Happy Birthday to Me!

Jan 02, 2011

Happy Birthday to Me!
Half way to goal...
Joined "Thrive" gym in Ferndale.
Hired a personal trainer for 10 sessions.
Look out goal, here I come!  

On Returning to Work

Oct 31, 2010

 After surgery I was not scheduled to return to work for 10 days. Dr. Castaneda had suggested longer, but like most people I work for a living and only have so much sick/vacation time to take off. However, I was very fortunate that all my time off was approved as sick time. 

I had spent the time after surgery in getting plenty of rest, proper nutrition, walking as much as possible, and doing healing meditations. So when the time came to return to work, I felt up to the task. Yet, after one full day on the job I was physically and emotionally exhausted. I was not in any pain at work, but I was extremely uncomfortable, and very easily tired to the point of wanting to sleep on my own therapy couch! 

Fortunately, I work for very caring people and with clients who are flexible in scheduling*. After talking with them, arrangements were made that for the first week I would only work half days. With a return to full time the following week. If you can do this at all, I strongly recommend it. The gradual progressive return to the full expectations of my life (wife, mother, counselor, etc) was much less taxing on my system. 

By the time I returned to full time, my stamina had returned for the most part. And I was no longer as physically uncomfortable. All of which made the days much more enjoyable. So my advise: a gradual progressive return to pre-surgery levels of life are best. 

*Note: My co-workers did know that I had WLS. As they are a large part of my support network, and I didn't want anyone to think I was seriously ill especially when I started loosing lots of weight. So, I had shared with them what I was doing. My clients (I'm a child  & family counselor) did not know why I was out, except that I was taking a vacation in Mexico. To anyone who doesn't know, if they ask, I'm doing the South Beach diet. Which I am. I just leave out the surgery part. 

Home Again, Home Again - Adventures in Flying!!

Oct 29, 2010

Four days after surgery, it was time to go home. 
Surgery was in Puerto Vallarta - FABULOUS!
But home is in Bellingham Washington - 6 hour flight with a 2 hour lay over. Not so fabulous.
I was torn between a straight flight of 6 hours, or breaking up the flight with a 2 hour lay over. 
Since I wanted to be able to get up and walk to lessen the risk of blood clots from sitting too long, I opted for the lay over. 
There is no way around it, the flight and lay over were hell.
Quit simply, there is no way to get comfortable on the airplane. 
Get up and walk in the aisle, do leg stretches in the seat, it doesn' t matter. 
No real pain, just great unending uncomfortableness. 

So, then the lay over. 
I had hoped it would give a nice break in the flight. 
But it was little better. Yes I could walk about freely, but there was still no way to get comfortable. 
And the flight got delayed, so the lay over got extended.
Again, I wasn't in any real pain, just great discomfort. I wanted to lie down, but it wasn't a possibility.
I very nearly cried.
Then I had to get back on the plain again, for another three hour flight. 
Once in Seattle, I then had a two hour drive home, but at least in the car I could recline in relative comfort. 

Which do I recommend - a direct flight or one with a lay over?
On a direct flight I could have taken a sleeping pill and been oblivious, but would have increased my risk of blood clots.
On the lay over, I had greater opportunity to move about, lessening the risks but lengthening the discomfort. Granted I probably could have taken a sleeping pill on the lay over flight, but wasn't sure how I'd be when we changed planes. 
So, if you are traveling a long distance home after surgery allow me to suggest paying extra for first class for the return flight. 
I didn't but definitely wished I had!!

VSG Surgery

Oct 29, 2010

 OK, I'm a flake and posting this really late, but since I do get contacted by others interested in surgery in Mexico, I thought I'd better update. 

My coordinator from the hospital arranged transportation to pick us up at the hotel and take us to the hospital. Us is my husband and myself. Check in was really easy, a little paperwork and a blood draw for labs. Then we were take to our private room. Pictures of the hospital room are posted in my photos. There was a couch/bed for my husband to sleep on, and it was expected that he would stay in the room with me. The nurses were nice, and for the most part did speak at least some English. I was introduced to Dr. Castaneda's team, given a description of what would happen, and had any questions answered. 

