A bariatric patient on PD dialysis *

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  • Name: Tom Knox
  • Age: 54
  • Surgery: Gastric Sleeve
  • Surgery date: November 9th, 2016
  • Testimonial date: December 7th, 2016
  • Surgeon: Dr. Galileo Villarreal
I must say I was rather skeptical at the thought of going out of the US to get my operation, but my insurance refused to pay for it, and I could not see a way to afford the cost of having it done in the states. See, here is my story.

I was diagnosed as stage 5 (end stage) renal failure in July, 2016. I knew this day was coming, and had already decided to do Peritoneal Dialysis (PD). I had already gone through the operation to have the PD catheter installed, and started PD on July 19, 2016. I made an appointment to go to Emory Transplant Center to get screened for a kidney transplant. The earliest that was available was early in October, 2016, so I impatiently waited. When I went in to the transplant center I spent the day going through exhaustive tests, only at the end of the day to find out that I was not eligible because of my weight. I was told I needed to lose 64 pounds before they would put me on the list, and I needed to lose it ASAP because the longer I was on dialysis the less chance that the kidney transplant would be successful. They highly encouraged me to get bariatric surgery and set me up an appointment with Emory Bariatric Center. I spoke with the people at the bariatric center, and with my insurance, and found out that my insurance doesn't cover bariatric surgery under any conditions, even if medically necessary. I also found out that the total cost to have the surgery done at Emory was going to be around $25k, all inclusive. Boy was I bummed.

I then started looking at my options. About the cheapest I found that I could get it done in the states was a minimum of $15k with all the ancillary expenses, so I started looking at surgery in Mexico. First I tried a LOT of the doctors in Tijuana, and none of them were willing to accept the risk of performing surgery on me with my PD catheter. Finally I found out about WeightLossAgents, and thought I would give one more place a try. They first tried Tijuana doctors because of the lower cost, but again none of them were interested. Finally they submitted me to Dr. Villarreal. He said YES, providing I could get a release not from my nephrologist for surgery. The cost was a little more I thought but still less than 1/3 of what I would pay in the states.

So I got the release letter from my nephrologist, and we all decided on the protocol I would need to follow with my dialysis after the surgery. I booked my date for surgery (November 9, 2016) and arranged a flight down for my wife and I. For two weeks before the surgery I followed the pre-op diet strictly. During this time I lost 6 pounds so I was filling rather good about myself. Finally the day arrived for us to leave (November 8, 2016) and we flew into Laredo, TX. We were met at the airport by Surgey (spelling?), our driver, who was not only courteous and attentive, but is intelligent and an extremely safe driver! He drove us across the border to Nuevo Laredo, and first took us to the hospital, "Hospital de Especialidades" for some lab work, and an EKG.

Now when we pulled up to the hospital my first note was it was nowhere near the size of American hospitals. I don't consider that a bad thing at all, as you tend to become an "unperson" at the bigger facilities. The next thing I noticed was how clean it was, and the fact that they appeared to have modern equipment. They did a quick register of me at the front desk then sent me off for my blood work. After just a VERY short wait I was called back, and the person drawing my blood was quick and efficient. Mind you she didn't speak much english, but it was not a major issue as we both managed well. As a matter of fact, during the entire trip I felt quite comfortable with everyone there. We found out rather quickly that "Google Translate App" is your best friend for the nurses, and other staff that weren't fluent in English. After they took my blood they sent me over for an X-Ray of abdomen and chest. Again, very little wait, and the staff was quick and efficient. Then off to get my EKG.

While I was waiting for the EKG, Dr. Villarreal cane up to us. He is a very nice gentleman, and speaks Spanish, English (and French I discovered). He introduced himself, and talked about how the procedure would go the next day. He also discussed my medical conditions, and informed me that I was an extremely high risk patient. He then went on to say that my safety came first, and at any time during the procedure he felt my health was at risk he would stop immediately, and either correct the issue before proceeding, or stop the operation entirely if he deemed it best for my safety. He then asked if we had any other questions or concerns, and we spoke about a few things. Finally he excused himself and said he would see us tomorrow morning. Both my wife and I were very impressed with his honesty, and openness about everything. They immediately took me back for my EKG.

Next, we met with one of the staff to complete the admission forms. There were a few tiny communication issues, but we worked everything out without any problems. Finally we were done and Surgey took us on to our hotel room. He also gave us his number and said if we needed any driving to just let him know. We found out later that he was a childhood friend of Dr. Villarreal and was chosen for this position because of his integrity and good work ethics.

We spent a comfortable night in the hotel, and walked next door to the bar and grill. Of course I didn't get to eat, but my wife said the food was EXCELLENT. Her meal, the two margaritas she had, and the one virgin margarita I had was less than $16. Try to do that anywhere in the states! As a matter of fact, every meal my wife had was under $5 (less the alcohol) so expect cheap but good food for your companion(s) if you bring any.

The next morning Surgey was at the hotel to pick us up for the short drive to the hospital. They quickly admitted us and put us in our room. Now let's talk about the room. When I was researching Tijuana facilities it seemed most if not all put you up in a double room, unless you wanted to pay extra. Well, our room was a LARGE single room, again very modern and clean, but also with a very homey feel to it, very unlike the spartan rooms you see in American hospitals. The entire floor had marble tile walls and again was so clean it was remarkable.

They started preparing me for surgery, first putting me in a gown, starting an IV, and putting on compression hose. Now I have very large,fleshy legs, and have always had trouble getting compression hose to fit me right. This was no exception. After they were on, they felt uncomfortable, even a little painful, but I just put that off to them being so tight. Later I discovered they had bunched at the top and pinched some of my skin, leaving a few welts, but nothing that needed hospital attention. Finally, Dr. Villarreal came in, and we discussed things again. Again he emphasized that my health came first, and that I was a very high risk patient and he would stop the procedure at the first sign of serious distress, or risk to my health. After a little more discussion he excused himself to prep for surgery.

