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Hi all,

I have been an "arm chair" observer in your forum ever since a friend (physician) confessed that her weight loss was not due to the traditional methods I had assumed. She spoke freely about her experience and surgery in Mexico. Ever since then, I have been curious about the sleeve.

A little back ground...I am 47 and had two children later in life (at the age of 39 and 42). I have been a yoyo dieter, and have achieved my goal weight (within a few pounds) several times by strict exercise, Jenny Craig, WW, etc. I am about 50 or 60 pounds overweight with a BMI of 32 or 33. I do not have any "co-morbidity risks" and I exercise frequently.. I am also a veterinarian with a strong background in surgery. But I think I am becoming a wimpy patient in my old age..LOL...I'm fine with performing a surgery but not so keen on being on the receiving end of things..:) I would love to finally be in a position where my obesity doesn't

shadow my whole life. I could probably lose the weight through exercise and diet, but am confident I would eventually gain it back

unless I quit my job.

That said, I have LOTS of questions. I know that answering these forums takes time. (so as a payback feel free to PM any dog or cat quesitons you may have and I will do my best to answer them.)

So here are my questions:

1. Why isn't the surgery more well known? In this day of paprazzi/etc. I've never heard of a celebrity having this. And they have more pressure to be thin. Is it more common than the public knows?

2. Since I am considering the surgery, but have a lower BMI, would any US doctor perform this surgery for me if I paid out of pocket? I just worry about surgical follow-ups in the US. if I do it in Mexico.

3. I'd love a realistic idea of pain involved post-op. Is it an ache? Please describe. Some have said it is excruciating while others said a mere inconvenience.

4. I inquired online and was given the name of Dr. Jose Rodriguez in Juarez, Mexico. But most members (including my friend) seem to have had the surgery performed by Dr. Alberto Aceves or Dr. Alanza Reyes. They seem to perform the most number of sleeves. Any feedback on any of the above dorctors?

5. What do you feel like when you eat after the surgery? What is "foaming"? Is eating uncomfortable or painful? How long until

eating (not over-eating) feel normal?

6. I would prefer to have a slightly larger sleeve so the weight loss is more gradual and my weight manageble. What are the options? My friend has a 5 oz sleeve.

7. I am freaked out by two possible side effects: gall bladder problems (very painful) and Hair loss (doesn't sound too preventable unless the weigh loss is more gradual). In the US, doctors use a medication aimed at preventing gall bladder issues...is this standard in Mexico and is it effective?

8. Any regrets? Or any tidbits you wished you'd know and prepared for before hand?

9. How difficult is the post-op diet? I like Soup, chili, etc. but not so sure I can handle "mushy" food... :)

PLEASE EXCUSE ALL MY QUESTIONS. They've been building up and thought I'd post them all at once!

THANK YOU FOR YOUR TIME!!!

Maybesleever

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So here are my questions:

1. Why isn't the surgery more well known?

The sleeve has only been used as a stand alone procedure for approx 5 years. Prior to that it was the first stage surgery for people who were too obese to have gastric bypass initially. Many people were having the surgery and losing enough weight with the sleeve alone, that it became a stand alone procedure.

2. Since I am considering the surgery, but have a lower BMI, would any US doctor perform this surgery for me if I paid out of pocket?

Most surgeons look for a BMI above 35 so you would need to ask, this would be a case by case issue.

3. I'd love a realistic idea of pain involved post-op. Is it an ache? Please describe.

This is one of the variables that I have had a WIDE range of responses to. My pain was minimal, but I did have a spinal block which surely helped. I have since had two friends who had surgery and both had enough pain that they needed pain medication, but not to the point that it was unmanageble.

4. I inquired online and was given the name of Dr. Jose Rodriguez in Juarez, Mexico. But most members (including my friend) seem to have had the surgery performed by Dr. Alberto Aceves or Dr. Alanza Reyes. They seem to perform the most number of sleeves. Any feedback on any of the above doctors?

I can only speak to my own experience. I had surgery with Dr. Aceves and had a very positive experience. I have emailed that experience to several others so if you want more info then email me and I will send it to you. (wannalise@hotmail.com)

5. What do you feel like when you eat after the surgery? What is "foaming"? Is eating uncomfortable or painful? How long until

eating (not over-eating) feel normal?

