Tijuana/Dr Garcia/Florence Hospital - My story (June 8)

[itsmedave 15]

My apologies if this gets a bit lengthy, but I hope to give a full story of my sleeve experience and include some details I hadn't read much about in other reports,

After reading many reports on this site, and speaking with 4 coordinators, I chose Dr Garcia and Ready4Achange in early May. I was particularily impressed with Alma, who I spoke with over the phone. Whereas some of the other coordinators gave a hard sell or wouldn't stop talking long enough to answer any questions (and 1 wanted to charge a 15% surcharge if i used a credit card!), Alma was very professional, answered all my questions, and also explained that I would only be accepted if I agreed to their diet and procedures and after the Dr reviewed my file.

I was 401lbs when I made that call (although at the time I didn't have a scale and estimated I was 380) which would've given me a BMI of well over 60. Dr Garcia charges $4700 for BMI of 40-50, $5200 for 51-60, and $5700 for 61 - 70. Alma immediately offered that I should be able to lose the 11 pounds in my pre-diet so she put put me in the middle tier for payment. The next day I bought a scale and realized the 11 pounds I needed to lose was actually 32!!! It became obvious I would need to start my pre-op diet immediately.

Another benefit of Ready4achange was that they were able to use my health savings card to pay for the $500 downpayment (with only a 3% surcharge) Apparantly they (unlike many of the other groups I spoke to) are registered as a health organization, and thus eligible to use the card. I considered using financing to pay for the rest (and Alma was very helpful in arranging contacts for this) but I came into some money and was able to self pay.

So, I had 1 month to lose 32 pounds, The pre-op diet for Dr. Garcia is 2 weeks of Protein Shakes for Breakfast and lunch, with a small amount of meat and salad for dinner, drinking only Water or Crystal Light. This worked really well for me and was far less restrictive than other doctors diets. Also, being able to eat real food at dinner meant I wouldn't be trying to go to sleep hungry. I took the first 3 days to make a final tour of my favorite foods and restaurants, and then got to the diet. I am very proud to say I never once cheated, motivated as I was by saving that extra $500.

The plan was to fly to San Diego on June 7 (my birthday), surgery on the 8th, Mariott for three nights, and home on the 12th. My wife would be coming with me, but neither of us really wanted her to stay at the hospital all the time, so Alma arranged for her to stay my two hospital nights at the Marriott for $68 a night.

I have never been really sick in my life, not on any medication, never been in a hospital as a patient since birth, and I don't even have a family doctor...so this would be a very new experience for me. I was always overweight but active, but a few years ago I strained my back while moving boxes which limited how long I could stand or walk without pain. So I put on weight fast, which gave me hip pain as well. Unable to exercise because of this, the weight came on even faster. Loving to travel and to play with my beautiful 8 year old daughter, I was hoping this operation could help to lose enough weight to regain the mobility I used to have and avoid the high blood pressure and diabetes that would likely come as I aged at this weight...which went from the mid 200's to 401 in 5 years. My last physical had been 3 years ago, and I was concerned what the pre-op blood tests woulds show...but couldn't find much information on what those tests were and what were acceptable scores. More on that later.

The diet went amazingly well with me losing about a pound a day. The days before our flight out I hit 369. Made it! (Of course that was on my scale...what if the hospital scale had me a few pounds over...what if my height measurment was off my half an inch...would I still have to come up with the extra $500 anyway?

June 6...my last day at work before flying out in the morning. I get a call from Ana, the hospital coordinator for r4ac, who tells me that they had a cancellation for June 7, so I could come directly from the airport and do the surgery 3 hours after I land in San Diego. For me, this was a terrible idea for several reasons. 1. I did not want to be tired from travel and do it on my birthday. 2. I wanted to have a day of fun for my wife and I in TJ before I was all cut up (we got in at 10:15 am) 3. With the 24 hour liquid diet before surgery, I wouldn't be able tio eat anything else from that point, and I was counting on my last dinner and eggs the following morning before the flight (the diet allows for a small breakfast before the flight when the surgery is the next day. 4. I was counting on one more day of liquids only, accompanied by some TJ excerise to give me another pound or two of leeway so I could hit the BMI level I needed. So, I declined. I am happy with that decision, but in hindsight I think having my operation on the weekend led to several mistakes by the medical team that might have been otherwise avoided.

