General Advice for Those Considering Weight Loss Surgery
Ok, so I have been meaning to write this post for a long time. I get asked a lot of questions by people new to wls, and I often find that they all ask very similar questions, so I figure that I can write it out in a post, and maybe it will help others that have those question, or are looking for advice.
A little bit about me and my experience, I was sleeved Oct. 5th 2012, I had my surgery through the Santa Fe Medical Group, and my surgeon was Dr. Sergio Quinones in Tijuana, MX. I did not choose to have surgery in Mexico because of financial constrictions, I could have had surgery anywhere, paying for the surgery was not an issue for me personally. I research over a year before I had surgery, and believe me when I say, I research every aspect of this surgery possible. I consulted with many surgeons both in the US and in Mexico, and broke apart every aspect of the process to find the best surgeon for me. My husband and I own a number of technology development companies, so I have an extensive back ground in technology, web development, and internet marketing that gave me a huge advantage when researching. For a while after surgery, I stayed so busy with work that I was really not active on the forums, it wasn't until I hit a long stall
I would like to put out there that I am not writing this post to start a battle on where a person should have surgery, or whom they should have surgery with. I only wish to provide those that are considering surgery in another country with information that I found to help me when I was deciding on my own surgery. So respectfully, I am very aware that many people would never consider going out of the US for bariatric surgery, and by all means, you are entitled to your opinions, but please do not post negative, or condescending comments on this thread, as this is meant to be informative for others and help them achieve better research to make their own informed decisions.
I would like for those of you that read this to feel free to ask questions. I am well aware that I have worked in my career field for so long that I sometimes talk in techy lingo that many people may not understand. So, if something needs clarification, just write it down, and I will try to word it better. Ok, onto the info!
First and foremost, research is SO SO important, so you need to make sure that you have covered everything you possibly can, until you are blue in the face...and then research some more! With that in mind, there are some things that you should consider, and I am betting that many people do not. I am rather OCD when it comes to research, so I know this goes overboard, but really...can you ever be TOO educated when it come to your health.
1. When researching a surgeon, please please, do not see the flashy banner ads running across Google, Bing, Yahoo, various wls forums, and pretty much everywhere in between, and make the wrongful assumption that because one surgeon is highly advertised, he/she MUST be the best. I know this is a simple concept, but I see many people make this mistake all the time. Now, I am not implying that the surgeons that are well advertised are bad surgeons, they may very well be great surgeons. I am just saying don't let the spiffy advertising be your only research. There is a reason that marketing is a multi-billion dollar industry, it is specifically designed to be appealing, and sometimes down right deceiving. Another common misconception that I see, is people assuming that a highly advertised surgeon must have the most surgical experience. This is not always true, a lot of individuals and companies invest in the medical field, especially in medical tourism...and it is very possible that a relatively new surgeon would team up with an investor, to help build his/her surgical business. On an opposite note, you should also never assume that a surgeon that doesn't advertise isn't as skilled. It is not uncommon that highly intelligent and skilled professionals, know virtually nothing on how to properly market themselves or their business, and even more common that they know nothing about advertising on the web. The moral of the story is that advertising or lack of advertising really tells you next to nothing about the actual quality and skill set of the surgeon and/or Hospital. There are tons of reasons why someone may or may not have great advertising, so don't let that be a major factor in your decision.
2.The Ads are there for a reason. Don't be misguided into thinking that because you see the same doctors face in multiple locations, that that surgeon must be highly regarded by the search engines, blog posters, ranking sites or more importantly the forums...those surgeons pay to be on all of those places. Now, I am certainly not bashing any of those places for selling ad space...let's face it, they are businesses, and businesses must make money to survive, make improvements, pay employees etc. Just realize that there are only a handful of reasons that those guys are plastered all over the web, they are either paying cash to be there (Most likely thousands), they are working in a mutually beneficial partnership with a particular website(s), or they could be the owner(s) of the website all together. So again, be aware of these things as you do your research.
