I had not realized that I was crying out inside; to God, the universe, or anyone that would listen… but I was quickly becoming tired of living in my uncooperative body. I was fat, very much so, but my only comorbidity was pain. Bone deep and getting worse. My life was quickly contracting such that I didn’t go out for fear of ridicule and unforeseen challenges… like arms on chairs and seatbelts that would not reach. I had to strategize a trip to the grocery store around my pain threshold. On November 9, 2012 the final straw came. It does not matter what it was. It happened. God had heard the crying I didn’t realize I was pouring out and a solution was presented. On Sunday, November 11, my mind was all but made up that I would undergo the VSG procedure in order to provide my body with a powerful tool to reshape my life.

With many hours online and a face-to-face interview with a former patient of his, I selected surgeon Dr. Jaime Ricardo Ramos Kelly of Tijuana to perform my VSG. Much has been noted on the VerticalSleeveTalk boards about recent changes with Dr. Kelly’s staff and I was in the thick of the transition. I started out working with Omar who left the practice (friendly separation), then came Alina who was lovely but learned quickly her heart was elsewhere, and finally working with Lora Lee, an American they hired who was also a recent Dr. Kelly VSG patient. I had moments of paperwork confusion through this, but NEVER concern for my surgeon or what I would experience once there. And Lora Lee worked HARD in the days before my surgery to be sure I was no longer confused and on the “right page”. Enough about that!

With the decision made that Dr. Kelly was the surgeon for me, paperwork began. I weighed in and learned that my weight, the highest I’d ever seen it, was 529lbs. I worried this would preclude me from surgery but, again, Dr. Kelly has experience working with very high BMI patients and he was confident that with his experience and my dedication this would be a good match. We settled that I’d be operated on Saturday, February 2, 2013. I had all the “normal” up and down emotions… I’d done my research and the risks scared (still scare) the heck out of me, then the moments when I allow myself to dream of the moment when I can shop without being stared at, with less (or no) pain made me excited and happy. At the heart of it, I had PEACE that this was the right decision and God-led. I was scared of the post-op pain and drains and how it would be to not really eat for days… But I knew that I had loved ones to hold me up and encourage me, and really… would the post-op pain really be worse that I was living with right then? Onward!

My Mother-In-Law (MIL) was my traveling companion, I love her to bits. I might have preferred my own Mom to be there but she and I both know seeing me hurting or struggling would have been hard… I needed someone with a cool head and a tiny bit of detachment. We boarded a plane on Friday morning, February 1 from Seattle to San Diego. I had back up phone numbers and instructions for arrival time. The flight was quick and before we even hit the terminal, Cecy called to reiterate where to meet her outside. Cecy is the Gal Friday of Dr. Kelly’s business. She’s his wife, a nurse, a nutritionist (her passion) and the driver right now. Her English is not extensive, but we got on just fine… her English is better than MY Spanish! We were met with a large white Chevy passenger van. My only complaint was that with my size and weak legs, I had trouble getting in and out of it. We had to have a curb right next to the van or use a little step stool. So, be sure if you have trouble pulling yourself up that you ask to be sure there’s help for that if a van is how you will be traveling around. The border crossing was quick even with an inspection stop. It was great to arrive in the daylight and really look around at the transition from San Ysidro to Tijuana. There were vast changes in a short drive from obvious poverty to more middle and upper class areas. It’s clear to me that Tijuana, like any larger city, has its safer places and its places you need to exercise more caution.

It took about half an hour to reach our destination: florence Health System’s Oasis of Hope Hospital. This hospital is best known for its alternative Cancer Care program but it also caters to many Amish folks from the US and a variety of other groups. I’d known from YouTube videos and the interview I’d had with Dr. Kelly’s former patient that the hospital LOOKS were aged. The building on the outside appears to be a 1980’s office building and the décor inside was expected to be dated about the same. I was surprised! They’re remodeling! We came in a set of doors by the Emergency Room and operating theaters into the lobby and the look is being transformed into more modern aesthetics and is warm. I had some more papers to fill out, administration stuff for the hospital (these are independent of Dr. Kelly’s papers)… things like liability and agreement to pay overages if they happen. These were in Spanish but I had enough Spanish vocabulary to know that what I was being told they said was accurate… besides, was I going to come all this way and get this close to not sign and go home? Uh… no. Sign away!

