Hi all,

I am trying to decide on a surgeon and I found one that seems very competent, has good reviews, and is in my price range. The problem is he has a video up of him doing a surgery and his nose is not covered by his mask. No one in the operating room has their nose covered actually. Should this be a deal breaker? Or is it not that big of a deal? I checked several other videos and most surgeons have both mouth and nose covered even if wearing eye glasses. I did see one or two where someone other than the surgeon didn't have their nose covered.

In addition - I think I saw the first one (nose not covered) open a package of something - maybe a bandage - while wearing his gloves. Would that be an issue? I doubt the package would be sterilized on the outside like instruments are so....? What do you all think?

Lifeislikeaboxofchocolates, do you purchase equipment for a hospital?. Just curious where you got the 2k price tag. I order for my practice and our Coviden endo GIA single use triple staggered titanium stapler/cutters are a fraction of that cost. Perhaps the multiload, laparoscopic versions are more expensive?

Edited May 31, 201412 yr by Kindle

Unfortunately @@lifeislikeaboxofchocolates - timing is important here. In the next month or two, I have time to get this surgery -after that - not so much. That means I fall within this price range. I have changed my mind from my first 2 original considerations and am leaning toward another doctor. I will ask about the staples being titanium - do they cost 2k in Mexico or is that USA prices? I am going to ask the doctor or coordinator all of the questions you have posited. If you can think of any more, please post them.

@@Mencinas - sorry I thought I had replied to your post. I didn't see the cell phone - which video was that?

@@Dr-Patient - sorry, I thought I had replied to your post. Do you think it would be enough if the surgeon agrees that everyone has a mask over mouth and nose or would this be too much a major indicator of other sloppy practices as lifeboxchoco says (and I wondered about before)? It seems most of the Mexican doctors in my price range were either not themselves covering their nose AND/OR some of the staff. Even the one in the 6,500 range in the center of excellence had 2 people in the distance noses not covered (well one was the anesthesiologist but he was behind the tv screen).

It is a dilemma because I need this surgery (diabetic) and this is the time frame and price range I can do. Most people seem to come back ok. Do I take the plunge and do what I can? Or do I not get the surgery maybe for a few years (or maybe never) while diabetes continues? I am not insulin dependent (yet) and the prognosis is good for remission.

@@Kindle - It does sound like a lot doesn't it? I know supplies in Mexico are cheaper than the USA. That is why people go over the border to get medicine - from Mexico and Canada.

Edited May 31, 201412 yr by Travelmego

I do, however agree with everything lifeislikeaboxofchocolates said in her post. She found a surgeon who met all of her requirements and felt completely safe with him "as is". So did I. Different surgeons, but we may have had different criteria in our search. And personally, I didn't "negotiate" my surgeons techniques and sterility protocol. I wouldn't have gone into it knowing I would only feel safe if he "made an exception" and did the right thing for just my surgery. Surgeons are creatures of habit and having a patient tell them how to do their job would not go over very well.

We never know what a surgeon does when lights out. I don't think it is telling a surgeon their job if you express your concerns. I expressed my concerns about having bottled water due to sanitation. Go to gastricsleeve.com and there are forums for nurses who have had the surgery and they can give you more info. I wish you nothing but the best on your journey.

@@Kindle Hmm good point. I need to rethink again and again.

@@cbcatlover - yes, I agree that I don't think it is telling a surgeon how to do their job especially if it is phrased right. I will check out that forum too.

Perhaps a good way to address it with the surgeon is to ask BEFORE you make the trip/decision. Like "Hey Dr. Such&Such, I notice in your video you didn't have your nose covered. I'm curious as to why as in the US we are used to surgeons with nose and mouth covered." I have a slightly unreasonable fear (regardless of surgeon-US or abroad) that something (gauze, clamp, scissors) will be "forgotten" inside me. I watch too much tv. I'm sure it's a crazy fear but I fully intend to let my surgeon know that is my fear and ask him to double check that everything that should be out is out before they close me up.

Ya good idea candy. I might just say 'mexican surgeons' rather than single him or any of them out. I can put that in terms of a general fear like you suggest.

It still leaves the bigger question of overall sterile procedures.

I doubt there is a rule that mandates MUST be worn every single time in every single instance. I guess the more relevant question is - if someone gets an infection and the surgeon was not covering their nose - how would a mal practice lawsuit view that? How would insurance view that doctor? How would other peer surgeons view it?

