Last year, I had almost four months of misery. I couldn't breathe or sleep. It was like chronic bronchitis or asthma, but didn't respond to my asthma medication. When we went on our vacation to Hawaii, I couldn't go to see the observatory on the Big Island, because of my respiratory condition. Fortunately, after our vacation, I began to feel much better (even with a cold!). I'm still not sure what was wrong, but it's likely it was some kind of acid reflux disease.
When I got better, I started evaluating things again. I drew up a wishlist of things I want to do in life, and it turned out that #1 was pursue a career in travel and #2 was pursue weight loss surgery. The second goal was more obviously achievable than the first, so I started in on the process.
I checked into local bariatric centers, and enrolled in a program. I was about a third of the way through the process when I discovered that the insurance that I had chosen two years ago, because it DID cover weight loss surgery decided that it did not want to cover it anymore. No coverage. Some people encouraged me to appeal the no coverage issue, but I just couldn't see that a clear policy exclusion warranted a different result.
Rant: I do, however, think that it is ironic that the number one killer of Americans is obesity and that only successful, documented cure for obesity is weight loss surgery, and that the health care industry would rather pay to treat millions of people with diabetes and heart disease than to pay for weight loss surgery. From the insurance company's point of view, it appears to be that by the time a particular individual requires expensive treatment for diabetes and heart disease, it'll be Medicare's problem--not theirs.
Anyway, once I accepted that I had no insurance coverage, I had to figure out how to get a surgery that would cost between $25,000 - $30,000 at the clinic I had enrolled in. Quite frankly, the numbers were just not adding up, especially when you remember that yours truly wants to start a new career in travel even above having weight loss surgery. (Don't worry clients, I am not planning up giving up my present career anytime soon). This is when I started to think outside the box. A friend of mine got Sexual Reassignment Surgery in Thailand for a fraction of the cost of that charged in the U.S. I read an article about the same time she went to Thailand in Time Magazine about medical tourism. I reread that article, and I said, Hmmmmm...
The internet is an amazing thing. I began to research the idea. It turns out that weight loss surgery is done in a number of places in the world, with surgeries costing as little as $4,000 in parts of Africa and South America. People who travel for weight loss surgery usually to go India or Mexico, though. The cost of surgery in India would be between $7,500-$9,000. The cost of surgery in Mexico varies a little more, but it tended to cost about $11,000.
Deep breath. Yes, I could do $11,000. Not easily. It would take a lot of hard work to get there. Okay, Mexico it was.
For those of you who might wonder how one eats their way into a Lane Bryant store, I suggest you read Gary Taubes' Why We Get Fat And What to do About It. Here is the link on Amazon: http://www.amazon.com/Why-We-Get-Fat-About/dp/0307949435/ref=sr_1_2?ie=UTF8&qid=1330205559&sr=8-2. You might also want to consider that even when we are successful at losing weight, some ridiculous number of people relapse. Current medical thinking suggests that the reason for this failure of dieting is linked to a hormone called ghrelin, which is produced in your stomach. http://www.nytimes.com/2011/10/27/health/biological-changes-thwart-weight-loss-efforts-study-finds.html?_r=2&scp=2&sq=obesity&st=cse When you lose weight, your body freaks out about having lost the weight, and produces more ghrelin, which makes you hungrier and lowers your metabolic rate.. Studies show that ghrelin levels remained increased for years after you've given up on your diet, and generally cause you to gain more weight than you took off during your diet.
If the above sounds a little defensive, it is. You cannot imagine how many people asked me why I didn't just eat less and exercise more. In fact, my diet has never been out of control. I stopped eating french fries in 2010, and I rarely eat out in restaurants. We work out a few days a week, although it's pretty hard to be enthusiastic about working out when you feel like unmitigated crap. No excuses here. Just read the Taubes book.
Anyway, given the range of symptoms I was experiencing and my family's medical history, I chose to have a gastric bypass. This procedure divides your stomach and reroutes your small intestine into the upper portion of the stomach. The lower portion of the stomach remains dormant, and because that is predominant place where ghrelin is produced, the surgery works for long term weight loss. There are easier weight loss surgeries. This particular surgery results in permanent malabsortion of calories and nutrients, and require a life-long commitment to take vitamins and maintain a low-glycemic diet. Another more modern surgery is called a gastric sleeve and is much easier on a person's body. A third procedure is called a lap-band, which I did not even consider, because there are just too many stories of failure. And because I don't want a foreign object living in my body that has a port. It's to avoid that result that I am having weight loss surgery in the first place.
