BetaOneAgonist
Eating For The First Month
Jan 10, 2008
I can't POSSIBLY stress how important it is to get all your protein drinks and "stuff" WELL before surgery, so you can try them out.
That being said, even things that you were able to consume BEFORE surgery (when you were still hungry) may EASILY not be things that you like AFTER surgery. Yes, this can be an expensive lesson. I'm sorry, that's just the way it is.
I have struggled to consume enough protein, and most of it comes from "real" foods. I have been a "label reader" for quite a long time, but now I have to realize that what the label considers a "serving size" is probably at least twice what my serving size is post-op. I'm just not hungry.
I also believe that weight-loss, which is hugely important, must be balanced with the health of your cardiovascular system, and GI system... not to mention psychological well-being and an overall sense of well-being. Fiber is a carb... so i differentiate between fiber (soluble and insoluble) and "bad carbs." Monounsaturated fats are good for cardiovascular health (as, of course, is weight loss)... so I differentiate between cholesterol, and the poly vs monounsaturated fats.
Also, I think that when our calorie intake is extremely low post-op, it's just not quite as important to be a carb-nazi or a hugely focused on fat grams. Actually, I apologize for using the term "nazi," I think that the use of that word has crept into American lingo in a hugely inappropriate and insensitive way. It's not a matter of "political correctness," it's a matter of communicating effectively with the widest range of people. Instead of just re-wording the first sentence, I'll leave it in here with my explanation, because my communication patterns are actually part of my "New Year's Resolution."
Things that have "saved me" for the past few weeks:
Refried beans with cheese. About 2 Tablespoons (or less) of refried beans, (I smash the bigger beans with the back of a fork), with about 2 Tbsp of chicken broth. Heated, then add an ounce of cheese to the top. I can't eat things that are as HOT (temperature-wise) as I used to, but I also find that I eat so slowly, things become cold before I finish... so sometimes I have to re-heat things half way through.
Cottage cheese. Luckily, I like cottage cheese, always have. I like it straight, sometimes with a little pepper on top. I add a cup of cottage cheese to lime jello (after you've mixed it up, but before it sets).
Soy milk. You have to be careful to get a soy milk that does not have a lot of added sugar. I like Silk "vanilla" soy milk, or Kirkland "organic plain" soy milk. Sometimes I'll add 1/3 of a banana and blend. Sometimes I add in a scoop of vanilla EAS protein powder or any other protein powder (I have Unjury unflavored and Any Whey powders too).
Eggs. Or, more appropriately, egg... since I can only eat one at a time (if that). Scrambled egg (not cooked to death, still soft) with cheese on top has comprised many of my meals, regardless of the time of day.
My parents have had a hard time with getting in enough food to have any energy... as well as protein. I suggested instant oatmeal, which has a good amount of fiber, but is also higher in carbs (added sugars etc). But, when nothing is going down very well, it will help get you on the road. My mom eats oatmeal just about every day. Later on, she may not want those carbs, but she will have more foods available to her that she is able to consume, so she can phase that out at her own schedule. I will remind her that she can buy sugar-free instant oatmeal too... the apple-cinnamon kind is pretty good.
If I find that I'm not eating, and not really drinking, yet have a headache that tells me that I'm low on everything (both hydration and fuel) I drink good ol' apple juice. Not watered down, not low-sugar varieties, just plain juice. I've considered having some juice boxes in my car for "emergencies" but haven't gone that far yet.
Apple sauce. No sugar added, sometimes I have the cinnamon kind, sometimes I have a strawberry kind (individual packages from Motts are very convenient for my lunch box). I've thought about trying to add a little protein powder to them.... but you really can't add much to such a small container without changing the taste... so you can't add much. I have to remember that every little bit counts, though.
Dannon Naturals yogurt. No artificial sweeteners, no high-fructose corn syrup, which I have made huge attempts to avoid for the past year. It has real sugar, and active yogurt cultures. If i'm feeling icky, I'll water it down with water or juice, and eat it very slowly. This is very good for you after all of the antibiotics of surgery. These are also very easy to pack in my insulated lunch-box, and have protein too!
In the past (recent past, but before surgery) I have made my own plain yogurt... which is SO EASY TO DO, I don't know why everyone doesn't do it. Many people who are lactose intolerant can consume yogurt, because the very NATURE of yogurt is to grow a bacterial culture which consumes lactOSE and leaves you with lactic acid (which is what gives unsweetened yogurt its' "tang"). This doesn't hold true for everyone, so your mileage may vary. I may go back to making my own yogurt and playing with adding different protein powders to it to make protein-rich concoctions.
That's about it for now... I'm down about 22.5 lbs since the date of surgery... so I'll probably be about 25lbs down by 1/18 which will be my one-month "surgiversary" as the people on the VSG board call it!
Hope all is well with you,
Beta
That being said, even things that you were able to consume BEFORE surgery (when you were still hungry) may EASILY not be things that you like AFTER surgery. Yes, this can be an expensive lesson. I'm sorry, that's just the way it is.
I have struggled to consume enough protein, and most of it comes from "real" foods. I have been a "label reader" for quite a long time, but now I have to realize that what the label considers a "serving size" is probably at least twice what my serving size is post-op. I'm just not hungry.
