Journal of an OCC bandster

[NoWorry]

Step 1: The decision

I was banded by Dr. Ortiz in Tijuana, Mexico on May 16, 2007. As far as I can tell, the procedure was a total success and my first three days of recovery have been excellent.

During my research, prior to my banding, I looked extensively for a complete picture of the entire banding experience. While I found mounds of useful information in forums, magazines, books and internet articles, I was unable to find a complete picture.

This, then, is mine. I hope it helps you.

I have been obese for around 9 years. I spent almost all of those years trying to lose the weight. If you

[NoWorry]

Step 2: Why Mexico?

Since my friend was the deciding factor, it made sense to approach her doctor

[NoWorry]

Step 3: Which Doctor?

I made a spread sheet and started listing all the pros and cons for each doctor. I factored in cost, level of care, distance to travel, cost of travel, number of procedures performed by each surgeon, quality of my contact with them and a bunch of other less tangible elements.

I ruled out Cancun

[NoWorry]

Step 4: To Tijuana

In spite of all my tendencies towards research, I

[NoWorry]

Step 5: The OCC

It

[NoWorry]

Step 6: To Hotel Lucerna

Now I just have to wait for Mrs. Ortiz to drive me to the hotel.

And wait.

And wait.

A little over an hour later, Mrs. Ortiz arrives. Not so much as a hello, a nod, or an acknowledgement. She

[NoWorry]

Step 7: Surgery morning

I set the room alarm for 7 a.m. I have my own travel alarm. I set it for 7:05 just in case. I woke up when the first alarm went off. I was making a pot of coffee when a buddy calls from the east coast. I happen to mention that the coffee is brewing. He asks if I

[NoWorry]

Step 8: Prep for surgery

There

[NoWorry]

Step 9: The OR

Inside the OR, it

[NoWorry]

Step 10: Discharge

The next thing I know, it

[NoWorry]

Step 11: The day after surgery

I have a hot, hot shower and examine my surgical incisions. The four small cuts are actually rather tiny. I

[NoWorry]

Step 12: Heading home

The next morning, I bathe and pack my stuff. I check out and settle up the 50 cents I owe for the call to the Clinic. I

[MikeyLikesIt]

Man, I don't know where to start. I think I should start off by thanking you for taking your time which I can see you totally have by posting up your complete experience with details that are sooooooooo much appreciated. 2nd I want to say the fact that you are not of Mexican/Hispanic decent has a little and I do stress when I say little to do with your comfort level entering and having surgery in a country that is so unknown to you. I am Mexican American and will be having surgery on July 18th of this year. I can tell you from the get go I have expectations and that are not high from having surgery in Mexico. You might ask why but honestly it's not in a bad way. Mexico is great, my family comes from there. I believe the care you received was average and so not Beverly Hills. This I expect...but again I stress I'm Mexican and know this. I speak Spanish and know how to ask questions should I feel my travel arrangements are in the air. So for that said I can totally understand how you felt kind of in aww about certain things including Mrs. Ortiz appearance and attitude and uncertain travel arrangements. Trust me if I went thru your experience and was in France I'd probably be in your same boat! The fact that you didn't have a chance to meet with Dr. Miranda or Ortiz I think also has to do with your comfort level arriving in Mexico. I've been to Tiajuana several times and like I said although I wasn't born in Mexico I do have that comfort level of being around my people and have the freedom of freely comunicating with them with ease. You on the other hand were not in that scenario and felt a little restricted. After reading your post I feel I am lucky that I am only 1.5 hrs from Tiajuana and had the chance for a consult 2 months before my surgery. Many just book the surgery over email or phone and just arrive for surgery the day before it seems. I don't think I could do that but then again I don't know if i would because that's not my case.

I applaud you for posting the pros and cons...it helps me a lot...that it does. I totally agree with you on the hotel situation. It sounds totally unfair about you not bringing someone so you basically get tricked out of a room you technically paid for but I think they look at the bigger picture which hello of course always comes down to saving money..."why have this luggage take up space when he's staying the night at OCC and not have that room vacant for another foreigner". Money needs to be made every which way, whether it's in the states or it's Mexico. But like I said I probably would've been shocked as you were to have them tell you to pack your bags before I get back to take you to OCC!!

