VSG with Dr. Rumbaut (a long report)

SMoran
on 12/2/09 3:28 am, edited 12/2/09 3:50 am - Washington, DC
I started writing this and it has turned out very long.  I will post in sections:

I had my VSG with Dr. Rumbaut on Thanksgiving Day. Before my surgery, I looked for a “blow-by-blow" write-up, so that I would know what to expect. I’m a person who strongly feels “knowledge is power", so I wanted to know everything. I pieced together a lot from the boards, but decided I would write the post that I had hoped to read. 

Let me say right off the bat – if you are squeamish, don’t read this post. I’m not going to hold back (well, except to the extent that my *own* squeamishness prevents me from having first hand knowledge, as you will see later). Also, although I will say that, overall, my experience was excellent, I will also write about the negatives I saw. Nothing is perfect, and since I am a person who likes to be prepared for things, I would rather be aware than not.   Also, having lived with my husband for so many years, I have developed a bit of a warped sense of humor, exacerbated by the aftereffects of the anesthesia… so, yes, there is humor throughout the post.  


We flew from the mid-Atlantic coast on the day before Thanksgiving. I was exhausted from getting things lined up at work to be gone, from getting up at 2am to catch the flight, and from not eating for 10 days. The driver met us at the gate with a placard with my name. He spoke no English at all; fortunately, my husband knows at tiny amount and was able to at least confirm that we were going to the doctor’s office. He was not exactly unpleasant, but also was not at all friendly. As my husband exchanged dollars for pesos, he stood staring blankly at the wall; my smiles unreturned.  

I have to say something about Monterrey itself, because I think that if I had known I would have been less apprehensive. The drive from the airport does not go through the best part of the city. My only experience in Mexico prior to this was to tourist-invaded Cozumel while on a cruise, so, when I saw two horse-drawn wagons traveling along the main highway (the “autopista", or something like that, which immediately put me in the mind of an autopsy!) I thought, “What have I done coming to this country to have SURGERY??"
SMoran
on 12/2/09 3:29 am, edited 12/2/09 3:50 am - Washington, DC
The taciturn driver may not have been friendly, but he was hell-bent on getting us to the office in the shortest amount of time. Be aware: the white lines in the middle of the road appear only to be advisory… and no one seemed to be taking the advice! Cars weaved in and out; four cars were simultaneously in three lanes. After a while, I was physically ill from the anxiety and simply closed my eyes for the remaining trip.  

The cardiologist’s office was in a surprisingly modern building. Monterrey is built into the side of a mountain. As I later discovered, there is a tunnel that seems to separate the upper town from the lower town. The upper town is distinctly more modern and technologically advanced. 


The driver escorted us into a high rise, and deposited us at Dr. Gonzales’s office. The secretary there was very nice, but again spoke virtually no English. I was becoming aware that this was the first time I’d ever really gone anywhere where the locals didn’t have at least a rudimentary knowledge of English. I have been to about 20 foreign countries, so I *thought* that I would be okay in communicating with people.   I was now realizing that, heretofore, I always was in the insulated role of “tourist", going to touristy places and purchasing services from people who were trained to deal with Americans. This was going to be different.  


Dr. Gonzales saw me immediately. He asked questions about my health, and the medications I was taking. His English was a bit weak, and my Spanish nonexistent, but we were able to make ourselves understood, ultimately. I undressed, put on the hospital gown. He listened to my chest, and then told me we were to take x-rays.    Again, my culturally-biased core was shaken when he led me into a closet of the office, which was lined with lead? Radiographic material? I don’t know.   I held the x-ray film, walked to the back of the closet, and Dr. Gonzales took the x-ray.   Rosy, Dr. Gonzales’ very nice receptionist, came back and did the EKG, and then drew blood. She walked us back down to the street, hailed us a cab, and we were off for the hotel within 45 minutes.
SMoran
on 12/2/09 3:30 am, edited 12/2/09 3:51 am - Washington, DC
We decided to stay at the Quinta Real, rather than at the Hampton, which is where most of Dr. Rumbaut’s patients stay. It is a very nice hotel, and if anyone would like to hear more about it, I will be glad to answer questions, but since most won’t stay there, I’ll not go into detail.  

