For more info about Dr. Ungson and having the Duodenal Switch (DS) with him in Mexico go to the Dr. Ungson Yahoo Group at http://health.groups.yahoo.com/group/Dr_UngsonSupport/
First and primary reason, my insurance wouldn't pay. I know that they (who shall remain nameless) do pay but the company my husband works for has it in the contract that nothing weight related is covered. Oh well.
I looked into several overseas doctors but liked Dr. Ungson best. He is qualified with over 200 DS's under his belt. He works in a state of the art private hospital. Hermosillo Mexico is a 6 hour plane ride from my home. Dr. Ungson does an open horizontal incision, thus no need for binders and a much lower incidence of post-op incisional hernia.
I know this will sound weird but I was also relieved to know that Dr. Ungson also prefers to be paid with cashier's checks as opposed to cash. You give the cashier's checks to the hospital admissions person when you check in at CIMA hospital. So no taking huge sums of cash into a foreign country like other over seas doctors require. When I read that several other foreign doctors require this kind of payment, several thousand dollars in US or Euro cash, that made me nervous. Dr. Ungson happily takes cashier's checks and I think the hospital will even take credit cards if necessary.
I went in August 2005 and his fees I felt were very reasonable. We spent $11,400 on all my doctors fees/hospital bills etc. That included a very modern spacious private 2 room suite with sleeper sofa for my husband and a TV in both rooms.
Some websites of interest for those considering Dr. Ungson:
Dr. Ungson's Official Website www.drungson.com
CIMA Hospital's Official Site http://www.cimahermosillo.com/principal%20eng.asp
International Hospital Corporation CIMA Hospital page http://www.internationalhospital.com/hosp/CIMA/hermosillo/
Dr. Ungson Yahoo Group page http://health.groups.yahoo.com/group/Dr_UngsonSupport/
Colonial Hotel Hermosillo http://www.grupored.com.mx/colonial/
Surgery report:
Day 1 8/18/2005:
Flew to Hermosillo... flight uneventful except that we left Tucson about 30 mins late and got to Hermosillo abt 30 mins late. Everything in Mexico is considered on time if it is about 30 mins late... just real laid back. Kinda nice. Customs no big deal. Michael (husband), myself, Thad (3 year old son), mom, and dad took a dvd player and a portable dvd player. No problems with customs with that or the cashier's checks. DVD players were nice for the kid and for me since I was hotel bound once I got out.
Sylvia (pronounced SYLBIA) met us. IMPORTANT NOTE: Sylvia speaks very little English. I did not know this. She works in the office area in front of Dr. Ungson's office at the hospital. I am not totally sure what she does but it is more than clerical. Everyone knows her and she gets the job done. But talking to her is hard because she knows only a little English and we knew only a little Spanish so just follow her lead.)
She had to get a van taxi for us to get us all and our luggage to the Colonial. That costs us $25.00 US but that was only because we had
so many folks and so much junk. We dropped off our stuff, kissed everyone, and Michael and I were off to the hospital in Sylvia's car.
(Note: we did not have a reservation waiting for us at the Colonial. I was not happy about this since I had confirmed with Dr. Ungson 2
weeks prior. They only had rooms available on the 2nd floor and no
elevator!!.)
Sylvia had some choice words with the clerk and we were assured 1st floor rooms by the time I got out of the hospital. We ended up with a suite and a regular room next to each other on the 1st floor. Very good, I ended up sleeping on the couch in the 10'x 12' living area of the suite. More on the hotel later... some of it kinda strange.) Once at the hospital, I got a chest x-ray... same as here in the US. Then I went to the check in desk, filled out stuff and gave them the cashier's checks for $11400.00 for the bill plus extra for the suite. This is where we met Snr. Estrada, hospital administrator extrodinaire... aka one of our guardian angel's. The man is wonderful!!!!!!! He took care of my family while I was in the hospital. He talked to them everyday and made sure they got anything they needed. My mom loved that man and he lived in the US and speaks spotless English. But more about him later.
