented voice. ?Danielle?? I looked up and saw the most adorable anesthesiologist leaning over me. ?How are you feeling Baby?? he asked me in Spanish. I told him I was nervous, and he said, ?Oh no Baby, don?t be nervous.? Then he and another hot guy (a nurse) leaned over me. Gorgeous. Yummy. I don?t remember anything after that.

Apparently, I walked back to my room. Once you?re closed up and woken up, two people walk you to the recovery room across the hall and put you into bed. I do not remember this at all, but P sure does as she says I was absolutely blue (normal after surgery) and she was terrified! Seeing her fear, Lupita said ?No worry! No worry!? and P responded in her thick Alabama accent, ?Of course I?m worryin?. She?s blue and you haven?t e?en taken me back yet!?

I faded in and out of sleep for the rest of the day. I was vaguely aware of pain each time I awoke, and had chills and then sweats off and on throughout the afternoon. P was always there, and I felt bad for her. She was alone with me in that claustrophobic room until eight p.m. when her surgeon was finally ready for her!

I had a somewhat difficult night. I had never been under anesthesia before and so didn?t know what to expect. I had a lot of nausea from the anesthesia, and vomited blood throughout the night. My nurse Alejandro, answered my call light within twenty seconds anytime I called, administered antinausea and pain medication frequently, and even mopped up the floor, changed the sheets, and took care of me when my IV leaked blood all over the room. Oops. I was a little nervous because they never brought P back to the room, but took her to another recovery room, which was better since I had such a fitful night.

Recovery in Mexico

Saturday:

We were moved to the recovery house in the late morning. It is a private home in a gated community. There is always at least one person there to administer standard medications for pain, nausea and sedation, and to cook meals for patients and families, as well as do some light housekeeping. It?s like staying in a family home. Many of the employees (Severo, Dr. B, Silvi, Elsie) have themselves had lapband, gastric sleeve or other procedures, so hearing their stories is pretty interesting.

There were patients and guests already staying upstairs. P and I were placed in the one downstairs bedroom, which was comfortable and clean, as was the entire home. I was experiencing some pain, but was given medications through my IV (which was kept in for everyone as long as possible to avoid the pain of injecting medications intramuscularly). I tried to walk to help dissipate the gas, but was still experiencing so much pain internally that it was very difficult. I also had such bad nausea that I couldn?t keep any fluids down at all. Severo, one of the nurses, told me that if it didn?t get better, I would have to return to the hospital for IV fluids. I protested mostly because in my nauseous state, I couldn?t bear the thought of the car ride! And the house was just more comfortable. Finally, in a moment of ingenuity, Severo gave me some medicine to relax me, and then hung an IV off of my bedside lamp to combat the dehydration. I felt much better when I awoke, and took a careful shower.

Sunday:

I woke up with some pain and still terrible nausea. I tried to sip any Fluid, and the only thing I could take in was half of an otter pop. Then it was time for the leak test. It was incredibly painful for me, and I had to do it TWICE! Because of the excruciating pain, the tech doing the fluoroscopy thought I had a leak, so he did the test twice to make sure I did not. It was awful. I have never felt so much pain. I was vomiting before, during and after the test.

Poor Omar (the driver)! I don?t remember a lot about the drive after the leak test. The pain was so bad that I sort of retreated into myself. He stopped at the hospital to get me something from one of the doctors, but of course, no surgeries are scheduled on Sundays so no one was there! That was kind of poor planning. We drove back to the recovery house, where Omar slid me down onto the couch and the nurse Teo came running with medication. He injected me with a big dose of pain medication, antinausea, and a sedative. The driver, the nurse, and another employee I didn?t know were all looking carefully at my x-rays, wondering what on earth was wrong when there was definitely no leak. ?Mira,? he said. ?Esta relajando.? I don?t remember anything after that. I woke up in my bed that evening, re-hydrated yet again, and feeling better. I felt that the worst was over. Now I would get better. I was supposed to return home the following morning, and if I felt as well as I did after my fluids and medications, I would be fine! They removed my IV that evening because it had clotted, and medicine would no longer pass through. I remember thinking that I wouldn?t need it anymore. I could take pills now that my leak test had had shown no problems, so I would be able to treat my own pain. I was optimistic.

That night was one of the worst of my life. Everyone went to bed early, but I was in pain. I walked around and around the living room, thinking maybe the pain and nausea would get better. I wanted more pain medicine, but it had been too soon since I last had some. The only nurse there that night was a young girl, sweet as pie, but only eighteen-years-old. Her name is Elsie. She telephoned the on-call doctor, a woman who treats the recovering patients with special needs. La doctora told Elsie to give me my antibiotic, two of my pain pills and some chamomile tea, and to put me to bed. I choked them down, shuddering in pain, and went to lie down, praying I could sleep and wake up better in the morning.