I also believe that weight-loss, which is hugely important, must be balanced with the health of your cardiovascular system, and GI system... not to mention psychological well-being and an overall sense of well-being. Fiber is a carb... so i differentiate between fiber (soluble and insoluble) and "bad carbs." Monounsaturated fats are good for cardiovascular health (as, of course, is weight loss)... so I differentiate between cholesterol, and the poly vs monounsaturated fats.
Also, I think that when our calorie intake is extremely low post-op, it's just not quite as important to be a carb-nazi or a hugely focused on fat grams. Actually, I apologize for using the term "nazi," I think that the use of that word has crept into American lingo in a hugely inappropriate and insensitive way. It's not a matter of "political correctness," it's a matter of communicating effectively with the widest range of people. Instead of just re-wording the first sentence, I'll leave it in here with my explanation, because my communication patterns are actually part of my "New Year's Resolution."
Things that have "saved me" for the past few weeks:
Refried beans with cheese. About 2 Tablespoons (or less) of refried beans, (I smash the bigger beans with the back of a fork), with about 2 Tbsp of chicken broth. Heated, then add an ounce of cheese to the top. I can't eat things that are as HOT (temperature-wise) as I used to, but I also find that I eat so slowly, things become cold before I finish... so sometimes I have to re-heat things half way through.
Cottage cheese. Luckily, I like cottage cheese, always have. I like it straight, sometimes with a little pepper on top. I add a cup of cottage cheese to lime jello (after you've mixed it up, but before it sets).
Soy milk. You have to be careful to get a soy milk that does not have a lot of added sugar. I like Silk "vanilla" soy milk, or Kirkland "organic plain" soy milk. Sometimes I'll add 1/3 of a banana and blend. Sometimes I add in a scoop of vanilla EAS protein powder or any other protein powder (I have Unjury unflavored and Any Whey powders too).
Eggs. Or, more appropriately, egg... since I can only eat one at a time (if that). Scrambled egg (not cooked to death, still soft) with cheese on top has comprised many of my meals, regardless of the time of day.
My parents have had a hard time with getting in enough food to have any energy... as well as protein. I suggested instant oatmeal, which has a good amount of fiber, but is also higher in carbs (added sugars etc). But, when nothing is going down very well, it will help get you on the road. My mom eats oatmeal just about every day. Later on, she may not want those carbs, but she will have more foods available to her that she is able to consume, so she can phase that out at her own schedule. I will remind her that she can buy sugar-free instant oatmeal too... the apple-cinnamon kind is pretty good.
If I find that I'm not eating, and not really drinking, yet have a headache that tells me that I'm low on everything (both hydration and fuel) I drink good ol' apple juice. Not watered down, not low-sugar varieties, just plain juice. I've considered having some juice boxes in my car for "emergencies" but haven't gone that far yet.
Apple sauce. No sugar added, sometimes I have the cinnamon kind, sometimes I have a strawberry kind (individual packages from Motts are very convenient for my lunch box). I've thought about trying to add a little protein powder to them.... but you really can't add much to such a small container without changing the taste... so you can't add much. I have to remember that every little bit counts, though.
Dannon Naturals yogurt. No artificial sweeteners, no high-fructose corn syrup, which I have made huge attempts to avoid for the past year. It has real sugar, and active yogurt cultures. If i'm feeling icky, I'll water it down with water or juice, and eat it very slowly. This is very good for you after all of the antibiotics of surgery. These are also very easy to pack in my insulated lunch-box, and have protein too!
In the past (recent past, but before surgery) I have made my own plain yogurt... which is SO EASY TO DO, I don't know why everyone doesn't do it. Many people who are lactose intolerant can consume yogurt, because the very NATURE of yogurt is to grow a bacterial culture which consumes lactOSE and leaves you with lactic acid (which is what gives unsweetened yogurt its' "tang"). This doesn't hold true for everyone, so your mileage may vary. I may go back to making my own yogurt and playing with adding different protein powders to it to make protein-rich concoctions.
That's about it for now... I'm down about 22.5 lbs since the date of surgery... so I'll probably be about 25lbs down by 1/18 which will be my one-month "surgiversary" as the people on the VSG board call it!
Hope all is well with you,
Beta
Well, Okay Then.
Dec 28, 2007
My purpose in writing the previous post/blog was to provide the other side of the coin. The reality is, the vast majority of people have NO problems, and come through surgery just fine and have no complaints.
I have receive many emails, ranging from statements of disbelief (I have been called a liar), to statements from people who had very similar post-op care and were very dissatisfied. However, every one of those people have been happy with their results in the long-run. The main complaint people have spoken of at this hospital is the nursing staff. If I had had the surgery alone, and had not experienced what was going on with my mother, then that would be my primary complaint too.
Many people do not consider the "other" implications of surgery in a foreign country, ranging from communications to different attitudes (not necessarily bad or good, but DIFFERENT), beliefs, and mores.
It is possible to have a negative experience in ANY country, including the United States. Anyone who has bariatric surgery is willing to undertake those risks in order to benefit their lives and health in the long-run.