The first few weeks you are just doing liquids/soft foods. I had to eat very slowly and eating wasn't uncomfortable so long as I paid very close attention to my full signals. For many (me included) the first few weeks when you drink Water it feels very strange, for me it felt very heavy and almost painful, I had to play around with it and either add crystal light or drink it ice cold and I am just fine.

Foaming or slimeys is when you are overfull (or for me) when you consume to quickly, your body produces lots of extra saliva the way you would if you were about to throw up, only all you do is slime. It is disgusting and will quickly teach you how fast you can eat or drink. (My worst slime experience was with ice Water that I apparently guzzled)

I am not sure what you mean about feeling normal about eating. I am able to eat ANYTHING just in really small portions and that has been the case for several months. After I got back onto solid foods it took a while to be able to fully enjoy spicy foods, but I do now and am thrilled about it!

6. I would prefer to have a slightly larger sleeve so the weight loss is more gradual and my weight manageble. What are the options?

Depends on your surgeon. I know there are some who are willing to do larger sleeves, I would want you to really talk this out with them. If you don't need extreme restriction or only need it for a short time, this may be something that would prove to extreme for you and eventually very frustrating, because it never goes away. I still can't sit down and eat a big old cheeseburger, this is what I want and needed, but there are still days that I want to eat the whole damn thing.

7. I am freaked out by two possible side effects: gall bladder problems (very painful) and hair loss (doesn't sound too preventable unless the weigh loss is more gradual). In the US, doctors use a medication aimed at preventing gall bladder issues...is this standard in Mexico and is it effective?

I already don't have a gallbladder, but even if you went to MX I am sure that you could request the medication. The Hair loss thing is in part to rapid weight loss, loss of estrogen, and just the result of trauma to your body. I won't lie it sucks. I followed all the rules to a T and like clockwork at 3 months it started and as I approach 7 it is slowing way down.

8. Any regrets? Or any tidbits you wished you'd know and prepared for before hand?

I have no regrets. It is awesome to be able to say that with all honesty. The stuff that I would encourage you to be prepared for are not the physical things, you really have to learn to be aware of yourself. Most days that feels really awesome, I had no idea how much I had become detached from my own actions. Also, there are some who say this is effortless and for them it is, for me that is not true. I have worked my a** off. The difference between this and a diet is that I like my life. I see results, I don't deprive myself, and I am in a position where for the first time in years I trust myself. I know that what I say to myself is true.

9. How difficult is the post-op diet? I like Soup, chili, etc. but not so sure I can handle "mushy" food... :)

Post op was not bad for me (mushy was my least favorite though) but if you can do Soups you will be just fine. I was rigid about that phase, I had the surgery in Mexico and I refused to wreck my investment because any complications would have been catastrophic for me. Look at the post op stuff as temporary and a part of your healing, it is the way to take good care of your body and you need to do it!

Keep asking if you need any other questions answered. Be very careful in making your decision, it really is permanent, but for me that is (most days) something I take a lot of comfort in.

Good luck!

Anna

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1. Why isn't the surgery more well known?

--I have no idea. It's fairly new, and it seems like all the hype these days is about lap-band. I am hopeful that as there is more long-term information about the sleeve, it will get more attention from the media and be a more "popular" choice.

2. Since I am considering the surgery, but have a lower BMI, would any US doctor perform this surgery for me if I paid out of pocket? I just worry about surgical follow-ups in the US. if I do it in Mexico.

--I really don't know this either. My BMI was much higher and I had surgery in Mexico, so I know little about the standards for low-BMI patients here.

3. I'd love a realistic idea of pain involved post-op. Is it an ache? Please describe. Some have said it is excruciating while others said a mere inconvenience.

--My pain was not excruciating, but it was pain. I had nausea with it, and dry heaving, which was the most unpleasant thing. The first day it hurt to take a deep breath, but after that first day it got better quickly, in my opinion. I didn't take pain medication after the 2nd or 3rd day, and was given Toradol for pain the whole time, didn't need anything stronger.

4. I inquired online and was given the name of Dr. Jose Rodriguez in Juarez, Mexico. But most members (including my friend) seem to have had the surgery performed by Dr. Alberto Aceves or Dr. Alanza Reyes. They seem to perform the most number of sleeves. Any feedback on any of the above dorctors?

--I went to Dr. Rodriguez (though in Tijuana, where he also practices, at the INT hospital). I had no complications and would definitely recommend him. He and his whole team of doctors were very professional, made sure questions were answered, were friendly, etc. I would be happy to email you if you have any specific questions, but it was a very positive experience for my husband and me (we had surgery the same day).