I almost did fall asleep, but the nausea was so bad that I could only lie down for about twenty minutes before I knew I had to get up. I rolled out of bed as quickly as I could and tried to make it to the bathroom. I almost did, but managed to make it to the trash can, where I vomited the Water and tea I had drunk. Then I took two steps to the sink, and vomited all of the pills, as well as some blood. Elsie was on the phone with la doctora before I could even look up. I don?t know what she said. The pain increased steadily from this point until I was in a kind of delirium. I just remember crying and saying over and over ?tengo miedo, tengo miedo, please please please?? I have no idea what I was asking for. Thank goodness I speak Spanish! At least some Spanish is an absolute must at this facility. I was able to speak to Elsie, and she could console me, reassuring me that the leak tests had all shown no problems and that I would be okay. In fact, she held my hand while I cried and writhed in pain like a total baby.

At about two a.m. the on-call doctor drove up and swept into the living room in her sweats. She drew up an enormous dose of morphine which Elsie administered. She helped me immediately to bed, where I felt relief from the pain and nausea melt slowly down from my head to my chest, belly and legs. Finally, I passed out for over nine hours. I woke up in the exact same position I had been placed in. My roommate said she and Elsie had been checking all night to make sure I was breathing since I was so heavily sedated. After all of the pain, it was bliss.

Monday:

I missed S and her husband, who left that morning. S had no complications and no pain. She felt totally normal the day after surgery as if nothing had ever happened. She?s on her way to an amazing new life!

When I came out of my room, feeling somewhat relieved but like I?d been put through the ringer, I was a little embarrassed to see a dining room full of well-dressed men in suits, my roommate P, two nurses, a 12-year-old kid, and another woman in a white uniform. Teo the nurse was at the stove, and he smiled and asked how I was. The woman in white was Elsie?s mother Silvi, Dr. Betancourt?s housekeeper, and the little boy was her son Angel who was just the sweetest, best-behaved child. He helped his mother and sister to clean the house, and later he did a puzzle with Teo.

The well-dressed, handsome man at the table was Dr. Betancourt, no longer a practicing doctor but rather a businessman who owns the hospital and recovery house. He stood up from his passionate eating to greet me. P and I spent an hour chatting with Dr. B. who is a kind, generous and funny, flamboyant gay man who has had the lap band and two tummy tucks himself. He made me turn around and show him my bootie, and he told me I have a nice ass. He also had me lift up my shirt and show all the world my drain, my sutures, and my fat, gassy tummy. ?Giiiiirrrrrl,? he said. ?You aren?t going to need ANY plastics!? He was fun! He saw me shifting from one foot to another and asked if I had pain. When I admitted that I did, he yelled ?Teo, give her some meds!? and I went back to blissful sleep. My pain was well-controlled all day with injections (which are themselves pretty painful) and I was able to rest and recover. I tolerated Gatorade and popsicles, and walked up and down the street many times.

I knew I?d turned the corner at last.

Home At Last

I felt ready to come home on Tuesday. Teo took out my drain, which was unpleasant and disgusting and a little painful. He also did a cursory exam, told me to keep my stitches in for fifteen days instead of ten, and exclaimed over how inflamed my new stomach sleeve still was. He injected me with some antiinflammatories which were a godsend, I said goodbye to P, and the driver took me away. Thank goodness I speak Spanish because the driver doesn?t speak much English and it was just the two of us in the car in the line to cross the border. We small-talked. He was young and cute, so that was fun actually. It only took about an hour and ten minutes to get from the recovery house in Tijuana to the San Diego airport. I then took the shuttle back to Mission Brewery, got my car, and began the drive north.

Those antiinflammatories made me happy all the way home, through Los Angeles traffic, and over the bumpity-bumps of the 405 Freeway. I wedged a cushion sort of around my left side under my boobs, and when I didn?t need two hands, I held it against my tummy to help stabilize and limit the jolting. It was actually fine, but I would not have been capable a day before.

The pain medication they give you (naproxen) is like a sugar pill. It does nothing, so that has been a little unpleasant. I was able to go to the store and do a load of laundry the day after arriving home, so I?m not feeling too bad. It is extremely difficult to get fluids in still because my baby stomach does not seem to like any fluids. For example yesterday, six days after surgery, I slowly ate a small, sugar-free crystal light popsicle, and my sleeve (whom we have named Elvira for her evil tendencies) behaved as if I had swallowed a glazed ham. I am working hard at getting accustomed to what works for Elvira, and was able to get enough fluids in yesterday for the first time!