Friday, June 7. We land at the airport, and as soon as I turn my phone on I get a call from Samuel the driver, that he is there and waiting for me once we have our bags. He speaks great English and is very nice as he drives us over the border. I am so far completely impressed by the service of R4AC. We get to the Marriott at around 11:30am and our hotel coordinator, Irene (who is not Mexican but Ukranian?!) is there to meet us. She is an absolute doll, and gives us tons of info and hospital forms to sign. She gets us checked in to the room and we have the rest of the day to ourselves. The Marriott provides a free shuttle to and from the hospital twice a day. They will take us at 6am Saturday.

This is the Marriott, so of course the rooms are very nice. They provide for free 3 large bowls of broth, 2 popsicles, and 2 bottles of water each day, along with the shuttle service. They also all speak great English and were always great to deal with. We decided to be tourists, and the bellman helped us get a taxi to Ave Revolucion. It was about 10 minutes away. We walked up and down a few blocks and I watched my wife have a very nice lunch at an outdoor cafe.

The famous shopping on this street I would advise to avoid. People constantly bothering you to buy the same crap at WAY overpriced prices. Yes, you can bargain them down, but we got our best deals at a local mall towards the end of our stay. Everything my wife looked at, including some leather sandals, a set of silver and opal earrings, and a Hello Kitty purse for our daughter, were all quoted at $45 U.S. My wife would up buying each of those items...all for $20 or less...but even then, I think we paid too much. I would advise going where the locals shop instead for a better and cheaper experience.

So 10pm that night is my cutoff for any liquids, meaning Dave will be a very thirsty camper when he arrives at the hospital. I order a late bowl of broth (delicicous)and head to bed. Happy 44th, Dave!

Satuday, June 8

The shuttle takes us to the Florence Hospital at 6am. But nobody is there, not Ana, and not even anybody at the front desk. The shuttle driver came in with us and looked around for awhile before bringing back a guy in jeans who apparantly mans the reception area overnight on weekends. We are taken to room three on the same floor as checkin. The hospital and room are clean, well maintained, and very acceptable. There is a full bed area for significant others that was far better than I imagined, and the room had a nice view of the hillside. They are over the hill, a good 30 minutes from the Marriott in a nicer area of town, 1 block from the beach.

We wait for about an hour til the visits begin. First comes a doctor I hadn't heard of who asks me all the questions I had filled out earlier. As we finish the 3 page form, the guy in jeans brings in that exact same form I had given him when we arrived. Still, the doctor says that my lack of medical issues makes me one of the healthiest he'd seen!

Several other doctors and nurses came soon after to introduce themselves. Most (except for the nurses) I would never see again. The only one I don't see is Ana from R4AC. Next, blood is taken (they found the vein on the first try!) and I get an EKG. Then, I am rolled to the X-ray room for a shot of my lungs. I am pretty dehydrated, but manage to produce enough urine for a sample for them. I am weighed and measured...and no mention is made of my BMI. All of the x-rays and other test results will be given to me upon my release from the hospital for other doctors to use, or, I guess...souveniers.

I was to be the only surgery that day for Dr Garcia. It was originally going to be done at 9am, then pushed back to 10:30, before eventually happening at about 11:30. A female doctor from the hospital comes to lecture me for 20 minutes straight how important walking is after the operation. She tells me my tests came back fine (actually the blood tests measured colesterol, sodium, glucose, and a few others and I was in the normal range for all...I would later learn) I would never see her again.

