The language barrier did not affect anything whatsoever. Trish is there the whole time, with the doctor, and she speaks English as good as you and I. The only time it is an issue is with the nurses, at night, but I told Trish my biggest 'fear' was being in pain after surgery (I wasn't hardly at all, which I found amazing, since I expected to be in as much pain as I was after my gallbladder surgery several years prior to this one), and she let the nurses know that I wanted to be on meds to relieve pain. Otherwise, it was good to go and you are only in the hospital for two nights, then in the hotel, which is lovely especially if you have a room overlooking the pool area, with the palm tree...very relaxing. All I can say is if I had to do it again, I would do it 100% with Dr. Ponce and Trish as his coordinator...I cannot say enough good things about Trish and all the extras she did for me that she really didn't have to at all.