3. Accreditation, Center of Excellence, and ESPECIALLY anything that's implying USA endorsement. Have you ever been on a surgeon or hospital's website and seen those highly emphasized stamps of approval by this or that super important sounding association, organization, or particular establishment. Man, oh man, THESE guys are my favorite. Back when I was researching my surgery, I came across a post from a person that was blatantly bashing everyone who didn't go to her surgeon, and then made a rather snarky comment on how she "Would NEVER use a surgeon that that was not yada yada yada certified" Ok, ***big spoiler alert*** yes, there are a number of agencies out there that provide international endorsements, special certifications, seals of approval and all that jazz...however, a good portion of those are pretty much set up to do nothing more than look good, and sound impressive. If you actually research those companies a lot of times you will find that they require very little experience, some cash, and maybe a letter of recommendation. The particular one that was referred to in the member's post that I mentioned only required a surgeon to have done 25 bariatric surgeries in a 2 year time frame, pay a little over 300 bucks, and send in a letter of recommendation...that was it. Sorry, but in my opinion only requiring 25 surgeries in a 2 year time frame seems a little low for such a prestigious organization, for an endorsement that undoubtedly is an influencing factor in the average wls researcher that doesn't know any better. These types of companies are essentially what we refer to in my industry as an impressive hustle. I cannot stress enough how important it is to really analyze every aspect of of the research process, when you do, you will have a great advantage to weed through all the meaningless pomp and cir****tance of the industry and be more able to base your decision on factual, meaningful considerations. Now, to be fair, there are some of these companies that do have high standards that must be met to gain membership, their are legit endorsements out there, just make sure that if those things matter to you, that you look into them so that you can separate the valid from the utterly useless.
4. Websites that rank hospitals and surgeons, here is another tricky aspect. For about 12 bucks, my 3 year old could purchase a domain, set up a website that sounds official and assign very bias rankings to any establishment that is in direct competition to his business. They are cheap, they are easy, they are effective at deceiving those who don't know any better, and thus can be very profitable. I know I know...how do you tell the real from the not real? There are a few ways, but you have to know what to look for, and even then it can be a craps shoot. You can start by looking for things like reviews posted by users...if a site has a ranking, but you can't tell how that ranking came to be, proceed with skepticism. My best advice there is find as many people as you can that had surgery with that surgeon, or at that hospital, both patients that were there a while back, and people who were there last week. Look for pictures, talk to patients, and use your own judgement, just make sure you get as much info as you can, from as many different sources as possible. A wide scope will give you a much better view of the whole picture.
5. If it makes no sense...there is a fair chance it is crap...so always check the facts. I can't tell you how many times both when I was researching my surgery, and still today, that I see a person that is either, not fond of surgery out of the US, a person/coordinator working for a particular doctor, irate ex-employee and/or patient that will go online and make a ton of terrifying, extremely bias, unfounded statements, or at times blatant lies, that inevitably start a heated debate between US vs. Out of US patients, and scare the crap out of many of the people new to wls. Please understand that this happens, and will continue to happen despite the best efforts of pretty much any website owner, especially the forums. Forums are huge, with thousands of post and threads made every day, it is impossible, even for the best of forums to be able to monitor everything, so your best bet while researching is to check the fact and form your own opinions. If you see a person that used to talk about how great so and so was, and the next day they have done a complete 180, I think it is worth while to check out why that may have happened. You have cases where said person may have worked for that doctor or company and now they are out for blood for whatever reason, or you will find sometimes that that person may have had a legitimate reason for their change in opinion...maybe they had a complication, and were not provided with doctor instructions, or follow up...maybe that person had a great surgical experience, but has recently learned about a questionable situation that has made them think differently. In either case, if you pay attention and follow the conversation, maybe even talk to that individual, in time you should be able to learn enough information to form an opinion. So don't read the first post made on a thread and automatically assume that surgery in another country isn't safe, or this doctor is a butcher, or that hospital is ill-equipped...there are two sides to every story, and I personally prefer to hear them both before jumping to conclusions.