All your topics touched base on questions I had....you have answered so many. From how long the blood work takes, to who picks you up in the morning to how you felt after surgery. I thank you again for posting up all your info...it's awesome to know that you have had an experience that I believe to be is appreciated whether you had a few glitches your totally not bashing anyone yet simply pointing out things you liked and disliked and just stating the facts. Thanks for your honesty.

I also plan on stating the events leading to my surgery once that day comes. I can only hope my surgery is as successful as yours was. Congrats on your success thus far and I'm sure you've helped so many people with questions like the ones I had.

[FurEllie]

Wow - that was good!

My experiences were similar, though I think I might have been expecting less than you and therefore wasn't as disappointed.

It doesn't sound like Francesco picked up you - the white van, AFAIK, is used as a secondary pickup. As you can imagine, having people coming in at different times and leaving at different times at the SD airport means someone will probably have to wait at some point. The drivers are always working so that's why they are on the phone a lot. Trying to move people around can be a PITA, I'm sure Crossing the border has never been a problem for me - in or out. I did have to get out one time and push the "Pass" button going into TJ when we were flagged. No biggie.

From what little I know, you aren't able to pick your surgery time. When I've had outpatient surgery in the states it's alway been first thing in the AM too. Ditto for the "no eating or drinking 12 hours before surgery". Heck, that's the same rule for my dogs too

Mama Ortiz is probably one of the nicest people I have EVER met. I had no idea she was classified as a "patient facilitator" as she's usually utilized to drive people to and from the hotel/clinic.

I didn't know I was going to have to check out either, but it makes sense - why would they pay for a room you're not in? I guess they could add another $100 to your bill and call it even though. I've also been asked all 5 times I've checked in if I wanted to put up a card for extras.

Your cell provider is who charges you the appropriate rates and many offer a "Mexico" plan - I use Cingular and my calls are 49 cents each. EDIT - they are 49 cents a MINUTE

And the nurses - they are awesome, aren't they?

Glad things went well for you!

[NoWorry]

Based on responses, it would appear that I didn't convey my frustration regarding the room situation clearly enough.

1. I paid for that room for three days. FurEllie suggests adding another $100 for it. No. It was already included in my $8500. Bandsters who bring a companion have the room for 3 nights and they pay the same total fee for it. (P.S. OCC's corporate rate for the room is 800 pesos, which is around US$74)
   
2. I understand that it seems to be a waste if I am not occupying the room, but I paid for it. It should be my choice whether I 'waste' the money or not.
   
3. I really don't mind saving OCC a few bucks. If I had been given clear, advance notice of the requirement to vacate the room and had planned for the packing and unpacking, rather than be told at the last minute, during a period of high-stress that I had to rush upstairs and pack, I would have minded a lot less.
   
4. I saw the final bill. The room had been charged for 3 nights, so no money was saved by anyone. I was put through all that frustration for absolutely no reason.
   
5. It makes the organization seem cheap and penny-pinching.
   

I have also received messages from two other bandsters who went down there alone and were never asked to vacate the room at all.

I expected and received a high level of professionalism in all areas. I got it in the clinic. I didn't in this instance.

I am not debating whether or not Mrs. Ortiz is nice. I never got to know her to make a judgment one way or the other. I am, however, seriously disputing her competence. Again, only relative to the other level of competence I experienced throught the rest of my experience. It reduced the overall level of my experience, my comfort, my feeling of safety and my likelihood of recommending the organization to friends.