Next comes Dr Luna, who would be my main contact. I was assured by my wife that he was as handsome as all of the ladies have written about here. He was also really fun to talk to. Very hip. I could imagine him doung extremely well with the ladies at the TJ nightclubs.

I am then introduced to the anasthesiologist, who assures me he uses the good stuff and I will feel nothing.

Finally Ana shows, but forgets to brings the folder with the diet instructions. She says she will see me after the surgery and leaves.

They attempt to hook me up with the IV, but after searching both arms a few times and making one unseccessful attempt, decide to let somebody in the OR to do it.

Lastly, the man himself Dr Garcia arrives with his trusty ipad to draw a picture of what my stomach now looks like and what it will look like in about 2 hours. He says that since I am the only one that day, they will take their time. 5 minutes later, he was gone. I have heard many other reports about how wonderful Dr Garcia is. and he WAS just great for the 5 minutes i saw him, but that would be the last time I would be in his presence while I was consious. This could've been because of the weekend, but I had expected to see more of him. Driving back over the border a few days later, I shared the van with another board member, Johanna, who said she had seen Dr Garcia several times. Dr. Luna made up for it, though, and visited me every day.

11:30am GO TIME. I climb onto a stretcher table and am wheeled to the operating room. Made me slightly naseous watching all of those ceiling tiles fly by as they rolled me around the hospital...don't know why I couldn't have gone there in a wheelchair instead. I am transferred to the operating table, and it could have been the anasthesiologist who was very proud of himself for getting the IV in on the first attempt.

I was expecting to have few words with the doctor, or at least have somebody ask me if I was ready (so I could reply with my Bundy-esqe "Let's Rock!") but I don't remember any of that. I woke with them asking me to help move to my regular bed. I also heard a voice telling me everything went fine...and then I was out again.

That first night was by far the worst, but even then it wasn't that bad. I had one bout of nausea caused by gas pressure in the chest area, but that was it. I never had to walk to lessen symptoms of gas pain in stomach, chest, shoulder, or back. I only had to call for the nurses twice during my stay, and they always came very quickly. My wife left at around 7pm and I spent the rest of the night alternately sleeping and awake for 90 minutes at a time. I did walk a little bit every couple of hours.

One major downer was the tv...which was non-existant. Other reports a month earlier had said they were switching to digital service, and I had hoped they would be done by now, but they weren't, so no tv at all. VERY BORING! The nurses came in often that night, but not so much the other nights, so I was able to sleep, and they were all doing their best.

The other issue that first day was thirst. I was not allowed any liquids, so my mouth was crazy dry. Dr Luna came in and gave me some damp swabs to roll around my mouth, which helped for about 5 minutes, but I was really looking forward to Sunday, when I could get my hands on some ice chips!

Sunday, June 9

I woke feeling pretty good, if thirsty. No pain or gas issues. Not at all hungry, even though I hadn't eaten in 2 days now. I read a little and waited.

Dr Luna arrived at 10am and said he was glad I looked so good. My color was as if I hadn't just had surgery. He said that usually they don't serve the ice chips until after the other leak tests, but because the initial leak test was fine and because the X-ray guy doesn't come until late on Sundays, he ordered the nurses to bring me the ice chips and a tray with small dixie cups of water, apple juice, and gatorade (which I couldn't stand) The water and apple juice were great though. He said that after the X-ray leak test, they would give me the blue dye leak test later that night.

Later my wife came and told me I wouldn't see Ana that day because it was her day off. She stayed awhile and then visited the beach. She had a great time, buth there and at the casino near the Marriott, winning almost $100.

The X-ray guy shows up around 1pm. He gives me some clear liquid to drink and takes an X-ray. I ask if everything looks fine, but he doesn't know because he was just a technican. I assume somebody eventually examined it, but nobody ever said anything to me about it. It was the next morning when I realized they'd forgotten to do the blue dye test at all. Another weekend issue, I guess.

