"A Patient's Experience"
Hi there my name is Shenaz and I went through a Laprascopic Swedish Adjustable Gastric Banding Procedure in Tijuana Mexico on December 2, 2004.
In 2004 I was a 53 year old female, a registered nurse, who has tried just about every diet you can think of over the past 20 years trying to regain something like the figure I had before I had children. However I have remained between 214 and 245 pounds at 5'1" for a long time . On the day before surgery I weighed 218 pounds this gave me a BMI of 41.3. I don't expect to go back to 114 pounds but would be very happy to get back to around the 130 pound mark, thus reducing my BMI to much more healthy 24.6! This means I need to lose 88 pounds to reach my goal.
In 1978, I used to wear a size 4 and although my weight fluctuated and I did gain up to perhaps 20 pounds now and again it really wasn't an issue until I started to gain weight after a back injury in 1983. I was bedridden for 3-4 months and unable to work for several years. My weight ballooned to 178lbs at that time and I was never able to get back to my old self. Dieting rarely worked and I always gained back the few pounds I lost whenever I started to eat more normally on the maintainance levels of most of the diets. Although I do not have diabetes, or other weight related diseases, I do suffer from osteoporosis and have had back pains due to the excess weight along with very painful knees. I found it hard to walk long distances both due to the back and knee pains well as some shortness of breath. I have had high cholesterol levels for which I take medications to control and suffer from depression due to the weight issues requiring the need for some anti-depressants. I find I have lost my enjoyment of social occasions and tend to avoid them like the plague both from the fact I dont feel I look good as well as the need to not overeat at them.
In 2002 I started to do research on the internet, looking at surgery options and surgeons in the USA, Canada, Mexico and Europe looking to find a safe way to have a surgical procedure to assist me in my goals to lose weight.
After much thought and careful consideration I decided against the very invasive programs of roux-en-y and duodenal switch, although I have friends and colleagues that have had both of these procedures done and have been successful in weight loss of up to 210 pounds. I felt that these programs, which are not reversible, have too many complications and carry a much higher risk of long term problems.
Over 130,000 lapbands have been implanted worldwide and the risks are much lower, both immediately after surgery as well as in the long term. Few USA studies are available since these procedures have only been approved by the FDA for the last few years. However Lap Banding has been done in Europe and other countries since1987 and studies are available for review from those countries and compare very favorably with the more invasive type of procedures.
Then came the decision on where to go for the procedure! After much research I choose Dr Sergio Verboonen and Dr Jaime Ponce de Leon and their associates Dr Eulices Frayre who assists with the surgery, Dr Indira Partida the internist that works with them along with Family Practice Specialist Dr Joanna Ayala in Tijuana Mexico. They were well assisted by Marlon Sanchez their Patient Coordinator and Antonio (Tony) Valdez patient services. While there were about 20 surgeons in Tijuana doing Lap Band procedures many of them did not respond to my emails and telephone calls to their offices. Of those that did respond my comfort level was highest with this group, who between them have completed over 1000 of these procedures!
My husband and I were picked up at the border parking lot in San Ysidro on December 1, 2004, by Tony and driven to the Obesity GoodBye Office where I went thru a physical exam, lab work, EKG and met all the surgeons and the internist. I was offered a choice of three brands of Gastric Bands including the Inamed BioEnterics® LAP-BAND®, the Swedish Adjustable Gastric Band® by Johnson & Johnson's Ethicon Endosurgery division and a third the Midband® made by Medical Innovation Development in France. Dr Verboonen explained the risks and benefits of all three bands but left the decision of which to use to me. I choose the one the I felt best met my needs with the least complications, it has been in use since 1987 in Europe, "the Swedish Adjustable Gastric Band". Although it is as yet is not certified by the FDA an application for certification is underway and should be approved within the next year or so. Testing of the band, I was told, was underway at approved testing sites in the USA.. I did realise though that I would have to return to Tijuana for most ongoing care until the SAGB was approved in the USA, but as a travel nurse I spend at least 1/2 a year in California and hope that will cut down on the travel costs to visit the group when I need fills or other treatment. After testing and the meetings we were driven to the Grand Hotel in Tijuana to relax for the rest of the day. Please be aware on the day of your Lab tests you need to be "NPO" (have nothing to eat) for at least 8 hours for accurate results to be obtained.
