New Information on Port Infections

Another long post - grab some coffee. Yesterday I had a long talk with one of the world's top band experts (opined by me, Inamed, and thousands of others.) Names aren't important at this point - it's all common sense. Do not accuse me of spreading rumors or slamming doctors. My telephone reception wasn't the clearest since I was talking to another country, so don't quote my exact words. This source is famous around LBT and other boards for his stellar reputation. Do not ask for names, I'm not here to insult or slam anyone. If you don't like what this says, ignore it, but I'm compelled to share based on what I believe to be truth and fact.

Those of us who have had port infections/revisions (red, swollen, infected, warm) have a good chance of eroding within two years of banding. Could be more, could be less, or you could get ultra-lucky. I'm practically counting on erosion (I feel the vibe.) I've decided against a new port, and I'll keep my band till I lose restriction. Loss of restriction is a warning sign of erosion. I'm expecting the worse. Let's hope I'm wrong. No worries, life goes on. Now's the time to focus on gaining control over my eating disorders.

"Port infections typically happen during band installation; the doctors in TJ are excellent surgeons, but the 'surgical centers' they work out of are not adequately equipped and can't afford necessary medical equipment."

The problem isn't with the surgeon, thank God! The problem is with these "surgical centers" that fall far below the standards of a sterile hospital, which is something we've been suspicious of all along. These laparoscopic tools called a "trochar" (thanks, Kimber) are so expensive that Mexican "surgical centers" (office buildings that have been converted to surgery suites) often re-use expensive surgical tools after sterilizing them. However, you can't get the tools hot enough to properly sterilize them without damaging the tool.

If a new tool is not used EACH time, bacteria will harbor. Will harbor, not might harbor. It might take a couple years, but the bacteria will be there, and it will eventually grow.

The large Mexican hospitals that are like our sterile US hospitals don't allow re-use of tools. New tools must be used with each surgery, which is why the Band surgery is more expensive in more reputable places. Cutting corners is a way for TJ to offer the Band at a lower price. Again, don't accuse me of spreading rumors because I'm simply relaying information that came from someone that's been placing bands for 15 years and hasn't had an infection in over 1.5 years.

I am NOT saying TJ performs with used tools. I'm saying I was told this by an impressive source, and it makes perfect sense since I have firsthand knowledge that a BRAND NEW surgical center in TJ re-uses medical supplies! The white surgical stockings I was given during my port replacement were used. They were clean, but they had snags and worn spots. Another LBT member saw a HYPODERMIC NEEDLE laying on a nurse's station in a different TJ surgical facility. These facilities are NOT sterile.

On a side note, he told me that US patients are coming to him. One person has been on antibiotics for her port infection for months (prescribed by a US doctor to kill the infection.) I almost cried for her. Her infection would go away, but every time she stopped the antibiotics it would return. Antibiotics can't kill a port infection. An infected port must be removed. AN INFECTED PORT MUST BE REMOVED.

It is my opinion based on 1.5 years of research that port infections begin during band placement from use of non-sterile tools.

It is my opinion a top Band surgeon is Swedish, and he uses the Swedish Band.

It is my opinion a top Band surgeon is in Italy.

It is my opinion a top Band surgeon is in Mexico, but not TJ.

It is my opinion Dr. Billy is on his way to being a top Band surgeon (I didn't put him on top yet simply due to the lack of time the Band has been in the US.)

It is my opinion that US citizens should avoid Tijuana "surgical centers" at all costs.

It is my opinion that you are responsible for asking your surgeon if he uses new tools and surgical supplies.

I may edit this thread as the day goes by since my mind works slower these days, but I won't change anything, I'll just add. Okay?

i was banded in TJ by doctor verboonen and ponce de leon of obesity goodbye . The facility was clean, i never felt in any danger.even tho it was atiquated by us standards. I didnt think to ask about the actual surgery tools! fingers crossed on that one, im 31/2 weeks post op and the sites look fine.