5. What do you feel like when you eat after the surgery? What is "foaming"? Is eating uncomfortable or painful? How long until

eating (not over-eating) feel normal?

--I have never had "foaming". I have eaten too fast (often!), and had pain and nausea. I haven't thrown up since the first few days post-op, but if I eat too much, there is pain involved. I started on "normal" foods at about a month post-op, and now I can eat almost anything, though I don't eat much bread or bread-type foods at all. I am 2.5 months out, and my brain still hasn't fully adjusted to the idea that I have a much smaller stomach, so I can't say I quite feel normal yet with the portions. I have learned to measure everything, because my eyeballs are bigger than my sleeve :)

6. I would prefer to have a slightly larger sleeve so the weight loss is more gradual and my weight manageble. What are the options? My friend has a 5 oz sleeve.

--I'm not sure, actually. I would say this is something you would need to talk about with your surgeon. You might also look into gastric plication surgery, as I have heard it works well for those with lower BMIs, but there is maybe not quite as much restriction as with the VSG surgery. There is another board with information about the plication, and some people are having very good luck with it. Just another option for you.

7. I am freaked out by two possible side effects: gall bladder problems (very painful) and hair loss (doesn't sound too preventable unless the weigh loss is more gradual). In the US, doctors use a medication aimed at preventing gall bladder issues...is this standard in Mexico and is it effective?

--Dr. Rodriguez did not use this as a standard medication. I haven't had gall bladder problems thus far, but I am considering asking my PCP for the medication anyway, as I'm a bit concerned about the possibilities, and it would seem better to prevent it. I'm worried about Hair loss, too! I'm not sure it can be prevented.

8. Any regrets? Or any tidbits you wished you'd know and prepared for before hand?

--About the first week or 2 after surgery, I had severe buyer's remorse. I didn't feel good, I couldn't eat, I was miserable. At a couple weeks out, I started to feel better, then the weight started coming off, too. I can now say that this is the best thing I've done for myself ever. I have a lot to lose still, but I am thrilled with how things are going so far. No regrets.

9. How difficult is the post-op diet? I like Soup, chili, etc. but not so sure I can handle "mushy" food...

--I had no difficulties with the post-op diet. I didn't feel like eating much at all, and I was unable to get in all my Protein at first, so that was a struggle. I didn't mind the mushy stage, and found a few go-to foods that I ate a lot. Then when I went to regular foods, those kind of went to the back-burner. I haven't eaten tuna for quite awhile, because I ate it for lunch every day my last week of mushies. I was surprised that I didn't have a harder time with the post-op diet, but I actually thought it wasn't too bad. The post-op diets vary a lot, though, so some are harder to live through that mine :)

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So here are my questions:

1. Why isn't the surgery more well known? In this day of paprazzi/etc. I've never heard of a celebrity having this. And they have more pressure to be thin. Is it more common than the public knows?

It's out there, it just takes research, and unfortunately unlike the band, there is no product to market so it's not going to be "seen" in the media much. But here is a plug for VSG with Nate Newton a pro-football player that had surgery. It is well known in the medical profession as well. It's just called a gastrectomy which has been performed for decades upon decades for stomach cancer and ulcer patients. . VSG has been performed as the 1st stage to the DS for over 20 years, and it's been performed for the super, super morbid obese as a safer option to get them to drop 200+ pounds and then convert to RNY or DS.

http://profootballta...on-wastes-away/

2. Since I am considering the surgery, but have a lower BMI, would any US doctor perform this surgery for me if I paid out of pocket? I just worry about surgical follow-ups in the US. if I do it in Mexico.

There is minimal follow up required with the sleeve unlike with the band and RNY. You'll need to have labs pulled, but your primary care physician should be able to do that for you. You can find a surgeon in the US to perform the surgery with a low BMI, and being self-pay definitely helps you in that regard. As a self-pay patient, you'll want to find out exactly what you're paying for. Some costs may not be included such as a nutritionist consult, will you get support via email/calls? Will you get labs pulled annually, or semi-annually? Will you get a support group to attend? Will you have your follow ups covered under your costs? Etc etc etc

3. I'd love a realistic idea of pain involved post-op. Is it an ache? Please describe.

That's all about how you react to pain. The gas pain is the worse by far. My band surgery was way more painful than my sleeve revision.

