For many who have been reading here for the past several years, HansMan (pronounced 'Hans Mahn') has entertained us with his antics... everything from climbing trees and attacking web worms to using our vacumn cleaner to eradicate fruit flies from hovering over his wine glass. The side bar category, "Anode Man Adventures" has documentation of about ten years worth of these type of antics.
This is more of an informational post and his step-by-step adventure of having his stomach sleeved.
Yes, you read that correctly. Stomach ! Sleeved !
HansMan has battled continuous weight gain for the past twenty years. He didn't lose five pounds and gain back ten. He never lost any weight. He just kept on gaining weight.
One. Pound. At. A. Time.
HansMan has been a part of helping write this post. These are some of the reasons he had for having the procedure:
1) My blood pressure, sleep apnea, and acid reflux...plus some lesser physical discomforts were all due to eating and drinking too much. I just enjoyed the 'good life' for too long.
2) I didn't like my appearance and steadily having to buy larger clothes. One wake-up call was when I had to buy an XXL shirt at Christmas.
3) I wanted to avert future health problems associated with diabetes, heart, ankle, and hip. I had both knees replaced several years ago.
4) All of my existing health issues centered around my stomach. Other issues were in the future.
5) One of our friends had the sleeve performed by Dr. Alvarez four years ago. Ever since, she has been the perfect weight. For four years she hasn't felt the hunger sensation and is full after a few bites. She is very healthy !
6) I have seen many before and after photos on Dr. A's website and the Facebook page of other patients a year or less out. The difference in their appearances is miraculous.
7) Dr. Alvarez's clinic is staffed with a team of professionals who specialize in just this one procedure. To date, the team has performed about 10,000 endobariatic sleeve procedures. In my opinion, this makes them the most experienced and qualified team in the Americas.
8) My goal is to lose 50 pounds from my January 1 weight of 244 pounds in six months.
9) My second goal is to compete in a punt, pass, and kick contest in November.
10) My third goal is to fit into my clothes that I have not been able to wear for years.
(This note from Kathy: Dear Hans...You will NOT be wearing your 'double knit-wide lapeled-John Travolta-Grease-Lightning-leisure-suits!')
"I believe that this is the closest thing to the 'Fountain of Youth' that I'll find. Losing weight and reversing the effects of being overweight in a matter of weeks or months is like going back in time twenty years to when I was in better shape."
For those of you who knew he was having this procedure but that's about all you knew, and are interested in the process . . . here's more than you probably ever need to know from the git-go. There are a few of our friends who asked for every detail.
So, grab a cup of coffee or glass of tea (no alcohol allowed) and join us for HansMan's newest adventure...
Last December, he informed me he was going to have his stomach sleeved.
My response was, "You're going to do what?"
He continued, "I said, I'm going to have my stomach sleeved. In Mexico."
After I got up off the floor and started breathing again, I wheezed "Are you crazy?" I may or may not have used an adjective beginning with the letter f- and ending with -ing in front of the word crazy. Okay. So, I did definitely use that word.
We have a very good friend who had this procedure done four years ago . . . in Mexico. . . by Dr. Alvarez and was the reason HansMan made the decision to proceed.
Before I continue, let me assure you, my initial feelings about having surgery done 'in Mexico' has changed. You will understand why if you continue to read.
Our friend had thoroughly researched this procedure in U.S. hospitals and Mexico. She came to the conclusion that Dr. Guillermo Alvarez was the best in the world. Evidently, there are thousands of others who feel the same. To date, Dr. Alvarez has performed about 10,000 stomach sleeve surgeries.
We'll continue with me getting up off the floor and heading to my computer to read more about the Restrictive Vertical Sleeve Gastrectomy procedure. Dr. Alvarez is one of only 11 bariatric surgeons WORLD WIDE with the "Surgeon of Excellence" designation.
To quote Dr. A, "This isn't magic and there isn't a given certainty that you will lose your weight. In order to be successful with your weight loss, it will be entirely up to you to make good dietary choices and making sure you are doing some kind of daily physical activity."