Because I did not fully appreciate the deeper implications prior to surgery, I wrote this blog to help people consider that there are two sides to every coin. Just as there are two sides to every story, the staff at Hospital Almater may not agree with everything I wrote.
However, I can faithfully promise that I have written these things to the best of my knowledge, based on my experience or first-hand communications with my mother and father. I will not plead with anyone to believe me, it is what it is. I have appreciated the vast majority of emails who found my post to have a ring of truth. I have had no intention to mislead or deceive, and I am happy that most people saw it that way.
I would like people to understand that this is not written for "shock value" or to "scare the pants off" of people, but to cause people to stop, think carefully, and consider what they would do if they felt they were receiving poor care in a hospital in Mexico(or ANY country where they were not a native, I'm not picking on Mexico), vs. a hospital in the US (or whatever country they lived in). Would you do anything different? Would you have different choices? Would you have the same options? More options? Less options? Would you know how to deal with the system of a different country?
If someone wishes to disregard everything I have said, you are well within your right. I will not call you a liar, please refrain from "shooting the messenger" if the message is not what you wanted to hear.
I realize there are a few factual errors in the previous post, regarding individuals' titles. This was not done intentionally, and I only know that they are errors because I received more information after the fact. The blog was honest and as exacting as I was able to be, given the information I had at the time, and given my direct experiences. No detail of significance has changed since I wrote the first post.
Please do not be reactionary, but take this as one persons' account of her and her family's experiences, out of many who have very good experiences and outcomes. My story only has the value you place in it, and I feel that you are all capable of being a thoughtful informed consumer... both regarding anything I say, as well as your choice of surgeon. I encourage anyone to read, research, and consider everything carefully. If my blog has caused you to consider things that you did not consider before, then I would believe you to be wise and conscientious.
I have receive many emails, ranging from statements of disbelief (I have been called a liar), to statements from people who had very similar post-op care and were very dissatisfied. However, every one of those people have been happy with their results in the long-run. The main complaint people have spoken of at this hospital is the nursing staff. If I had had the surgery alone, and had not experienced what was going on with my mother, then that would be my primary complaint too.
Many people do not consider the "other" implications of surgery in a foreign country, ranging from communications to different attitudes (not necessarily bad or good, but DIFFERENT), beliefs, and mores.
It is possible to have a negative experience in ANY country, including the United States. Anyone who has bariatric surgery is willing to undertake those risks in order to benefit their lives and health in the long-run.
Because I did not fully appreciate the deeper implications prior to surgery, I wrote this blog to help people consider that there are two sides to every coin. Just as there are two sides to every story, the staff at Hospital Almater may not agree with everything I wrote.
However, I can faithfully promise that I have written these things to the best of my knowledge, based on my experience or first-hand communications with my mother and father. I will not plead with anyone to believe me, it is what it is. I have appreciated the vast majority of emails who found my post to have a ring of truth. I have had no intention to mislead or deceive, and I am happy that most people saw it that way.
I would like people to understand that this is not written for "shock value" or to "scare the pants off" of people, but to cause people to stop, think carefully, and consider what they would do if they felt they were receiving poor care in a hospital in Mexico(or ANY country where they were not a native, I'm not picking on Mexico), vs. a hospital in the US (or whatever country they lived in). Would you do anything different? Would you have different choices? Would you have the same options? More options? Less options? Would you know how to deal with the system of a different country?
If someone wishes to disregard everything I have said, you are well within your right. I will not call you a liar, please refrain from "shooting the messenger" if the message is not what you wanted to hear.
I realize there are a few factual errors in the previous post, regarding individuals' titles. This was not done intentionally, and I only know that they are errors because I received more information after the fact. The blog was honest and as exacting as I was able to be, given the information I had at the time, and given my direct experiences. No detail of significance has changed since I wrote the first post.
Please do not be reactionary, but take this as one persons' account of her and her family's experiences, out of many who have very good experiences and outcomes. My story only has the value you place in it, and I feel that you are all capable of being a thoughtful informed consumer... both regarding anything I say, as well as your choice of surgeon. I encourage anyone to read, research, and consider everything carefully. If my blog has caused you to consider things that you did not consider before, then I would believe you to be wise and conscientious.
The Whole, Unvarnished Story of my VSG in Mexicali, BC MX
Dec 25, 2007
Well... here I am, 8 days post-op from VSG surgery in Mexicali, Mexico. This is going to be a SERIOUSLY long post, so sit back and relax, because I'm telling ALL of it!!
When I told my parents that I was considering VSG in Mexico, I thought I would get a lot of grief... but it turned out that they wanted the surgery too, and we all ended up having VSG on the same day, with Dr. Aceves in Mexico.
We drove down to Calexico, CA (it wouldn't have saved much time or ANY money to fly), and parked our vehicles in a huge dirt lot called "Double A Parking." $3 per day, supposed to be safe, looked kind of shady... but our cars were fine (but extremely dirty) when we came back to them. So, I recommend them. EVERYTHING in Calexico, and MOST of everything in Mexicali looks shady. I'm spoiled, I get it. I like it that way.
