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it seems like a lot of people here and on other forums use Dr. Carmina Cardenas in Tijuana or Dr. Francisco Saucedo in Monterrey. For other names, check www.realself.com It's a site where people rate doctors - all specialties - but most seem to be plastic surgeons. A lot of the patients post before/after pictures, too. people usually stay in the area for a couple of weeks after surgery to make sure everything is OK. Dr. Cardenas has a place where patients stay for the first week that is staffed by nurses. Not sure about Dr. Saucedo - if not, he has them stay in a hotel near his clinic (can't remember - but I did do an email consult with him and I'm pretty sure the price included this stay). as long as you do your homework and pick a reputable surgeon, it should be safe. you'll have to ask your insurance company if complications are covered. I had to have my PCP remove a staple that was sticking out (I had my surgery in the US, but out-of-state), and insurance covered it. I don't know if that's universally true, though. also, payment up front vs payments would depend on the surgeon. I suspect most would want it up front, but you never know...

@theexfatgirl - I think you may have already mentioned trying the unflavored protein powder? I apologize if you stated you had already tried it and it didn't work out. I put the unflavored protein powder into my jello and mixed it up (I was allowed jello, broth, sugar free popsicles, and the protein drinks or protein shakes I made myself. I have a bit of a lactose intolerance so was not able to make shakes with milk but I sure wish I could have! I added unflavored protein powder to my broth. I bought a variety box of protein soups from bariatric pal and in my 2nd week, I tried some of those. The one I thought would be the worst for my stomach, cream of tomato, my pouch actually liked but I figure I was just lucky. Also, I have a gastric bypass instead of a sleeve so I have no idea if that made ANY difference at all in being able to tolerate it. I think you said the protein drinks you tried were making your tummy hurt? I was just wondering about this as I have a LOT..and I mean a LOT of abdominal/intestinal cramping in general..and when added to the gas issues..I felt like my stomach..or what I 'used to call my stomach' was hurting so often! I don't know if it was because of my new 'anatomy' and plumbing, but I was given meds to help with this..cramping, spasms..and they seemed worse after drinking protein drinks (again, apologies for not knowing if it applies to both the sleeve and gastric bypass peeps) but I somehow managed to get them down...thinning them out helped a bit. I remember on Day 3 being VERY VERY DISMAYED and a bit angry that my hunger returned. Oh, I knew this was a chance BUT I was very envious of those who went months and even some...YEARS without feeling the return of hunger. I know some posters have mentioned trying to see if different temperatures help with your tummy issues. I found that oddly for me, warm things made my pouch MUCH happier than cold (and of course most protein drinks we drink are 'cold', well the pre-made ones I mean). I also used a heating pad for my abdominal area. Be KIND to yourself. You just had major surgery and your whole body is reeling from the impact as well as the anesthesia. This definitely made me grouchy..not saying it made you grouchy..LOL, just saying how I felt about it. I also had a hard time on my sibling thread although I was generally truly THRILLED for my surgery siblings....I am a slow loser and while I only had a few minor complications, I soon realized that a lot of what I was feeling was simply due to 1) Major Surgery 2) MAJOR MAJOR hormonal swings that I was warned about...3) Feeling in pain/uncomfortable 4) Wondering even with THREE years of preparing on a handful of days..if I had done the right thing. I was on liquids for over 45 days straight so I was VERY VERY frustrated with this. That being said, I only stayed down and frustrated for a few days. Don't get me wrong, I still get a bit down and frustrated but I am able to quickly step out of those feelings now that I'm over 3 months post-op. My surgeon and nutritionist were very encouraging when I was tripping out about not hitting protein goals..they told me to do the BEST I COULD in the first few weeks. I hope one of the suggestions or many of the suggestions are able to be of help to you..and of comfort. I will say my mood did a drastic pick up in weeks 3 and 4....and before I was even 1 month post-op, I was back in my secure feeling of knowing I did the right thing. For others it may take longer, but my fervent hope and wish for you is that you are able to find something soon you can handle to drink/eat and that the beautiful part of your journey starts (we often don't even know it has started until we look back in hindsight). Best wishes to you!! You CAN do this!!

