Travelmego

I have seen several posts about being sure to tip various people who provide services. So I would like to know how much is an appropriate tip for various scenarios. I know someone will say whatever you feel like giving but I would rather more concrete numerical examples. How much for: nurses in hospital (is this really necessary? and which ones should you tip? all of them? every time they bring you food or when you leave?) driver to and from airport? driver from hotel to hospital or vice versa? hotel room service? luggage handler? anyone I forgot or don't know about?

Let me clarify - the Dr. Garcia patient was naked on the table for just a few minutes while they were prepping for the surgery and then the nurse came and put the disinfectant stuff all over her stomach. However, for several minutes she was just lying there naked while people were doing things around the room. No one was paying attention but still. During the surgery itself, she was draped. I will put links to the various videos up. You said it exactly right when it seems no one is ticking all the boxes in the price range we are looking at. I am thinking of saving up enough to go to Pompa. Even pompa had 2 employees with noses uncovered but they were in the distance - not quite as bad. How much is Alvarez again?

That chart is very rough - I will be filling it out as I learn more information this coming week Try to submit it again and give Bill a call. He is the coordinator for Dr. Quionones and I really like him. Very open about stuff. I am also leaning between Quinones and Garcia but I have a few issues with both too. If you see my other thread, not covering the nose with a surgical mask is really bothering me. In Q's video -everyone had their mouths covered but no one had their nose covered. In Dr. Garcia's, everyone had their mouths covered, but he didn't have his nose covered in one and did in another. Some of his staff did and some didn't (from what I remember off the top of my head ...i will go back and see again and may edit this part of this post). Furthermore, in one video for Dr. Garcia, the patient was laying completely nude on the table while the OR staff was going about their business. I am like cover her up! (You couldn't see her private parts in the video from the angle but she was nude). So, I kind of have an issue with that. I mean I want to be covered up. I have no idea if this is normal or not but it just seemed so invasive. I am certainly going to request that I am covered and not just totally naked on the surgery table like that. WTH! Another issue is how do they close the stomach? I will be asking more details later. I know that Dr. Q closes the stomach with the 3 staples then sutures from top to bottom - which is very good. I wish he would add mesh and glue to that. I wonder if one can pay a bit more and get the mesh and glue. At the very least, I want my surgeon to do a complete top to bottom suture oversew on the staple line which Dr. Q does (not just the jointures where the cartridges were loaded). I don't know if Dr. Garcia does. So, I don't know what to do. Even Dr. Pompa - who has amazing credentials (FACS, MD, PHD, Center of Excellence) who is 6500 has 1 or 2 staff with nose uncovered. They are not right over the patient though but away. I know it sounds OCD but it is an indicator of sterilization for me. I would probably lean toward Pompa but another 2 grand is a lot to come up with in a short time. I really need to do this over the summer for my schedule. Also, in her video I didn't see her do a suture line but I can't imagine that she doesn't. Dr. Illan I can't find much info on. He has good credentials it seems (is also a trauma/er surgeon) but he worked with Dr. Kelly for like 4 years and Dr. Kelly's reputation was outstanding then went to crap after he had a patient (or 2) die. The details are confusing and murky on that. So, I don't know if Dr. Illan was involved in that surgery or if I should penalize him for association with Dr. Kelly. Also, (from what I recall off the top of my head), he did surgeries at Hospital Jerusalem as well but now is somewhere else. Whats THAT mean? I know I don't want anything to do with Hospital Jerusalem so...... It's all so damn confusing and it is hard to trust anyone around here especially coordinators. You know?

For me, classifying it as a disease - and a chronic disease at that - makes it clear that it is something I will have to manage for life rather than thinking I will do yet another diet, be wildly successful, and that will be that. Classifying it as a disease makes this distinction clear and makes me feel more empowered rather than less. It is not something I can just ignore. I have to actively confront it and take control. But that is just me and we all have our own interpretation of things.

Just curious but why the night before? Won't you just pick up contagions between cleaning your body with it and the time of surgery? I know NOTHING about this - first time I have heard of hibiclens.