I have yet to hear from a single professional who thinks it is ok to not cover the nose. My best friend asked a surgeon friend of hers and he said MAYBE it would be ok if they were not sneezing and stuff (as in maybe the patient would not get an infection in that particular surgery) but was bewildered at why anyone would take that chance. My primary care doctor said run. At least 3 nurses on here have said, "no way" and now there is a surgeon on here saying the same thing.

If we have sneeze guards over our salad bars, why would we not want them over our open wounds?

Like you, though, I would like to know how this actually works in the usa regarding the setting of protocols etc. You ask very astute questions.

Edited June 17, 201412 yr by Travelmego

As a surgery nurse in my earlier career, my opinion is that there is absolutely no way their noses should be exposed. I would not go into an OR knowing that.

As for the dressings, they actually could be sterile, but there's no way to know from a video.

Hi @@MichiganChic - thank you for your input, and congratulations on your tremendous success at weight loss.

@zmdh38 Everyone is (and should be) concerned with infection obviously. However, as a diabetic I have been told I should be extra cautious with wounds and infections.

Now the next question are........Assuming that covering the nose IS necessary as a standard operating protocol in the USA.....why are so many of the Mexican docs not covering their noses when they are touting USA medical standards? Or, are we just being biased assuming that USA surgeons cover both? IS this a quality of care gap between the two?

Pretty much all of the 4,500 price range surgeons have themselves and/OR a few people in the room with noses uncovered. Is there a difference between these doctors and higher priced Mexican doctors? If there is, what does this mean? Why are these other doctors higher priced? Reputation? Qualifications?

I know I am asking tough questions but I think most of us have asked ourselves these same questions. I realize people have favorite doctors on here that they don't want to see touched by any hint possible criticism. People feel so grateful to their doctors for giving them a new life, and I completely understand that. However, if we are going to go to Mexico, all doctors should be able to withstand close scrutiny and tough questions, right?

I am certainly not trying to put any one off of weight loss surgery, and I reiterate - I am probably 99 percent going to Mexico - I don't have much choice. However, I want to KNOW as much as I can.

Edited June 1, 201412 yr by Travelmego

What did you decide to do? I totally understand your desperation because of your time frame. I have found out that the surgeon I went to in Mexico now has financing. Yes he costs more, but it isn't because he's greedy. Watch some of the videos on you tube of Dr. Alvarez. He shows you the type of staple gun he uses with the titanium staples. Also listen to some of his radio show runs where people ask all these questions you're asking. You could ask him the question about masks on his show! Every Monday night, people from all over the world ask him questions. I think you need clarity. I know you want to have this done, as I was the SAME way. But you have to have peace and confidence in your surgeon. Another thought here...I enjoy painting pictures. If someone told me I must paint with gloves on, I would not be able to paint as well as I usually do. Why? Because I am not used to wearing gloves, and it would be uncomfortable to me. A surgeon is the same way. I have been a surgery nurse. All surgeons are artists. They are creating a body part. They have very specific rituals before and during surgery. Most listen to music, eat a specific food that day; they want certain people to stand in a certain place in the OR. point being....You can't tell an artist how to create his work of art, as you may

not like the end product.

Hi life. After a lot of research I picked Dr. Illan. I made a post with my reasons why. Thank you for your suggestions. I partially agree with your point about art and artists - except making a painting isn't life or death. I get your point though and I did think of that. As for the covering of the nose....as it stands I asked Dr. Illan's coordinator and he said they do and I saw a picture (not a video) where everyone is covered. I didn't see a video of him at all. I am going to ask him when I talk to him via skype just to hear it from the horses mouth.

Congratulations on your decision!!!

Thank you So, the 'Great Nose Debate 2014' comes to a rest without a really satisfactory conclusion (and yet may live again another day!).

However, we have more awareness and hopefully everyone makes sure to ask their coordinators if the doctors and staff all cover their mouths and noses. That way, if they are not, they will probably start doing so because it is a new demand from the Medical Tourism community.

Forget Ponce de leon - too many confusing and dodgy stories about him around.

Lopez - I have seen posts where people talk about him doing 9 and 10 surgeries in a day. He is supposed to be good though.

I don't know Dr. Ostsuna.

I picked Dr. Illan. The picture of him available has everyone with their nose covered. I couldn't find any videos. I asked the coordinator and he said they did. I talked to a recent patient of his who was still down there and she is a surgical scrub nurse in the USA. She said his sterile technique was perfect. I am going to ask Dr. Illan directly when I speak with him on the phone just to hear it from the horses mouth. However, he is the one I booked with.