Two Days Post Surgery: On My Way Home

This morning I had my last round of intravenous meds and a nurse removed the IV. The patient coordinator went over everything, and gave me a care package of instructions, medications, and supplies to clean the wound where the drain was. They also gave me copies of the bloodwork results, EKG, and all the medical info so it can go in my records back home.

I'm feeling OK and eager enjoy a week of rest and relaxation. 

A note about this blog. As I've mentioned, I'm writing this for myself and perhaps for anyone who might need this information from a firsthand source. Friends and family are very welcome to continue reading, but please feel no obligation, and not the slightest need to apologize if you want to stop reading. Deal?

A Big Improvement in a Short Period of Time

It's still the first day after the surgery, and I feel better and better as the day progresses. The doctor removed the drain -- ouch!! -- and soon the IV will come out and I can take a shower.

The hives are acting up, so they're letting me take my antihistamines now. 

This morning I thought, how am I going to travel on Thursday? But I already see that it's possible, and won't be so bad. I have to be super careful not to lift my suitcase, and to ask other people to lift it for me. And I have to walk slowly. If I do those two things, I'll be fine.

I wish I could go all the way home on Thursday! But alas, I can only get as far as Vancouver, then will fly to Port Hardy the following morning. Then I have an entire glorious week off work. Can't wait.

 

All Systems Are Go: Surgery and Flights Are Booked

It is on!

My surgery will take place on Tuesday, October 27. I'm really excited. I'm nervous, of course, but at a manageable level. 

On Monday, October 12 (Thanksgiving!) I begin the two-week fast. I spoke to the RD about this, and she said for most people, this is the worst part. The post-surgery liquid diets are not as difficult, because by that time, the stomach is very small, and fills very quickly. The most difficult part of that phase is ensuring your protein intake. 

But the pre-surgery fasting will be challenging. I'll be drinking Optifast, a protein-shake meal replacement. I'm especially concerned about fasting while I'm traveling down to San Diego. By that time I'll be off the protein shakes and drinking only water. 

The fasting is done to shrink the liver, which makes it easier for the surgeon to visualize using the laparoscopy -- which makes the surgery safer. In other words: important.

Well, everyone who has this surgery manages to get through the fasting, so I will, too. One day at a time. I'll count the days... and probably write a bunch of complaining posts. You've been warned!

Several people reading this blog have been very supportive. I appreciate it more than I can express. It means everything to me. Many, many thanks.

Clinic Approvals, Timing

Endo Bariatrics, in Piedras Negras (near-ish San Antonio, Texas), approved me for surgery almost immediately. They are now bombarding me with marketing emails, especially from their patient coordinator, a former patient herself, who used to weigh 400 pounds. I don't want to unsubscribe until I'm approved at the other clinic.

Oasis of Hope, in Tijuana (near San Diego), has asked for additional information -- a blood panel, an EKG, and a letter from a primary care doctor clearing me for surgery. Unfortunately, like most people in our town, we don't have a family doctor, but there is a primary care doctor that I see more often, the same doctor who referred me for the surgery in BC. I have an upcoming appointment to see her, and presumably I'll be able to tick the boxes soon after that.

After that, I can schedule the surgery anytime in October or November. There will be the two-week fast before surgery, which I have concerns about. But the big takeaway: it's happening soon.

A Little About the Process

First of all, I've changed my mind about which clinic to use. The Oasis of Hope Bariatric Center has a lot of experience, an excellent reputation, and hundreds of former patients singing their praises online. The fee, converted to Canadian dollars, comes out to $5600, plus air fare. That's a big enough expense. I've decided that I don't need to double that, just to get the Number One guy. The Number Two surgeon will be fine.

I can have the surgery any time I want. The clinic will tell me what days are available, but it's basically as soon as I'm ready. I'll do a semi-fast liver cleanse for two to four weeks -- the clinic will tell me how long. Some bloodwork, an EKG, and I'll be ready to go.

