My thought process behind Weight Loss Surgery {WLS}/Bariatric Surgery/Gastric Bypass {Roux en Y or RNY}

Next week, my husband and I celebrate our tenth wedding anniversary.  TEN.  Which reminded me how quickly time passes.  My mother, whose birthday would have been yesterday, died almost five years ago.  FIVE.  Again, with the time flying by thing.

My mom had said to me, about two or three weeks before she died, when she was still in the cardiac unit, just days after her open heart surgery that I really needed to get my weight under control, so that I would have less of a chance of facing something like that myself.  I totally agreed.

I should have already gotten a handle on my weight.  Thing was, when I did conscientiously try to lose weight over the years, I'd not only regain the weight, but often another three to ten pounds.  I thought that I'd have some time to get it under control, because I was sure that it was a matter of willpower alone.  And I figured I just didn't have enough.

There were many things that took priority and I was sure that once I focused on weight loss, I'd conquer that just like I had dealt with so much other stuff.  So, when I realized that now's getting down to the nitty gritty for more reasons than one, I considered a plethora of options regarding weight loss.

Here are a few of the other reasons I wanted to address this:  I turn fifty next year.  My mother, and her mother, and her mother all died from end stages of heart failure.  They were all in their early to mid~sixties.  Altho I do not have current heart issues, I am having some slight pulmonary issues, due to obesity.  My joints are wearing, starting to grind, click, and stiffen.  Multiple systems are burdened with the extra weight and not running as efficiently as they could.  I've been borderline hypertensive for a couple years now.  Diabetes runs prevalently in both sides of my family. And fifteen years will fly by in the blink of an eye, meaning that my midSixties are a lot closer than I may have realized.

Also, my husband and I have a wonderful relationship.  He takes after his grandparents {who both lived until they were 98} and is in excellent health, in most all ways except one that is a neurological issue.  I'd like to be around as long as I can to enjoy spending time with him.  And as the neurological issue worsens his ability to learn new tasks, and affects his memory, so that even things he knew how to do become more of a mystery to him; I'd like to be around to continue to have my love enjoy as much of his time as possible.

So my weight has been a HUGE matter of concern.  I moved it to the top priority on my list, really focusing on it.  This summer, I started to do some rather intense research.

My husband had had gastric bypass three years before I met him.  So by the time I came into his life, he was already at the weight his is now, about 155, plus or minus a few pounds.  From time to time, he'd suggested gastric bypass as an option for me to look into, but I was sure I could manage my weight loss without such a drastic move as surgery.   But this summer, I realized that if that were true, I've have done that by now.

If you do have an interest about my findings during the research process, just ask.  By the time I made a much more definitive decision on my own course of action, I probably could have written a dissertation proposal on the psychotropic pharmacokinectics of bariatric patients.  One third of all bariatric patients do take psychotropics of one form or another both prior and post surgery.  So it was very surprising to me that there is limited information available, research studies published in peer reviewed medical journals first began to address this area only about seven years ago.  Most of them agree on two main things:  more research is needed and extended release medications should be replaced with immediate release versions.

Once I had made my decision to pursue gastric bypass surgery in earnest, I contacted numerous programs and facilities with highly detailed questions that most could not readily answer.  This was a great way to narrow the pool of acceptable programs and surgeons.  I spoke with, via live stream video, several surgeons {this is not the norm, it's that the questions I asked were interesting to the surgeons and they were willing to provide explanations}.  Once I was satisfied that I thoroughly understood the process, along with the risks and benefits, I began to consider where I wanted to go.

Let me take a break here and explain that here in the USA, the insurance companies often exert a certain amount of control over what procedures can be performed on particular individuals.  The main priority is not your health, it is lower liability and higher profits.  The bariatric professionals are often NOT consulted or even considered when it comes to policy for the insurance companies, nor are the approval criteria reasonable, in some cases, the requirements are considered unnecessarily strict by those dealing with metabolic and bariatric issues.

Knowing ahead of time this and also that my husband's first wife spent over three years jumping thru hoops, tests, doc visits, etc all out of pocket {the insurance companies do not usually pay for procedures and such that a patient needs to perform in order to satisfy the insurance companies' criteria and prerequisites}, which created more stress and more health problems for her.  She was approved, but many are not; the fact that I have pre~existing {albeit well managed for about fifteen years now} mental health diagnoses would very much count against me.  Only one fourth of those with mental health &/or neurological disorders are approved for bariatric surgery of any type, less so for gastric bypass.