Ok, enough harping on the many many things that you should consider while doing research, now I would like to offer some tips.
6. Before having surgery in another country, do some calling around and get your follow up care set up and in place for when you return home. I know that many people fear that finding post-op care might be difficult...I think this depends on your area, I personally had no problem finding my follow up care. A PCP can run all the follow up blood work...I personally never saw the need for me to consult a NUT or a Shrink, but if you need them they should be easy to find. Now, very important, when you are calling around setting up the post-op care make sure you ask if their is a fee for people had surgery out of the US...some doctors will try and sneak that in on ya to line their own pockets...but not all try to sneak in this policy. I suggest of you talk to a PCP or Bariatric doc that does, hang up the phone, flip open the yellow pages and call the next guy. Personally, I feel that there is no reason to pay a special fee because my surgery was not done in this country, and neither should you.
7.Speaking of follow up, I suggest to everyone that they ask about the follow capabilities of their surgeon should you develop a complication. Listen, it doesn't matter how awesome your surgeon is, how great his reputation is, how low is complication numbers are, or where you have this surgery...it is a statistical FACT that someone, somewhere is going to have a complication, and I believe that everyone should be prepared for that just in case. So don't feel guilty or reluctant to ask your surgeon what he/she does in that case. I personally questioned mine to death...and let me tell ya that man has the patients of a saint! He and his staff were very thorough and patient in making sure I got answers to all of my question. I didn't have a complication, but when I was 10 days out from surgery my son decided to jump on my stomach, and did bust open my largest incision. I was so worried about it getting infected or not healing correctly...but I can honestly say, that my surgeon had excellent follow up and helped in any way that he could. He called me, and told me how to take care of that incision, requested me to sent him pictures so that he could make sure it didn't get infected, and then personally called or emailed me for the following 2 weeks until it had healed. It was fantastic to have that support, and I think that knowing that your surgeon will go that extra distance after you are back in the US, really adds to your confidence when having this surgery.
8. Finally, records...I suggest to anyone and everyone to make sure you get a copy of your surgical records and surgery video if your surgeon does the videos. Doctors take a lot of precaution in insuring they do everything possible to make sure you have a complication free recovery, but as I mentioned surgery is a numbers game, and it will happen to someone. Now, something to consider is that in Mexico, and I would assume this applies to pretty much every country, is that the medical facilities and doctors are required to submit your medical records in the countries native language...so for my my records were written in Spanish. Before you have surgery, give your doctor, or their staff a call and inquire about getting a translated copy of those record for you to bring home with you. I say to call before because getting a document translated can take some time, or they might charge a fee for the service, so you will want to know those things before hand. The same thing with the videos, with my surgeon, if we wanted a copy of the video of our surgery, he requested that we bring a flash drive with us, because the video files are too big to send through email. You may never use any of the records or video, but it is always nice to have on hand, just in case your medical professionals at home may need them.
I apologize for the lengthy post, I could go on and on, but I believe that people seeking this surgery should be as well informed as possible. I am not sure if my ramblings will be of any value, but I do hope that they might help some the people starting this journey. I have tons of advice, and quirky little tid-bits that I stumbled upon during my research phase, so if anyone has in specific questions, or is in need of advice, just ask. I am an open book about my surgery. I do not care what surgery you are having, who you are having it with, or where you are having it at, I would be happy to help if I am able to. Best of luck to you all, this journey is simply amazing.
WOW! Thank you so much for writing this. I'm researching going to MX because of cost. I appreciate your insight.
You're welcome. I had an excellent experience when i had surgery in 2012. If you have any questions feel free to ask. I am an open book.