Hi @Nomorepasta! You raised an issue that I also have had with my husband. He was very concerned 1) that I could do it on my own; 2) that the surgery wasn't safe, and 3) I was too old to have it safely. So, I pussyfooted around him for a while, quietly sticking to my shakes and my plan and did some research. There is research out there that shows that people over 50 are now viable surgical candidates for WLS and that we do very well with it. The complications that my husband was concerned about don't happen much anymore. When confronted with facts, and my determination, his tune has changed. I had to change my mindset though first. The surgery is for me, so that I can be healthy. I don't want to die of a comorbidity in the next 10 years; I'd like to see my grandchildren grow up. Most importantly, I really, truly wanted his support, but I was having the surgery anyway, regardless. That mindset was quite hard to put in place, mainly because I'm a pleaser and I go with pretty much everything he wants most of the time. I don't put my foot down very often, but I had to this time. Finally, I had to be selfish in my healthcare. I look after his health the best I can (he is disabled), but have ignored my own healthcare for a lot of years and it shows. Now is my time. I'm happy to report that he has finally come around and is supporting my decision, even though he still has some reservations. All the best to you. Keep on reading the threads here, they were very encouraging when my spouse was not. ((Hugs))

Hi! My surgery is scheduled for Dec 4th. I’m ready to go, finished with Dr’s and pretty much on protein shakes a day and a sensible dinner. My husband is trying to discourage the surgery feeling that I can do it naturally and that it’s not safe, even though I have battled with my weight all my life. I have had 7 prior surgeries and haven’t had the best track record regarding complications. I think I probably could lose some of my weight naturally, however as most of u know it’s maintaining it that’s the real issue. I need to stay positive but it’s difficult when my husband is praising me for the 12 pounds I have lost since starting this new journey and thinking “he” can support me through my “ binges” and food addition. Any advice asI am really conflicted. Every time I see my nutritionist or come from a support group meeting I’m on board, but when my husband sounds so sensible in that the surgery carries many risk factors/ side effects I feel like I should not have the surgery.

Just a quick update. Down to 353 which is a really good feeling. Thank goodness for the local thrift stores and second hand shops because I have dropped from a size 58 to 42 in pants alone and have pretty much needed to replace my wardrobe multiple times over the last few months. Huge milestone for me, I ran a 5K for Halloween. I was always the anti-run type guy. In fact I used to tell my coworkers that if they ever saw me running they should run too because the end of the world was behind me. Fast forward and I completed my first 5K which honestly felt amazing. I have signed up for another one in December this time doing a santa dash and I am hoping to improve on my times. Still have no complications and no regrets. I feel 100 times better and younger. I even managed to out walk my kids trick or treating on Halloween. As the one who always had to quit early it felt good for the kids to tap out first.

Hi everyone, I got a vsg in late May 2019, so it's been 6 months or so now, and I feel I did not make the most of the first 6 months. I healed remarkably well, and was able to tolerate all foods , and I had no discomfort or complications. My problems started when shortly before surgery, I started to worry that I would not get enough nutrients, and would become ill. I have young children and my main reason for wanting to lose weight is to be around for a long time for them. So for this reason I put more of the focus on eating healthier things. I did all my protein shakes, but I also spent a lot of time making green juices with no fruit and blending up greens. I took extra supplements such as turmeric and fish oil and a few other things. The first month or so I felt great, and looked better than ever, I felt like I was glowing with health, but I was chronically hungry from the start. I thought the best thing might be to add a lot of fat from natural sources like from avocados and meats and nut Butters and found that no matter what I did I was chronically hungry unless I ate that good amount of fat, I would wake up in the middle of the night looking for food to eat. Eventually I started adding in carbohydrates like breads, and found that I can eat a fair amount of them even though I know I should not be. I know that this is not the recommended diet, but I had a 1 meeting lesson on how to eat. Kaiser met with with a group of us patients pre-surgery and sent us home with a one-page quiz that we were asked to fill out and email a copy of to the nutritionist in order to schedule a surgery. There were no nutrition classes. I am an adult and I can research these things for myself, and I know I should have been eating things like protein and vegetables all along, but due to my fear if not getting enough nutrients, I fear I may have sabotaged my weight loss. I feel great and extremely healthy otherwise. No hair loss and no vitamin deficiencies. All 6 month bloodwork was excellent. My weight loss has been very slow. I went into surgery weighing 258lb, and today I weigh 225 . My question is about maximizing the first 6 months which I hear is so very important. Well, those six months are gone now, and I want to really make the most of this weight loss surgery. What would you all recommend as far as getting back on track in the healthiest way possible, and have I blown it I not maximizing that six months? Now that it's been about 6 months will I start to get even hungrier? Thanks so much for reading,and I look forward to your responses.