[Oregonson]

Hey Noworry. You sure sound like you have an axe to grind. You didn't like the grubby van driver,you wanted to tie up a hotel room when you weren't going to be there, they robbed you of an extra 35 minutes of sleep, Mrs. Ortiz wasn't friendly enough, and wouldnt lift your luggage, you accuse the dental exam of being some kind of service promotion when no other services are promoted, their nutritionist talked too simply to you, the nurse dragged you from the toilet to the Operating room. I can excuse some of your pre operative anxiety, we all experienced it to some degree. What you got for your $8500.00 was lap-band surgery from one of the most experienced surgeons in the field. Yes it was in Mexico, and Mexico is different than The USA. The language barrier can be intimidating. But I felt like the majority of the staff spoke very good to excellent english. If you felt like you weren't getting all your questions answered, all you had to do was ask. I asked a ton of questions while I was there. They were able to answer my questions to satisfaction. I was even given the personal cell phone numbers of the doctors and nutritionist as I am sure you were too. Please call them and express your questions and concerns to them directly. I am sure that they will do their best to help you. I for one am glad that I chose Dr. Ortiz.

[cja]

Hi noworry,

Thank you for all your pros and cons. I am just starting my research into lapband and I truly appreciate your detailed information. I value your opinions. =D>

I have joined this web site and have marked you to get progress reports on.

I have one question for you based on your reports. Costs. You stated it would cost about 7 to 9 thousand in the states? or was that in Mexico? I see where you (and others) paid 8,500. does that include fills? I saw that in Vegas it would be 17K. It really seems to be a wide spread on costs. :-?

I am reasearching more than just costs of course.

The deal with only drinkng liquids for 2 weeks is a little weird. Althought I went on a liquid diet for 4 months once so its is not that weird I guess.

I am very movtivated to find a long term weight loss answer, I have to have a lot of facts.

Thank you again for the good, bad and ulgy of the situation. Please keep posting. :-h

cja

[NoWorry]

Hey Noworry. You sure sound like you have an axe to grind.

I'm sorry you couldn't find a way to express your opinion without attacking mine.

Congratulations on your surgery and good luck on your journey.

[NoWorry]

I have one question for you based on your reports. Costs. You stated it would cost about 7 to 9 thousand in the states? or was that in Mexico? I see where you (and others) paid 8,500. does that include fills? I saw that in Vegas it would be 17K. It really seems to be a wide spread on costs. :-?

Mexico surgery is in the $7k to $9k range. US is in the $15k to $22k range. With OCC, fills are included, but are always done under fluoroscopy which is not included and costs $95, I believe. Transportation from San Diego airport to OCC and back is also extra. If booked through OCC, I am told it costs $130. By my math, that puts the total at $225 plus airfare.

In Dr. Ortiz's book, he says that experienced LAP-BAND surgeons use the rule of thirds: 1/3 need 1 fill, 1/3 need 2 fills and 1/3 need 3 or more.

The deal with only drinkng liquids for 2 weeks is a little weird. Althought I went on a liquid diet for 4 months once so its is not that weird I guess.

If you are referring to the post-op diet, some surgeons will put you on a 2-week liquid diet, but at the OCC, the post-op instructions are for a 4-week liquid diet. This is primarily for the stomach to heal.

I am very movtivated to find a long term weight loss answer, I have to have a lot of facts.

Thank you again for the good, bad and ulgy of the situation. Please keep posting. :-h

Good luck! You might also consider subscribing to LapBandTalk.com forum. They have a considerably higher volume of users and traffic. And as a result, a wider range of information and views.

[JCGrove]

Hey No Worry, that was one heck of a journal. I am glad you shared that with everyone. I would like to say to anyone reading this thread I had a very similar experiance, however I could not have given you such a concise recollection of events. I tend to try to go with the flow and easily dismissed many of the things No Worry pointed out. It takes someone who is sensitive to these things to highlight them and I think No Worry you did a great service by doing so.

At the same time I feel a liitle let down that you feel hesitant to reccomend the OCC, only because you have no good way to compare the incidentals that were your negative experiance with any other clinic. Translation the OCC does a heck of a job processing scheduling and delivering people they have only comunicated with via telephone and/or e-mail. Is there room for improvement? Sure. Can that be said of the competition? Probably.

Having said that, No Worry you were very accurate with your descriptions. I would like to cogradulate you for sharing and on your new band! I wish you success.

I hope those that are exploring will take your experiance into consideration and get answers to questions up front. I also hope the OCC will take note and try to get to a point where they are as smooth with logistics and communication as they are when they get you on the operating table.