After that, I got into a room. It was about 6pm by this point. I had requested a suite but one was not available till post-op so I settled into a regular room (which was nice and clean and looked just like a million hospital rooms in the US). Michael was expecting to stay with me that night but we decided he should go back to the hotel for the night to help the rest of the family get settled in. Before he left, Dr Ungson, Dr. Soto (the anethesiologist), and Dr. Monjardin (the internist) came in and checked me over. Dr. Soto was not comfortible with giving me a epidural so he said I would have a pain pump. I bent to his discretion. We talked for a while and Dr. Monjardin gave me a physical exam and asked me about my medical history. Dr. Ungson is fantastic and speaks very good English. He smiles all the time and is very confident like a surgeon should always be. Dr. Soto and Dr. Monjardin speak English but do so slowly and cautiously, not wanting to make a mistake. Both are very caring and very professional... as good if not better than any doc I have seen in the US.
When the docs were done we got to meet one of my other guardian angel's, the nurse Lorenza. Oh, she is the BEST nurse I have ever had. She speaks spotless English and is very good at her job. She got me settled in and calm and then.. get this.... she ordered delivery carne asada for Michael cause the hospital cafeteria was closed already and he was starving. She called her son and he reccomended a place called "Carne Express". She ordered it and went down to the front desk and got it for him. It was just the kindest thing anyone could have done. He hadn't had anything since noon in Tucson and was on his last leg. I also got to meet Lupita, another nurse, for the first time. She doesn't speak much English but she is very caring and got my IV in fast. She would be my nurse many times over the next few days. Snr. Estrada came in and checked on me too. I HAVE NEVER heard of a hospital administrator checking on patients in their rooms.... I told you, he is great!!!!
After Michael ate and I got settled in, Lorenza got Michael a taxi back to the hotel (about $3-4 US... dh usually just gave the taxi driver's $5 US). Everyone back at the hotel got settled in though my parent's were not thrilled with the food. My mom and dad like American Tex-Mex.. not northern Mexican food. There are differences. But my mom did love the Colonial's veggie soup. I tasted some later and it was good. She also liked the Mexican red rice. But more on food at the Colonial and the hospital later.
After Michael left, Lorenza gave me a little sleepy time pill and I slept well.
Day 2 Friday... surgery day 8/19/2005
Lorenza woke me up at about 5:30 am to prep me for surgery. They came in with a wheel chair to get me and wheel me downstairs to the pre-op waiting area at about 6 am.
My family got to the hospital about 6:30 and Lorenza made sure everyone came in to see me in the pre-op area. I was still very alert at this point and got to kiss everyone. All the docs came by and checked on me and my family. The docs showed my family where to wait for news of me post-op. At 7am the pre-op nurse came and gave me a shot in my IV and then they wheeled me into the OR. I remember the cold OR and the bright lights but that was it and I was out cold.
My surgery went flawlessly... Dr. Ungson came out to my family at 10 am and said "Kari is perfect."
(the next part is my honest opinion and my experience, everyone's experience is different.)
Next thing I remember is pain... pain like I have never had. I have gone through 19.5 hours of natural child labor and I have have had a c-section... those were a piece of cake compared to that pain.
I couldn't focus my eyes when I opened them, I couldn't hear anything but echos, I was choaking from the nasal gastric tube and was so nauseous from the nasal cannula they had propped up in my nose. I kept saying, "I can't breath" and "Pain, pain." I have a pretty high pain tolerance and can remember wondering if they had given me anything for pain. Dh said Dr. Soto had given me morphine and anti-nausea meds but I was still in a lot of pain. I just laid there and hurt drifting in and out. I was also very cold and threw up. To make a long story short my pain pump was not being kept up with because the post-op nurse was so busy with another post-op patient, a young child, who was screaming and frightened. After a few hours of my family wondering about my pain and nausea, Dr. Monjardin came by to check on me. He heard what they were saying, went over to my IV pole and (God love that man!!) he pressed my pain pump button and I finally got relief. He also took the nasal cannula out and the nausea went away. From then on that first day the pain was much much less. But I can say the pain I felt was like I had been ripped up inside. And from what the docs told Michael, they do have to lift and pull and retract and tug and push a whole lot of stuff inside there so I am not far off.