First, Hans had to figure out his BMI (Body Mass Index). There is a condition known as 'fatty liver.' which is a direct relationship between the patient's weight and the liver size. If the liver is too large and heavy, this could possibly prevent Dr. A from being able to see the part of the anatomy he needs to work on.
This is the link from the National Heart, Lung, and Blood Institute to calculate BMI.
If the BMI is too high, it is mandatory to begin a pre-operative diet to lose enough weight and be in a favorable condition for the surgery.
Here's the 'chart' for the length of the pre-op diet:
lower than 36: diet not required
37-41: 7 day diet
42-47: 10 day diet
higher than 47: 14 days
over 300 pounds: 21 days
over 400 pounds: 28 days
The diet consists of full liquids: shakes, coffee, tea, sports drinks, broths, some juices, and protein supplements. The daily intake should be between 800 and 1,000 calories. The complete list is on the website which will be posted below.
HansMan's BMI registered in at 34.26. Yippee! No pre-op diet !
It was time to make the pre-surgery shopping list. (Have I mentioned I love to make lists?) All the details of brands and types are also on the website.
Shopping List 1:
Vitamins - gummies, chewable, or liquid (for the first 4-6 months post-op, pills should not be any larger than an M&M.):
Multi-Vitamin - 100% recommended RDA
Vitamin B-12 - sublingual
CO-Q10 Enyme - 100 mg soft gel
Omega 3 - 900-1,360 mg soft gels
Calcium Citrate with Vitamin D - 600 mg
Biotin - 5,000 - 10,000 mcg
Liquid Protein (clear liquid):
Chicken Soup or Unflavored Protein Powder
Isopure - 40 grams protein in clear product
Liquid New Whey Protein Shots
Gaviscon - chewable or liquid
Gas X Strips
Dramamine - chewable
Tylenol - liquid
Dulcolax, Phillips Tablets, Miralax, Senokot, or Metamucil
Mederma or Scar Guard - 4 weeks after surgery
High Protein Shake Powders
Gatorade - (not red)
Juice - apple or cranberry (not acidic like orange, tomato, grapefruit)
Canned broth or bouillon cubes/granules
Tea bags - mild like Chamomile, Green (no cinnamon)
Blender or Nutra Bullet or something similar
Small plates/saucers/measuring cups/baby spoons to take small bites
Shopping List 2 for second week's allowed foods:
Chicken/Beef/Veggie Broth (low sodium)
Carnation Instant Breakfast
Frozen Fruit (no seeds for first few weeks)
Get rid of all the foods in the house you are not to eat before leaving for surgery
(Not totally possible if someone else is living in the house)
Make sure to have lots of fluids on hand to drink after arriving home
Buy all groceries needed for at least two weeks after surgery before leaving home
The past week's schedule:
Sunday: flew to San Antonio - stayed at La Quinta on Halm
Monday: was picked up by Rosy in the van and driven to Eagle Pass, TX
Tuesday: was picked up by Rosy and driven to Piedras Negras - day of surgery
Thursday: driven to San Antonio by Rosy to La Quinta
Friday: flew home
Saturday: HansMan walked in the Lions Club parade (14 blocks) Yes! He did!
Sunday: HansMan cleaned off his desk.
Monday: TEN pounds lighter and at work
Here's the next list (Yes, another list)
Be sure to pack:
Robe or easy pull on elastic pants
Personal hygiene products
C-Pap Machine if using one
Book, Magazine, Kindle, Laptop, etc. (Rooms have WiFi. Phone provided to call home on.
I just put my phone on Airplane Mode so there are no roaming charges and use e-mail or Facebook messenger to communicate with family/friends. There is a TV in the room with 3 English channels. )
Powder mixes: Crystal Light, Broth cubes/granules, Gas X Strips, Dramamine-chewable, Chapstick, Snacks for companion if someone goes with you.
Small bills - most every place takes dollars but change is usually given back in pesos. Although, every place at the market gave change back in dollars.
I took several projects as there is ample time both days to work on them.