I am a respiratory therapist and yes you can sterialize rubber, we used to all the time using cidex and metrazone. You cant plastic which most of our modern supplies are made out of. I still would not want a reused cath tho ick!

johnette

"Would it not be better to be checked out now and maybe have your band replaced, rather than having it erode to a higher degree and have to have it removed without a replacement?"

Wow, Mari, I would never have thought of that. But honestly, I'm exhausted. I'll probalby have my band removed, maybe for Christmas. It's a good idea, but I'm feeling really crappy today, plus since I'm a woman I have the right to change my mind in an hour Feeling poopy today.

Hi everyone

This is a very interesting discussion and DeLarla thanks so much for sharing all of it with us.

I am a 57 year old who worked as an RN up till 8 years ago. I remember in the old days that we used a strong disinfectant to soak rubber tubing and the rates of infection were not high. In fact we had less infections in the old days, maybe because it was before Managed Care came into being. Nothing was throw away then and it was a high quality of rubber. Perhaps the difference these days is that everything is made to be thrown away and so if clinics attempt to disinfect it, the materials become erroded and then harbor bugs. It sure makes sense to me what you said DeLarla.

I am sure glad that I didn't have to go to a second rate place and get complications and infections. I am so very sorry DeLarla and all of you out there who have had these horrible problems. It sure can take a toll on your health to keep an infected port or whatever inside of your body. You will get sicker and sicker until it's taken out. That's standard medical practice in the US. As for the reuse of hypodermic needles, I wouldn't put it past them. Anything to save a few pesos.

I lived in Mazatlan 30 years ago and my experience with the Mexican Hospital there was really an eye opener. They did not have trained nurses working with the patients. It was filthy at that time and I was horrified that people had to be treated in there. They didn't even know to turn the oxygen tank on my friend, who was blue and having severe respiratory problems. They put the nasal cannula on her and left the oxygen off!

Just in need of some clarification - are you saying that these doctors are re-using "disposable" Trocars? I guess the easiest way around that is to find out if your surgeon uses (used) disposable trocars instead of stainless steel (which can be autoclaved very effectively). I would probably limit myself to a surgeon that could afford to buy the real tools. JMO. DeLarla - I know that you have had a rough go of it and I hope things get better for you soon.

Just as there are horror stories in MX there are in the US too. Any type of invasive surgery puts a person at risk of infection, let's be realistic here. People must use common sense in researching their surgeon and the facilities no matter where they're located! In my opinion, a person would be very foolish to go get their band with anyone with a questionable rep or facility and it isn't too intelligent to make your decision based solely on price! Floating advertisements on MX websites with "specials" are not exactly somewhere I'd choose to get my surgery. There are numerous facilities in the US I would not go to either. I did have my surgery in MX, due to my surgeons reputation, his resume, his professionalism, his facility and I am very happy I did. I have nothing negative to say about my particular experience in MX, but from the looks of a lot of "clinics" I saw driving around I would definitely recommend anyone considering surgery in MX or any other country that does not have "high" health standards, to do extensive research.

Those of us who have had port infections/revisions (red, swollen, infected, warm) have a good chance of eroding within two years of banding. Could be more, could be less, or you could get ultra-lucky. I'm practically counting on erosion (I feel the vibe.) I've decided against a new port, and I'll keep my band till I lose restriction. Loss of restriction is a warning sign of erosion. I'm expecting the worse. Let's hope I'm wrong. No worries, life goes on. Now's the time to focus on gaining control over my eating disorders.

Can't tell you how depressed this paragraph made me with my recent medical complications. It just doesn't seem fair that those who have the most problems, and yet remain dedicated are the same ones who ultimately end up losing their bands!!! Please PM me if you get a chance. I don't know that there's ever a great time to reach me, but I would love to ask you a couple questions. BTW, Dr. Billy called me on Thursday before my surgery on Friday and talked to me for about 20 minutes. I was very comforted by his concern, and the answers that he gave me. Also, I know you gave me your phone number, but I don't know how to access old PM's, if you can. Thanks!! Erin