Well, if it is working for you ...then why not? Maybe you should double check with your doctor though - and take some Vitamins or something? I guess the only advice I would add is to try to do some other things to jump start your weight loss in addition to phentermine. Perhaps increase your exercise or something. Definitely do what you are doing to deal with stress eating. That way, once you go off phentermine, you maybe can avoid regaining weight like before when you went off it. So, maybe try to make a lifestyle change while taking it and then ween yourself off slowly once you lose the weight. The sleeve and the phentermine are just tools that buy a person time to deal with lifestyle and emotional stuff, I guess.

I have taken phentermine before so I am certainly not going to judge one on taking it - no worries there. , too, lost a lot of weight on it then gained it right back. I also have wondered about taking it post-op since I have a bunch left. I see you have lost a lot of weight with your sleeve. Are you wanting to take the phentermine for more weight loss or just to clamp down on hunger? The only thing I would worry about is becoming mal-nourished with adding the phentermine. (That and the usual side effects like blood pressure.) I am surprised your hunger remained the same. I thought the sleeve is supposed to remove the gherlin production so no way could it remain the same. Don't get upset with my next question - just throwing it out there for consideration in case you haven't thought about it. Have you considered it might be emotional hunger? That you are not really physically hungry but emotionally?

I am still researching too. I am editing this post because originally I answered your question that between the 2 I would pick Aceves....but now I have read susans post about 'think 100 times before going to mexico' and I think Aceves is the doctor she is talking about. Now, after doing a lot more research, I would pick neither of them. From what I have seen about Lopez he is supposed to be good but I have seen various reports on the forums with complaints about not being able to reach him afterward, and a few with complications. The lack of contact post surgery kinda puts me off him. I also saw a post where he did 9 surgeries in a day. Same with Ariel Ortiz (6,500 and considered fabulous)- excellent surgeon but complaints post surgery about not being able to have contact, or get records easily. I made a google doc where I am adding information comparing various doctors as I come by it. It is very rough right now because I just started. Empty boxes just mean I haven't looked for that information yet. Also, it is not very well organized yet as I am still figuring out what questions to ask. https://docs.google.com/document/d/1Jd4oi1BFANNxuZ28L5w-D79fg2Pm6WWeG7pfQVDfW3U/edit

Ok, I have watched videos by many of the docs in Mexico. I have yet to find one where all of the staff have their nose covered - and that includes Pompa, and Aceves (and maybe Alvarez) - and those guys are considered the best. Sigh. I still want to go to Mexico.

Sure! U can ask me anything. I don't really have any specific problem with the post op diet. It's just because its completely different of what I was used to, eating habits, portions etc. so the struggle is with myself trying to follow liquid diet, shakes etc when my head is saying take me to Olive Garden and eat until you are about to pass out. That's the hard part. Hi, do you know how Dr. Garcia closes his sleeve? Does he have the 3 lines of staple thing? Does he do an over sew of the staple line as added precaution (some do, some don't)? I am considering him, and a few others.

I didn't mean to insult you. I just wanted people to be able to easily read what you took the time to write. Sometimes various browsers will make text come out in one long form because it takes paragraph formatting out automatically.... so I wanted to let you know that there is an edit button. I couldn't find it for several days.

I appreciate your strong and professional feedback. Thank you for explaining the difference. I think I was the one that said about seeing a dentist use one but I took that part out before I saw this post. I had meant simply that I saw one with a shield - not to imply it was good enough for surgery. The face shield I meant that might be good enough for surgery is the helmet like one in that first video. Do you think that type is ok? It is at 4:50. I haven't seen any surgeons doing the bariatric use that style....this video shows a heart operation - I was just looking for face shields to see an example.

I accidentally double posted so removing this post

I would be fine if a doctor wore a face shield. The problem is when there is nothing - no shield, no mask. Here is a surgery where they are wearing shields. See the 4:50 min mark Here is a regular heart surgery with the doctor wearing a mask and has glasses - all of the staff and he cover their noses.

I have decided to put together a google doc table to help with my research. It will be here: https://docs.google.com/document/d/1Jd4oi1BFANNxuZ28L5w-D79fg2Pm6WWeG7pfQVDfW3U/edit?usp=sharing Obviously, I just started making it like 3 mins ago. I will start adding data and questions tomorrow when I am more awake. Feel free to put questions you would also like to know in the comments there or here.

RHW - what was Florence Hospital like? I read in a post somewhere that it isn't a real hospital - meaning fully equipped with icu, bloodbank, etc. Can you please tell me what it was like?