Because of a scheduling SNAFU, their driver wouldn't be there for several hours, and since we were so close, we decided to take our roll-ey suitcases and just walk across the border and have a different driver from MBC (Mexicali Bariatric Center) pick us up. Higher BMI patients or people who can't walk a long way probably shouldn't try this. The MBC people were pretty surprised that we walked from Calexico, but my whole family are all pretty good walkers, healthy, and not extremely high BMI's (I'm the highest at 44... 5-8 and 300lbs). It was about 8 blocks, and you just go to the pedestrian bridge and go thru a turnstile. It's no big deal getting into Mexico.... but on the other side the wait is 3+ hours to get into the US. Mostly because they don't control who comes into Mexico.
Anyway, we walked to the Hotel del Norte (near the gate) and someone from MBC picked us up and took us to Hospital Almater for pre-op testing. We got to see the hospital which is SERIOUSLY IMMACULATELY CLEAN, and whoever did their tile work couldn't figure out how to do corners!! The tile-work was just a visual irritant during my stay... EVERY corner was screwed up. But the cleanliness was actually important. There's a legion of people who clean 24/7... and they clean EVERYTHING...floors, walls, desks, lamps, mirrors. They clean things that are already clean. You actually get sick of the smell of their cleaning solutions. We got our EKG's and chest Xrays, blood work, and urine samples, and then we were driven to the Hotel Lucerna (beautiful!!) and told not to eat after 10pm. They gave us a fluroquinolone antibiotic and an Atavan for sleeping, which we were instructed to take before 10pm.
There are restaurants all over the place, but we just went to the restaurant at the hotel Lucerna. It was beautiful, looking out over the pool (there was a young couple making out in a chaise lounge during our ENTIRE dinner!! You'd think their lips would have gotten tired!?!). We all ordered the same thing... a huge platter of Mexican food (enchilada, rice etc) which also came with a salad and a thin steak (delicious), a Pacifico beer, and chocolate cheesecake for dessert. The menu is in pesos... but they use dollar signs... so it looks like your meal is going to cost $300.... but that's only about $30 USD!! The service was MUY FANTASTICO. Dad tipped the waiter about $35, and it was worth it.
The next morning we were up early at met the driver from MBC at 6:30am. We drive to Hospital Almater and FINALLY met with Dr. Aceves. Everyone else raves about how much time they spent with their surgeon, and I didn't find this to be true at all. Meeting the guy the day of surgery, when you're already pretty committed to the whole thing, didn't impress me much. But he went through the whole song and dance... this operation is a tool, and you can fill it with Twinkies and fail, or fill it with good quality foods and succeed. Which is true, but I was more interested in actually getting SURGERY info from the SURGEON... not nutritionist info.
Mom was nervous so she went first... dad and I "rock paper scissors'd" for who would go 2nd and I won. Dad went last. Mom says she woke up during surgery!! (THIS IS A NIGHTMARE I'VE HAD FOREVER!!!) she says she felt like she wasn't getting enough air, and they weren't breathing enough for her. She opened her eyes and tried to tell them, but you can't talk with a breathing tube down your throat and in between your vocal cords. In a few seconds, she says she just have gotten more drugs, because she was out again and didn't wake up until the recovery room.
I didn't wake up during surgery, but I woke up in recovery in a LOT of pain. Lots of bubbles and gas in my chest, and my throat was beyond raw. I had a hoarse voice for the rest of my hospital stay.
Dad's surgical experience was the worst, he ALSO woke up during surgery (he says he wasn't "wide awake" but more like "opaque awake") and felt a lot of "pressure" in his chest and abdomen as the surgery was being performed. He says it wasn't painful, but acutely uncomfortable. He was also given more meds, because he went back to sleep and woke up in recovery.
Whew!! So... I'll cut to the chase here... None of my complaints in this ENTIRE story are about Dr. Aceves (except for only talking to him right before surgery). But you have to wonder about the anesthesiologist. As you will see in the rest of this post, I'm not terribly thrilled with the quality of the majority of nurses at Almater, and I *DEFINITELY* think the internist Dr. Campos made some very poor decisions in the management of my mother's healthcare.
My mom was instructed to discontinue her heart medications on the day of surgery. She doesn't have major problems, but she has a tendency to have atrial fibrillation, and sometimes SVT. She has high BP, and takes a pressure med as well as a beta-blocker... she was nervous about going off of those medications.
The day after surgery, we were laying pretty low. We all felt a lot rougher than we thought we'd feel, and all of us had lost our IV's during the night. (Mine had come out part-way and I buzzed the nurse... who was apparently some type of nurse who doesn't know how to or is qualified to put in IV's. She fussed with it for a while, muttering "Dios Mio!"... which was NOT reassuring... and then figured she had it fixed so she turned on the IV again and left. Within half an hour, I felt my hand swelling and figured out that the IV had infiltrated. So I DC'd it on my own without calling the nurse. They never replaced the IV... we all got little cups of crushed and dissolved pain and sleeping meds instead. I had terrible nausea for the entire hospital stay, and they would give me a shot in the hip if I complained enough, but kept trying to give me those nasty, bitter dissolved meds. I guess they thought that I was faking it... what nauseated person (who can't even stomach more than an ounce or so of juice) is going to suck down nasty bitter meds? Please. By the time I left, there were three or four cups of meds on my bedside table... I just never had pain meds or sleeping meds.... so I was in pain and slept poorly. I also consumed about 8 ounces of fluid TOTAL in the three days after surgery. Dehydrated much? You'd think they wouldn't be okay with that, but apparently that's not something they get concerned about??