Here's a story! I was ON THE TABLE, put to sleep... SURGERY DAY (this was just in September) and they woke me up 20 minutes later and said "sorry, we can't operate. You have a huge mass in your stomach and we don't know what it is." YEAH. So I'm more-than-half drugged... confused... asking everyone who will look at me "DO I HAVE CANCER??" and getting answers like "we don't know what it is, yet. The doctor will talk with you when you are awake." I clearly remember replying OH I AM AWAKE NOW. They referred me to OBGYN and I found out a few days later I have a huge cyst on top of my uterus. I am heading back into surgery this coming Thursday for a hysterectomy and, if there are no surprises or complications, I will also receive my gastric bypass surgery at the same time (the two surgeons coordinated and are working together). So there's a story for you! : )

Hello! My first post... BRAND NEW here! Hi! I'm (almost) 48 and went in for my surgery back in September of this year. They put me to sleep, woke me up, and said "we can't operate. You have a large mass in your stomach." WHAT??! Long story short, they referred me to OBGYN and I found out I have a cantaloupe-sized cyst parked on top of my good-for-nothing uterus. The OBGYN said she would consult with the bariatric surgeon and if her surgery is without any complications, they could both operate on the same day. She will be the lead surgeon, as the hysterectomy takes precedence, and if there are no adhesions/nothing unexpected, the bariatric surgeon will begin his procedure once she is out. I've googled quite a bit and it doesn't seem as though there is much information out there addressing this type of procedure. I'm a little nervous but I trust that these surgeons will be safe and do what is in my best interest. But it's scary... surgery is scary, regardless. Anyway~ that's my introduction! I'm 5'7", 260 pounds, and expect to look like a 30 year old supermodel this time next year. Or an "improved me." I'm happy either way!

My hubby has overall been great. He really wants to be "Mr. Helper" and with all the complications, he's had ample opportunity!

I added this to the" revision... omg" page but ill add it here too This is from a surgeon's perspective not mine. The sleeve is not for everyone. Some people did not have the correct surgery for their needs. (My perspective: The may have needed extreme malabsorption along with restriction because the lifestyle changes just could not last. And what to you say to people like that? Just try harder, knowing they cannot? Thats cruel. Give them better tools to do the job.) Sleeve was originally part 1 of 2 of the Switch (DS) but it worked so well some people never needed to have part 2. Then insurance companies allowed it to be billed as a stand alone procedure. But that didnt mean everyone should have stopped at part 1, some people needed to go forward with part 2. When regain happens (Goodbye honeymoon phase) its seen as their fault instead of noncompletion of the process. Shame and guilt adds fuel to the fire and getting insurance companies to cover the "revision" without a complication is an epic battle. Also structurally (VSG or any WLS) is not infallible. Many things can go wrong immediately or even years down the line. *Disclaimer not pointing any fingers at anyone or this thread at all but perhaps the caste system the entire WLS community has created?* IMHO I think its easy and possibly careless to forget that we all (here) needed some level of intervention from WLS after we are successful. It becomes problematic to believe if do everything absolutely correctly (maybe even the first time) some cosmic merit/lottery/award will be paid out for all of our hard work. And those that need more help are getting off easy. Not everyone will lose or maintain 100 % excess weight let alone 65% & the surgeons will tell us this but we ignore it constantly. Sometimes it just doesn't work like in the books no matter what/who's at fault I have learned to mind my business big time because if someone goes through hell and back, the doctors & insurance companies open the pearly gates then they must have their reasons. Apologies for the length

I can chime in a little here about sleeve failure (although mine didn't fail me) This is from a surgeon's perspective not mine. And I've asked a few. I wish I would have recorded it. Some people did not have the correct surgery for their needs. Sleeve was originally part 1 of 2 of the Switch (DS) but it worked so well some people never needed to have part 2. Then insurance companies allowed it to be billed as a stand alone procedure. But that didnt mean everyone should have stopped at part 1, some people needed to go forward with part 2. (Goodbye honeymoon phase) When regain happens its seen as their fault instead of noncompletion of the process. Shame and guilt adds fuel to the fire and getting insurance companies to cover the "revision" without a complication is an epic battle. But y'all heard this all before...