Thank you so much for trove of information. After many months of consternation, I've finally bitten the proverbial bullet. Surgery 11/24, with Dr Garcia in Tijuana. Much to my surprise & delight, my daughter's father-in-law, sis-in-law & her husband all had vsg' ssix months ago with Dr Garcia. All are doing well. My questions to you are 1)How does your body know when to stop losing weight? I'm 5'3", 201, BMI 35.6. My goal is 125lbs. 2)I know this is a very strange question but I've read horror stories on gas problems. I've never been able to burp. Will that make life unbearable after surgery? Hasn't been a problem so far in my 60 years of life. Thanks so much :)
Congratulations on your decision. To answer your first question, VSG surgery is a restrictive surgical option only, meaning that it has no effects like the bypass or RNY, where they actually reroute your intestinal tract, so that food passes through your system more quickly creating a mal-absorbtive effect along with the restriction. So since VSG doesn't have that mal-absorption aspect, once you hit your goal, and you feel as though your body is still wanting to lose more weight, all you need to do to maintain, is change your eating habits to insure you are getting in the calories and nutrients needed to maintain. Just make sure that those calories, carbs, fats and other nutrients are healthy ones.
As for your 2nd question, if you are referring to the gas pains people talk about right after they have surgery, they are not really talking about traditional gas pains. If you read most people we say thing like they had pain/discomfort in their upper left shoulders due to gas pains. What actually causes that, is this. My surgeon. Dr. Quinones does 3 seperate leak checks before his patients come back to the states.
The first leak check is perform while the patient is still in surgery, after the sleeve has been created, before they are closed up from surgery. Once the sleeve has been formed the surgeon will inflate the newly formed sleeve an air pump. The air is pumped into the stomach to inflate it, so that the surgeon can tell if there are any leaks along the staple line, before he/she closes the patient.
Now, your stomach oddly enough is surround by nerve endings, that can sometimes get irritated during this leak test, those stomach nerve endings some how are connected to the nerve endings in the shoulder, usually the left one, and that is what actually causes the gas pain that you are probably reading about.
When I had my surgery, I was told to walk as soon as I could after surgery, as often as I could after surgery, and take gas-x strips to help metabolize those gas pains. To be honest I am not sure if burping or farting has anything to do with metabolizing that gas pain...it might be something that you ask your surgeon about. I don't recall burping or breaking wind after my surgery, I just simply walked it off and took gas-z strips, and it went away after a few days.
Now if what you have been reading about is referring to people getting pains, that they feel are gas pains in their stomachs after surgery, they might not be talking about actual gas pains at all. When you come back home from having surgery, your stomach is still very swollen, so the initial restriction that you feel for a few weeks after surgery is not the REAL restriction you are going to feel once all of that swelling goes down.
At some point in time, because it takes about brains a long time to catch up to the limitations of our new sleeves, you are bound to over do it as you transition from your liquid, puree, to more solid food diet phases. I have had many times, because I was a fast eater that I overate, and this is NOT a pleasant feeling. That pain almost feels like, as if you just had a big Thanksgiving dinner where you seriously over done it to the point that it hurts a little. Or you might feel as though you have something caught in your throat, and you just can't get it to go down. This is also not really gas pain, the pain is a result because your sleeve is simple packed full of food. The few times that I did this, my stomach would just feel SO full, and I would feel that lump in my throat, and it never failed that any excess food I had ate would come back up my throat, and I would end up hovering over a toilet. It wasn't like when you get the flu and you just poltergeist start throwing up every where, literally the food just slide back up my throat and I would spit it into the toilet...no burping needed to make the discomfort subside, I simply needed to get rid of the excess food that was not going to fit in my sleeve.
There are a few things you can do to avoid this, after I learned this lesson, I started eating with my son's baby spoons, so I would take smaller bites. I would put the spoon down in between bites and wait a sec before taking the next bite to give my brain time to register if I was full or not. I would also drink from my son's sippy cups, so that I didn't intake my liquids too fast, because gulping your liquids down will also give you that discomfort feeling that resembles gas, but is actually caused by you just drinking too fast.
You are going to hit some miserable feelings as you adjust to your new way of eating and drinking, and discover your personal sleeve limitations, but those pass, your brain will catch up, and you will learn in time how to work with your new sleeve.
I hope this answers your questions and helps you out some. Feel free to ask if you have any more.
