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It is 4:22 P.M in the afternoon as I write this. Day 3 is like a breath of fresh air! In the morning Dr. Edgar Campos, the Bariatric Nutritionist, stopped by to visit. He had come in, before leaving home, in the evening of Day 2 to check my IV and make sure all was well. Early morning he stopped by, again, to check both my IV and stomach drain. Uneventful, which is exactly how it should be! :) 

As soon as he left, the shift nurses came to introduce themselves. Miguel, the English speaking nurse, came to administer the anti-acid medication through the IV, when I suddenly felt a burn. I told him of the sensation and he checked my hand only to realize that my IV had moved out of my skin. So, he took off the IV completely and gave me the anti-acid in powder form, for me to take. I was, also, told that I needed to consume more liquids throughout the day in order to stay hydrated. 

Upon finishing the anti-acid treatment, Miguel brought me a small glass of apple juice with a blue coloring. I took small gulps. There is a rather, unpleasant aftertaste, but not that bad. It took me close to two hours to drink the entire glass. The purpose of this is to ensure none of the blue juice makes it to your drain, as that would be an indication of leakage. The surgical team, before closing the incisions during surgery, runs a similar test, so the second one is simply for precaution, just to be on the safe side. 

I was told my urine would be blue for the next 24 hours. 

My morning breakfast consisted of a hot cup of chamomile tea, which I absolutely hated, but the nurse insisted I needed to drink the tea to help me with any inflammation and to pass gas. I also got a glass of Gatorade and apple juice. This is when Dr. David Beltran, one of the surgeons assisting Dr. Wilhelmy stopped by to check on me and let me know that I needed to make an effort and drink at least two out of the three drinks they would be bringing me throughout the day. 

So far, I drank half cup of chamomile tea, two glasses of Gatorade, and am half-way through my apple juice. They have told me I need to drink in order, not only, to stay hydrated, but to ensure I understand my level of full, on liquids. They want to make sure when you leave, here, you know how much your stomach can take on liquids. 

Today was also shower day, which was refreshing! I washed all my incisions and made sure not to wet the drainage too much. My sister helped me shower, comb my hair, and put on my pajamas. I brought a pant PJs to stay warm a few days before coming down. My sister also took the surgical dressings off my calves, which felt so good! 

We went for some long walks inside the hospital. I accompanied my sister to the hospital cafeteria three times when she picked up lunch, a snack, and a drink. I'm most certain she will make me go with her when it is dinner time, just so I keep walking. 

The nurses have agreed that I don't need to drink my chamomile tea once I pass gas. I'm so glad I will not need to drink that for dinner! :) :) :) 

I’m still using the Incentive Spiro Meter. My goal is to consecutively lift all three balls by end of day. I've done it a few times, already, but not consistently, because my stomach drain hurts when I do it. But, my sister keeps pushing me to do them, and whenever I lift them all, she cheers! lol 

Now, I'm going to take a nap. It has been a busy day, so far, and tonight, I'll be drinking more clear liquids and resting for Day 4. Wow, today, time has really gone by quickly. 

I wanted to leave this for my review of the staff and hospital, but I'm really glad I picked Mexicali Bariatric Center to have my surgery. They are absolutely wonderful! The staff, the doctors, the nurses, everyone is so attentive and caring. I’ll write more about my overall experience on Day 6. 

Until Day 4, everyone! 

I skipped writing about Day 2, because I was out for most of the day and night. Day 2 was brutal after all it was Surgery Day! I was nervous, but Dr. Wilhemy assured me all would go well and so far it has! :) 

Ernesto came to pick my sister and me from the hotel at 6:30 A.M. As soon as we arrived at the hospital, my Patient Coordinator, Rosales, showed us to my private room. I immediately noticed a nice clean scent. We got a mini tour of the bathroom; they provided us with clean towels, enough toilet paper, bath soap, and shampoo. They even asked if we needed toothbrush and toothpaste, but we opted out from getting those, since we had brought our own.

My sister helped organize our belongings in the closet and helped me put on my hospital robe. I wanted to keep my underwear for surgery, but was told to be completely naked under the robe. I also took all my earrings, watch, and other jewelry off. As soon as I was ready, Esmeralda, the nurse that would accompany me into surgery, came and put in my IV. This was around 7:20 A.M. 

At exactly 7:45 A.M., the surgical team came to my room with another hospital bed and asked me to lay in it. I was immediately escorted to the operating room. My sister was allowed to walk with me, until we reached the main doors (it is more like a hallway with several operating rooms, side by side). Now, I was on my own, which was a bit nerve wrecking. They brought me into the surgical room. There, I moved onto the operating table, where Esmeralda began wrapping my calves with a surgical dressing. This, they explained, was to ensure I didn't get any blood clots. 