I definitely relate...Just had bypass on October 1. I wanted the sleeve for me and so did my primary but my surgeon said I needed the bypass because I was over 300 lbs. The sleeve is for smaller people he said. The bypass is known for it's complications which is why I didn't want it and of course...I got the complications. I've had so many complications and you can prepare all you want mentall and with psych appointments but nothing "really" prepares you for this. Yes, I miss real food. I'm also looosing sooo slow. Here is the thing, I already did this to myself and now I guess I need to make the best of it. This surgery landed me in the hospital 2 weeks later. Thank god I had insurance I saw those bills. $85,000.00 for the hospital on the surgery and $35,000.00 for the 2nd hosptial visit were there was a tear in where the doctor sewed me up. Sorry to digress getting off topic. But hang in there and know you are not the only one. xo - Panda

No I don’t have any complications. Half of your stomach is removed so it’s hard to take in a lot of anything right now.

Just curious - are you having complications that prevent you from getting in the protein. Are you on shakes? I am having surgery on the 13th ... this post is an eye opener.

Thanks everyone SO MUCH for the thoughts and prayers. So quick recap: went in for my sleeve on 11/1. When I came out of recovery I immediately did not feel right. I was up and walking right away but so nauseous. All the other sleeved patients look so much better than I did! I was shaky and vomiting for the next 3 days. I failed my upper GI test twice. The contrast would not move past my esophagus into my stomach. I found out along the way that I had the sleeve done AND a hernia repair. They let me eat and discharged me home despite these complications on my 3rd day. My first night at home I vomited 5 times. I called my surgeon and he told me to come back in the morning so he could do an EGD. Went back to the hospital and they tried to do a cat scan with MORE DYE. I told them I couldn't drink it and proved it by throwing it up. They finally got themselves together and took me back to the OR where I had the EGD done and repair once more of my hernia. Apparently, my sleeve came up through the hernia and was blocking and putting pressure on my esophagus. It's why I couldn't swallow and food wouldn't go all the way down. I came out of recovery feeling 1000% better. I got discharged back home yesterday and I'm tolerating my clears no problem. GUYS, thanks so much for thinking of me. Please advocate for yourselves. If you dont feel right, you guys know your bodies! Don't be afraid to speak up and fight for yourselves. Sent from my SM-G965U using BariatricPal mobile app

No I was originally sleeved but converted to RNY But if you have the sleeve (with no complications) it was originally created to be 1/2 of the DS (and I guess now SIPS) process. RNY Is the progression to control reflux (what I had) If I had weight regain (but no reflux) with my sleeve I would have seriously considered DS/SIPS Speak with your surgeon and they will conduct testing which will ultimately make the final recommendations. Good Luck 💙

I know surgery requires you to stop nicotine use( not an issue) due to nicotine potentially causing issues but wondering if anyone has used MJ for post op pain or even just recreational? Would there be any possible complications ? Sent from my SM-N960U using BariatricPal mobile app

If only intellectual answers could conquer emotional problems. It is not easy and not thrilling. Now tell me more about that metabolism.. I need to take a crash course. Think some of my summer medical complications sent my hormones into some delusional concept I am ready for the next life phase.

Hi hi.. mine is on December 1.. I'm pretty nervous about it and got pre-OP anxiety .. I'm very afraid of general anaesthesia ..eventhough deep down I know it's nothing.. like everyone has been telling me It's like dreaming.. and I am afraid of pain and complications too .. like gallbladder stones.. I mean I'm only 24.. well ,soon to be 25 lolol (my bd is on december too😁) just thinking about removing my GB at such young age scares me a lot...but overall I think it's worth it ; to have a healthy body and dress pretty too, not just some oversized sh..t😅 plus no more of those people judging you when you pass🤦 If you think about the results it's worth it... that's what I'm telling my self too🤓♥ hope it goes well for all of us😍

Wow!!! Great job! May I ask if you had any complications? I am wondering why you stayed in the hospital for 7 days.