I researched my doc heavily before I booked my surgery. I dug around looking for anything, something to make me change my mind. I saw so many people go and come back fine. I did know about DeLarla's port trouble before I left, and I knew that my doc did her first port repair that didn't heal due to the tubing. That was the only hesitation I had. I also contacted former patients, several of whom were nurses or husbands were docs (no docs though) who gave me reports as to the facilities. While noone said it was over-the-top lovely, first rate, top-notch, any of that...they all reported that while it was small, it was well-equipped and clean. Equipment wasn't new, sheets were well worn but clean, etc etc. What I experienced was certainly in line with what I heard. And I returned with a good surgery, good band placement, no infection, no problems (except me, swelling and scaring the toots out of me, barely being able to sip water during the first week) and so I, too, went and came back happy.

Just to clarify, I have no idea if the catheter that was in me was used and disinfected...it just didn't look like the clear tubing US hospitals have...it was rubber, I guess...different, and it made me wonder. Obviously, I'm fine, so that's good. If it is the old-fashioned, disinfectable rubber catheter tubing, then however they cleaned it did the trick, since I had no complications from it.

Do your research people. Know what to expect the best you can. Ask around, interview, search the old threads, go early and visit the hospital for a tour of the facilities before you hand over money. Take a medical friend with you. Ask questions. Get a great surgery.

A thread with straight talk is always handy. Thanks.

I have run across a few threads with good info and thought I'd post links here for folks researching. This one is about the hospital Dr Kuri uses and the posts are accurate...I was there and wht she wrote was right in line with my experience.

http://www.lapbandtalk.com/showthread.php?t=9573

and then this person, apparently a US doc, had band surgery with Dr Kuri and had a few things to say on this thread...although I cannot verify whether or not this person has any ulterior motives??? You always wonder, but it's good research anyway.

http://www.lapbandtalk.com/showthread.php?p=117319#post117319

I also went to the profile of the physician and read "all posts by this member" and got some good reading.

I realize this thread is about MX, and not Dr Kuri, so I don't want to hijack and make it a Kuri thread....certainly not under the heading of Port Infections, but it's all pertinent. Happy researching everyone!

I had a wonderful experience in Monterrey, MX with Dr. Sanchez and he does his surgeries out of Santa Engracia hospital. This is one reason why I chose him. I talked with patients of other popular MX Dr's and saw pics of the facitilites and was NOT impressed. Everyone I talked to said the facilities were clean looking but shabby and outdated. Santa Engracia hospital was cleaner than any American hospital I've ever been in and that's a lot because I'm an EMT so I've been inside over 100 hospitals easily. I'm also considering going back to an associate of Sanchez's who practices out of the same hospital for future plastic surgery. I had a wonderful experience and no comlaints or complications. My personal opionion - Tijuana scared the shit out of me just from everything I've heard - that was another reason I chose Monterrey, I was told it was a richer part of Mexico that was pretty Americanized - I was very comfortable there.

DeLarla,

Regarding erosion - what comes first, the port infection or the erosion? I have read that the eroding band causes drainage along the tubing that irritates and infects the port area. Or is it that the infection from the port travels up the tubing to the band and irritates the tissues around the band, causing erosion? Did you get any insight on this from your talk with the doctor?

If I were you I would go ahead and get the endoscopy to check for erosion. Are you going to get your band removed even if there is no sign of erosion?

Take care,

-Yvonne

First of all, I did thorough research before banding. I followed Doctor Karen H., who has her medical degree and doesn't let doctors touch her without knowing every aspect of the facility, surgeon, techniques, skills, experience. According to her research, my resarch, and stellar recommendations by Inamed, both Karen and I were banded at the best facility with the best band surgeon, so for anyone to insinuate that some of us might not be doing our research is like a slap in the face. And I hit back (laughing here, so don't take offense.)

I don't know if rubber tube can be disinfected, but rubber tube doesn't sound very expensive. I only said the very expensive tool was being reused.