Dr. Rumbaut’s office had sent me a “welcome letter", which was different from the “surgery details" letter. The “surgery details" letter had said they would leave a message/fax at the hotel telling me of my time to meet with Dr. Rumbaut. Honestly, I was so stressed and exhausted I didn’t even look at the “welcome letter" sent to my e-mail address before I left home. Consequently, I was panicking because there was no fax, and I didn’t know when I was supposed to be there. My own fault for not reading things carefully. So, my advice is, print off EVERYTHING the office sends you, and put it in a folder to take with you before the surgery. Even if you don’t read or remember everything at the time, you’ll have hard copies to refer to.  


We caught a taxi to Dr. Rumbaut’s office. It took about 10 minutes from the Quinta Real, and the cost was about $5 US. I first met with Dr. Lisselle (I KNOW I’m going to get that wrong – I’m sorry!). She is Dr. Rumbaut’s surgical assistant. She is extremely sweet, and, in my opinion, very pretty, with small bones and a “girl-next-door" wholesomeness. I liked her immensely. She explained the surgery, gave me lots of written information about post-surgery diet and concerns, and a “starter kit" of supplies – a protein drink, some Crystal light type water, some bouillon cubes, and some tea.    


One concern I had about the surgery was the insertion of the IV.  I explained that, in the past, it had been VERY difficult to get IVs threaded into me. They could hit the vein, but then not be able to thread it through. Dr. Lisselle made that note on my “admittance sheet", and later, Dr. Rumbaut promised me they would give me a pill so that I wouldn’t care if they had to dig around in my arm.  


Dr. Rumbaut dispelled all of my apprehensions about having the surgery in Monterrey. I felt like I was in very good hands. He is personable and speaks English exceptionally well. His office is decorated with pictures and statues of “round people". (I’m going to find one to send to him too.) He talked about the technology at the hospitals, and seemed extremely competent at what he does. Both my husband and I left his office feeling very comfortable, which was quite a feat after my earlier perceptions.  


A fun fact: I went to the restroom at Dr. Rumbaut’s office and there was the BIGGEST toilet seat I have ever seen! Seriously, it was like a loveseat! I guess he has people there even bigger than me!  
SMoran
on 12/2/09 3:31 am, edited 12/2/09 3:52 am - Washington, DC
I was scheduled to be at the hospital the next morning at 10 am. We arrived, met with the receptionist, and checked in within one half hour. My surgery was at Hospital St. Jose, and I have to say, it was wonderful. I live in a large metropolitan area, and had a hysterectomy a couple of years ago in one of the better-known hospitals here, and that one had nothing on St. Jose. It was infinitely nicer than the Kaiser building my husband goes to! It was exceptionally clean, modern, and the staff, while having limited English, were very committed to patient care.   

We sat for about an hour in one of the patient waiting rooms, until a nurse came, asked me to undress in one of the restrooms, and then walk to the pre-op area. I was a little concerned about walking with the open back, but I held it together for a while, until a nice nurse performed some miracle in the back that kept me from mooning the world.   

My husband and I were taken to one of the beds. I was given a pill to relax me, and then they immediately set forth to put the IV in. WHOA!! I looked around in panic, as my husband fumbled to find the words to say that IVs were an issue. Eventually, they brought down the anesthesiologist himself, who, I have to say, was TERRIFIC. He found the vein on the first try, and threaded it, with the least pain I’ve ever experienced with an IV. I can’t remember his name, but… “You ROCK!"

(When I awoke from surgery I had two IVs, and two other bruises where, apparently, they were unsuccessful in putting the second one in, after I was under. So, it isn’t that my veins are that much better… he was just good.)