As she was wrapping them, Dr. Andres Gutierrez, the anesthesiologist, must have given me the sedative for the surgery, because all I remember is waking up in the recovery room. 

My sister mentioned that around 8:30 A.M. she asked Yolanda, the Hospital Coordinator, to call the operating room to find out how the surgery went and they were just stitching up my incisions (a total of 4 small cuts). At around 9:00 A.M. Dr. Wilhelmy stopped by the room to inform my sister that all had gone well and that I was in recovery and would be brought back to the room in two hours. The first time my sister saw me after surgery was, according to her, around 11:20 A.M. 

At every hour/hour and half, for the rest of Day 2, my sister would make me use the incentive spirometer. I would have to suck in the air no more than 10 times, making sure that I got to lift the first two out of the three balls. Every time I sucked the air in, my drain would just hurt. In addition to doing the breathing exercises, which did remove quite a bit of phlegm from my lungs (which is what you want!), she made me walk up and down the hall twice. 

The reason, I was explained that they make you walk is to help pass gas. As part of laparoscopic surgery, the abdomen is usually insufflated with carbon dioxide gas. This elevates the abdominal wall above the internal organs to create a working and viewing space. The reason they use carbon dioxide is because it is non-flammable. Since laparoscopic surgery uses electrosurgical devices, this is the safest of the gases to use. 

When I was not using the incentive spirometer or walking, I was laying on my side, sleeping. I asked to go off the morphine. As a matter of fact, by the evening (before 7:00 P.M.), I was no longer using it. I didn't enjoy the way it made me feel. It may be the best painkiller, but it made me feel quite dizzy and groggy.

Day 2 is brutal. It is a very, very long day. It is worsened by the fact that you cannot drink or eat all day. Remember, I stopped drinking liquids at 10:00 P.M. on Day 1. So, this is the hard part. Your mouth is dry, your lips are a bit chapped, and all you think about is Day 3 (the day when you'll get to drink liquids, again). You're hooked to an IV and that is how you get your fluids. The nurses did allow me to put water in my mouth and then spit it right out, which helped a bit. 

The fluids from the IV will make you want to go to the bathroom. I'm so thankful my sister came with me, because she helped me in and out of bed, taking off and putting my underwear back on, and positioning me properly on the toilet seat. Every time you go to the bathroom, you have to let the nurse know. They make you pee into this bedpan that is hooked to your toilet seat. Each time, the nurse must check your urine's color and smell before dumping and flushing it out. Reason for this is to ensure your kidneys are functioning properly after surgery. 

I did have quite a bit of heartburn on Day 2, for which they gave me medication via my IV. In fact, I was woken up by it several times, at night. The medication helped a little and I was told that once my drainage is removed, it should improve. 

Overall, Day 2 was a very discouraging and bleak day. I was in discomfort and pain for most of the day, but my sister kept reminding me that, "This too shall pass." 

So, my advice, is to just stay strong! :) 

I'll try to keep this one short, as I need to get some sleep before I go under the knife tomorrow...but can't make too many promises! :) lol 

I live in Arizona, so my sister and I drove to Yuma. Mexicali Bariatric Center agreed to pick us up from the Yuma International Airport. Ernesto is the Mexicali Bariatric Center driver.  He was wearing an official polo shirt with the Mexicali Bariatric Center's logo and had a sign with my full name. He politely asked us to wait in front of the terminal while he picked up the vehicle. Once he brought up the van, he helped us with our luggage and we proceeded to drive to Mexicali. As soon as we left the airport, he called the Almater Hospital to let them know we were on our way. 

Upon arrival, we kept our luggage in the van, only carrying with us our passports, money, and phones. My sister brought her laptop, but due to the heat, Ernesto advised she carry it inside with her. As soon as we stepped through the doors of Almater Hospital, Ernesto showed us a reception area where we could sit and brought me my urine cup. I went to the restroom, while my sister waited in reception. There she met Rosales, one of the Patient Coordinators, who took my urine cup, escorted me through blood work, x-ray, and an electrocardiogram (ECG).