Allan could come with me and stay in the same room, but we've decided that double the air fare, plus dog care, is prohibitive. Plus we don't have dog care right now, so it might mean leaving the dogs at the vet's kennel, and we're not keen on that. So I'm going alone. An adventure!

I'll fly from Port Hardy to Vancouver to San Diego. The clinic will pick me up at the airport. The facility is about 30 minutes away.

Day one, the day I arrive, hey'll do any final bloodwork, and I'll meet the surgeon and the anesthesiologist. 

Day two is the surgery. I'll spend the day recovering in a private room.

Day three is a full day of recovery. 

Day four, the clinic drives me back to the airport and I fly home.

Upon return, I'll have to self-isolate for two weeks, according to Canada's covid traveling restrictions. That's easy for me to do, because I can work from home.

Post-surgery there is a lot of adjustment. At first you can only have clear liquids. Then you advance to thick liquids -- blenderized food. Then you have to re-learn how to eat.

That will be a long process, and it may be a difficult one. If I were having the surgery done in BC by our public health care, there would be mandatory sessions with a registered dietitian who specializes in post-surgery care -- counseling, weigh-ins, and so forth. I'll have to arrange my own support, but I can still do that through public health.

For now, I'm focusing on the present.

I Found the Best (Bariatric) Surgeon in Mexico

I have been reading copious threads in forums, along with reviews on Google and Facebook. I know how to tell the difference between real reviews and stealth marketing, and I'm quite sure these are real reviews by real people.

I quickly narrowed it down to two clinics. One is immediately over the border from San Diego (California), and one just over the border near San Antonio (Texas). They both are clean, modern facilities with English-speaking staff, and top-notch surgeons. They pick you up at the airport, you stay at the hospital the whole time, and they drive you back to the airport.

The one near San Diego sounds very good. It has hundreds of 5-star reviews, a very low complication rate. They have several surgeons and offer a choice of several surgeries.

The one near Texas is the private clinic of (what seems to be) one of the most experienced bariatric surgeons anywhere. This doctor pioneered the gastric sleeve. That's all he does, and he's the only surgeon there.

I like that. Many places have several surgeons, and you don't know who you're getting until you're there. Or, you expect to see Dr. X, but you get there, you learn Dr. Y will be performing the operation. 

I also like that he offers only one surgery. It means he's got lots of experience.

I don't mean to harp on the relative costs of these, but this is where we are.
Montreal - $20,000 or more
near San Diego - $5,000
near San Antonio - $11,000

The $5,000 price tag is tempting, and it comes with my second-choice hospital. It has an excellent reputation. I'm sure I'd be fine there.

But since we're talking about surgery, it would be best if the final decision didn't come down to price. This is a stretch, but it's possible.

So, I'm going with Endo Bariatrics.  (The runner-up, if you're curious, was Oasis of Hope. They were first and still are a cancer clinic.)

Now that I've made the decision and have chosen a doctor, I'm really excited to get going. 

* * * *

I thought I announced this in a subsequent post, but now I can't find it. I ended up choosing Oasis of Hope. Endo was more difficult to get to, plus they approved me for surgery in less than five minutes. This made me a bit wary. 

Oasis of Hope is closer to home (easier to get to), has an excellent reputation, and didn't approve me for surgery until they had more medical information. And do I really need to spend an additional $2,500?

Real Answers to All My Questions: Forums

Last night I told my partner I was still unsure about whether or not to have the surgery done in Mexico. I need more independent information about clinics and doctors. That's what it's all about, right? The competence of the surgeon and the quality of the clinic.

As we were talking about it, I suddenly realized what I needed: a forum. Message boards. 

A quick search turned up many forums about bariatric surgery. Naturally people are posting and sharing about every aspect of the surgery, from the initial decision, questions about specific issues during the life change, and the inevitable progress reports. 

Every forum includes a board specifically on surgery in Mexico. There's a lot of discussion about which surgeon to choose, and reviews by people who went to this or that surgeon. 

This is exactly what I need to make an informed choice.