However, let's say that I was approved.  Not counting the out of pocket expenses to go thru the prerequisite process to gain approval; just considering the co~pay alone, it would have been MORE than to go elsewhere to obtain services with higher success rates, fewer complication rates, and better overall healthcare.  So I looked at programs indepth elsewhere.

I ruled out quite a few countries, including Canada, right away.  In the end, I decided on Mexico.  Tijuana has a booming medical tourism industry.  The market for bariatric services is intensely competitive there.  If a program is not good, it doesn't survive.  Too many eyes, not just  those of the health department, but from other programs, facilities, surgeons, and the patients themselves, are scrutinizing every aspect that exists and then some.

Personal opinion can be expressed and seen in evaluations, so I kept that in mind when I did narrow down the programs and surgeons to a mere handful and turned toward reading reviews from past patients and there are always those who "know of" someone who had some horror story to share.  There were some that seemed legitimate and some that were just not quite believable because details were vague or missing altogether or because conflicting factual evidence was easily obtained.

My surgeon actually teaches at one of the foreleading programs that focuses on Bariatric Surgery.  This to me was the cherry atop the whipped frosting on the ice cream cake that I can no longer have, unless it's enjoyment of the memory of such a thing.  I do have those memories.  Yummy.

My package for the program included shuttle service from the San Diego airport across the border to the Tijuana Marriott Bonvoy, Executive Suite; the hotel stay and expenses such as my chicken broth, popsicles, bottles of water, etc; shuttle service to the CER Hospital; the pre op tests, lab work, and other services; the surgery, including all the services like the anesthesiology, etc; the post surgery recovery period, including all medications, and three additional nights at the hospital; all my meals at the hospital; the shuttle returning to the hotel; two additional nights at the hotel, including executive lounge services and my food; a shuttle tour thru Tijuana with extremely well informed drivers who know what the bariatric patients are allowed to have, so we stopped at a place  which served five  types of paletas that were acceptable for us to have; and the shuttle services from the hotel, back across the border to the San Diego airport.  Everything was included for one companion {for me, it was my husband} except his meals outside of the executive lounge at the Marriott.

All expenses, including those listed above, gas to and from our local airport, the seven day long term parking, the house/petsitter fee, and the two round trip flights from Jackson MS to San Diego CA cost LESS than the copay for most insurance companies for the surgery alone {not considering hospital expenses that accrue or any of the other expenses that mount up here and there}.  There were no hidden expenses with the Tijuana Bariatric Center's program.  They are very forthcoming with all the details, including that the hotel asks for a one hundred dollar deposit for your stay that can be reimbursed if you do not run up any expenses such as the minibar or eating at the restaurants within the hotel.  That's pretty standard practice in the USA as well, so no big surprise that the hotel would do so there.

Every one, from the USA coordinator, to the shuttle drivers, to the hotel personnel, to the nurses, to the Mexico coordinator, to the surgeon, to the anesthesiologist, to the follow up Dr, to the nutritionist, every one was an absolute delight to deal with.  I know that not everyone has the same experience, even if the same things occur, because perspectives and expectations are different.  I did a ton of research and pretty much knew what to expect.

There was only one matter that concerned me and I did bring it to the attention of all the other areas of the program so they might be able to consider several other alternative courses of action, including asking the patient to sign a release of liability so that the patient can retain control of their usual medications that they have taken that are not related to the hospital stay or procedure, provided that the surgeon approves the continuation of those medications.  I did get prior approval and would have gladly signed a liability waiver.  However I did surrender my usual medications to the hospital's pharmacy for dispensing to me.  There was an issue with the scheduling of when they administered those meds; however, it was for a limited time, several days, and I was able to reinstitute my own schedule once I was discharged.

This was the ONLY issue I had encountered out of a week's stay in Mexico.  Now I don't know about you, but I have never had any hospital stay, medical in office procedure, etc that went so smoothly as this major surgery involving multiple agencies, including the potential for complications due to language barriers and misunderstandings.  I speak next to no Spanish and yet no one chided me for that; in fact, a couple nurses apologized to me for not speaking very good English, while I was in THEIR country.  Most of them spoke better English than quite a few USAmerican adults whom I encounter every week.

Thank you, to everyone involved.  I appreciate you more than you know.  Thank you.