Once the electrocardiogram was completed, I met with the anesthesiologist, Dr. Andres Gutierrez. He walked me through the process (disclaimer: this plan is tailored for me, only. This does not mean he uses the same anesthetics with every patient). I will try to break down my plan:

1. The anesthetics will be administered intravenously (IV), so no mask. I was explained that this would help minimize the nausea after the surgery. Since the anesthetics will be given intravenously, it can take between 25-35 minutes for me to go under.
2. The anesthetics to be used are propofol (the sedative) and fentanyl (the painkiller). 
3. A respiratory tube will be inserted through my mouth, into my throat, after I've gone under (so glad don't have to be awake for this part!). 
4. He will monitor my blood pressure, my heart rate, and temperature during the surgery (typical for all anesthesiologists).
5. After surgery, he will shut the valves that pump the anesthetics through the IV so that I can slowly wake up. He said it takes about 5 minutes for me to wake up from the drugs and another two hours for me to resume full consciousness. During that time, he will continue to monitor nausea. 
6. After surgery, pain will be monitored two ways: 1. Opioids (Morphine) and 2. Other nonopioid pain relievers (Tylenol/Ketamine). There is no painkiller pump, so these will be administered based on my own needs. 

After going through the process, Dr. Andres Gutierrez asked if I had any additional questions. Right after he left the room, Yolanda, the Hospital Coordinator, brought in a folder with all the paperwork needed for me to review, sign, and initial. I really enjoyed the fact that I was allowed to bring all the paperwork back to the hotel, which gave me time to review everything before signing and initializing. Here is what to expect in your packet:

1. Surgery Consent (Mine: Vertical Sleeve Gastrectomy Consent)
1. They will use a laparoscopic technique
2. Hospital Liability Form
3. Patient Referral Form 
4. Case History Form (a more in depth form than the one filled online)
5. Post-Surgery Diet
6. Food after Surgery
7. Post-Surgery Instruction (VSG) which goes over your incision care and other post op tips (i.e. not lifting weight, taking walks, etc.). 
8. Useful Phrases while in Mexico - used to point out to nurses who won't necessarily speak English. Yolanda said that they usually provide nurses that do speak English, but in case one of them is on vacation. They also indicated that non-English speaking nurses know the drill and if there is something they can't quite understand, they immediately pick up the phone an call Yolanda or one of the Patient Coordinators. 
9. Recommended 3, 6, and 12th month tests, labs, and check-ups to get done with your local doctor. 

Along with the forms, Yolanda also gave me two pills to take that evening: 1. An antibiotic to prep my body; 2. Ativan (an anti-anxiety) to calm my nerves and help me sleep. Once I finished meeting with Yolanda, Rosales accompanied us to the hospital lobby to wait for Ernesto, who took us back to the hotel. 

Back at the hotel, I was allowed to have one last BIG supper, so my sister and I splurged at one of the hotel's three restaurants. I was told I could eat anything I wanted before 5 P.M. and then could continue to have liquids from 5 P.M. to 10 P.M. At 9:45 P.M. I took my antibiotics and skipped the Ativan. Now, I can have no water or food. 

Almater Hospital put us up in the Lucerna Hotel (http://www.hoteleslucerna.com/). It is a really quaint, well maintained hotel. I guess there are a set of rooms just reserved for the hospital and all the employees know the drill and helped us get settled and food in our bellies before 5 P.M. As far as restaurants are concerned, there are three: an Italian, Mexican, and International. We picked the international because I wanted Steak and Lobster for dinner. My sister had their Ahi tuna, which she loved. The food was absolutely delicious! We also had dessert! I had their Apple Strudel with the tiniest scoop of vanilla ice cream and my sister had the Crème brûlée. After early dinner, we headed to the grocery store across the street from the hotel, called Soriana Super, where we picked up drinks and treats. 

Another note, the hotel has a really nice pool. I would recommend not forgetting to bring your swimwear. I really wanted to go for a dip, but I was not able to, because I forgot the proper attire. After all, you want to enjoy as you embark in this new journey! 

Off I go to bed! Day 1 was a jammed packed day, but tomorrow is going to be crucial...wish me luck! 

There is a ton of information out there on Bariatric Surgery, doctors, locations, etc. So how does one go about making the best decision? Let me give you a glimpse of how the research and decision process worked for me...

I've contemplated Bariatric Surgery since 2013. I met with doctors in Canada and the US, but due to work related relocations I never quite took the next leap. 

This year I swore to myself that I would do the surgery. I hit the forums, reading about people's experience with the Bariatric Gastric Sleeve surgery and their surgeons/centers/locations, etc. In these forums I learned that Mexico was becoming a hot location for Americans and Canadians looking to get this type of surgery. Aside from being cheaper, the surgeons are just as qualified, if not better, than the surgeons in US and Canada. I spent several days reading posts after posts and the three main Bariatric centers that kept coming up, were:

1. Obesity Control Center - Surgeon Dr. Ariel Ortiz. He was showcased in Newsweek in 2011 as the top 15 Leaders in Bariatric Surgery and a patient of his and her surgery was featured on the Oprah Winfrey Show. Price Tag: $6,500 +
2. Baja Bariatrics - Surgeon Dr. Jalil Illan. Also a top ranked surgeon in Bariatric Surgery, he completed a fellowship with Mexican's renowned Bariatric Surgeon, Dr. Juan Lopez Corvala, who is considered the top 10 best Bariatric Surgeons (specializing in laparoscopic and gastric band surgeries ONLY) in the world. Price Tag: $4,600
3. Mexicali Bariatric Center - Surgeon Dr. Rodolfo Wilhelmy, who worked side-by-side with the late Dr. Alberto Aceves who was, not only, a close friend of Dr. Ariel Ortiz, but also considered a top leader in Bariatric Surgery, especially known for his wonderful bedside manner. Price Tag: $6,000                                                                  

I'm not going to lie, it was a difficult decision. My decision was based on the friendliness and attentiveness of the staff (Surgeon, Coordinator, Nutritionist, etc.), transparency of information, communication, and price. Here are my insights:

1. Dr. Ariel Ortiz: It is hard NOT to be impressed by Dr. Ariel Ortiz's credentials, but the price tag of $6,500 was for the surgery and the airport pick-up ONLY. It did not include medications (extra $200) nor the incentive spirometer ($10-$20). In addition, my sister who planned to accompany me was not allowed to be at the hospital during my surgery day and only allowed to come see me during visiting hours. Plus, I wasn't too keen on the post-op process (1 day at the hospital and 3 days at hotel). I would rather stay in the hospital for 3 days and 1 day at the hotel. 
2. Dr. Jalil Illan: Dr. Jalil Illan was very accommodating with my schedule but the coordinator was unorganized, never answering my e-mails or getting back to me in a timely fashion. I felt like I was always running after them to get answers to my questions. For me this was a red flag. 
3. Dr. Rodolfo Wilhelmy: He may not have all the accolades of Dr. Ariel Ortiz, but he is a board certified physician and a Fellow of the American College of Surgeons (FACS). He practices in an accredited health care facility (Almater Hospital, which is also accredited by the Better Business Bureau (BBB)) and was a bariatric patient, himself. Dr. Wilhelmy has been doing Bariatric Surgery longer than both Dr. Ariel Ortiz and Dr. Jalil Illan. 

Decision: I went with Dr. Rodolfo Wilhelmy with Mexicali Bariatric Center. 

As I write this, I'm in Mexicali, staying at the Hotel Lucerna. Tomorrow, I go in for my surgery. I will still try to write another post about my Day 1 experience. BUT, before I do that, below find a few tips on researching the right physician for you:

A lot of people feel anxious about coming to Mexico for surgery. Reading the forums, some days I was comfortable about my decision, other days, I was apprehensive. To calm my anxiety, I did research on the accreditation of both the Doctor and Hospital I had picked for my surgery. Here are my recommended tips:

1. The Mexican government has a registry for all accredited professionals (https://www.cedulaprofesional.sep.gob.mx/cedula/indexAvanzada.action) and their respective licenses. Your surgeon should be on here -- if they aren't, find yourself another doctor! 
2. Make sure your surgeon has a FACS accreditation (https://www.facs.org/search/find-a-surgeon). Do not take this accreditation for granted, because for them to have this they need to meet ALL of the following criteria:
1. Must be Board Certified
2. Need to be a Fellow of the American College of Surgeons
3. They must practice in an Accredited Health Care Facility
4. The Hospital must be accredited and evaluated by The Joint Commission. Basically, what this means is that the hospital has met The Joint Commission's quality and safety standards. 
3. All Other certificates/accreditation: check every single one of them.  Yes, it is time consuming, but this is your life, here! You want to make sure you are being watched and taken care of before, during, and after going under the knife. I called a number of accrediting organizations to make sure everything checked out. Most of them have websites and directories, where you can either find or not find your doctor. In my research, I did come across doctors who said they had this or that accreditation and when I either searched or called the accrediting entity they denied having some of those doctors on their directory. So, make sure you do your homework and check.
4. Patient Referrals. I did not prioritize this, because people don't always want to be contacted by strangers looking to ask questions about their procedure. However, it is good to know that Almater Hospital encourages patients to sign a release form to be referrals for other prospecting patients. It is a way for people to not feel so frightened about their trip or procedure in Mexico. Mexicali Bariatric Center also has a private Facebook page. It is a great way to connect with former patients and get additional feedback. I even got to talk to one of the patients who was undergoing surgery two days before my scheduled arrival. When I got to the hospital, today, I ran into the patient and we had a pleasant chat.

All in all, I feel I did the research necessary to make the right decision for ME. In no way does this mean that the other surgeons are not qualified. It just means that I felt comfortable with my choice and, thus far, I'm happy about it. :)