Every few hours a nurse would arrive to change the large IV bottle or add painkiller or nausea medication to it. I never had to specifically ask for the extra medication, but I wasn't going to refuse it either! They would also take my blood pressue and temperature.

My blood pressure was always fine in the daytime when they used the big machine on wheels, but at night the nurse would bring this little portable deal that wouldn't fit around my upper arm (which really isn't all that big to begin with) So, she would try to hold it down, only to have it continually pop open upon full inflation. So, then she would do it around my lower arm, and it would come back very low. So, then she would instruct me to breathe heavily to raise the blood pressure. On Sunday night, they got a reading that I wasn't getting enough oxygen so I spent the night with air tubes in my nose. But the next morning, when the big machine came, both the bp and oxygen were fine. All I had to do is get through the night and I could check out!

Monday, June 10

Ana and Dr Luna get there at around 10am. Ana gives me the diet packet info, and a large bag full of medication and bandages. Dr Luna gives me more instructions and removes the drain and rebandages the 4 incisions. The IV needle (which had been changed to different locations three times) was removed and I was released. I hadn't used the bathroom much and with the 7 liters of IV Fluid they had given me each day, Dr Luna estimated I was about 15 pounds heavier than when I arrived. It would be a full week later until I was actually lighter than I was before the operation. That doesn't happen to everybody, as Johanna told me she had already lost significant weight since her surgery.

The Marriott shuttle brought me back to the hotel, and Irene called to make sure everything was okay and asjked if I wanted her to come visit me. Not necessary but nice. She and Dr Luna would arrive the next day to deal with the staples.

I ordered some broth, and while it was good, I could only get through about 1/3 of it. The popsicles were melon flavored...awful. I mostly hung out at the hotel that day and skyped with my daughter. No pain, no gas, no hunger.

Tuesday, June 11

I had my last visit with Dr Luna and Irene when they arrived at around 2pm to remove the staples from the 4 incisions. No pain. Also, no pain when the drain was removed. He said it might feel weird, but I didn't really feel anything.

My wife and I went shopping at the mall, visited the casino, and found our best bargains at the local Walmart, which was only a few minutes from the hotel.

Wedneday, June 12

Time to go home. Samuel picked us up at the agreed time, and was awesome on the ride back, talking about all the vendors around the border as we waited the 90 minutes to get back to the states. Very simple process at the gate, the immigration dude just collected our passports, asked why we were there, handed them back and we were off. Since we had a long time til our flight was due, Samuel drove us around the marina and showed us the maritime museum.

The flight went fine, no pain issues.

SO, 2 hours of writing later, that was my experience. Despite a few hiccups, I would have to say I am pleased with my decision to use Dr Garcia and Ready4achange. I would espicaily like to thank Dr Luna and Irene...and while I didn't have much interaction with Dr Garcia himself, my lack of post op pains and symptoms makes me feel he did a great job as well.

Hope this hasn't been too hard to slog through. Let me know if you have any questions.

Dave Day 8 364lbs

[Melixxa 125]

Thanks for sharing all this valuable information! I'm scheduled with Dr. Garcia July 2nd, and I'm so grateful that people who have gone ahead of me are wiling to let us know the ins and outs.

[Olivia23 68]

Yes thank you so much for that. I'm flying out Monday (tomorrow) and I'm going alone so I'm very nervous about complications. Reading your story made me feel better. I am having my surgery Tuesday the 18th and I will definitely post details also. I cannot tell you how helpful these stories are to people like me. They help so much in making my decision.

[maybaby 17]

Thank you for writing your story...I was Sleeve by Dr Garcia on May 17th...take special care of yourself now...

[joannao74 112]

Hey Dave..how are you doing???

[pantala 125]

Dave, thanks so much for the detailed story of your surgery and experience in TJ. I was sleeved on March 28 by Dr. Garcia and his team at florence Oasis and couldn't be happier with my surgery and the results.

I think you are right that some of the slip-ups at the hospital were due to coming in on the weekend. My husband always calls the weekend staff anywhere "the B team".