I was given my hospital band and led to my room. Again, they’re in the process of remodeling and the patient ward I was in had only just started to get attention. Regardless of aged décor, the room was clean and comfortable, very simple. My Mother-In-Law had a daybed arrangement for her comfort and she said she was indeed comfortable and happy with the accommodation. My hospital bed was exactly that… however, for a hospital bed it was comfy too! I was pleasantly surprised by that. We were introduced right away to the shift Nurses and Doctor. Some spoke better English than others but again, we’d get it right in the long run. They were especially happy when I attempted short replies in Spanish, they appreciated it. Dr. Kelly was going to greet me later that night. Not long after arriving I was told that Chemistry would be coming in soon… AKA “Labs”. There was to be a blood draw that night. We put in a request for our room to be cooled down, coming from Seattle, 72 degrees in the room was hot. A knock at the door and a gentleman came in carrying what appeared to be a tool box. He was in a flannel shirt, jeans and casual shoes, crew cut. He smiled and we genuinely thought he was maintenance to work on the heat. He opened the box and pulled out a band like they use to find veins and I said, “OH! You’re from Chemistry?” Si Si! I don’t remember his name but he was great. He took time to find a good vein and I did not feel a single thing when he did the blood draw. Best darn phlebotomist I’ve ever had! He confessed to me that my veins were “rolling” and he was praying hard as he placed the needle that God would see fit to make it stay put. LOL

Dr. Kelly came to visit and his bedside manner and passion was all that I’d been told to expect. He had some hard, honest words for me… telling me that what we were doing was extreme surgery due to my size but that it he’d do all he could to make it a tool I could count on. He and the surgical team had conferred and I’d be in and out of anesthesia as fast as possible, though I was otherwise healthy he did not want to take a chance. He was quick to add that he’d not sacrifice doing the procedure 100% correctly and with care for speed, but this is why I choose him. His many years of doing the VSG could allow him to be faster and safer. I was set to go into the OR at about 9am the next morning. I had a good cry when he left. It’s hard to hear that your body is qualifying for “extreme” surgery and how had I come to this… but the peace in my bones, that this was right for me, was still there.

I’d been given a mild sleeping pill after Dr. Kelly left me but I woke naturally at about 5am. They’d wanted me up at 5.30 to shower and be ready for the IV to go in at 6 am and the rest of the pre-op tests to start. Sure enough… 6am sharp the nurse came in to place the IV. The first two attempts were awful. I even made my very tough MIL turn green as she held my hand. I have weak and rolling veins, combined with being nervous, it was a battle. I heard the nurses conferring in the hall how to do this better for me. They got creative and filled a glove with hot Water and put that on my other hand for about ten minutes. My shy veins reveled in the heat and were nice and perky now. The third attempt was fast and not so bad and successful. Whew! I was next taken for my chest X-Ray (clear!) and the cardiologist came in to do an EKG, also normal. Every doctor/nurse/specialist was surprised I was not diabetic, hypertensive or had any other disorder.

At about 9:15am they came to get me on the gurney for the OR. I was honestly terrified and had every last moment thought you could imagine. Half way to the OR I started to shake. When I was moved onto the table and my arms stretched out, I started to cry. They were kind to me, noticed my fear and elevating BP and asked if I wanted help. I said yes and they started the anesthesia right away. The last thing I remember seeing was Dr. Kelly come into the room, but it was his reflection in the metal of the operating lights that had not been turned on yet. The next thing I knew I was starting to feel “fuzzy”… out of it… I don’t know how to describe it… and the anesthesiologist telling me to feel a slight burning in my arm was normal. I nodded and closed my eyes to combat the feeling in my head and that was it. No counting or talking, nothing. Fifty minutes later they had moved me back to the gurney (I wonder how many of them that took!) and there was a doctor flicking my nose and saying my name… “Amber! Time to wake up please!” Flick, flick. My first words? “Dude, I’m working on it!” LOL That must have satisfied them. Next feeling was sort of scooting or half falling back into my bed (the gurney was just an inch or two higher than the bed to help me help myself and them as I moved.