About 1 or 2 pm I was moved into room 144, a suite. Michael stayed
with me while Snr. Estrada called his driver, Manuel, to take mom,
dad, and Thad back to the hotel. Most of the early afternoon is a blur to me but Michael wrote everything down. This is when we met Erica for the first time. She is another angel nurse. She speaks very good English and is a very sweet person. She helped me get settled into the room. She monitored me for several hours and helped me when I got nauseaous from the hideous nasal gastric tube. Erica then got me up and into the recliner. I NEVER returned to the bed. The recliner is heaven compared to the bed!!!!! I sat and slept only in the recliner. I got nauseuous from the nasal gastric tube and got the dry heaves a couple times. I did my breathing excercises with the spirometer... aka, the toy. I had to use that blasted thing for days at least once every hour I was awake. I had lots of clear phlegm and coughing hurt like hell!!! For the rest of the day, I rested.
Michael went back to the hotel to check on everyone and collect
supplies. Everyone had been in the pool and had been having some fun after the stress of the morning. That made me happy.
Michael got back to the hospital and Dr. Ungson came by. He said the
surgery was "perfect" and that "it was a breeze." Dr. Monjardin came
by and check my lungs and gave me the once over to make sure
everything was as it should be. Dr. Soto came by to check on me and
was also very concerned about my family since my initial pain had
upset everyone so much. He was very concerned that everyone was okay, not just me. He is a very sweet man.
One of the nurses helped Michael order dinner again... carne asada
again. One day, I get to eat it!!! ;-)
Late that night I got up and walked around the room for a few minutes. Pain was not bad at this point. The pain pump was working well. Then I went to bed quite tired. The stupid nasal gastric tube was making me nauseous but the meds helped. My IV came out but Lupita came in quickly and put in a new one nice and fast and I was back out. That IV lasted till the end of my stay. Lupita is a good nurse!!
I got through the rest of the night well. We did have to listen to the
O2/heart monitor beep all night and the little leg compression machines.
Day 3 Saturday 8/20/2005
Dr. Monjardin came by early and took out my urinary cath.
Michael got help from the nurses and another doctor and ordered me the biggest bouquet of flowers I have every seen outside of a church!! They were gorgeous!!!
Erica came by in the mid morning and helped me get a shower and took out that awful nasal gastric tube. YEAH!!!! She cleaned up my incision and rebandaged it.
Both Dr. Ungson and Dr. Soto came by too.... everything was fine. All
my family came by and I was thrilled to see my son.
I rested a bit and then later after Michael and the whole family got
back from a trip to Walmart, I walked around the nurses station for
the first time and went to the potty for the first time post-op. My
pain meds were also toned down a bit too and the pain was abit more
from having to move around and go to the potty.
Michael and everyone went to lunch in the hospital cafeteria. Snr.
Estrada, who was so attentive, made sure everyone got what they
needed. He is such a sweet man.
The rest of the day and night was spent sleeping, walking, and
pee-peeing. All the docs came by again in the night and everything was fine. My nurse for the night was Belen and she is a such a doll. She speaks some English but is very quiet, gentle and caring.
Day 4 Sunday 8/21/2005
More walking, resting and pee-peeing and I got some ice chips...
yeah!!! Pain meds toned down some more. All the docs came by twice and everything was fine. Erica came by and helped me clean up again.
My family got moved to new rooms at the hotel and everything was fine with that. Adelberto at the Colonial was very helpful.
Day 5 Monday 8/22/2005
Walk, walk, walk. Got a shower with a little help from Erica. And
after eating some jello and sipping water I finally really went to the
bathroom and passed gas. That was my get out of jail free card. Dr.
Monjardin came in and was so happy. Dr. Ungson came in at 4pm, took both my drains out.. not fun but not really painful and asked me if I was ready to go. Was I ???!! They packed me up and I was out the door at about 7 pm. Sylvia took us to the Colonial and my pain meds and heparin shots got delivered to the hospital later on. Cost about $170.00 US.
Got to the Colonial, took up residence on the couch in the livingroom
and never gave it up. Dh had gotten me one of those arm pillows at
Walmart. That combined with about 4 pillows, some pain and sleeping
meds, and then finally sleep was mine.
Day 6 Tuesday 8/23/2005
I woke up in pain a couple times in the night and took the pain meds
perscribed but they were just not strong enough. We called Dr. Ungson in the morning and he came over to the Colonial. He prescribed some stronger pain meds and also some meds to settle my tummy and help with gas. He is just the best doctor. He collected up Michael and took him to a pharmacy and helped him get the meds. Mexico has very few of what we would consider "perscription" meds, where you actually need a docs written perscription. Dr. Ungson said our way in the US is much better since many very strong pain killers are available over the counter in Mexico. Dr. Ungson got Michael and the meds back to me and he told us to call if we needed anything. So sweet!!