The evening of the day after surgery, my mom felt her heart going into what she calls "palpitations" (a superventricular tachycardia) she told Dr Campos (the internist who takes care of you post-surgery) about her heart, and he didn't pay attention to her, not even bothering to listen to her with a steth. My mom spent the rest of the night trying to sleep, with her heart in SVT.
So, the next morning, my mom tries to walk down the hall to my room with her heart meds to get me to crush them up so she can swallow them, and she bumps into Dr. Aceves. He asks her how she is, and she says her heart is terrible. He and another internist have her lay down, and in about two seconds figure out that she's not bullshitting and then EVERYONE gets excited... 12-lead, blood work, telemetry, and an IV started (hers had blown after surgery too) with amiodarone per IV. She's been in a-fib/SVT for more than 8 hours and now she's exhausted (of course). Pale, cool, diaphoretic, and looks like shit. (of course).
A couple hours later (I didn't even know all this had happened, i was kind of around the corner from her) Aceves comes in and reassures me that they're taking good care of Mom... I was like... WHAT?!?!?!!? AT first I was really polite, I want to know what the results of the blood work is, I want to see her EKG, and I want to have a meeting with the cardiologist. I get NONE of these things. So then, my dad and I start raising hell, and say that we want to talk to the cardiologist, and to know the results of the blood that had been drawn 3 hours earlier. Well, they can't do that. They can't access the results, "no speaka english," yadda yadda. My dad and I explained that my mom has a cardiologist, and we want to know what's going on, call him, and make sure that she's getting proper care. If not, we're calling the State Department and getting a friggin helicopter to hoof Mom back to the states.
We spent hours getting a lot of lip service, and Sergio (who's sort of Dr Aceves' patients' hand-holder... might be a nurse, probably not) tells me that I "scare the nurses." To which I reply that I commonly scare anyone who doesn't know what they're doing, because I hold people accountable and fire people who don't know how to do their jobs. It's part of my charm :-)
Anyway, by this time, mom's heart has converted into NSR, she feels better but exhausted, I'm nauseated, and we're just anticipating the moment we're good to leave.
The upshot is this... Dr. Aceves was fine, the care that we got from Dr Aceves was fine, the Cardiologist was probably good, but I will never know because I NEVER talked to him (this would NOT have happened in the US.) The attitude in Mexico is that (and I was SPECIFICALLY TOLD THIS) I should trust them because they're good doctors. Yeah... that's what they said. And that I was not "qualified to determine what was good medical care," (which would have gotten them fired on the spot had I had ANY OPTION) and that calling my mother's cardiologist wouldn't change anything. There are partial truths to everything they said. I don't have my advanced degree yet, and my mom's cardiologist was 400 miles away... but I could certainly check to see if what they were doing was right. I definitely know enough to be able to read blood work, and take a look at troponin levels and CK-MB levels. I know how to see if there's ischemia in a 12 lead.
No one down there seems to understand, that I was able to research Dr Aceves... but I had no faith whatsoever in their cardiologist... I don't know him from a quack, and they didn't do anything to alleviate my fears other than send in Sergio to speak calmly and slowly to me (I started off liking him, but I was ready to wring is neck after a half hour of him blabbering). And I have no faith whatsoever in Dr. Campos' clinical judgement. I'm sure it was evening, and he was tired, but you don't ignore a patient complaining of her heart "jumping out of her chest."
Anyway... its kind of one of those things... "alls well that ends well." But if I had it to do over again I would NOT go to Mexico. Not because they're not capeable of the surgery, it's what might happen at other times or in other situations, and the consequences thereof. You can get some good deals in the US... people are paying about $12k with Cirangle in San Francisco and all sorts of other US doctors who are very experienced, and who work at top-flight hospitals. Just my 2 cents. I had an email shortly before I left from another person who did not recommend going with Aceves, not because of his experience as a Bariatric surgeon (which is esteemed and extensive) but because when other things go wrong, you're stuck in Mexico, with Mexican laws and you don't have nearly the same type of patient rights as you do in the US. I went ahead with my plans, because I felt that I'd already locked myself into my plans and I wanted to get this done on MY schedule, but my decision could have cost me my mother. That would have been difficult to live with.
Anyway, I anticipate losing a lot of weight. The bariatric surgery was good, I thought the nursing care was all very nice but pretty low quality, and the whole thing with my mom still pisses me off every time I think about it. I wish everyone the best of luck. Please feel free to email me back if you have any questions.
There have been lots of successful bariatric surgeries in Mexico, and if that's what you're thinking, you're right. This whole blog entry is here to try to get you to think about what ELSE can happen, and WHAT BEING IN MEXICO MEANS TO YOU, WHEN THINGS GO WRONG.