Also I would LOVE to see threads where people who need/want revisions and don't have medical complications explain how they were able to get it done. Too often you see GERD + weight gain = revisions but not everyone develops reflux and regains. It can be either/or/none. What about the percentage of patients with no issues at all and the band/sleeve/etc just wasnt very effective on them. Or start at a very high weight with the sleeve then need to go on to the DS/SIPS. I think that could help others see that sometimes is no just about you doing everything right or wrong

Get it out! A gall bladder can get infected just like an appendix. You can get very, very sick and toxic from an infected GB, which makes surgery more difficult, risky, and emergent, possibly even resulting in an open surgery vs laproscopic. You really do not want to go there. Open GB surgery used to be one of the most painful surgeries there was, with complications like pneumonia because of the long incision under the ribs which made breathing difficult. Laproscopy changed GB surgery like night and day. If you have already had multiple attacks, it is time for it to go bye-bye.

Hello Everyone! I now 53, I had revision done from lapband to gastric bypass 12.10.18. Thus far I have lost 100 lbs. Sad to say i wish it would stop. Lol. No major complication, now I am dealing with a lot of snagging skin, butt look like elephant legs, breast look like IV bags and arms look like a turkey neck.🙄. Health wise I feel pretty good. Wishing everyone the best of luck, please, please follow your doctor instructions.

I told everyone! Makes life so much easier and you don't have to deal with any questions as to why you are losing weight or eating little or need to go to the hospital for complications, etc. Plus, I ended up inspiring some people to have the surgery. Like, there is no natural way I would have lost 158lbs in less than a year. It would have been stupid obvious anyways. Like "Oh yeah, Brenda. My low-carb diet and exercise helped me lose 150lbs in 10 months." In no reality ever.

It is difficult to compare the two directly as few surgeons do both, (Mitchell Roslin in NYC is the main one I can think of that actively performs both) so there a lot of variables that get in the way. The DS is indeed the most powerful procedure commonly available, but it is also the most complicated to do, which is why few surgeons offer it. It has been around since the late '80's, it is one of the procedures endorsed by the ASMBS (along with the VSG, RNY and bands) and accepted by US insurance as a mainstream WLS procedure (they can't call it "investigational" any more since Medicare started paying for it.,) The SIPS (SADI, Loop DS, and other names that it goes by,) is newer and not as well established, nor quite as standardized, as everyone is still figuring out the optimum configuration. It is being promoted as being "almost as good as" the traditional DS, but "more accessible" - simpler so more surgeons can offer it. The hope is that it will fall somewhere between the RNY and DS in performance, with fewer side effects and limitations than either. If that holds true, then it will earn a spot in the WLS world, and if not, it will be another procedure that doesn't quite make it, like the "mini" bypass. Most of the BPD/DS surgeons don't offer the SIPS as they don't need a simpler procedure, and already have the VSG for the less challenging patients. Here is one very biased opinion on it from one of those surgeons: https://www.dssurgery.com/weight-loss-surgery/sadi-sips/ The position of the ASMBS on the matter: https://asmbs.org/resources/position-statement-single-anastomosis-duodenal-switch and, here is Dr. Roslin's take on it: https://www.nycbariatrics.com/weight-loss-surgery-options/sips-procedure Dr. Roslin is well quaiified on the BPD/DS (and is one of the few with the skills to do the very complex RNY/DS revision) but it seems that he is actively working on the SIPS for the greater good of the WLS community as a whole - that "almost as good as, but more accessible" concept that can hopefully benefit more patients over the long run. At this point, only time will tell. As an individual decision for right now, that's a tough one. With your regain history, I would be inclined to go the the well established BPD?DS, as that has proven to have the best regain resistance, but that would likely involve travelling for you (I don't know of any DS docs in MA, but there are several in the NY/NJ/PA area.) It is good to see that you are doing the "head work" as that is an essential part of any of these procedures - one can "eat around" any of them, though it is harder to do with the DS. One of the things that I have found to be helpful is what this doc covered here - One of the things that doesn't get covered much by other surgeons is that our eating capacity does increase slowly over time, and this is something we have to compensate for. One may or may not get along with this doc's prescription for a veg first diet, but it does make sense from the perspective of filling in that added capacity with bulky, low calorie veg. Think about it, discuss it with your therapist, and maybe you find a different approach to handling this problem. Good luck!