I took my new meds and took a nap... I felt much better. The rest of
the day was spent sleeping and trying to eat. I hate jello plus it
seemed to give me worse gas so I broke the rules and got Michael to
get me some broth from the hotel resturant. Dr. Ungson likes you to
stay on clear liquids (water, tea, jello) for the 1st week post-op. I
had to have some nutrition and it made me feel better. I also
discovered I HATE protein drinks. I have tried many and they all
tasted bad. I had some veggie soup broth and it was heavenly. It also
made me feel a bit better.
I had some pretty nasty diarrhea. I think I went to the bathroom 6
times. I got a water squirting bottle (like the kind you drink out of
but that has the squirt lid) and used the water spray to keep clean
back there. Wiping your bottom is hard post-op anyway and if you don't do it well, it stings like fire!! So the squirt bottle was a bottom
saver!!!
With the new meds, I slept better that night.
Day 7 Wednesday 8/24/2005
I stayed around the hotel and rested. Nothing really interesting
except that Dr. Ungson scheduled my post-op appt for the next day at 11am.
My family did and had been doing a little sight seeing and shopping.
They got some iron wood carvings and my husband got some boots and sovenier hats.
They had also been eating very well. Dh loved both the hotel and
hospital resturant. We actually thieved a menu from both and will post
it in the "files" section so people can see what they both offer. I
will put in a scan of the Carne Express menu too. Michael loved
everything from them. The hospital resturant was open until 6:30pm and the Colonial resturant was open until 10pm with room service. The room service menu is more limited but you can always try asking for
anything and see if they will deliver it. Dh's favorite at the
hospital for breakfast was motulenos (corn tortilla topped with beans,
eggs, ham, cheese, and red and green salsa) and for lunch was the meat lasagna or the shrimp tacos (tacos de camaron). At the hotel his favorite breakfast was "Sonorense" Style Breakfast, for lunch Pork
"Torta" aka Torte Colonial (looked like pork BBQ sandwich to me) and
for dinner Beef tenderloin Fajitas albanil style. And the soups at the
hotel were really flavorful and good. Everything from breakfast seems
to come with refried beans. I nibbled a bit and they are good. Sadly,
I missed out on all of this :-( but dh and family ate well.
Prices for food are good. I doubt anything dh ever ordered was over
$10.00 US. He drank water most of the time... the hospital and hotel
both offer water and while the hotel is supposed to charge extra for
more than 2 bottle per room per day, most of the time they didn't. He
also drank some Mexican beer with dinner at the hotel resturant. He
said it went well with the Mexican food and was also very inexpensive. My parents got pepsis and other soft drinks along with tons of US snack food at the Walmart. Crackers, Triskets, yogurt, cottage cheese, cookies, candy... they didn't go hungry. Walmart has just about everything you need and prices are a bit better than here in the US.
Day 8 Thursday 8/25/2005
Felt better. I had an appointment with Dr. Ungson at 11am at the
hospital. His office is right down the hall from where you get your
initial chest x-ray. He has an exam room in his actual office.
Exam was fine. My incision had healed up nicely. He thought everything was great and told me the residual pain should be considerably better by 10 days post-op. He also told me I could have YOGURT and broth. I asked him about cottage cheese and he said sure. I was thrilled. Yogurt was too sweet but cottage cheese was just right. Michael went out immediately and got me some.
I would get my stitches out Friday and then I was free.
I spent the rest of the day learning how to eat real food. Chew, chew, chew... wait, wait, wait. About 3 to 4 bites you are done for a couple hours. It really was amazing how quickly I started to feel better after I got some real food in me.
Day 9 Friday 8/26/2005(last full day in Hermosillo)
Saw Dr. U at noon and got my stitches out. Got my orders on what to do and when, my surgical report for my PCP, and the receipts for taxes. Said bye to Dr. U, had some broth in the hospital resturant, and went back to the Colonial to pack up. I also broke the rules and nibbled a touch of broiled fish. Yum!!!
I can not say enough about Dr. Ungson. He is a wonderful doc!!! I
recomend him highly.