Really, I want to give up. There seems to be something I don't like about every surgeon in my budget. Either it is a hospital associated with a surgeon I have deemed dodgy, or it is not a real hospital, or it is a real hospital but it looks meh, or or or. I will check out Dr. Alvarez. I would love to go to Aceves or Ortiz but they are out of my budget range. Sigh.

Hello good people! EDITED to add: dr. Ponce de leon is pretty much out for me. There are too many conflicting accounts to make me feel comfortable going with him. Others have reported great experiences so don't let my choice deter you. Do your research - don't listen to me or anyone as gospel. Edited again: Wow. After reading these links, I can't believe I ever considered this place or any doctor who has ever been associated with it. Thank you to my friend on here who sent me a private message giving her reasons for not choosing this place or doctors and starting me off on the research journey. Mexico is my best alternative. After a cursory run through on this forum, I am leaning toward Dr. Ponce de Leon. I have a few questions if you all don't mind.... 1. In another read I read some spat over coordinators but it didn't seem to touch the doctor himself. So, what's the deal with coordinators? Do we need them? I am very well traveled in the world so I have zero fear of going to another country for surgery and navigating my way. (Can Tijuana really even be considered another country? Isn't it like a suburb of San Diego? ha. ) 2. So, all I know so far is that this doctor seems good, and the price is right. I see the Hospital Jerusalem site offers in house financing with half down and you must have a bank account and a visa card. What does this mean? How does in-house financing work? 3. Are there any hidden costs that get sprung on you once there? Gratuities, extra treatment charges, etc. 4. Is the quality of the materials used (staples and such) on level with what we would expect in the USA? Best regards!

Hi, I thought I replied to these last 2 posts. I need to go read through this entire thread again because I decided not to go with dr. Ponce de leon and I am now researching all of these other doctors. zmdh - the whole coordinator thing is frustrating. It is indeed hard to know what is what around here. Covatila - i love the idea of staying a few extra days. If I were not taking my mom with me, I could probably do that.

Ok - that kinda decides it for me. The surgeon seems very nice but infection is a huge risk - even more so for a diabetic I think. I asked my primary care physician today about the nose/mask and he said run away. Good point on 'best behavior' @ life. .

Ohh we should also check out puerto vallerta - a beach resort! http://specializedbariatrics.com/weight-loss-surgery-puerto-vallarta/

Thank you page. I am trying to decide between several doctors now. I wonder if this is 'ok' or considered bad.

Ok, see this confuses me because in the big Ponce de leon thread - Alex (the forum owner) said that they do not offer the special through Hospital Jerusalem. A coordinator for Dr. PDL told me on the phone that Hospital Jerusalem was closed cuz the owner died. I have no clue what is going on with this doctor, this special and which hospital is being used. Good luck if someone figures it out. PS - The reason for the pre-operative diet is so the liver loses fatty deposits and shrinks. This enables the doctor to see the stomach easier and work around the liver. By losing the fatty deposits, the liver is also not as slippery to hold. PPS It would be great if you could edit your post so that it has paragraphs lol. Just point near the quote button and you will see an edit button materialize.

No, I had no idea about orange cats being usually male. She is the sweetest cat. @Travelmego Wow -- that's really interesting -- did you know orange cats are almost always male (like 95%) and orange females are usually sterile? It's the opposite with calicoes -- they are usually female and the males are sterile. Aren't kittens the greatest!

Aww being depressed sucks. I wouldn't panic over 1.5 lbs - that could just be Water you know. A gallon of water weighs like 8 lbs. You definitely don't need the stress of panicking on top of being depressed so let that issue go for now. Perhaps changing what you are grazing on? Like sugar free Popsicles instead of Oreo Cookies? Yea, I know...just not the same. They say exercise is great for depression. I always hated that saying lol. However, it is true. If you can just get out of the house for a bit, it might make you feel better. . I was thinking to make a themed photography sharing thread here - like "color blue". Then one can take a picture of something blue while on a walk (or wherever) and post it. Do you like photography? I am a point and click shooter myself - no skill involved - but I love themed stuff. If you don't like photography ....Hey, I know - you can write a paper for me! I am so not looking forward to doing that. No? Ok, what else. Um...well I like watching movies and tv online. We could make a thread where we watch the past oscar winning movies or something? Audio book club? How about going through the classics? Go to a craft store and take up a new hobby?