At this point, I was half awake for a short time. I remember my upper chest hurting like I’d had a toddler bouncing on me for days and there was a hard rolling sensation in my chest and guts. I knew this was the gas. I WANTED to get up and move, but I just could not do it at that moment. I needed sleep. In reality, I was still heavily sedated and could not have moved much. I remember the shift doctor coming in and asking AGAIN if I’d had high blood pressure because they were concerned about my BP, it was maxing out at a scary 170 over 85 (ish). They were threatening to give me a sublingual pill to bring it down. I think Dr. Kelly put a stop to that, prior to surgery and in the days before I’d been having LOW BP. It was the anesthesia. My BP stabilized at that level and then quickly went down as the day went on without intervention. I also remember the director of the Hospital itself coming in to visit with my MIL, he was keen to know how the stay was for us, if we were happy and he was excited to explain about the renovations. It was lovely that he was proud of his facility. That says a lot to me. Too bad I was too out of it to reply too! My MIL reports that after that first moment, I was out for an hour. I woke up and expressed that I knew I needed to walk but just could not do it yet. I was hurting but still “gone”. I was told to sleep more. I closed my eyes again and thought it had been just another hour. When I asked, MIL reported that I’d been back in the room for FOUR hours now, I freaked out and got right up (blood clots and gas pains were foremost in my head). I managed to stand with some help and I think I used the bathroom. I managed to walk only the length of my room. This set the pattern. Down for sleep about two hours then up to walk, have some ice chips and move a bit, then back to bed.

I think everyone wants to know about the pain you feel after the operation. Yes, I certainly had some. Like I mentioned, there was a deep ache in my upper chest, diaphragm area. Deep breathing was a chore. The belly/stomach pain I felt was largely psychological I think… I could feel every ice chip go from the top down and it was not pleasant at first because it was so foreign feeling. My worst pain was located on my left side and went from the top of my abdominal muscules straight down to just above where I imagine the pelvic bone starts. It was not IN my body, but through my fat layers. It was a bright pain and felt to me like a knife when I moved. Once I was done moving, I was fine, I could handle it. But getting up, laying down, standing sitting, I’ll be honest… it was tough. I was terrified that I’d pulled stitches or harmed myself. Thank God Dr. Kelly came in that afternoon to check on me and assured me it was just the drain and would indeed be the worst part. I’d been told about this and thought I knew what to expect… I was wrong LOL. I had to get through 48 hours with it and then it would be removed and all would be well. I’d come this far… I could do it! Truly, I think the ONLY reason I needed pain meds after surgery was because of that stupid drain. But it did its job. I consider myself lucky, I did not have near the bloating or gas pain in my body cavity that I expected… some but not much and it seemed to dissipate quickly. Also, I got lucky… I’ve had NO nausea or vomiting. I don’t know what I did to please God enough to get to avoid this side effect, but I’m grateful. If I HAD to have the drain in some weird deal with the Universe to avoid throwing up, I’d take it.