The other doctors, both Dr. Monjardin and Dr. Soto, were very
professional and kind. They did an excellent job.
I also highly recommend CIMA Hospital. It is so clean and modern. The
cleaning ladies cleaned up my room 2 times a day. It was so much more sanitary than any hospital I have been in in the US. They use all the same equipment we use here. The only thing that was different that I noticed were the beds. They are electric but not quite as fancy as the ones here... but they were just as comfy for the short time I was in one. I loved the recliner post-op!!
The nurses were always there and ready to help. I never had to wait
for more than a minute. My favorite nurses were Lorenza and Erica who spoke great English and were just the sweetest nurses I have even had. I also loved Belen and Lupita who spoke only a little English but were so attentive and caring. All the nurses did a great job and kept me very comfortable.
Day 10 Saturday (leaving Hermosillo)
Our flight out was at 12:15pm. Snr. Estrada arraigned for his driver
Manuel to take us all to the airport in the hospital's SUV. That was
nice. Manuel picked us up at 8:30 am and got us there in about 40
mins. He was so nice to come out on a Saturday in the morning we gave him a big tip. Customs was non-existant. Noone even so much as looked at our bags. I got a wheel chair... it was small but a life saver. I could never have walked around the airport and then out to the plane. We went upstairs to the airport resturant and got some breakfast. It was big and okay... I ate a couple bites of eggs but they were too greazy for me. The beans were good and I had about 3 bites of them.
Then we waited for the plane. Michael did some duty free shopping and we waited. Remember what I said about 30 mins late.... yep. The plane left late. Oh well.... Hermosillo airport is not real luxurious but it
was air conditioned. The waiting area was smokey from the bar and
smelled heavily of perfume from the duty free perfume shop but we just sat on the other side of the room and we were okay.
Aero California is a super budget airlines but they got us where we needed to go and cheaply. AeroMexico seems a bit more luxurious but did cost a bit more so... oh well.
We got into Tucson about 45 mins late but we were in no hurry.
We did have the problem that at Tucson there was no wheel chair for me and the international terminal and customs is down a large hill from
the rest of the airport. That was bad. I could not make it up the hill
so Michael had to go up and get a skycap with a chair for me to come
down and help. Customs was not bad. They asked about my medicines and I told them my doc in Mexico perscribed them for me. That was fine. Dr. Ungson had given me a note for them but I didn't need it after all.
After all the exhaustion of the flight, getting the rental car, and
getting to the hotel... I took a nap.
Days 11 & 12 Sunday and Monday, Tucson at the Hilton El Conquestador Golf Resort
Dh and dad got some golf in. We did a little sightseeing and spent
time at the pool. We drove up to Kitts Peak Observatory.. very cool but tiring. I actually got into the pool at the Hilton for a
couple hours. Dr. U said it was okay after my stitches were out and I
had no open wounds or seromas. It was nice!! I slowly was eating a bit more but VERY slowly and only stuff I could chew up well.
Day 13 Tuesday, back to Nashville on Delta through Atlanta.
Long hard day... slept good that night in my own bed!!
Things of note:
The hotel lobby and the hotel suite has no microwave and the cheapest one at Walmart was $70.00. It does however have coffee and hot water for tea I think all day.
You can find almost everything at the Walmart Supercenter so if you forget something... they should have it.
The hotel offers a recliner to sleep in for $18.00 US a day. I was
happy on the couch so I didn't need it.
The pool is small but my 3 year old had a blast!!! At night on
weekends, it can get a bit loud at the pool.
The room AC will freeze you out even if it is 111 degrees outside so
be prepared to bundle up if you get cold easy. I ran it only during
the day and ran the "fan only" at night. The AC made my post-op phlegm worse so the fan only at night helped me sleep better.
The taxi drivers are normally very nice. We just kept a supply of $5
US bills or $50 peso bills for taxi rides. Most places are $3 to 4 away.
The taxi's have no shocks. My husband learned how to say "Go slow
please, my wife had surgery." Most listened to this and went slow.
The taxi's rarely have AC. Hermosillo is bloody hot in August!!!!! The
lowest low while we were there was 80 degrees. The highest was 111.... and although it is drier than here at home.... 111 is hot no matter what the humidity is. Sun screen is absolutely necessary if you spend any time out. I went out only a couple times in the evening to watch my son swim. He was slathered up well.