Also I think since Dr. Garcia is so busy he is relying more on Dr. Luna for patient interactions - great choice as everyone LOVES Dr. Luna! The surgeon's skill is what we want in the OR right?

Please keep us posted on your recovery and weight loss progress!

[itsmedave 15]

Doing great, Joanna, hope you are as well. When our plane touched down at 11pm cst, we were thinking about you "poor Joanna, she hasn't even left yet" What did you do the rest of the day? I'm still looking forward to those tortillas!

[itsmedave 15]

Thanks Melixxa, and best of luck Olivia, I'm sure it will go great!

[joannao74 112]

Doing great' date=' Joanna, hope you are as well. When our plane touched down at 11pm cst, we were thinking about you "poor Joanna, she hasn't even left yet" What did you do the rest of the day? I'm still looking forward to those tortillas![/quote']

 

Omg Dave it felt like a eternity at the airport..not much in there..and i didnt want to walk around outside.....i got home at 8:30 am the following day..and slept and laid in bed all day and night....i wish i would of purchased some tortillas jajjaja..tell your wife i said hello..:-)

[Melixxa 125]

I have a question for those of you who did the Dr. Garcia/Florence surgery: After your first night at the hotel, when you go to the hospital, do you take all your luggage with you? I was wondering if I should be checking my luggage at the hotel, or do I need to bring a small enough bag to take to the hospital, or can I bring my big suitcase with me?

 

Thanks in advance!

[maybaby 17]

You actually check out of the Hotel and bring all your stuff with you to florence Hospital!

[Melixxa 125]

You actually check out of the Hotel and bring all your stuff with you to florence Hospital!

 

Good to know. Thanks!

[Flagstaffian 31]

Dave,

Thanks for sharing your story! I was wondering, even after the little things that went wrong, did you feel like they were legitimately professional? It didn't concern you or your wife that they kept "forgetting" to do medically necessary things for you? (Sorry, I'm a worrier). I know you specifically said you don't typically "see" doctors at home, and we all need to be our own medical advocate, but I'm just wondering....

Also- update on YOU, please! How are you feeling now?? Losing?

[Jiggly Puff 53]

Thank you so much for helping us pre-sleevers with your detailed experience. It is very much appreciated! Congrats and good luck!

[itsmedave 15]

Flagstaffian and others,

Thanks very much for your kind words.

As for the minor mistakes...I guess the one I was most concerned about was the forgetting of the blue dye test...but they had done 2 previous tests and I had been drinking with no bad effects...so when Dr. Luna showed no concern that it wasn't done, it seemed more like an extra precaution than something that was "medically necessary". I figured that if the guys who do this operation 3-4 times everyday aren't worried, then I shouldn't be either. But on the whole, yes very professional, and I suspect a better experience than many get in the states.

To your other question, I am doing great! My outside wounds are still healing (slower than I'd hoped in one case) but I don't feel anything different in my stomach on the inside. The only after effects seem to be getting full really fast, and the occasional loud burps when I drink too much or too quickly. I have never had nausea.

It took me about 5 days for my first BM (but again, I didn't eat anything to make the poop) but now I am averaging about once every 2 days.

Since I have had no stomach issues, I have added a few of the pureed foods in a bit early. My usual days food consists of: Breakfast: either a Protein Shake, or cream of wheat sweetened with splenda. Unsweetend applesauce for a snack. Lunch: A few tablespoons of cottage cheese. Dinner: either some chicken broth with chicken or turkey baby food stirred in, or creamy Peanut Butter with a small glass of skim milk. I figure around 400-500 calories a day. I am not hungry on this diet.

When I left for the surgery, I weighed 368 on my home scale...when I got back home 8 days ago I weighed 373 (5 pounds more)...today I weighed in at 358. So, yes I am losing, Had to punch through 3 new holes in my belt.

But I will be happier when these incisions fully heal so I can take a proper shower again.