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What do you wish you knew before having surgery in Mexico?

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Hey all, my wife is looking into the gastric sleeve surgery, of course I am the one with all the questions about it. Hoping maybe someone could help with any anecdotal evidence at least. I'm trying to reduce the "I wish we knew x before doing this" ...

Anyway, for obvious reasons we are looking at Mexico. The first one she sent me was Elias Ortiz out of Tijuana. So I looked into him more, and read about some very poor (in my opinion) things about him, I think mostly when he was with ALM (or whatever it's called). Of course the first surgeon we look at giving me the eebie geebies is not a great start. He's not officially out of running, but we have looked into the following now. Odd that there didn't seem to be lists of them. Haven't looking into everything equally, our spoken to the coordinator on prices or anything, but these are probably in order of what we like.

Endobariatric in Piedras Negras with Guillermo Alvarez

LIMARC in Tijuana with Liza María Pompa González

Obesity Control Center in Tijuana with Ariel Ortiz

Elias Ortiz & Co in Tijuana

VIDA Bariatrics in Tijuana with Gabriela Rodriguez Ruiz

So I guess the questions are the following. If anyone could answer whatever question you may be able to add to, that would be great. Thanks!!

1) After deciding on Mexico, what was the overriding determinant in picking a surgeon, was it only price?

2 Did you get to pick the bougie size? I read a study (odd that I only found one) about bougie sizes - apparently 32 fr and 40 fr are the 2 commonest sizes? Anyway the study said that there was no materially significant weight loss difference between the two sizes, but there were less complications with the 40 fr size. Also in her situation, she's 5'10", and her general body type is such that her most healthy weight is going to be more than others her height, so I fear something too restrictive could come with problems of their own.

3 I've read about issues where people's Drs don't support post op care for out of country surgeries. This was old info though. Have people found this to still be the case? Is it only for the primary doctors, or only bariatric doctors? Or both, or is that not really a thing anymore?

4 What about complications during surgery. I have to imagine they send you to an ER in the states. I understand at that point our insurance will cover the emergency internationally, but not sure the MX hospital would be adequately staffed, and may have to send us to a place in the US. Any issues with transportation delays having to cross border?

5 Complications after you return home... I assume no, but are there any that, if we are about to make it back out, would fix the problem for like no cost or reduced fee?

6 Post op care. Like weeks/months/years... Is there a type of support you wish you had but was not provided? Nutritionist, or type of PT or psychologist/psychotherapist that focuses on mental issues that may arise after the big life change, to avoid body dysmorphia from moving to a different body part... I know the OCC place mentioned 5 years worth of support. Not sure if that is worth it, or if it's just something out there for fluff because it seems like something that would be useful for patients, but actually patients after the fact realize it's not helpful.

7 anything you know now, but would've been really helpful to know beforehand? Whether generally, or issues that would be specific to MX vs going to a place in US?

8 wondering the success of people with situation like her... In my opinion her problem isn't with overeating/the size of her stomach. She doesn't eat because she's hungry, so I'm not sure the impact this has on ghrelin will be a huge help. She invites an environment where she keeps low metabolism, skips meals, Snacks on crap, drinks artificial sweeteners, takes medication that has been shown to lower metabolism. I tell her she needs to eat more Protein, Fiber, and 'eat like a diabetic' and when she works out (which she doesn't even do anymore), it's more of a benefit to go shorter sessions, but with more intensity, as that is best for your metabolism ... She says "Believe it or not, I actually learned this in college (for her nursing degree) and I know what I need to do" but yet does not do at all what she needs to do - and yet also simultaneously complains that she's tried everything to lose weight, even though that's not the case, particularly in last few years when she's out on anywhere from 20-40 pounds (guess). Looking at all the pre and post op diets, it looks like there's a focus on protein (as one would expect). So she's like, addicted to the dopamine I guess that she gets. She eats because she knows it's there. So while I am sure she will lose a bunch of weight offer the first 6-12 months, I tell her I'm more worried about being back where she is now 5 years after the fact, due to her behaviors that have put us in this situation in the beginning. There have been a handful of things that she's done (each successive thing being more expensive), where she's like "if I get x then it will force me to do y" and that's basically her 'argument' here.

9 related to above, how does one stay hydrated while exercising, esp in heat? Or even being sick? Is it recommended to drink warm Water, due to the quicker absorption than cold?

Edited by Klumzyfule66
Specify sleeve

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I just went to Renew Bariatrics in Tijuana Mexico on 6/4. YOU WILL NOT FIND BETTER DOCS! Look em up on Google. They are double board certified in the US and Mexico. They all speak English. It was $4600 and that includes transportation from hotel or San Diego airport to the facility and then back to either one after 2 nights in hospital. One night hotel stay included but I opted out. I wanted to get home to my baby's and felt no pain after surgery whatsoever. Dr Perez was AMAZING!! He only did 2 incisions bc my liver was so small 😍🙌 They have a Facebook group and all where THOUSANDS of ppl have gotten the surgery. Before and after pics. All diff questions answered. It's so awesome! I'm 16 days post op and down almost 22 lbs. Feel free to email me personally, I'll send pics n all. Totally forgot I even joined this group until I got a notification today. Would love to help all men and women go to Renew Bariatrics! Seriously you won't regret it 🙃

cjones61985 @yahoo.com

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i did not have my surgery in mexico. I wanted to be close to home but after researching mexico. The one place that stood out beyond the rest was ENDOHOSPITAL with Dr Alvarez. Its such a nice hospital, Just a stones throw from the border and he is a USA educated doctor. If i would have went the mexico route i would have chosen him. Tho he only does sleeves. So if you were looking into bypass then it would not work with him.