So, the rest of Saturday passed in a blur of sleeping, working to get up to move and generally trying to remain kind to myself. My MIL was wonderful, helping me balance, encouraging me to walk farther and generally moving things around so I could get to them. She does not think she did much, but it meant the world to me. It’s hard for me to ask for help, ever. I was introduced to the spirometer in the late afternoon and dang diggity that was a tough nut to crack! I want to take a moment here to talk about the nurses… They were wonderful. Yes, not all of them spoke English, one or two had none at all, but they were all patient and attentive and wonderful and it all worked out. In example, our room was still too warm/still for us at 68 degrees (it’s generally in the 40’s right now in Seattle) so they hunted down a fan and it was on the WHOLE time for us. Also, when they needed to change my bedding, they asked me to sit in the chair that was in the room… this is one like you see in US hospitals that a person could recline in and sleep in if they had to. Well, it was too low to the floor, I was afraid of it. They did not ask, just saw my fear and figured out my problem… while I was out walking to avoid sitting, they actually muscled the one chair out and brought in a proper recliner (huge thing!) to the room from another room, like you’d see in a living room. It was lovely and comfortable and I was so grateful! The darn thing was so comfy my MIL actually slept in it that night! I think the anesthesia fully wore off in the late hours of the day because all of a sudden I HAD to use the bathroom and I was somehow more aware than I’d been. I made three trips to the loo that night, each one easier than the one before in terms of getting myself up off the bed and moving. In these wee hours of the night is when I finally got a little brave and looked at my body a bit. I could not handle, emotionally, seeing the drain so I tried to ignore it but I looked at the incisions. I was SHOCKED they were all across my upper abdomen, below the breasts. No wonder I felt like kids had been jumping on me! I expected they’d be all over my belly in places… but there’s a nice neat line of them marching across me. The nurses encouraged me to shower on Sunday morning and again in the afternoon. I didn’t have the Spanish to explain that I would throw up seeing the drain. Luckly, Dr. Kelly stepped in and assured me that if it was a mental thing rather than physical they would leave me be until Monday morning when I’d have to shower in preparation for next steps. Okay, deal. Otherwise, Sunday passed in a similar fashion to Saturday afternoon. Sleep, up, walk, bathroom, ice chips, spirometer, iPad, sleep. At some point we noticed that my need for sleep was decreasing… the length of time I was awake began to elongate. By the end of Sunday, I was wakeful for about 4 or 5 hours at a time. Go me!

Monday morning around 6am I got up all by myself and did the shower. I cried a little seeing the damn drain but just kept in mind that it wasn’t for much longer. Around 8am preparations for discharge began. I had my last round of medicines in the IV, the nurses were pleased I’d showered LOL… I really messed with their routine. My MIL made me laugh (ouch!) that I just had to think of this process of unhooking me from drains and IVs as being rescued from the Borg (StarTrek reference)… I was terrified to have the drain removed (can’t live with it, don’t want to have it removed? Yeesh! Pick an emotion!). Alas, it was time and removing the drain was not painless, but it WAS fast and Dr. Kelly and all the other folks who talk about it were right, I felt a bazillion times better after that was done. In short order, my IV was removed (again, not so painful a process as I’d built it in my mind) and I was FREE. What’s next?

At mid-day, Cecy and a crew came to wheel me out to the van. It was time to move to Hospital Angeles for my final leak test (one or two are done during surgery before you’re closed up). They had a foot stool for me and getting into the van was not awful but I was glad when I was done! We did ask why Oasis Hospital did not have the fluoroscope for leak tests and were corrected. They DO have one, but Dr. Kelly thinks the picture quality at Angeles is better. It seemed to be his ONLY criticism of Oasis. At Angeles, I felt like I was cheating, just walking into the Radiology area with no waiting, but they were waiting for ME. I wasn’t sure what to expect with the contrast medium/barium in terms of taste/texture. I’d seen on YouTube another Dr. Kelly person going through it but that is not the same. For me, the contrast medium was clear and had an odd lime sort of taste to it. It was horrible, but not unconquerable and done in a moment because I had to take so little (less than a quarter cup). It was strange to gulp something, I’d been practicing sipping for weeks and I felt that go through me like a train. Goodness the noise my gut made! LOL My MIL watched the video and Dr. Kelly talked her through it. He was pleased with it and assured me he’d left me just a tiny tummy and I was leak free at 50 hours since surgery.