4. I inquired online and was given the name of Dr. Jose Rodriguez in Juarez, Mexico. But most members (including my friend) seem to have had the surgery performed by Dr. Alberto Aceves or Dr. Alanza Reyes. They seem to perform the most number of sleeves. Any feedback on any of the above dorctors?

I have zero personal experience with either surgeon, but I did research them. You can search the forum for threads on both surgeons. You'll find that Aceves has several years more experience and no leaks with his sleeves patients. As for Almanza, I'll let you find those threads, and you can read about the complications, leaks, and patient testimonies on his program and facility.

5. What do you feel like when you eat after the surgery? What is "foaming"? Is eating uncomfortable or painful? How long until

eating (not over-eating) feel normal?

You drink a lot of your calories post op. So, it is difficult to explain what it feels like because not everyone has the same experience. Some heal faster, some have less swelling. Again, your recovery will be unique to your body. Eating can be uncomfortable if you overeat or do not chew well. It took me several months to feel "normal". Also, perception is 9/10ths of the law when it comes to surgery. I feel normal, but anyone that hangs out with me in real life does NOT consider how I eat, or what I eat "normal".

6. I would prefer to have a slightly larger sleeve so the weight loss is more gradual and my weight manageble. What are the options? My friend has a 5 oz sleeve.

You'll want the standard size sleeve. Getting bigger sleeves show regain, and more patients do not lose their hunger with the bigger sleeves because the fundus isn't fully dissected. Your body will lose at it's own pace, and your weight loss can be managed easily with dietary changes.

7. I am freaked out by two possible side effects: gall bladder problems (very painful) and hair loss (doesn't sound too preventable unless the weigh loss is more gradual). In the US, doctors use a medication aimed at preventing gall bladder issues...is this standard in Mexico and is it effective?

Gallbladder surgery was a breeze, the couple of gb attacks I had were a pain in the ass literally LOL. Diarrhea and little vomiting, but it wasn't horrific. Hair loss is temporary, and hair grows back. It has nothing to do with how fast/slow we lose weight. There's a lot of factor that contribute to hair loss. I lost hair for 2 months post gallbladder surgery and I hadn't lost any weight. I didn't take Actigall (gallstone prevention medication) I chose not to, and my only 1/4 of my surgeon's patients need to have their gb removed post-WLS.

8. Any regrets? Or any tidbits you wished you'd know and prepared for before hand?

None to either. Well, I wish someone would have told me that I'd feel "this fabulous".

9. How difficult is the post-op diet? I like Soup, chili, etc. but not so sure I can handle "mushy" food... :)

It isn't that big of a deal if you just see it as an end to a means. Seriously, it's to protect the staple line, it's there to allow healing, and if you fret over a couple of weeks of liquids then you'll feel like it's torture. If you just look at as a couple weeks of healing, it's really not that big of a deal. I kind of think of as that long, agonizing 6 weeks after having a baby that you shouldn't have sex, "Yeah it sucks, but in the grand scheme of things, it's better to let your parts heal, than to rush into something and cause issues.".

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Haven't had my sleeve yet, but I must agree with Tiffy on most everything she said. I had a band a a few babies so I know the healing part and the pain part and they are both totally worth it in the end. I am going to Dr Aceves next week and can report back on my experience with him then. As for after surgery eating, my friends never thought i was 'normal' with my band, who the heck eats 4 oz of food and is full, not even my super skinny friends! they can put it away like some football players, but have metabolisms of hyper 2 year olds!

you have to take everything into perspective. you are in this for the long haul, you do not want a Dr going in there and making your sleeve too big so that in 2 years you are having a hard time keeping the 100+ pounds that you worked so hard to get off, off! KWIM! You want to keep it off FOREVER! Get the small sleeve adjust your eating now, let it relax after the swelling and healing goes down and see how much you can consume after you reach goal. If you feel you need to eat more, than instead of having 3 meals a day have 6. It is easy to adjust your life, not so easy to keep going under the knife. this will be my 2nd WLS in 2 1/2 years because me and my band failed each other. We didn't follow the rules and when life got tough, I didn't see the signs and it slipped really bad. I now see this, but it is too late. Hope this helped a little bit!!!

Will update you on my surgery next week.

patti

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Hi there,

I am going to Dr Rodriguez in November and if you go on to obisity help.com and put in Dr Rodriguez there is alot of information on him. He has had 0 leaks and complications are at 1% and I think that is good cause only GOD is perfect.