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At Renew Bariatrics they do bypass and gastric and some ball one...🤔 and the band. Most ppl get gastric (they even have mini gastric) or sleeve. Renew is right across the boarder too. Literally a 7 min drive once through the boarder. I was anti Mexico but omg these guys are AMAZING! Can't express that enough. Best decision ever.

Anyway. Gotta go weigh myself 🥳🙏

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I had VSG in Tijuana, Mx. at HospitalBC with Dr. Illan, so I can only speak to my own personal experience. I did about 200 hours of research before my surgery and based on that research, finances, and other personal considerations, decided to go the Medical Tourism route and have been very happy with that decision.

These hospitals ONLY do bariatric surgeries and are geared towards medical tourists. They run a VERY well oiled machine from intake to discharge. The process was so smooth, I was completely confident going alone. The surgeon I chose is highly accredited, has done thousands of WLS procedures, has relationships and mentorships with some of the most well known US bariatric surgeons for continuing ed, is board certified, etc. He is just as qualified, if not more so, than many of the bariatric surgeons in my area.

The reality is, there are amazing surgeons in the US and just as many in Mexico and other places. Conversely, there are terrible surgeons here and everywhere else. There are pros and cons to each, and every person has different needs. Ultimately it boils down to doing your research, finding a surgeon you trust, and a program that fits your needs.

Regarding your questions above:

1 - No, it was a combination of finances, timeline, convenience, and other factors.

2 - No, I did not get an option. My surgeon uses a 32 as his standard and will only deviate when appropriate for the patient.

3 - I met with my PCP before I went and she was extremely supportive. She does all my post-op labs, checked my incisions, offered dietary support, etc. She now recommends my surgeon to other patients who are interested in going out of country for the procedure.

4 - The hospital I chose was staffed with additional medical personnel in case of emergencies, but that really wasn't a consideration for me. The instance/risk of major complications DURING surgery is essentially nil.

5 - Complications aren't usually the result of a surgical mistake, so there is generally nothing for the surgeon to "fix" they typically are just the result of a person's own body's healing. For instance, a stricture is one of the most common (though still extremely rare) post-op complications, and they are almost never a direct result of surgical error. They just happen.

6 - My hospital offers lifetime nutritional support, which is great. That being said, I HIGHLY recommend some serious counseling before & after to deal with the emotional/mental work that has to be done. I was really well informed pre-op but still felt like the extra support would be critical, and it was. I would also suggest ongoing community support - either here, or something like BariNation (which I LOVE), or a local support group. I am a card carrying, people hating, highly independent introvert and have still found community support to be vital to my success.

7 - I wish I had known how ridiculously kind and accommodating the staff would be. I went alone and really kept to myself, but the one time I needed the staff they were incredibly responsive and very kind. In hindsight, I wish I had been more engaged.

*going out of order* 9 - It takes time. Most people will NOT be able to hit their Protein and Water goals right away. It took me probably 3 months before I was able to get there consistently. It just takes a crap ton of work. I keep water handy at ALL times, and drink, drink, drink like its my job. I was never advised to drink warm water or to adjust my intake in any way. Just drink, all the time.

8 - I am going to say this as gently and with as much love as I possibly can - This is not your journey and you would serve your wife best by keeping your opinions to yourself. Unless you have lived in her brain and her body, you cannot understand what she is going through, what is driving her behaviors, or what toll it is taking on her mental health. I can guarantee you, she feels plenty of shame already and doesn't need you second guessing her ability to be successful. The best thing you can do is research, report back, support her, and shut up. My husband is thin and has the metabolism of a hummingbird. He has never struggled with his weight and as such has no frame of reference and no ability to understand. He recognized this early on, and has thus deferred to me on every diet, every fast, every medication, and ultimately my decision to have surgery. His unconditional support, free of opinions and judgment, was the kindest gift he ever gave to me. I know you love her, and you clearly want her to succeed. But the baggage you are forcing her to drag around is entirely unhelpful. A much more valuable way to help would be to help her find a therapist so she can do the work that would set her up for success long term.

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I didn't have my surgery in Mexico - and didn't have a sleeve - but I want to comment on just one item:

do NOT rely strictly on cost. The most important thing is the surgeon's reputation, skill, and experience. Look at reviews. Lots of reviews. There are excellent surgeons in Mexico, and there are also bad ones. Do your homework. It's not worth dying or having severe complications to save a buck.

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