Tijuna is disgusting. Maybe the surgical centers seem clean and well-equipt, but LQQK at the city, LQQK at the buildings that the surgical centers are in! My husband was horrified that the pillars would cave in because the buildings aren't up to code. Most of Tijuana, Mexico is a scary, creepy, nasty, foul place. These Tijunana surgical suites are recently remodeled office buildings. Imagine going to a 10 story bank in a creepy neighborhood. Climb up a couple crooked stairs while wondering why the building looks slightly slanted. Pass the grungy lobby, into the dank smelling, rattling elevator that makes you wonder when it was last serviced. An elevator shared by all the other businesses in that building (trust me, nobody in surgical scrubs in those elevators!)

Exit the 3rd or 9th floor with bad carpeting, then finally come to a door with fancy writing that says, "Surgical Suite." THAT is what you get when you go to Tijuana.

Nice new floors, fresh paint. Tea served in china, not sterile hospital dishes. Tiles crooked - everywhere. Hmmm, what business was being run out of this suite last year? Is there proper ventilation to prevent germ spreading? What's in the Craftsman tool box? Perhaps surgical supplies? Is a Craftsman tool box a sterile environment? Did they steralize it, or did it come out of a truck from the Craftsman warehouse?

The only place I'd ever "consider" in Mexico is Monterey (probably the same facility mentioned above.) The big hospital in Monterey runs by American standards. They don't reuse tools.

I did not say Tijuana surgeons reuse tools. I said, "a top surgeon informed me that he has firsthand knowledge that surgical centers in Tijuana reuse tools." I'm basically spreading a rumor because I believed a top surgeon so I repeated what he said.

"Quote: are you saying that these doctors are re-using "disposable" Trocars?"

I'm saying that a surgeon in another country, who is friends with Mexican surgeons, and who is familiar with the Tijuana surgical centers, told me that they re-use Trocars. He did not specify if ALL of the surgical centers re-use them. He did mention a very popular name that reuses Trocars. He said "Trocars cannot be sterilized because you can't get them hot enough without destroying them." He said, "Tijuan is very poor and the surgical centers can't afford necessary equipment."

I've said this before, and I'll say it again: Tijuana surgical centers do NOT have an ICU unit. Better hope you don't have any complications with anesthesia or other potentialy life-threatening urgencies, because you'd have to get transported to an ICU, and that critical hour getting to an ICU could kill you, couldn't it?

I'm not a nurse or doctor, just a nosey patient that talks to and meets a lot of Band surgeons.

Quote: "What comes first, erosion or port infection?"

Answer: I don't know. Two of my friends went back to Tijuana for fills. During the fill, the doctor noticed the barium wasn't flowing through the band correctly, so they each had to get an endoscopy. The endoscopy confirmed erosion. Neither had symptoms, and neither had port infections.

Port infections often lead to erosion. Bacteria on the port tube leads to the band. Even if the port is removed, tiny bacteria usually remains. It can hang around for a couple years before growing again.

Don't quote me, I'm just telling you my experience.

It does and doesn't come down to doing your research... you have to be just a tad smarter than that. Some people think "research" is reading at LBT. It has to go way, way beyond that. Call every surgeon that will take your call. Ignore every positive post that you see, and jump right to the ugly ones (like mine.)

What's more important, the majority of people that come out of Tijuana in great shape, or a bunch of people that came out with horror stories? Take your pic.

not a good word for my Greek surgeon?

i did a lot of research with my husband as he is also surgeon, he watched all the procedure and the operation and he was suttisfied by the surgeon, his tools, the stuff,

the hospital, everything..

pls add some good words for me the Greek

I don't know anything about Greek hospitals, although I have read some alarming reports of people going on holiday there and being taken ill. Their care did leave something to be desired. However I think that it is somewhat arrogant to think that a poor country's hospitals must be dirtier than american ones. I live in England, not a poor country, but I went to Hungary, which is a much poorer place,to have my banding. It cost me £2500 as opposed to £8000 at home. Everyone there, even the staff behind the enquiries desk, wore clean white uniforms, if not modern and new. The cleaning lady came into the room twice a day and every patient had a MRSA scan before admittance. I can honestly say that the hospital was cleaner than the very large one opposite my house. We can thank the wretched Thatcher for that!