Merry Christmas to all,
Beta
PS.. I just read this out loud to my mom, to make sure that I wasn't making anything up, and she says "That's the truth! That's exactly what happened"... so there ya have it. You're going to be fine and happy as long as nothing unusual happens, but in the future I would never bet on that.
When I told my parents that I was considering VSG in Mexico, I thought I would get a lot of grief... but it turned out that they wanted the surgery too, and we all ended up having VSG on the same day, with Dr. Aceves in Mexico.
We drove down to Calexico, CA (it wouldn't have saved much time or ANY money to fly), and parked our vehicles in a huge dirt lot called "Double A Parking." $3 per day, supposed to be safe, looked kind of shady... but our cars were fine (but extremely dirty) when we came back to them. So, I recommend them. EVERYTHING in Calexico, and MOST of everything in Mexicali looks shady. I'm spoiled, I get it. I like it that way.
Because of a scheduling SNAFU, their driver wouldn't be there for several hours, and since we were so close, we decided to take our roll-ey suitcases and just walk across the border and have a different driver from MBC (Mexicali Bariatric Center) pick us up. Higher BMI patients or people who can't walk a long way probably shouldn't try this. The MBC people were pretty surprised that we walked from Calexico, but my whole family are all pretty good walkers, healthy, and not extremely high BMI's (I'm the highest at 44... 5-8 and 300lbs). It was about 8 blocks, and you just go to the pedestrian bridge and go thru a turnstile. It's no big deal getting into Mexico.... but on the other side the wait is 3+ hours to get into the US. Mostly because they don't control who comes into Mexico.
Anyway, we walked to the Hotel del Norte (near the gate) and someone from MBC picked us up and took us to Hospital Almater for pre-op testing. We got to see the hospital which is SERIOUSLY IMMACULATELY CLEAN, and whoever did their tile work couldn't figure out how to do corners!! The tile-work was just a visual irritant during my stay... EVERY corner was screwed up. But the cleanliness was actually important. There's a legion of people who clean 24/7... and they clean EVERYTHING...floors, walls, desks, lamps, mirrors. They clean things that are already clean. You actually get sick of the smell of their cleaning solutions. We got our EKG's and chest Xrays, blood work, and urine samples, and then we were driven to the Hotel Lucerna (beautiful!!) and told not to eat after 10pm. They gave us a fluroquinolone antibiotic and an Atavan for sleeping, which we were instructed to take before 10pm.
There are restaurants all over the place, but we just went to the restaurant at the hotel Lucerna. It was beautiful, looking out over the pool (there was a young couple making out in a chaise lounge during our ENTIRE dinner!! You'd think their lips would have gotten tired!?!). We all ordered the same thing... a huge platter of Mexican food (enchilada, rice etc) which also came with a salad and a thin steak (delicious), a Pacifico beer, and chocolate cheesecake for dessert. The menu is in pesos... but they use dollar signs... so it looks like your meal is going to cost $300.... but that's only about $30 USD!! The service was MUY FANTASTICO. Dad tipped the waiter about $35, and it was worth it.
The next morning we were up early at met the driver from MBC at 6:30am. We drive to Hospital Almater and FINALLY met with Dr. Aceves. Everyone else raves about how much time they spent with their surgeon, and I didn't find this to be true at all. Meeting the guy the day of surgery, when you're already pretty committed to the whole thing, didn't impress me much. But he went through the whole song and dance... this operation is a tool, and you can fill it with Twinkies and fail, or fill it with good quality foods and succeed. Which is true, but I was more interested in actually getting SURGERY info from the SURGEON... not nutritionist info.
Mom was nervous so she went first... dad and I "rock paper scissors'd" for who would go 2nd and I won. Dad went last. Mom says she woke up during surgery!! (THIS IS A NIGHTMARE I'VE HAD FOREVER!!!) she says she felt like she wasn't getting enough air, and they weren't breathing enough for her. She opened her eyes and tried to tell them, but you can't talk with a breathing tube down your throat and in between your vocal cords. In a few seconds, she says she just have gotten more drugs, because she was out again and didn't wake up until the recovery room.
I didn't wake up during surgery, but I woke up in recovery in a LOT of pain. Lots of bubbles and gas in my chest, and my throat was beyond raw. I had a hoarse voice for the rest of my hospital stay.
Dad's surgical experience was the worst, he ALSO woke up during surgery (he says he wasn't "wide awake" but more like "opaque awake") and felt a lot of "pressure" in his chest and abdomen as the surgery was being performed. He says it wasn't painful, but acutely uncomfortable. He was also given more meds, because he went back to sleep and woke up in recovery.
Whew!! So... I'll cut to the chase here... None of my complaints in this ENTIRE story are about Dr. Aceves (except for only talking to him right before surgery). But you have to wonder about the anesthesiologist. As you will see in the rest of this post, I'm not terribly thrilled with the quality of the majority of nurses at Almater, and I *DEFINITELY* think the internist Dr. Campos made some very poor decisions in the management of my mother's healthcare.
My mom was instructed to discontinue her heart medications on the day of surgery. She doesn't have major problems, but she has a tendency to have atrial fibrillation, and sometimes SVT. She has high BP, and takes a pressure med as well as a beta-blocker... she was nervous about going off of those medications.