They wheeled me to surgery, and told me I would be under soon… and I was.


 I remember some of the recovery room, although not all of it. The main thing was that I awoke with a pain in my chest. Somehow, while I am aware that the stomach itself is higher than mid-abdomen, I didn’t really connect with the idea that the incisions would be high (just under the bra line, in my case). That, combined with the gas that is used to help visibility, caused me to wonder if I was having a heart attack. It was a little scary until I understood what was going on.
SMoran
on 12/2/09 3:31 am, edited 12/2/09 3:53 am - Washington, DC
The other thing I think I overlooked in mentally preparing for the surgery was the presence of the drain. The drain was placed dead-center of my chest, and consisted of a lightweight tube, about 4mm in diameter, connected to a small reservoir about the size of an orange. It is there so that the staff can monitor the fluids in the area, to see any cloudiness, clots, or other signs of problems. 

For me, it was the cause of much anxiety and stress. It is translucent, and I couldn’t bear to see the bloody discharge emanating from my body. The nurses drained it regularly, and I hated hearing the sound of it. I was always aware of it; I constantly feared pulling on it and dislodging it from my chest (wouldn’t happen, but it was a fear). The day after the surgery the nurse’s aide who helped me take a shower pinned it to my gown, which meant I didn’t have to constantly be checking on its location. This was a great blessing. Take a safety pin and do it the first day, would be my advice.  

A note about modesty: I am typically a pretty modest person. I’m not one to be comfortable with people seeing me naked, even back when I had a great body, much less now that I look like an ancient fertility goddess! The bad news is that I had to get over it --- while the nurse’s are good about not exposing you more than necessary, sometimes it seemed that the entire staff of the hospital was coming by to check my incisions and look at the drain. When the aides came by to help me to the showers, I was stripped down, helped to the shower, and then taken out and patted dry by very solicitous hands. The good news is that I, at least, was so loopy, I didn’t care that much.

    I only stayed only one night in the hospital, at my request. I found the bed to be uncomfortable (I have a bad back), and the constant checking of blood pressure, incisions, and drain to mean I could not get to sleep. The IV unit malfunctioned in the middle of the night, beeping constantly. The nurse would come in, “fix" it, walk out and it started again. This repeated itself four times within 10 minutes before she was about to work out what was causing it. I also hate IVs and desperately wanted them out. So, I dutifully did what was necessary to get out: took my shower, walked around the hallways on the second day, peed and pooped on demand. (Well, okay, the pooping wasn’t on demand, but I did manage a bit during the day!)

 
SMoran
on 12/2/09 3:32 am - Washington, DC
Dr. Lisselle came to see me each day, as did Dr. Rumbaut. He arrived about 4, and said that, assuming my “leak test" went well, he would discharge me to the hotel that night. The leak test wasn’t nearly as bad as I feared, and I often have a hard time swallowing gross liquids. The solution was bitter, but they cut it with some Crystal Light. Ultimately, I didn’t need to drink more than ½ cup, so it was tolerable. 

    Dr. Rumbaut was in radiology with me, and I talked to him about the heinous drain. I asked if I would get it out before I went home, and he said yes. I asked him if it would hurt, and he said it wouldn’t hurt him at all! J He then assured me that it didn’t hurt me either.

    The film came back perfect, so I was ready to go home. Dr. Rumbaut met me on the elevator as I went back to the room, said he’s just filled out the discharge papers, and we’d be on our way soon. HOORAY!!! I sat on my bed, my back killing me, waiting for someone to come and take the hated IVs and drain out of me. And I waited. And waited. An hour went by. Nothing. Another 45 minutes. Nothing. I started to cry. At this point all of the depression and second-guessing kicked in. What had I done??? Ohmigawd. I’ve mutilated myself. I was exhausted. My back hurt. I had tubes running into my arm and out of my chest. I just wanted to go home…. errrrr… the hotel.