Here's our Journal:
Sunday: We flew from Grand Junction to Dallas and from Dallas to San Antonio. (Must arrive before noon the day BEFORE surgery) So, just in case there was a cancelled flight or missed connection, we added a 'buffer' day. We rode the shuttle from the airport to La Quinta, dropped our luggage, rode the shuttle to the car rental, and drove to downtown San Antonio to walk around downtown to see the Alamo and have dinner on the Riverwalk. This was pretty much HansMan's 'last supper' for several weeks. Anyway, the last time he would have a nice glass of wine with dinner for a looooong time !
Monday: We had a leisurely breakfast provided by La Quinta and was ready to be picked up by Rosy, the chauffeur, in the van by 11:15 a.m. We met a young lady who was also having the surgery and her parents in the lobby. There was one other gentleman and his wife, but because of a delayed flight, they did not make it in time to ride down with us in the van. Once they arrived in San Antonio, they rented a car and drove to Eagle Pass to catch up with us to cross the border the next day. It's about a two-hour drive to Eagle Pass and Rosy stops along the way to stretch, buy snacks, and have a potty break. Once we arrived at the Holiday Inn Express, we just hung out in the room and took short walks. Later, we had a light meal at the Jade Palace next to the hotel. (No food or drink after 11:30 p.m. and NO alcohol !) This room is included in the Dr. A's fee.
Holiday Inn Express Lobby
Tuesday: Rosy arrived bright and early and we were all loaded in the van by 7:30 a.m. The other couple joined us that morning. The hospital is in Piedras Negras (black stones) and only about ten minutes from Eagle Pass. (For companions, you can take food from breakfast with you over the border, but fruit and specific other items cannot be brought back into the U.S.) We arrived at Dr. A's office which adjoins the private hospital and each patient had a private consultation with him. We met Anali, one of his very proficient, English speaking nurses. (Anali was sleeved by Dr. A in 2014. The day after her surgery, she was back at work discharging patients.) After the consultations, all three patients had blood work done and chest x-rays before being taken to their private rooms. Dr. A gave his patients the choice of what order they wanted to be taken into surgery. True-to-form, HansMan let the other two decide, so he went last. At some point, my need for coffee kicked in, so Anali gave me a quick lesson on how to get out of the hospital and not stay lost for any length of time. She walked me outside, showed me a great restaurant across the street, the farmacia on the corner, and then...drum roll please...the coffee/pastry shop where they brew an Italian coffee . . . "Illy" . . . I was thrilled. HansMan went into surgery about 11:30ish and Dr. A was back in the room to let me know everything went well about 90 minutes later.
HansMan was out of recovery and back in his room very soon after that. I'll not go into detail about the 'conversation' between Anali and Hans as the anesthetic was wearing off, but she did look at me and ask, "Is he always like this?" To which I replied, "Yes. Why yes he is. With or without the anesthetic."
He was not too fond of his oxygen mask, the little clip on his forefinger, or the IV in his arm. Not too long afterwards, his oxygen level was good enough, he was able to take the mask and clip off. That allowed him to watch "Patton" on his iPad and the latest dog-and-pony-show-reports about the Presidential candidates. Anali was relieved by Jessica and Brenda, both English-speaking nurses. I walked across the street to a restaurant for lunch and Jessica delivered dinner to me later that evening. (Just let her know what you would like to eat.) I slept in the room with HansMan on a quite comfortable couch. All four doctors, Dr. A., Dr. Garza, Dr. Rosales, and Dr. Salinas came in during the day to check on him. We had to press the little call-buzzer a couple of times, and the nurses were in his room in a flash ! He sat on the edge of his bed several times but did not walk around yet. His private room had a nice-sized bathroom with a large shower and lots of hot water.
Wednesday: HansMan did not complain about much. Maybe just about one of the incisions and a slight pain in his shoulder because he 'slept wrong.' His biggest complaint was that he couldn't drink anything. The nurses did allow him to swish his mouth out which made him feel a lot better. No swallowing ! Later that day, he was allowed to have ice chips to suck on. Not to crunch, but to just let melt in his mouth. He was given anti-biotics, anti-nausea, and acid reducing meds through his IV. His legs were wrapped to keep the blood in his lower legs circulating, but were taken off later in the day. He never had much nausea or any vomiting. He walked around with his IV pole a few times, but it was capped off in the afternoon allowing him to walk freely up and down the hallway. Both Dr. A and Dr. Garza visited with him several times during the day. About 4:00, the family members were able to ride in the van, accompanied by Eric and Jessica, to the market. Guess who loaded up and went with us? Yup. HansMan was not going to miss out on a shopping experience. He had walked for several blocks up and down the street earlier in the day. Later in the evening, all the patients and their companions met with Jessica, Brenda, and Dr. A to receive their discharge instructions and medications to take home. Dr. A gave each patient his personal e-mail and direct phone number. (When have you ever had that happen?)