In retrospect, I must have had a poor reaction to the anesthesia which no one could have known about because I have never had surgery before. The reaction led to all of my extreme nausea and violent vomiting. The consistent and violent vomiting led to extreme swelling in my stomach, which allowed no Fluid to pass, further increased my nausea, and contributed to my pain. Despite this set-back, I was pleased with my experience in Mexico. When going to Mexico for surgery, you must adjust your expectations. I was treated like a sister or a daughter, and my complications were handled quickly and appropriately, and in some cases, creatively.

[goal160 0]

wow,gotta take my daughter to practice but i will soooo be back to read this!

[KathyM 14]

Nursygirl -

Thank you for your post. It was refreshing to read about someone who had maybe a less than ideal experience, but did not resort to trashing the Dr. It sounds like you had reasonable expectations and were able to adjust when things didn't go as you planned. I appreciate your humor also! I am going to be sleeved in Mexico next week Thursday and found your post to be really helpful.

Good luck in your recovery, hopefully you are past all the little speedbumps and are at the threshhold of your new life!!

Kathy

[mommaof4yoopers 3]

glad you're home and resting!

[NursyGirl 1]

Thanks! I'm so glad you found it helpful. I remember how I wanted every little detail when I was in the planning process, so I'm more than happy to answer any questions that weren't included here.

I definitely represent an unexpected outcome, as I am young and comparatively healthy, but had a bad experience with anesthesia. I'll know next time! I caution people who choose Mexico only because it is not like having surgery in the U.S. and expectations need to be different. I had done extensive research and knew exactly what to expect from the staff and facility, and thus mostly, my expectations were exceeded. It was a great fit for me, but would not have been for many other patients.

[Sunshine 1]

Thank You for posting this.

[KabinKitty 11]

I have had 8 surgeries, 4 being open abdominal surgeries and I've never experienced anything as horrific as this!!

I pray that you don't have any more complications and have a good recovery!

[1MP4Life 2]

Wow, NursyGirl, what a scary experience, thank you for sharing it. It is a good thing you spoke the language, I can't imagine trying to explain to the nurses and Docs what was going on with a language barrier. Thankfully you are recovering well now.

My mom had a similiar experience after knee surgery at a hospital in the US. It was a scary 48 hours with her, we had no idea about the reaction she would have to anesthesia.

[mp8btpc 33]

I am glad your recovering and made it past the horrible reactions you were suffering. It is a good thing you can handle the morphine they shot ya with because that is the one thing I do know from a past surgery. Morphine is not tolerated so well by me. I get dizzy and nauseated all alone from it. I was praying through the middle of reading your post you werent going to tell us that they gave you morphine for the pain and suddenly it was even worse nausea lol.

Keep us posted on how your progressing and welcome home.

[possumtrot 2]

Thank you so much for your candor. I'm 5 days away from surgery and appreciate everything you've written. I've had general anesthesia before and haven't had problems, but my mother had it earlier this year and had all sorts of issues too...it can be very nasty for some folks!

Glad to hear you're doing so much better now. How does it feel to be on the loser's bench?

[Dansha 16]

WOW.... What a great narrative. I couldn't stop reading it. I loved the details... the good and the bad. I'm soooo glad you are OK. Please keep us updated on your progress. Good luck on your WL journey sweetie.

Deb

[NursyGirl 1]

Thank you everyone!

That's the thing about anesthesia; you never know until you have it! Thank goodness I had no reaction to the morphine, other than blissful, oblivious sleep!

[Sunshine 1]

Wow. What a 'story'. That must have been extremely hard on you. I don't know you, but I wish I did (and wish I there for you). You definitely needed someone. You are a strong person.

THANK YOU for writing this. I knew coming onto these boards that I would hear, "The Good, The Bad, and The Ugly". But isn't that what REAL life is. Surgery does NOT go well for everyone.

Yes, the details were what I wanted to hear (others may not care, and I'm sure others appreciate it). Me? I loved it. Generalizations can be formed very easily ....and for me, well...I like details.

So, how are you now?

[NursyGirl 1]

Feeling fine, thanks. Don't regret my decision to have surgery, or my decision to go to Mexico. Struggling to get fluids in, but not nearly as badly as my friends who had in done here in the U.S., go figure. I've had no complications since arriving home, just expected restriction. I'm forcing fluids and reaching my goals mostly. Can't tolerate much beyond Soup yet, but it's getting better. I'm happy.

[ellie123 374]

You write so eloquently. So Sorry about this ordeal. Hope it’s. Smooth loosing for you from here!