Mexican Surgery and Going it Alone

[aprillperkins]

The thing is, I can't find any patient testimonials and feedback, at least not enough to seal the deal. All I have to go by is what Nina the coordinator is saying. He definitely trained with the best but that is not enough for my peace of mind and I can't wait more years to have bariatric surgery. I guess I will get the gastric sleeve for now and maybe in a few years after more info can be verified along with patient support I will get a revision...if I need it. I was thinking Dr. Ramos Kelly at Hospital Angeles for the sleeve...would love all feedback!

 

[hilary1617]

@aprillperkins is Dr. Greenbaum a viable alternative for you? He has an excellent reputation and purportedly the lowest self-pay rate in the US ---> http://bariatricfacts.org/threads/d...mbers-on-cost-of-self-pay-ds.3428/#post-50741

 

[DSRIGGS]

The thing is, I can't find any patient testimonials and feedback, at least not enough to seal the deal. All I have to go by is what Nina the coordinator is saying. He definitely trained with the best but that is not enough for my peace of mind and I can't wait more years to have bariatric surgery. I guess I will get the gastric sleeve for now and maybe in a few years after more info can be verified along with patient support I will get a revision...if I need it. I was thinking Dr. Ramos Kelly at Hospital Angeles for the sleeve...would love all feedback!

Respectfully I don't think that is a good idea. As Hilary just posted and I said earlier, Dr Greenbaum is an excellent surgeon and was just as cost effective as Ungson.

You will more than likely not lose as much weight if you just do the sleeve and IF You get approved for the DS later as you would from doing the DS now. There is synergy between a fresh sleeve and switch at the same time.

 

[aprillperkins]

Thanks hilary1617 and DSRIGGS!
I will definitely look into Dr. Greenbaum.

 

[DSRIGGS]

Thanks hilary1617 and DSRIGGS!
I will definitely look into Dr. Greenbaum.

You are quite welcome....we are here to help our fellow bariatric peeps.

Good luck and if you hear what his requirements are to do the surgery, current cost and how quickly he can schedule that would be appreciated. My big brother (6'4 and probably 450) really needs the DS and has no insurance or really means to pay for it, so I am investigating for him with hopes that my Father can help him or they might offer a payment plan.

 

[Larra]

While I don't know any specifics about Dr. Esquerra, I would like to present another perspective.

A couple years ago, Dr. Stewart, an excellent and highly regarded DS surgeon in TX, died suddenly and unexpectedly. His practice was taken over by Dr. Ayoola, whom most of us had never heard of. However, we learned that he had been working with Dr. Stewart for a good length of time, doing the DS's with him, and there were people we trusted who knew him who assured us of his abilities and personality. Since then, Dr. Ayoola has gone on to develop an excellent reputation in his own right and even does RNY to DS revisions, which are very challenging surgeries. We are fortunate to have him as a DS resource.

So what do we do now regarding Dr. Esquerra? There are two differences between these cases:

1. Dr. Ayoola is in the USA and Dr. Esquerra is in Mexico. It is harder to put our trust in the medical system of a foreign country. And for some people, specifically for Mexico. I understand that, but would point out also that some of the worst stories we've encountered over the years have happened right here in the USA. Given a choice between Dr. Esquerra and some surgeons in the USA I would be headed across the border in a heartbeat.

2. With Dr. Ayoola we had inside information, so to speak, from someone in the medical profession who was very much trusted. With Dr. Esquerra our information comes from an employee only. The numbers sound good, but it would be better if someone we really knew was there to reassure us.

It will be up to each individual to decide whether the experience that is being attributed to Dr. Esquerra is sufficient for them or not. I would not presume to make this decision for anyone. One last thought: there was a time when Dr. Ungson was the new DS guy. He trained with Dr. Balthasar in Spain. At some point enough people went to him in Mexico that we heard all about him and recognized him as the "go to" guy for the DS in Mexico. I hope Dr. Esquerra can fill that role, because we really do need good self-pay resources for so many people.