I was nervous. I was not having second thoughts, but had never had surgery before. Even when I had my children, I had one at home and after the other I left the hospital after a couple of hours. I was trying to use my calming meditation, because stress increases pain. I was able to keep my mind calm, but I was shivering and my eyes were leaking. I wasn't actually crying as such. My breathing was normal and I wasn't making any mournful sounds. My eyes just wouldn't stop tearing, which I took as an indication of my stress level. After all, surgery, any surgery, does have the potential of complications - including death. The worst part was leaving my husband in the room and being wheeled into the surgery alone. The team were so sweet, they kept patting me, trying to sooth me, and asking if I was OK or needed anything. I felt silly and just explained I was nervous, but OK. I had decided long ago that the benefits of getting healthy far out weighed the risk of death. Especially since death is inevitable at some point, and I really wanted another chance at life!

They put the warming support hose on my legs (not an easy thing to do to a fat woman!), got me positioned on the table (there were huge lights everywhere), then put something in the IV to make me sleep. My surgery was about three hours long, which is longer than most. But I had a tubal ligation as well as the VSG.  I groggily woke to my name being called. Dr. Castaneda was saying it was all over and it went very well. Then came the most bizarre part - they asked me to exhale. As I did, they pulled the intebation tube out of my throat. I'd never been intebated before, and was still quit very very out of it, it was surreal to feel it slip out of my throat, yet I wanted to swallow but it was going the wrong way. It didn't hurt, but was so bizarre. 

The next awareness I have is of them lifting me off the gurney onto the bed in my private room. This was not pleasant. Not that it hurt, but definitely not good. In that movement I became aware of just where in my abdomen incisions had been made, which organs had been moved around and still weren't back in their original configuration yet, and just how challenging it was to breath deeply after trauma to the abdomen. I was told to relax and to sleep. I was very happy to see my husband. He held my hand and I slept off and on. Dr. Castaneda did check on me again, and the nurses came in fairly frequently just to check or to offer pain medication. Don't try to be brave - use the meds when you need them. Unnecessary pain is a stressor your mind and body does not need!

When the anesthetic finally wore off and I was coherent again, I became aware of just how uncomfortable I was. Movement was not my friend. Yet, getting moving is exactly what I knew I had to do. Moving made my abdomen muscles clinch up, which hurt like I'd had the wind knocked out of me and did make deep breathing a challenge. Not only was my stomach traumatized, but my internal organs now had to try to resettle, plus I had drainage tubes, and an IV to contend with. I decided the best thing was to remain immobile. Not a good idea. Yes, it hurt less and was less uncomfortable, but it also made things stiff. Which made it worse when I did have to move. So I decided to force myself to walk 10 circles around the room every half hour. I did not enjoy this - at all. But, the more I did it, the easier it got. To the point that on Saturday, when Dr.Castaneda came in to check on me, I actually hopped up on the bed (I'm short, so it is how I'm use to getting on tall beds so I didn't think anything of it). He was astounded that I was doing so well. It was decided that I could leave the next day if I felt up to it. 

That evening, I did take a shower at the hospital. They had a huge marble shower and brought me a chair. It was a sinfully delicious experience. I felt so icky before and so refreshed after. It was easier to sleep after a shower. 

I did have a problem that night. Apparently I was feeling well enough to turn in my sleep (which still made my stomach clinch like the wind was knocked out of me). During one position adjustment I must have hit my IV and pulled in not out of my arm, but just out of the vein. So the fluids were still going into my body, but only into my arm. This didn't hurt, but I awoke about 2am with one forearm the size of my thigh!! My husband was full of popeye jokes! The nurse simply removed it from one arm, and then inserted it in the other to continue the IV (in 48 hours my arm had returned to normal size). From then on, I decided not to take the pain medication, just the fluids. This would allow me to see what it would be like without them. I wanted to know, so I knew if I wanted a RX for pain meds. Honestly, yes it did hurt, but it wasn't horrible or unbearable. I did decide on taking the RX for pain meds to use to help me sleep and during the long plane flight home.