Next stop, Hotel Lucerne! What a lovely place!! Cecy connected us right up with a really helpful porter and we were settled in a lovely room. We had a view out the balcony of a cool fountain and the hotel pools (too cold now to swim though). The room was well appointed, our only minor inconvenience was that it didn’t have a fridge or microwave. But the porter was happy to heat things up for us, including the rice hot pack that Cecy let me borrow (HEAVEN! Bring one if you can, it felt so good on my incisions!). We went over my post op instructions with Cecy, they gave me very clear instructions about what each drug was (only three of them) and exactly when and how long to take them for. At this time, I’d been up for more than six hours and needed a nap. The beds were sooo comfortable, soft but firm and I was out fast between that and the heat pack. Cecy took my MIL to go get some drinks for me and look around this area of Tijuana a bit. She came back and had Gatorade, apple flavored Water and Jello for me. Around 6pm we ordered “dinner” for me, my first broth in more than three days (I’d been on water only from Friday morning on). I loved their broth, it was heavenly and managed about a quarter cup. I tried the Jello next. Two half spoon fulls later and I FELT the moment my new stomach was DONE. FULL. NO MORE. KNOCK IT OFF GIRL. I smiled and nearly cried. MIL asked what was up. Kids, for the first time in my life that I can remember, I realized I knew when I was full, that I was done and it was time to put the spoon down. Can I tell you how ELATED I was? It was at THAT moment it was all worth it. I slept peacefully that night.

Tuesday, after checking out my incisions and asking how I was doing with eating and drinking, Cecy (remember she’s a nurse too) invited us out to explore downtown Tijuana, she has other places she likes to take folks away from Revolution Street (tourist trap she said! LOL). I elected to stay at the hotel. Remember, I started this adventure with some pretty extreme body pain as my chief complaint and though I’d had surgery, I was/am still very obese. I was concerned I’d just be slow or lose my energy, need a bathroom or come under ridicule. And, truly, as an introvert, a few hours of alone time would do me good. MIL reports a great time was had… exploring an award winning Mexican coffee shop (a must for any Seattle-ite), a great big Bodega and even their premier “United States-Style” mall. Cecy was a lovely tour guide. That night another bowl of broth was ordered and all was well and comfy. Dr. Kelly came Tuesday night for one more visit. He asked how I was physically and emotionally. He was satisfied with how my incisions were doing, he used Dermabond on me rather than stitches thankfully! I was worried a little about blood clots and flying and Dr. Kelly takes the travel into account when administering Heparin (blood thinner) during and after surgery, noting that I’m protected for a long while after surgery, it is not gone from your body at a fast rate. I asked him about this happiness, near euphoria I felt. I’d been prepared for a depression or at least just a “I feel the same” kind of attitude, happy feelings were a surprise to me. He asked me to describe it more and he smiled and said, “Amber, that’s just you… IN CONTROL!” And he’s so right. I am in control of this now. I have a tool that will help me reshape my life and I AM IN CONTROL. This may not be the reactions of others, but this is my truth right now.

Our adventure was almost over now, we were picked up at 9am on Wednesday morning to begin our border crossing and process through the San Diego Airport. Our border crossing was smooth, there’s a short cut on the Mexican side for those with a medical pass and the US side then was only about 20 minutes. I did use my passport and they asked about the nature of the visit. When I noted a hospital stay and surgery they did inquire about pharmaceuticals I was bringing over but Cecy described the three and the agent was satisfied. We were not even asked about souvenirs! We were early to the airport but that was just fine with us. We even arrived back home to Seattle half an hour early!

If I could give my other Mexico sleevers some advice that they may not have seen or what really made the difference for me, it would be to 1. Have wheelchair service both going to San Diego and definitely coming back from there. It’s easy to order and VERY VERY helpful. It even may get you through the TSA lines faster and 2. That hot pack made me just that much more comfy and I’m using one here at home to not only comfort me but to protect my incisions as my curious and lovable cats explore around me. Six days out now from surgery, I’ve only had one bout of nausea and I think I figured out it was because I was genuinely hungry. Sipped Gatorade and had a few spoon-fulls of Jello and I was right as rain. Celestial Seasonings Mint Mix tea is my go-to beverage now too. Broth is okay, I like the “Better than Bullion” brand but I’m starting to notice the saltiness of things. I’m only using the pain pills at night so I can get a full night of sleep comfortably.