Just a few minutes later they came with a bed to wheel me to the Operating Room. We went up to the next floor, where they started me on a little "happy juice" to calm my jitters, at this point the rest of the staff came in and introduced themselves. All the OR staff that I can remember had a good grasp on English. Finally they wheeled me into the OR. The operating room was bright, clean, and again had all the modern equipment.

They moved me over to the OR table, secured my arms and legs, and started my anesthesia. During this time Dr. Villarreal had small talk with me, I think to help calm me. Of course I was nervous, but in the end it was not necessary. The next thing I remember is waking up as they helped to move me to recovery. The one thing I heard before I dozed back off was that the operation was a success, a textbook case.

Finally, the anesthesia started wearing off, and I started to feel more coherent. After I period of time (it seemed to take forever in my post-operative state) they released me from recovery and took me back to my room. My wife was there, as happy to see me as I was to see her, and the doctor came in shortly afterwards and we talked for a bit. He said that at one point my blood pressure was extremely low but they stabilized me and they were able to finish without any other issues. He told me that no food or drink for about 24 hours to give myself time to heal a bit. He said he would be back the next day and left.

During that and the following morning the nurses I had were very kind and attentive. The doctor came by and checked me out and did a dye test on me. It came back with no leaks and he decided that doing the contrast dye test would stress my kidneys and we both didn't feel it was necessary at that time. He authorized me to have my first meal that evening and said if there were any cramps or pain to notify the on-call nurse immediately. He left, and I a little while later my food was delivered. It consisted of tea, jello, and apple juice, but to me it was like ambrosia, having gone since Tuesday night with nothing. I had no problems keeping the food down, and no cramps or anything.

The next morning, the Dietician came by with my post-op diet plan, which she modified to take into consideration the fact I would be back on PD soon. Then the doctor came in, and checked me out, and took out my drain tube. Well, before he did I mentioned that I had being having pain in my left shoulder. He informed me that it was caused by the drain tube pressing on a nerve and once it was removed the pain would instantly be gone. He removed the tube, not a fun experience, but not terrible, and sure enough, my shoulder pain stopped instantly! He said that since I had kept down dinner the day before, and breakfast, and now lunch that He felt confident I could be discharged. He also gave me a prescription for Tramadol for the pain, and something else for constipation. Apparently the pain meds in my IV could lead to constipation. He was extremely right! They released me, and Surgey drove us to the hotel to spend the night before our flight out Saturday morning. Again that night my wife ate at the bar and grill just beside the hotel, and again her bill was trivial compared to what we would have paid in the states. I tried doing a flush of my PD cath, and the waste contained a lot of blood but I was expecting that. I did 4 500cc flushes, and by the last the fluid was much clearer. We attempted to put me on my cycler that night, but either I got the programming wrong, or it was not saving a few of my values, so we stopped the cycler after the second transfer, to started it back up the next night. During the night I was having some sever cramps, but they were intestinal, and ended up just being a bout of severe constipation. Finally it passed, literally. :)

Finally Saturday morning came around. Surgey and his fiance picked us up and off to Laredo Airport we went. Going through customs is a hit and miss as to whether they target you for further inspection. Well,today was our lucky day. They pulled us into a spot, and inspected all of our luggage. We had told them we had Tramadol for my pain, that is probably what got us targeted. It seems that is a controlled substance, and cannot be transported across the border. When he saw how little I had (10 pills) he decided to let us keep it and let us know that next time we might not get to. I assure you I will make sure not to mention it if there is a next time! We made it to the airport with plenty of time to spare, and had a very uneventful flight home.

Over the next few weeks I followed the post-op diet, and went in to see my nephrologist. They decided to hold off my PD dialysis to give my peritoneum a chance to heal a bit. Finally I was able to restart my dialysis, first by doing a couple of manual transfers during the day, finally getting back to the point that I was on the nightly cycler.

I DID end up with a secondary infection, along with a really sever cold and sore throat (thanks to my grandkids). One of my incisions had become infected and started leaking puss and other fluids. I went to my primary care physician, and she gave me an injection of antibiotics, plus put me on two oral antibiotics. Ten more days passed of taking the antibiotics, and it appears the infection is under control. This has been the only REAL complication I have had, and it's not clear if I got the infection after I got home or not. In either case it was nothing to serious.

Finally, it's almost a month after my surgery. I am doing well, back of solid foods, and have adjusted my portions to my stomach size. Only twice did I eat more than I should have, and boy, let me tell you, it's not pleasant. I weighed this morning, and I am down almost 30 pounds since surgery! I am ecstatic! I need about another 30 pounds then I can go on the transplant list! If things go right I will be down to what I consider a healthy weight for me by summer!

So, to conclude, yes, I was nervous about going to Mexico for my surgery, but I think I chose the best doctor and the best facility to do my surgery. Everyone was kind, attentive, and no one in the least bit treated me different because I was obese. The hospital was clean and modern. Dr. Villarreal was exceptional, Surgey was wonderful. The experience was much better than I had anticipated it would be. Knowing all I know now I would do it again without hesitation.

I have included some before pictures, and will add some after pictures soon.

I am also uploading my experience to youtube. The link to where I am storing it is below.

* This is an actual testimonial, however, your results may vary. For more information, please read our Testimonial Disclaimer and Risks of Surgery.

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    * The testimonials, statements, and opinions presented on our website are only applicable to the individuals depicted, and may not be representative of the experience of others. For more information, please read our Testimonial Disclaimer and Risks of Surgery.