JC

[NoWorry]

Day 11 update.

My post op diet is going swimmingly well. As advised, I am not paying attention to weight loss (although i do weigh myself every morning, and I am secretly pleased that I have dropped 5 lbs)

For the first seven days when there was no physical hunger (but quite a bit of head hunger), the liquid diet was rather easy. Broth, Jello, Vitamin Water and lots of Crystal Light mixes. Although I've stocked up on juices and Gatorade, I decide that the sugar content in these is simply too high and I can't justify drinking them (I'm a little surprised that OCC is recommending them with no footnote for diabetics). They get evicted from my fridge. I cheat just a tiny bit by having Kellogg's K2O water - it's almost clear and it gives me a tiny boost of protein.

Surprisingly for me, what I wind up craving the most is salt. Almost everything I drink is sweet and I've been having low-sodium broth. So when I start having the cravings, it takes me a while to realize that it's salt my body is crying for. Unprepared the first night, I wind up eating two mini-pretzels. Fearful of eating my first solid, with 3 weeks to go before it's remotely allowed, I chew it till it can't remotely be described as solid by anyone's definition. The next day, I switch to regular broth and the higher sodium content seems to satisfy my salt cravings. On one occasion, I even add a few drops of hot sauce to deal with the blandness and to increase the sodium a little more.

A bit of hunger starts to kick in at the end of the first week, but now that I'm allowed protein drinks, I find that three Atkins Advantage shakes (high in protein, very low in sugar) go a very long way towards keeping my appetite in check. I have a new mantra: "Is it worth $9000?" Whenever I have cravings and the head hunger kicks in - and this happens a lot when I'm just sitting around or watching tv (those ads can be cruel) - I ask myself my mantra question. It immediately changes my perspective and the answer is not even close.

Pizza!!! Is it worth $9000? Nope.

Four weeks is a long time looking forward, but I remind myself that when I look back on it, it will only have been the blink of an eye. I am training myself to look at the big picture, to see the positives of these changes and not focus on the negatives. At some times it's harder than others. But so far it's been working fine.

I am lucky that I have family and friends who are hugely supportive. Immediately following surgery, most called every day, asking for updates and offering encouragement. The calls have tapered off since then, but not a day has gone by when at least one supporter has not enquired. I have been a loner most of my life, but I'm glad I'm not doing this alone.

[NoWorry]

A bit of stress

Immediately following surgery, my port site incision was puckered and leaking every so slightly. My nurse looked at it, dabbed away the leakage and assured me that all was well. A doctor examined the incision as well, and felt there was no cause for alarm. He did add, though, that if the port had not been properly seated, they could fix it later with a small follow up surgery under local anaesthetic. At the time, it didn't occur to me that I would have to travel back to TJ for this. Duh.

A few days ago, I started noticing a very prominent bulge at the port site. The area is distended by almost a centimeter and I can very clearly feel a hard knot bulging out - my logic says it has to be the port. But since I have no pain or discomfort, I decide to wait. Unfortunately, there's no mention of this symptom in Dr. Ortiz's book under the section "Troubleshooting the Band," so I can't find a quick solution there.

Then, on Friday (Day 10), a friend makes a comment - he can see the bulge under my fairly loose-fitting t-shirt. It looks like the thermometer that pops up on a Butterball turkey.

Now I feel there's no alternative; I call Dr. Ortiz's office and leave a message with the receptionist. I sit by the phone for the remainder of the day. No one calls me back.

In the meantime, I post a query on Ortiz's forum and two fellow bandsters post reassuring responses. It's like a human Valium. I think I know that there is no cause for alarm. But I also don't know what the solution is.

Day 11, I call again. It's Saturday of the Memorial Day weekend and I really don't want to have to wait until Tuesday to get a response. Otherwise, it's going to be a very stressful weekend. Luckily, I am right away put through to a doctor whose name I don't catch. He assures me that if there is no pain and no redness, I should not be alarmed. What should I expect to happen now? I ask him. He suggests I talk to Dr. Martinez and gives me his cell number.