If you talk to the cordinators they will give you lots of names and numbers to call people that has had the surgery and they have all great things to say about him.

I feel really good about my decision in having him for my Dr.

Good Luck to you!

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The sleeve is 'relatively' new as a stand alone surgery. Tiffikins is the expert on just about anything you need to know! I think from what a nurse in my surgeon's office has said, sleeve surgery has been perfected now, like most things after a little while. Reassuring, isn't it? Although bypass is still more popular and that is what insurance covers! The nurse I'm referring to had a revision five years ago, and her sleeve is larger - she has considered going back and having it redone. The most common size now is a 32 I think, she said any smaller and there are some times problems and larger ones have a bigger percentage of regaining, like Tiff said. (which she has experienced to some degree)

Mine is a 32 and the restriction is perfect. My BMI was 36, I had no health issues and was a cash pay patient. I had my surgery done in Dallas, I was not as brave as you are, I didn't consider going out of the country. If you do, I think Dr. A is better than going anywhere near Juarez, which is a war zone, no place for anyone to be unless you are a drug dealer....just my personal opinion. (I am a Native Texan and my mom was raised in El Paso) Just google it!!! :)

I had the easiest time and I think that those of us with lower BMI's and no health issues have an easier time with the surgery....I lost 23 lbs before surgery (June 11th) - today is 4 months and I've lost a total of 72 lbs. I'm just 6 lbs from my surgeons goal for me. I'll lose a little below that, but I feel great, I have NEVER had "buyers" remorse!!! Go for it!!!!! Like you, I'd done many things....Weight Watchers, phen/phen, seen a nutritionist, Optifast.....I've lost and regained 50 lbs twice and lost and regained 30 lbs on several occasions over the years!!! This is great! Do it, it is wonderful!!!! Good luck!

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1. Why isn't the surgery more well known?

No idea. I've only met one person in real life who's even heard of the sleeve, and she has had gastric bypass herself. I think it's the best-kept secret out there!

2. Since I am considering the surgery, but have a lower BMI, would any US doctor perform this surgery for me if I paid out of pocket? I just worry about surgical follow-ups in the US. if I do it in Mexico.

Yes. I had a starting BMI of 32 and Dr. Ara Keshishian in Glendale, California did my surgery for me as a self-pay. He is wonderful and I recommend him without reservation!

3. I'd love a realistic idea of pain involved post-op. Is it an ache? Please describe. Some have said it is excruciating while others said a mere inconvenience.

I had very little pain. I was on IV pain meds in the hospital (about 24 hours) and only had to take one dose of the liquid pain meds they sent home with me.

4. I inquired online and was given the name of Dr. Jose Rodriguez in Juarez, Mexico. But most members (including my friend) seem to have had the surgery performed by Dr. Alberto Aceves or Dr. Alanza Reyes. They seem to perform the most number of sleeves. Any feedback on any of the above dorctors?

If I hadn't found Dr. K, I was going to go to Dr. Aceves. Dr. K says he's very good.

5. What do you feel like when you eat after the surgery? What is "foaming"? Is eating uncomfortable or painful? How long until eating (not over-eating) feel normal?

I haven't had any "foaming." Immediately post-op, you eat VERY SLOWLY and it's just... odd. Not uncomfortable or painful unless you overdo it, which you will a few times until you get the hang of it. It took me a month or so to really get the hang of it.

6. I would prefer to have a slightly larger sleeve so the weight loss is more gradual and my weight manageble. What are the options? My friend has a 5 oz sleeve.

I don't really know the size of my sleeve but my loss has averaged about a pound a week, which has been fine with me.

7. I am freaked out by two possible side effects: gall bladder problems (very painful) and hair loss (doesn't sound too preventable unless the weigh loss is more gradual). In the US, doctors use a medication aimed at preventing gall bladder issues...is this standard in Mexico and is it effective?

I haven't had any Hair loss or gallbladder problems. I didn't have any gallbladder meds, either.

8. Any regrets? Or any tidbits you wished you'd know and prepared for before hand?

My only regret is that this surgery wasn't available 20 years ago! Seriously. I'd do it again in a red-hot second!

9. How difficult is the post-op diet? I like Soup, chili, etc. but not so sure I can handle "mushy" food... :)

My doctor didn't have any prescribed post-op diet. Told me it was fine to eat anything I could tolerate. I was eating soft Protein within days.

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