I will HIGHLY recommend Dr. Kelly and his crew to anyone now. All the YouTube, Message Boards and personal references I got were all correct. Their experiences prepared me for mine and I never once felt like I’d been led astray. My experience was as I had been told to expect it to be. Dr. Kelly is a passionate physician and from the way he spoke of frustration with medicine for not being able to figure out why diets fail to his willingness to talk about his life and family, it’s clear he cares about his patients. I think Lora Lee’s addition to their staff is brilliant and I’m still grateful to her for the long phone calls and replies to email that she made in those last days before I made my flight south. But mostly, I’m just feeling blessing-filled and lucky that God/Universe saw fit to put me on this path. I don’t know what the days ahead hold but I’m hanging on to the new feeling of control and, most of all, the hope it gives me.

I apologize for the novel, it’s just how I write. I hope this helps another person. If you have questions, ask away!

--MeasureOfMe (AKA Amber)

Highest Weight: 529lbs

Pre-op Diet Loss: 21lbs

Weight at Hospital Angeles: 505lbs (though I don’t know if I “trust” this)

Next Weigh In: February 20^th.

I am happy to have read the very begining of your journey. I have not begun Mine,Having just decided to do it Just this week . I was very afraid to go to Mexico to have a surgery but I see here there are lots of people who do . I weigh 263 AND AM 5'3" and fly quite a bit and totally understand what you mean by ridicule from other people. I hate some of the looks I get... but enough of that .

I am looking forward to hearing more of your progress ! Thank you for posting ,

Amy

Glad to have given you some insight Amy. The journey really does start before you ever pick a doctor. Going the self-pay Mexico route does add some extra thoughts to the planning, but for some its the only way and quite viable with research and full disclosure of risk and reward. Good luck to you!

Amazing adventure. Thank you so much for sharing. You had me in tears at some points. It's a very similar experience to mine.

Amber,

I'm so thrilled you shared such a detailed accounting!! I'm glad that you were not down or just feeling the same after surgery; while it's not a concern I've really been able to identify, as soon as you said it I recognized it.

I'm willing to bet a lot of us worry that we will go, have this surgery, go through the emotional and physical beginning of this journal and just feel "the same".

I can't wait to see how you progress!!

~Kat

An amazing and touching experience. Thank you for entrusting us with your story.

Amanda Rae

Thank you so much for sharing your story! I will be seeing Dr.Kelly on March 1st and your story has helped me feel comfortable about my decision. I pray you have a quick recovery and best of luck on your wonderful journey

I'd love to hear an update on how you're doing!

Amanda Rae

Hey AmandaRaeLeo! Thanks for asking. The euphoria is definitely worn off, the emotional dam broke two days ago when we had a crisis at home. But, when I am objective, the joy is still there, just overshadowed a bit by head hunger and some mourning of old ways. Physically, I am really doing great. Most of the aches and pains are about gone, and the incisions are healing really well it seems (a real fear of mine had been infection). Sleeve still let's me know it is there and working when my sips are too big or too much and my first Protein drink yesterday went down easily. Don't know about weight loss, I think I am in a stall but could not prove it... Not going to the clinic to weigh in until next week.

Now, if I can just make it to day 22 when I start transitioning back to "real" food, I will be golden. I cry when I think how far away that feels.

Hey AmandaRaeLeo! Thanks for asking. The euphoria is definitely worn off' date=' the emotional dam broke two days ago when we had a crisis at home. But, when I am objective, the joy is still there, just overshadowed a bit by head hunger and some mourning of old ways. Physically, I am really doing great. Most of the aches and pains are about gone, and the incisions are healing really well it seems (a real fear of mine had been infection). Sleeve still let's me know it is there and working when my sips are too big or too much and my first Protein drink yesterday went down easily. Don't know about weight loss, I think I am in a stall but could not prove it... Not going to the clinic to weigh in until next week.

Now, if I can just make it to day 22 when I start transitioning back to "real" food, I will be golden. I cry when I think how far away that feels.

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I worry about head hunger too. I'm thinking of joining Overeaters Anonymous to help. Lets fave it, we are addicted to food.

I'm glad you're recovering physically. Your head and heart will catch up.

Amanda Rae