The day after surgery, we were laying pretty low. We all felt a lot rougher than we thought we'd feel, and all of us had lost our IV's during the night. (Mine had come out part-way and I buzzed the nurse... who was apparently some type of nurse who doesn't know how to or is qualified to put in IV's. She fussed with it for a while, muttering "Dios Mio!"... which was NOT reassuring... and then figured she had it fixed so she turned on the IV again and left. Within half an hour, I felt my hand swelling and figured out that the IV had infiltrated. So I DC'd it on my own without calling the nurse. They never replaced the IV... we all got little cups of crushed and dissolved pain and sleeping meds instead. I had terrible nausea for the entire hospital stay, and they would give me a shot in the hip if I complained enough, but kept trying to give me those nasty, bitter dissolved meds. I guess they thought that I was faking it... what nauseated person (who can't even stomach more than an ounce or so of juice) is going to suck down nasty bitter meds? Please. By the time I left, there were three or four cups of meds on my bedside table... I just never had pain meds or sleeping meds.... so I was in pain and slept poorly. I also consumed about 8 ounces of fluid TOTAL in the three days after surgery. Dehydrated much? You'd think they wouldn't be okay with that, but apparently that's not something they get concerned about??
The evening of the day after surgery, my mom felt her heart going into what she calls "palpitations" (a superventricular tachycardia) she told Dr Campos (the internist who takes care of you post-surgery) about her heart, and he didn't pay attention to her, not even bothering to listen to her with a steth. My mom spent the rest of the night trying to sleep, with her heart in SVT.
So, the next morning, my mom tries to walk down the hall to my room with her heart meds to get me to crush them up so she can swallow them, and she bumps into Dr. Aceves. He asks her how she is, and she says her heart is terrible. He and another internist have her lay down, and in about two seconds figure out that she's not bullshitting and then EVERYONE gets excited... 12-lead, blood work, telemetry, and an IV started (hers had blown after surgery too) with amiodarone per IV. She's been in a-fib/SVT for more than 8 hours and now she's exhausted (of course). Pale, cool, diaphoretic, and looks like shit. (of course).
A couple hours later (I didn't even know all this had happened, i was kind of around the corner from her) Aceves comes in and reassures me that they're taking good care of Mom... I was like... WHAT?!?!?!!? AT first I was really polite, I want to know what the results of the blood work is, I want to see her EKG, and I want to have a meeting with the cardiologist. I get NONE of these things. So then, my dad and I start raising hell, and say that we want to talk to the cardiologist, and to know the results of the blood that had been drawn 3 hours earlier. Well, they can't do that. They can't access the results, "no speaka english," yadda yadda. My dad and I explained that my mom has a cardiologist, and we want to know what's going on, call him, and make sure that she's getting proper care. If not, we're calling the State Department and getting a friggin helicopter to hoof Mom back to the states.
We spent hours getting a lot of lip service, and Sergio (who's sort of Dr Aceves' patients' hand-holder... might be a nurse, probably not) tells me that I "scare the nurses." To which I reply that I commonly scare anyone who doesn't know what they're doing, because I hold people accountable and fire people who don't know how to do their jobs. It's part of my charm :-)
Anyway, by this time, mom's heart has converted into NSR, she feels better but exhausted, I'm nauseated, and we're just anticipating the moment we're good to leave.
The upshot is this... Dr. Aceves was fine, the care that we got from Dr Aceves was fine, the Cardiologist was probably good, but I will never know because I NEVER talked to him (this would NOT have happened in the US.) The attitude in Mexico is that (and I was SPECIFICALLY TOLD THIS) I should trust them because they're good doctors. Yeah... that's what they said. And that I was not "qualified to determine what was good medical care," (which would have gotten them fired on the spot had I had ANY OPTION) and that calling my mother's cardiologist wouldn't change anything. There are partial truths to everything they said. I don't have my advanced degree yet, and my mom's cardiologist was 400 miles away... but I could certainly check to see if what they were doing was right. I definitely know enough to be able to read blood work, and take a look at troponin levels and CK-MB levels. I know how to see if there's ischemia in a 12 lead.
No one down there seems to understand, that I was able to research Dr Aceves... but I had no faith whatsoever in their cardiologist... I don't know him from a quack, and they didn't do anything to alleviate my fears other than send in Sergio to speak calmly and slowly to me (I started off liking him, but I was ready to wring is neck after a half hour of him blabbering). And I have no faith whatsoever in Dr. Campos' clinical judgement. I'm sure it was evening, and he was tired, but you don't ignore a patient complaining of her heart "jumping out of her chest."
Anyway... its kind of one of those things... "alls well that ends well." But if I had it to do over again I would NOT go to Mexico. Not because they're not capeable of the surgery, it's what might happen at other times or in other situations, and the consequences thereof. You can get some good deals in the US... people are paying about $12k with Cirangle in San Francisco and all sorts of other US doctors who are very experienced, and who work at top-flight hospitals. Just my 2 cents. I had an email shortly before I left from another person who did not recommend going with Aceves, not because of his experience as a Bariatric surgeon (which is esteemed and extensive) but because when other things go wrong, you're stuck in Mexico, with Mexican laws and you don't have nearly the same type of patient rights as you do in the US. I went ahead with my plans, because I felt that I'd already locked myself into my plans and I wanted to get this done on MY schedule, but my decision could have cost me my mother. That would have been difficult to live with.