Sunday morning, Dr. Castaneda himself took me down to do the leak test. He was very kind and personable. The stuff I had to drink wasn't good, but it wasn't the worst thing I've ever swallowed either. They did an x-ray and found no leaks. So I was cleared me for discharge. After returning to my room, the nurse brought me a simple lunch. Since I hadn't eaten since Thursday night, I was hungry. Eating was odd and I wasn't sure what to expect. I only ate the jello and the warm tea. Just like the shower the night before, I felt much better afterwards. 

Dr. Castaneda gave me the Rx's (one for pain and one for a gall bladder med) and some post surgery instructions. We stayed a few hours more, only because we didn't realize we could go. We kept waiting for someone to bring us discharge paperwork to sign. Nope, there wasn't any. When we were ready, we just had to tell the nurse and she called our coordinator. We were then driven back to our hotel. The culture is very laid back and doesn't rush you out. 

The drive back was hell. Recent abdominal surgery and driving over cobble stone streets do not go well together. The driver was trying so hard to be soft, but there was no way. It made me laugh, which only made my abdomen clinch more. After getting to the hotel, the walk to the room was soooo slow and uncomfortable. But I felt accomplished. Like I had just begun a grand adventure. And so I had!


Dr. Castaneda - Answers to FAQ

Jun 08, 2010

Hi Everyone,
I've had a number of people contact me regarding my experience with Dr. Castaneda. Thanks to one very detailed question filled e-mail (thank you Fattytoslim!), I've got a number of answers readily available to share! If you have more questions, or just want to actually chat about my experience, please feel free to message me!

1. WHY DID I CHOOSE DR. CASTANEDA: I chose him for a number of reasons. First, he has experience. Second, he does a max of 2 surgeries a day - one in the am and one in the pm. This means he isn't exhausted and is therefore less likely to make errors. Third, he has never had a patient die. Fourth, his complication rate is very very low (less than a half percent). Fifth, he and his people were very warm, understanding and helpful. Sixth, I wanted to vacation in Puerto Vallarta. Bonus, he is there! But he also has an office in Guadalajara. Seventh, I grew up in So. Cal and did tourist trips to Tijuana. Nice place to visit, but wouldn't want surgery there! (Of course, things may have changed!). Eighth, I wanted a tubal ligation at the same time, and he was willing and able to do this (fertility can increase with weight loss). Ninth, his price was really good. About $7000 for the VSG and tubal ligations surgeries combined. 

2. WHO DID I USE TO SET IT ALL UP: To set up the surgery I used MedicalTourism.com. Hazel was my coordinator. She was, and is (she checks in on me) fabulous. Answered every question and walked me through the process. And yes, I will use them again - when I get plastics!

3. DID I TALK TO DR. CASTANEDA PERSONALLY PRIOR TO SURGERY: We had e-mail via Hazel. I could have spoken to him directly, but felt comfortable enough that I didn't feel it was necessary. I did, however, talk to him once I arrived in Puerto Vallart prior to the surgery date.

4. WHY DID I DECIDE ON A VSG, DID HE SUGGEST IT: I chose the VSG because it is a simpler procedure, has no malnutrition issues, has no food restrictions, no dumping, and if need be can be transitioned into an RNY. I wanted something that would let me live a normal life - just with smaller portions and healthier choices!
Dr. Castaneda is a specialist in the digestive tract (don't know what that specialty is called) and surgery for diabetes. As such, he is experienced in any of the surgeries and very able to handle any anomalies (ie hernias) that may be unexpected. He did not recommend one surgery over an other. Other than to suggest that If I had diabetes (I have insulin resistance) that I might want to consider a bi-pass instead. But, I had done research and knew what I wanted before I had Hazel contacted him. 

5. HOW WAS WERE I STAYED: My stay was different from others. I had a planned two week vacation while there. I stayed at the Melia. It is an all inclusive resort. It was my first time there and I will be going back. As such, I did not stay at the place the agency refers people to. They refer people to the Marriot, I believe they have a deal with them for $85 per night. I've heard it is very nice.  But, I really liked the Melia.