 

[DSRIGGS]

While I don't know any specifics about Dr. Esquerra, I would like to present another perspective.

A couple years ago, Dr. Stewart, an excellent and highly regarded DS surgeon in TX, died suddenly and unexpectedly. His practice was taken over by Dr. Ayoola, whom most of us had never heard of. However, we learned that he had been working with Dr. Stewart for a good length of time, doing the DS's with him, and there were people we trusted who knew him who assured us of his abilities and personality. Since then, Dr. Ayoola has gone on to develop an excellent reputation in his own right and even does RNY to DS revisions, which are very challenging surgeries. We are fortunate to have him as a DS resource.

So what do we do now regarding Dr. Esquerra? There are two differences between these cases:

1. Dr. Ayoola is in the USA and Dr. Esquerra is in Mexico. It is harder to put our trust in the medical system of a foreign country. And for some people, specifically for Mexico. I understand that, but would point out also that some of the worst stories we've encountered over the years have happened right here in the USA. Given a choice between Dr. Esquerra and some surgeons in the USA I would be headed across the border in a heartbeat.

2. With Dr. Ayoola we had inside information, so to speak, from someone in the medical profession who was very much trusted. With Dr. Esquerra our information comes from an employee only. The numbers sound good, but it would be better if someone we really knew was there to reassure us.

It will be up to each individual to decide whether the experience that is being attributed to Dr. Esquerra is sufficient for them or not. I would not presume to make this decision for anyone. One last thought: there was a time when Dr. Ungson was the new DS guy. He trained with Dr. Balthasar in Spain. At some point enough people went to him in Mexico that we heard all about him and recognized him as the "go to" guy for the DS in Mexico. I hope Dr. Esquerra can fill that role, because we really do need good self-pay resources for so many people.

Larra

As always your advice/perspective is fantastic. We are so lucky to have you.

As we have discussed before, there is more bariatric surgical demand than supply of good seasoned DS surgeons so at some point the "new DS surgeon" has to be given their shot. As you articulated so well above, it is important to get as much information on that surgeon's history as possible and from an insider if possible ....but with the demand for these services we must get an increased number of qualified DS surgeons as possible to keep pace with that demand.

 

[Larra]

@DSRIGGS in particular an all too large segment of that demand is people with either no health insurance, or insurance that excludes coverage for bariatric surgery, or that doesn't cover the DS, or that provides such limited coverage as to be useless for major surgery. And unfortunately I don't see that changing any time soon. For some people the price of self-pay in the USA is workable. For others, it isn't. And that isn't going to change any time soon either. We need more DS surgeons both for those with insurance coverage and also for those without it.

 

[aprillperkins]

Thanks Larra for offering another perspective and you are very correct...but I'd rather wait it out and read about/research Dr. Esquerra in a couple of years.

Gosh darnit...talk about frustrating.

While I don't know any specifics about Dr. Esquerra, I would like to present another perspective.

A couple years ago, Dr. Stewart, an excellent and highly regarded DS surgeon in TX, died suddenly and unexpectedly. His practice was taken over by Dr. Ayoola, whom most of us had never heard of. However, we learned that he had been working with Dr. Stewart for a good length of time, doing the DS's with him, and there were people we trusted who knew him who assured us of his abilities and personality. Since then, Dr. Ayoola has gone on to develop an excellent reputation in his own right and even does RNY to DS revisions, which are very challenging surgeries. We are fortunate to have him as a DS resource.

So what do we do now regarding Dr. Esquerra? There are two differences between these cases:

1. Dr. Ayoola is in the USA and Dr. Esquerra is in Mexico. It is harder to put our trust in the medical system of a foreign country. And for some people, specifically for Mexico. I understand that, but would point out also that some of the worst stories we've encountered over the years have happened right here in the USA. Given a choice between Dr. Esquerra and some surgeons in the USA I would be headed across the border in a heartbeat.

2. With Dr. Ayoola we had inside information, so to speak, from someone in the medical profession who was very much trusted. With Dr. Esquerra our information comes from an employee only. The numbers sound good, but it would be better if someone we really knew was there to reassure us.