Thursday: The very first thing was breakfast in the the form of a juice box! Because HansMan was not familiar with the workings of a juice box, the first thing he did was squeeze it. The juice shot out and drenched his shirt. The main rule: Sip. Sip. Sip. No big swallows or gulping. Once again, Dr. A met with him for an examination and to discuss what to expect. He reiterated with him: No lifting anything over FIVE pounds for a week and only adding five pounds per week after surgery. Rosy showed up with the van, we loaded up, and headed back to San Antonio where she dropped us off at the same La Quinta we stayed in Sunday. The room charge is included in Dr. A's fee. We arrived mid-morning, so because it was a beautiful, warm day, we headed to the swimming pool and sat in the sun/shade for the rest of the day. (No swimming or hot tub for several weeks!) The hotel shuttle took us to Quarry Market where we had dinner at P.F. Chang's. He had several sips of egg drop soup and we took the rest back to the room with us. Had I known this place was a shopping mecca, we would have arrived there much earlier. There is ample time to head back downtown, but since we did that on Sunday, we opted not to go back.
This morning in the hospital
This afternoon by the pool
Friday: The airport shuttle runs every thirty minutes. We were headed to the airport by 9:00 a.m. and arrived home at 4:30 p.m. HansMan had no problems traveling. I lifted our carry-ons because of the NO LIFT rule. He did have a low-grade fever both nights after arriving home, but it didn't last long either time.
Saturday: HansMan walked 14 blocks in the Lions Club parade. He came home, napped, and sipped, sipped, sipped.
Monday: It's almost been one week since HansMan's surgery and this is what he has to say:
"I weighed this morning and had lost ten pounds. I'm wearing slacks I haven't had on in almost two years. Only one of the small five incisions is still a bit sensitive. It's just over one inch and is certainly a minor 'feeling' compared to other incisions I have had. It is just a bit sensitive when I cough or hit a bump in the road. There is a 'knot' that I feel in my throat and proceeds down to my stomach, especially if I swallow too much or too quickly. I feel a little lethargic due to the drastic diet change. On a scale of 1 to 10, with 10 being the worst, my discomfort is a 2 or less. Any pain or discomfort is gradually subsiding. It's important to have a positive attitude and educate yourself with all the information Dr. A has provided. I made up my mind to to do this because of all the reasons I mentioned earlier. There was no shortage of people who tried to talk me out of this, but they were all uninformed. The reason Kathy has created this blog post is to put the experience in our own words. Everyone will have a different experience. Mine has been 100% positive."
For exact and complete information from Dr. Alvarez, visit his website. (Links and info below):
Dr. Guillermo Alvarez 866-697-5338
Susan George is his LVN/Patient Coordinator. She is basically on call 24/7, and her e-mail, a toll free number, and her cell number are provided to all his patients.
Endobariatric Facebook Wall This is a closed group, but just click on "join" to be approved.
This is where you can read testimonials, see before and after photos, post questions, receive support from those who've been there, get great tips about what tastes best, talk about the 'loser's bench,' etc.
Subscribe to Dr. Alvarez's You Tube videos.
Piedras Negras - is the capital city of the Mexican state of Coahuila. It is on the U.S.-Mexico border, across the Rio Grand from Eagle Pass, Texas. It is in the Central Time Zone. The climate is semi-arid and hot with the hottest months being May-September. The average temperature is between 79-88 degrees. Be sure to ask Anali, Jessica, or Brenda about taking the van to the market. While there, enjoy one of the fruit smoothies. And no, the patients don't get to enjoy one.
Peso to Dollar Conversion
In Dr. A's office
Thanks to Susan Irizarry for the following photos of the facility . . . inside and out.