The "Swedish Adjustable Gastric Band" that I chose: 
On the day of surgery we were picked up and taken to the Lityen S.C. Clinic in Tijuana Mexico, where the procedure was carried out in about 45 minutes and had started at about 9:45am. My husband, also a registered nurse, was able to watch the surgery thru a window to the operating room. After surgery Dr Verboonen spoke with my husband about the procedure and assured him there were no difficulties. There are photos of the room I used as a patient in the clinic below as well as of the operating room.
Within 3 hours I was up walking in my room and the corridor and feeling pretty good except for some minor aches caused by the insufflating carbon dioxide gas used during the operation to fill the abdomen which takes a few days to get absorbed. I was on continuous IV fluids overnight and received antibiotics and painkillers as needed. I was fed clear liquids and jello starting at 3pm and every 2 hours from then while I was awake.
The next day I was discharged from the clinic by Dr Frayre back to my hotel room where I rested for the day while continuing to drink clear fluids and eat jello every few hours. I exercised by taking a 1/2 an hour walk thru the lobbies and areas on the ground floor of the hotel every few hours to help displace and absorb the gas left in my abdomen. The hotel by the way is as good as any 5 star US hotel, with several restaurants for your companion to eat at and has 24 hour room service as well. There is a pharmacy on the property which by the way has the only ATM in the hotel but it closes at 7pm. At 6pm that first night Dr Ayala came by the hotel to check on me and to further discuss nutrition and other useful information.
At 7:30am on Saturday morning after a somewhat restless night due to pain from the gas in the belly I called patient services and Dr Frayre, with Tony, came by the hotel with a pain shot for me at 8am, 4 hours later I was picked up from the hotel by van and driven to the doctors office for a final checkup by Doctor's Verboonen and Frayre at which time they offered to have me stay an extra day in Tijuana but feeling much better and wanting to go home I was then taken back to my car in San Ysidro for us to drive back home to Los Angeles. By the time I arrived home 3 hours later I was a little uncomfortable with the pain and seemed to have a low grade fever (100.4 degrees). My husband called Marlon's cellular and was immediately put on the phone with Dr Verboonen who reassured him that the mild fever is normal after surgery and did not require antibiotics at this time and to take a cool shower and a tylenol to reduce the fever, which worked well.
By Sunday morning I was feeling much better, the fever gone and only mild discomfort left over from the procedure.
The costs of this procedure including all local transportation, hotel room, all doctors fees, the Gastric Band, operating clinic fees for the surgical suite as well as the overnite stay, medications, IV fluids, nursing care etc were all inclusive at US$7500.. However the costs have now increased to $7800 for the above all inclusive package. Costs obviously are somewhat higher if you include the flights to and from your home city, but Tony would meet you at San Diego airport and return you there for your flight home. There is a package that includes all the above and airfares for you and a companion for the surgery and again for you to return for the first fill which is $9000.
My plan is to return to Tijuana in February for a refill on my band and Tony has assured me that he will be there to pick me up again. Refills I was told are US$150 and are done under fluroscopy.
Any prior concerns I had in regard to having surgery in Tijuana or anywhere else in Mexico were proved by the group to be un-necessary. All the Doctors understood and spoke English reasonably well except for Dr Jaime Ponce de Leon, and either Marlon or Tony were with him to translate for me. The nurses in the clinic had limited english but we managed to get thru to each other what I needed or what they wanted me to do and I do not speak spanish at all, both Tony and Marlon were available by telephone, in an emergency, to translate for me while I was at the clinic should the need have arisen, a service however that I did not need to take advantage of. I have included a link though below which offers a translation guide for the most common needs of a patient, courtesy of a spanish speaking nurse that I work with in Los Angeles, I would recommend printing it and taking it with you for your procedure.
Below please see some photographs which would give you an idea of how well I was taken care of and the inside of my room at the clinic as well as some photographs of the Staff involved.
Marlon Sanchez, Patient Coordinator
Company transport van
Tony (patient services) and Shenaz
Dr Freyre with Shenaz just before discharge from the clinic
Below some photos of the Lityen Clinic where I had my Surgery
And the next two are post op photos
Dr Joanna Ayala visiting Shenaz in her hotel room the night after discharge from the Lityen Clinic
Below are some photgraphs of the Grand Hotel Tijuana where we spent the night before surgery as well as the second night post surgery