Anyway, I anticipate losing a lot of weight. The bariatric surgery was good, I thought the nursing care was all very nice but pretty low quality, and the whole thing with my mom still pisses me off every time I think about it. I wish everyone the best of luck. Please feel free to email me back if you have any questions.
There have been lots of successful bariatric surgeries in Mexico, and if that's what you're thinking, you're right. This whole blog entry is here to try to get you to think about what ELSE can happen, and WHAT BEING IN MEXICO MEANS TO YOU, WHEN THINGS GO WRONG.
Merry Christmas to all,
Beta
PS.. I just read this out loud to my mom, to make sure that I wasn't making anything up, and she says "That's the truth! That's exactly what happened"... so there ya have it. You're going to be fine and happy as long as nothing unusual happens, but in the future I would never bet on that.
Up to my A$$ in Alligators
Dec 06, 2007
Well, school has me running hard (mentally) but I have to focus on that and NOT THE FACT THAT I'M HAVING VSG ON 12/18!!
Super DUPER excited, can't wait, yadda yadda. I'm currently in the midst of what everyone on this board calls the "Pre-Op Liquid Diet." Except that mine isn't liquid???
My surgeon wants us to do 2 weeks of less than 30g of carb per day, and low-fat. Well heck, i've been low-carbing since the beginning of August, so I can do THAT standing on my head.
Since August, I've lost 35 lbs. In the past week, I've lost 7. So I guess I haven't been REALLY consistent with the low-carbing, or I wouldn't have lost that much weight when I started getting SERIOUS and jumping onto the pre-op diet plan.
I'm having surgery in Mexicali, so I can drive down there (long drive, but better than the whole airport fiasco... by the time I deal with the airports and junk, I might as well drive. I believe the drive is a little over 9 hours).
I just talked to the office assistant at Dr. Aceves' office, the schedule looks like this:
12/17 Meet with their driver in Calexico, California, and he drives me over the border to Mexicali and to the hospital by 1pm for pre-op testing (blood work etc). Spend the night at a motel in Mexicali
12/18: Up with the chickens, and to the hospital for surgery, stay at the hospital that night (private room).
12/19: "Drink test" and scan to check for leaks. Spend the night at the hospital.
12/20: Back to the motel (if i want, or stay at the hospital if i want), drinking water and clear broth, resting.
12/21: I'm outta there!
Cake walk, baby. I just can't wait for it to be over and done with. I said I was going to lose 100 lbs this school year, well darn it, with this surgery I just might.
I can spend HOURS on this topic on the net. I found a fitness website where people were talking about their height/weight and what size pants they wore. I was interested, because I don't even REMEMBER what sizes I was wearing when I was fit. Turns out, that most people that are 5'8" and about 135 are wearing around a size 8. Neato!
And then I think... that's 160 lbs of fat to lose! HOLY MOLY. I have FRIENDS that don't weigh 160. I have to lose the equivalent of two small asian girls!
Super DUPER excited, can't wait, yadda yadda. I'm currently in the midst of what everyone on this board calls the "Pre-Op Liquid Diet." Except that mine isn't liquid???
My surgeon wants us to do 2 weeks of less than 30g of carb per day, and low-fat. Well heck, i've been low-carbing since the beginning of August, so I can do THAT standing on my head.
Since August, I've lost 35 lbs. In the past week, I've lost 7. So I guess I haven't been REALLY consistent with the low-carbing, or I wouldn't have lost that much weight when I started getting SERIOUS and jumping onto the pre-op diet plan.
I'm having surgery in Mexicali, so I can drive down there (long drive, but better than the whole airport fiasco... by the time I deal with the airports and junk, I might as well drive. I believe the drive is a little over 9 hours).
I just talked to the office assistant at Dr. Aceves' office, the schedule looks like this:
12/17 Meet with their driver in Calexico, California, and he drives me over the border to Mexicali and to the hospital by 1pm for pre-op testing (blood work etc). Spend the night at a motel in Mexicali
12/18: Up with the chickens, and to the hospital for surgery, stay at the hospital that night (private room).
12/19: "Drink test" and scan to check for leaks. Spend the night at the hospital.
12/20: Back to the motel (if i want, or stay at the hospital if i want), drinking water and clear broth, resting.
12/21: I'm outta there!
Cake walk, baby. I just can't wait for it to be over and done with. I said I was going to lose 100 lbs this school year, well darn it, with this surgery I just might.
I can spend HOURS on this topic on the net. I found a fitness website where people were talking about their height/weight and what size pants they wore. I was interested, because I don't even REMEMBER what sizes I was wearing when I was fit. Turns out, that most people that are 5'8" and about 135 are wearing around a size 8. Neato!
And then I think... that's 160 lbs of fat to lose! HOLY MOLY. I have FRIENDS that don't weigh 160. I have to lose the equivalent of two small asian girls!