It takes Dr. Martinez only a few hours to return my call. Saturdays, he explains, are busy because of fills and because of many others like me who have questions. As he was before the surgery, he is again hugely informative and incredibly reassuring.

The lumpy knot is inflamed tissue, not the port, he informs me. He asks me to palpate an inch below the incision and, sure enough, I can feel the port there, tucked safely below my skin in its proper place. The bulging knot is inflamed tissue caused by the incision, by the sutures placed around the port and those placed under the skin wall. The inflammation will recede as my body heals. It varies between individuals. In very rare cases it can take up to a year to heal completely, but in most cases it's gone in a few weeks. He expects that there will be no sign of it by the time for my first fill. Whew!

Since I have him on the phone, I ask if there is any benefit to using Neosporin's "Scar Solution" pads or any topical ointments to assist with the healing. There's no long term evidence of benefit in reducing scarring, he tells me, but they can speed recovery. The pads are better than the ointments, since the latter can just rub off against my clothes. The fact is that I'm already wearing the Scar Solution pads, and now I have the validation necessary to keep wearing them.

I am totally reassured and can now dismiss this worry from my mind. Poof! The stress is all gone.

[NoWorry]

At the same time I feel a liitle let down that you feel hesitant to reccomend the OCC, only because you have no good way to compare the incidentals that were your negative experiance with any other clinic. Translation the OCC does a heck of a job processing scheduling and delivering people they have only comunicated with via telephone and/or e-mail. Is there room for improvement? Sure. Can that be said of the competition? Probably.

Hi JC,

I know exactly what you're saying, and I struggled with that. The tricky part, of course, is comparing something you've done with something you haven't done. For all we know, one of the competitors out there is vastly superior, or by the same token, vastly inferior.

I guess what I'm saying, and I think you're agreeing with, is that it would be ideal if OCC could fix the small hiccups. That would instantly make an unqualified recommendation a no-brainer. And let's face it, if no one complains, how will OCC even know these problems exist? But in the absence of changes by them, knowing what I know now, I know I would have done more research. Chances are good, though, that I would still make the same decisions.

I think you've already guessed the main reason for my posts: to set up realistic expectations for future bandsters.

The reason for many of my small disappointments were simply my expectations. I had read nothing but raves on this site, without the tiniest indication of any hiccups. So, when I encountered them, I was surprised and disappointed. If I had read a journal such as mine prior to surgery, I believe my experience would have been much better because each time I encountered one of these hiccups, I would have been prepared and would have not given them a second thought.

While I was at the Lucerna, I had the opportunity to meet with another OCC bandster who was back for a fill. When I mentioned my disappointments, she was not the least bit surprised. Her experiences were almost exactly the same as mine. She has posted on this forum over 40 times and on LapBandTalk over 60 times, but never once mentioned any of these experiences. For selfish reasons, I wish she had.

So I took it upon myself. If my journal helps one future bandster, my effort will have been justified.

[JCGrove]

Hey NoWorry, you could try pedialyte for those salt cravings. I was very dehydrated for a couple weeks after surgery and nothing quenched as well as pedialyte.

Just a thought.

JC

[JCGrove]

Hi JC,

I know exactly what you're saying, and I struggled with that. The tricky part, of course, is comparing something you've done with something you haven't done. For all we know, one of the competitors out there is vastly superior, or by the same token, vastly inferior.

I guess what I'm saying, and I think you're agreeing with, is that it would be ideal if OCC could fix the small hiccups. That would instantly make an unqualified recommendation a no-brainer. But in the absence of that, knowing what I know now, I would have done more research. Chances are good, though, that I would still make the same decisions.

I think you've already guessed the main reason for my posts: to set up realistic expectations for future bandsters.

The reason for many of my small disappointments were simply my expectations. I had read nothing but raves on this site, without the tiniest indication of any hiccups. So, when I encountered them, I was surprised and disappointed. If I had read a journal such as mine prior to surgery, I believe my experience would have been much better because each time I encountered one of these hiccups, I would have been expecting them and would have not given them a second thought.

If my journal helps one future bandster, I feel my effort will have been justified.

Well stated!

JC