    My husband went to the nurse’s station to see what the hold-up was. They were working out the paperwork. Thirty minutes later a nurse came in to take out my IVs. I pulled up my gown, waiting for her to take out the hated drain, and she backed away, looking confused. “No, senora". No? NO????? Yes! 

    Through my tears, I’m saying “Dr. Rumbaut said that you’d take this out too." The nurse left and a few moments later the phone was ringing. It was Dr. Rumbaut. The drain would be taken out before I went HOME, not when I went to the hotel. I realized that I had asked him if the drain would come out before I went home. In my head, I was thinking hotel, but... he was right. I said “home". 

    So, me and my hated drain (which I was now trying to make friends with by calling it “my bubble") tried to get dressed. It was then that I realized I have only underwire bras. I remembered someone mentioning getting a sports bra on the board, but the necessity of it didn’t hit me until that moment. I decided not to chance disturbing the bubble, put on a nightgown, my snap-front robe, and rode in the taxi braless. A week ago I would have been appalled at the prospect. At that moment, I only wanted to get home.
SMoran
on 12/2/09 3:33 am - Washington, DC
Dr. Rumbaut said that Dr. Richard would be coming by the hotel with medicine and post-op instructions. I had met Dr. Richard briefly at the office and we’d talked a couple of times on the phone as we planned my surgery. I remember being surprised to always hear music and people in the background when we spoke.   He is a very good-looking young man, and I would guess he has a very active social life. ;-) He also seems to be noctural: after we’d gone to bed at 11:30 pm, the telephone rang and the front desk announced that the good doctor had dropped by a package for me. We’d just gotten back to bed when Dr. Richard called us to ensure we got the medicine. Hey, it was better than the IV beeping.

    Back at the hotel I could rest much more peacefully, despite the hated dra…. errr… bubble. It bothered me when it got heavier, so my poor, wonderful husband was enlisted in the task of draining it a couple of times a day. I would become faint and nauseous even looking at the thing, and so I’d stand as far away as I could, leaning on the doorframe and humming to myself so that I wouldn’t have to hear it. Fortunately, my wonderful DH isn’t as squeamish as I am, and he was able to get through it.

    I was tired and sore. Surprisingly, I wasn’t as nauseous as I thought I would be. I stayed in the hotel for the next couple of days. On Sunday, Dr. Richard came to visit, and reported that I looked like I was ahead of schedule in terms of recovery. 

    Monday afternoon we went to Dr. Rumbaut’s office. Dr. Lisselle, my guardian angel, finally removed the bubble.   It didn’t hurt, but it was uncomfortable and weird. The sensation is rather like someone pulling a vacuum tube out of your chest. I didn’t look, but one of the other patients in the waiting area said she did, and it was longer than she expected. Honestly, I didn’t care if it hurt when they took it out. I just wanted it GONE.


    I talked to Dr. Rumbaut briefly, got my surgical report, a refresher on dietary restrictions, and we were off.  

  I know this is a very long report. I hope that it is useful to someone. 

    Despite any glitches or negatives I’ve written about, I have to say that, if you are going to have this surgery, I would highly recommend Dr. Rumbaut. He is a very good surgeon, and genuinely cares about safety and your health. The hospital was as state of the art as any I have been in, and the nursing staff was caring and gentle. 

    Now begins my new life.
   
renebeau
on 12/2/09 4:06 am
What a wonderful, detailed account! As a preop, it was VERY helpful to read about your experience. Thank you so much for taking the time to share!

And congratulations on your successful surgery. Good luck to you on your journey.
SMoran
on 12/2/09 5:29 am - Washington, DC
Thank you.  I'm glad it was helpful.

If there are any questions I can answer, please feel free to ask.
Brandy K.
on 12/2/09 4:39 am - Garland, TX
Awesome!  Thank you!  My surgery isn't with Dr. Rumbaut, but it's with a surgeon who used to be Dr. Rumbaut's assistant.  It will also be in the Hospital San Jose, so I assume that my experience will be much like yours. 

I'm glad you posted this!
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