It will be up to each individual to decide whether the experience that is being attributed to Dr. Esquerra is sufficient for them or not. I would not presume to make this decision for anyone. One last thought: there was a time when Dr. Ungson was the new DS guy. He trained with Dr. Balthasar in Spain. At some point enough people went to him in Mexico that we heard all about him and recognized him as the "go to" guy for the DS in Mexico. I hope Dr. Esquerra can fill that role, because we really do need good self-pay resources for so many people.

 

[aprillperkins]

Hi DSRIGGS...
Just want you to know I've decided not to go with Dr. Greenbaum simply because I don't want open surgery. I'm going to get the sleeve and I'm thinking either Dr. Ramos Kelly or Dr. Corvala at Angeles Hospital.

You are quite welcome....we are here to help our fellow bariatric peeps.

Good luck and if you hear what his requirements are to do the surgery, current cost and how quickly he can schedule that would be appreciated. My big brother (6'4 and probably 450) really needs the DS and has no insurance or really means to pay for it, so I am investigating for him with hopes that my Father can help him or they might offer a payment plan.

 

[hilary1617]

Hi April,

Congratulations on your decision. I wish you the best!

Just as a heads up, sometimes it is necessary mid-procedure to convert from a laparascopic approach to open. This is rare but in theory could happen during your VSG.

You may want to consider talking with your the surgeon and specifying on the consent form that should conditions arise in the OR that in your surgeon's judgment require a switch from laparascopic to open approach for completion of the VS whether you would prefer to end the procedure "as is" and leave without a VSG or consent to have the procedure completed as open if necessary.

Good luck on your journey!

 

[aprillperkins]

Thanks for the heads up hilary...

Hi April,

Congratulations on your decision. I wish you the best!

Just as a heads up, sometimes it is necessary mid-procedure to convert from a laparascopic approach to open. This is rare but in theory could happen during your VSG.

You may want to consider talking with your the surgeon and specifying on the consent form that should conditions arise in the OR that in your surgeon's judgment require a switch from laparascopic to open approach for completion of the VS whether you would prefer to end the procedure "as is" and leave without a VSG or consent to have the procedure completed as open if necessary.

Good luck on your journey!

 

[DSRIGGS]

April I understand your trepidation about an open procedure and I don't know your health situation, but please make sure you fully understand the following:

1. A virgin DS is your best health and long term weight loss option.
2. Surgery sucks open or lap so why have two surgeries instead of one?
3. The sleeve is just a little more successful than a gastric bypass in terms of long-term weight loss.
4. Two stage DS patients don't tend to lose as much of their weight as virgin DS.

It is your call but I would ask you to consider do you really want to postpone the inevitable because you don't want an open procedure. You are talking a week or two possibly more for recovery versus years of potential frustration.

Best of luck with your decision.

 

[southernlady]

Personally, I would do an open DS over a lap VSG.

 

[aprillperkins]

I am just really disappointed. I feel as though the DS is off the table for me right now.
I do know I DO NOT want an open procedure, of everything that scares me most, I don't feel comfy using Dr. Esquerra for DS, and I need to have bariatric surgery NOW.
Yes I understand that having the DS in 2 stages may not give the best weight loss results but to me I have no alternative because I do not want open surgery if it can be avoided.
I have also been looking into the mini gastric bypass (aka one-anastomosis gastric bypass or loop gastric bypass). Feedback appreciated...

Thanks everyone

April I understand your trepidation about an open procedure and I don't know your health situation, but please make sure you fully understand the following:

1. A virgin DS is your best health and long term weight loss option.
2. Surgery sucks open or lap so why have two surgeries instead of one?
3. The sleeve is just a little more successful than a gastric bypass in terms of long-term weight loss.
4. Two stage DS patients don't tend to lose as much of their weight as virgin DS.

It is your call but I would ask you to consider do you really want to postpone the inevitable because you don't want an open procedure. You are talking a week or two possibly more for recovery versus years of potential frustration.

Best of luck with your decision.