6. DID I HAVE ANY COMPLICATIONS: No. I did so well he kept saying he was amazed. At one point he wanted to check on my stitches, and I literally hopped up on the bed. He was agast. I can not emphasize how important it is to get up and get moving. You wont want to, but you must. Also, don't be brave - use the pain meds! Stress from pain slows healing.

7. HOW LONG WAS MY HOSPITAL STAY: I checked into the hospital on Friday around noon. Had surgery around 2pm. Was fully awake in my room by 5. I should mention that my surgery was a bit longer than most, as I also had a tubal ligation. I stayed in the hospital all of Saturday. And checked out Sunday around noon. I was surprised about the check out. After the doctor clears you to go, there is no paperwork or anything. When you are ready, you just let the nurse know, and go. My surgery was at CMQ Premiere Hospital. There are pictures of the hospital room in my photos section.

8. DID I GET TO MEET ANYONE WHO HAD USED HIM PRIOR TO DECIDING UPON HIM: I did not get a chance to meet anyone else who had used him. There were some patients from the US., but they weren't available to be used as references.  He does have some interviews on his website. I watched those. I couldn't find anyone besides Spanish speaking people from his practice in Mexico. So I looked at his education, experience (200+WLS), mortality rate (0%), complication rate (less than a 1/2%), and the fact that he does the surgery laproscopically, and took a leap of faith. 

9. DO I KNOW HIS STATS: Yes. He has done over 200+ WLS, has a mortality rate of 0%, and a complication rate of less than 1/2%, and he only does 2 surgeries per day. Besides his mortality rate and complication rate, the number of surgeries he had completed was one of the questions I asked Hazel. Amazingly, he has far more experience than any US doctor I considered. Likely because the VSG was approved in Mexico long before being approved in the US. It is also a bonus that he does do it laproscopically, most do but not all. 

10. DOES HE SPEAK ENGLISH: Yes he does. Yes, he has an accent, but he is perfectly understandable. (Remember, to him, WE have accents too!). Yes, most of his team also spoke English. Some of the nurses in the hospital didn't readily speak English, but what English they understood combined with what Spanish I understand made it work. 

A couple of other things you may want to know:
For a VSG, the size sleeve he does is 32.
He does use a drainage tube, which he removed prior to my discharge from the hospital.
He does give prescriptions post-op. One for pain and for for gall bladder. They were easy (and less expensive) to fill in Mexico. 
He recommends two weeks off from work after surgery. AND I strongly agree if it is at all possible! 
He expects that you have arranged for a doctor to follow your progress back home post-op. Even so, he does want to get monthly updates, just to make sure things are going well. 


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Puerto Vallarta - The Adventure Begins!!

Apr 10, 2010

We arrived at the Melia All-Inclusive Resort in Puerto Vallarta today.
Oh my this place is sooo nice. The people are friendly. And all-inclusive is fabulous!!
I could get use to this!
We were picked up at the airport by a patient liaison from the hospital.
I didn't realize I would be assigned my own coordinator. 
Again, it is fabulous. She has arranged everything. All I have to do is show up!
Where I was nervous before, now I am calm and happy. 
Puerto Vallarta was definitely the right choice for the surgery!

February OH What Now Support Group Meeting

Feb 13, 2010

Well, the February support group meeting came and went. 
Unfortunately, no one but me came. 
At first I felt sad, then determination took over. 
I need the support, even if no one else does!
Therefore, I will continue to hold the support group meetings. 
Come if you can to the next one.
I welcome all the support I can get!! 



January Oh What Now Group Meeting

Jan 09, 2010

 We had our January group meeting. Only two of us showed up, but it is a beginning!! After all, it was short notice. 
I look forward to seeing more people at upcoming meetings. Message boards and chat rooms are nice, but there is nothing like actually connecting with a person!

I feel more supported already!!


Welcome to Tryshh! And our little group grows!!

Jan 08, 2010

Welcome! Please check out all I've posted and add your own. We have an upcoming meeting if you are available. Hope to see you there!

Welcome to SeaShelly! It's nice to no longer be alone!!

Jan 07, 2010

Hope to see you at our first group meeting!