The orange juice in Hermosillo is not very thick... kind of watery.
Not what I like but some may like it.
Doing laundry at the Colonial now totally requires tokens from the front desk. No quarters at all, period. The tokens cost 50 US cents each and it take 4 tokens to wash and then 4 tokens to dry but each wash load needs 2 dry loads. So 1 full load requires 12 tokens or $6 US to wash and dry it.
The cost:
Here is a breakdown of all the bills I received upon checkout in PESOS
not USD. Remember PESOS run about 10 to 1 USD so $40.00 PESOS are close to $4.00 USD.
Hospital and care: $41,620.91
Dr. Ungson: $51,940.00
Internist (Dr. Monjardin): $10,000.00
Anethesiologist (Dr. Soto): $10,000.00
Assisting surgeon (Dr. Garza): $5,000.00
__________________________________________
Total: $118,560.91 PESOS which today equals $10,962.10 USD.
The exchange rate goes up and down everyday so one day it may be more or less but that give you an idea of the cost. Plus, they have to
change our USD cashier's check which costs them a fee. It is all
worked into the $11,000.00 cost.
I took 2 cashier's check equalling $11,400.00 to cover everything
including my 2 room suite which cost approx $125.00 more a night. I
considered it a bargin before the surgery and now consider it all a
miracle. You could never get this surgery in the US for that much and
certainly never get the care I got for that kind of money.
I am actually HAPPY my insurance said "no pay, no way." Otherwise my family and I would have never met Dr. Ungson and his wonderful staff and would have never been able to have such a good experience. We would probably still be fighting with them. Plus, it is quite empowering to self-pay!!
Update: 1/17/2006
I hit 199 today!! WOW!! ONEDERLAND in less than 5 months. I eat just about anything I want though I still steer clear of too much white carbie stuff like white bread, white rice, and plain pasta. A little is fine but too much and I get gas!! I drink one proteins shake a day though I have learned to like the taste of Pro blend 55 Chocolate. I am getting in 110-150 grams of protein a day and eating 1300-1800 calories a day. Drinking at least 64 ounces of fluids a day, usually more. Vitamins are good too. Using Vita4Life with some extra supplementation on top. They go down much easier than the ones I started out on. I am also trying to up my fiber using Benefiber. Makes everything run smoother. No real complaints other than the occassional sore bottom. Fiber helps with that too. I try to exercise 3-4 times a week and can walk from 2-4 miles each time. Feels good!! All in all, I am thrilled!!
Update: 6/19/2006
I'M NORMAL!!! BMI 24.9... NORMAL!! I have never been normal. 10 months post-op and normal. Just seems like a dream!! And I feel great!!
Update: 8/19/2007
2 years out and everything is perfect!!
My thoughts....
Me and hubbie got to thinking about my DS and all this just
came flowing out.
I am sitting here eating whatever I like, I am thin, I am happy. My
life is great now. Is that not miraculous?? Now I know it ain't no
walkin' on water or nothing but it is still a miracle to me.
If I had the RNY, I would be playing the same old self blame, follow
the rules game. Plus I would have had a whole new set of rules too. I
would be walking the tight rope I was walking before beating myself up
for every slip up, every error in judgement, only I would also have
the constant worry of dumping and strictures and ulcers and regain.
But I had the DS. Thank God I had the DS. The rules no longer apply
cause the DS changes the rules. It's a whole different game and the
game is actually fun.. not a chore. That is what I would like to put
in every one of those bleedin' RNY "work your tool" posts. My DS is
not work, it is fun. And it ain't a tool, it's a miracle.
I am a foodie. Why do you think I was 294 lbs? I love food and
wine and beer and all the things put on this blessed Earth to make us
happy. I ascribe to Ben Franklin's adage that "God made wine because
he loves us and wants us to be happy." What a JOY, a gift filled,
wonderous JOY eating is now. It is amazing to NOT be hungry all the
time and eat what I want when I want. It is a JOY to be thin and
healthy for the first time in my life.
Is there any doubt why we DSers are zealots? Hell, it is a sin to NOT want
to share this with all those unhappy obese people out there even if
they are too blinded by their own self loathing to listen. Wake up, there is a solution, a wonderful solution!!
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