So, having made the decision, on February 16th, Tom and I packed our bags and left for Mexicali, Mexico, the capital of the state of Baja California, and located about 90 minutes west of San Diego. We were met at the San Diego airport by a driver from the medical clinic and driven to the hospital in Mexicali, where I had my blood drawn, was hooked up to an EKG and had a chest x-ray. I met the surgeons for the first time, and I handed over my hard-won certified check for $10,500 (I'd already paid a $500 deposit). We were then driven to the hotel and we had a nice "last" dinner in the hotel restaurant. I ate chocolate cake and had a diet coke.
Early the next morning, we were picked up at the hotel and driven to the hospital. We were checked in our room, and I met the anesthesiologist (who was ridiculously charming, btw). They stuck me with an anti-coagulant, and shortly thereafter, I was wheeled into the operating room, where the last thing I remember is having the IV inserted. I think I woke up in a recovery room, but I don't remember any of it.
The thing about medical tourism is that there are horror stories. I read about a woman who had become badly infected after having a full body lift in the Dominican Republic. There was a woman who had weight loss surgery in Puerto Vallarta, and almost died from the conditions. Right now, there is a doctor in Tijuana whose surgery is located in a storefront in a stripmall. His rate of infection is extremely high and his patients have been robbed at his "recovery house".
So, you have to know that I was really comfortable that I had not placed myself in one of these situations. Reputable providers of medical tourism will have all the accreditations that a local medical provider would have. Their business practices will appear streamlined. They will have in-house patient coordinators, preferably. (There are free-lance patient coordinators who are paid on a commission basis for the surgeries they book). You'll have consistent information given to you throughout the booking process. And there will be positive reviews on the internet from people who you can contact. Finally, the provider will have some sense that they are providing services to a population that is traveling long distances and may not have appropriate aftercare available to them at home.
So, I wasn't really worried going in, except that this is not minor surgery so much as it is routine surgery. I would be in the hospital for about five days, which is a ridiculously long hospitalization compared to U.S. doctors, who usually release their patients after one night in the hospital. Tom would stay with me in the room, getting his meals from the hospital cafeteria while I ate broth and water.
The recovery was uneventful. I didn't eat or drink anything until Saturday night (the night after surgery), when I was allowed to sip water. The next day, I had a dye test to ensure the integrity of my new stomach. The day after that, I had a barium test to ensure there were no leaks. Once I passed that, I was good to start phase one of the diet, broth, apple juice and water.
On Wednesday, I was released from the hospital as planned, and Tom and I were driven back to San Diego to catch our flight. We returned home late.
Since then, I have struggled with the things most bariatric patients struggle with. I'm not able to keep my food down. Nothing tastes good. And it's hard to remember to take tiny sips of water. These things will pass. I'm not worried about them. I do hate the fact that my emotions are all over the map, and that I can't seem to manage to keep my medications down. I'll probably contact the after-care coordinator tomorrow if my situation doesn't improve.
Here are the things you can do to help me. You can ask questions and check in with me about my progress. If you host me, understand that my diet will be extremely limited for the next month or two, and after that, I will be eating very, very small portions of meat and green leafy vegetables. It's not an insult to you if I don't eat more. My stomach can hold 2-4 ounces.
I won't be drinking for the next six months, at least. After that I'll have to limit what I drink substantially, because I'll be a serious light weight. I may choose to stick to tea or water instead. (Yes, in this process, I had to go cold-turkey on diet coke... my only true addiction).
It might not be so helpful to tell me that I'm looking sick or tired. (Weightloss surgery patients tend to lose a lot of weight initially in their faces, and it takes a while for things to even out, resulting in a gaunt appearance). You can always admire my beauty, but I'm not doing this because of any sort of feelings of inadequacy about my appearance. That train left the building a long time ago. My future self would really appreciate it if you would not look at the plate of food in front of me and wonder why the heck I'm eating THAT! As time passes, gastric bypass patients begin to eat more normal size quantities. They may be able to eat things that are not entirely healthy for them. I will be able to eat pizza and sweets in moderation. And if your goal is to question my recent weight gain, realize that some rebound weight gain is common, and I'm probably aware if I've gained more than is good for my health. That doesn't invalidate the years I'll have added onto my life by deciding to take this jounrey.
Ultimately, some people think that weight loss surgery is the easy way out. If having your innards rearranged, your food choices permanently limited, and your nutrient absorption permanently affected is the easy way out, so be it. The truth is, that weight loss surgery is still a last resort. If we could have done it any other way, we would have.
So, that's my story. I didn't come forward about this before I did it out of a desire to be all Star Jones about weight loss surgery. I simply wanted to be done with the surgery before I told the world. It's not my way to be secretive about my medical life, but initial reactions were definitely mixed, and I didn't need pushback while I was preparing for surgery. It wouldn't have changed my mind; it would have caused stress that we know is NOT good for us.