Some statistical improvements include:

• Diabetes: Resolved in 77% and improved in 86%.
• High cholesterol: Improved in 70%.
• High blood pressure: Resolved in 62% and improved in 79%.
• Sleep apnea: Resolved in 86% and improved in 84%.
• 40% reduction in death rate from all causes.

Patients who have had obesity surgery benefit in many other ways:

• Improved quality of life
• Improved psychiatric well being
• Decreased cost of medications

The overwhelming evidence is in favor of obesity surgery when non-surgical methods have failed to achieve weight loss. If you have decided that obesity surgery is right for you and you do not have adequate insurance coverage and you do not have the financial means to have surgery where you live, consider having your surgery done by a qualified surgeon in a safe hospital in Mexico.

The two types of obesity surgery are restrictive and malabsorptive. Some procedures combine both restrictive and malabsorptive properties. Before you go you should decide what type of surgery is best and that it is safe for you to have surgery. You should also arrange for appropriate follow up care which may include medical management and nutritional counseling. Each type of surgery will require that you have some sort of responsible follow up. Many people have successfully traveled to other countries for obesity surgery. There are many clinics and doctors available everywhere that can help you manage life after surgery.

Restrictive surgery limits the amount of food you can put into your stomach at any one time. Examples of restrictive surgeries include the laparoscopic adjustable gastric banding (LAGB), commonly known as the Lap Band TM or the vertical banded gastroplasty (VGB). VGB provides a 66% two year weight loss.

Statistically speaking, you can expect about a 55% weight loss up to 9 years later. Unfortunately the complication and revision rate in VGB is a little high and most purely restrictive surgery is accomplished now with the LAGB.

The LAGB utilizes a synthetic fluid-filled, doughnut-shaped band, which is wrapped around the top portion of the stomach. A small port is attached to the band by a thin piece of synthetic tubing and the port is surgically placed just under the skin on the abdomen. The port is therefore easily accessed so that a healthcare professional can inject or remove sterile saline from time to time to adjust the size of the band. This ability to adjust the restrictive nature of the band has eliminated the need for revision surgery that used to be necessary with the VGB procedure. In addition, the stomach is not cut so there is minimal risk of leaking from the stomach. LAGB is the safest of all bariatric procedures and carries a very low 0-0.05% mortality rate. And, because the lap band is very simple to perform the cost is generally much more affordable. Weight loss with the LAGB is 42% at one year and about 55% at five years. Weight loss tends to be more gradual compared to malabsorptive procedures but at three and five years, the comparative data between the two types of surgery is nearly identical.

Strictly malabsorptive procedures cause food to bypass certain areas of the intestinal tract that absorb nutrients. Calories are not absorbed by the intestines and end up in the toilet and not in your body. Standard strictly malabsorptive procedures include the biliopancreatic diversion (BPD) or the BPD with duodenal switch (DS). Malabsorptive procedures result in more rapid, long lasting weight loss. One study on BPD reported a 72% average weight loss at 18 years. Nutrient malabsorption and a higher complication rare are the major drawbacks of these procedures.

Complications of BPD and DS:

• Diarrhea and foul smelling gas (due to fat malabsorption), with an average of 3-4 loose bowel movements a day
• Malabsorption of fat soluble Vitamins A, D, E, and K
• Vitamin A deficiency, which may cause night blindness
• Vitamin D deficiency, which may cause osteoporosis
• Iron deficiency –a similar incidence with the RYGB (less frequent with DS)
• Protein-calorie malnutrition
• Ulcers (less frequent with DS)
• Dumping syndrome (less frequent with DS)

Some procedures, such as the Roux-en-Y gastric bypass (RYGB) combine both restrictive and malabsorptive components. The RYGB procedure is similar to the BPD and DS operations in that the stomach is divided and the intestines are reattached in a manner that allows food to go around (bypass) the absorptive portion of the small intestine. With the RYGB the attachment is higher up (when compared to BPD) resulting in less dramatic malabsorption. Because the RYGB also involves a restrictive procedure (stomach is divided and a small pouch is formed), rapid, profound weight loss is also achieved. Also, there seems to be more appetite suppression with the RYGB.

Advantages of RYGB

• Better weight loss than after purely restrictive procedures
• Low incidence of protein-calorie malnutrition and diarrhea
• Rapid improvement or resolution of weight-related health problems
• Appetite suppression

All Patients who wish to undergo Obesity Surgery should:

• Be well informed and motivated
• Have a BMI >40; for individuals with a BMI between 35 and 40 with at least one serious concomitant obesity related medical problem such as diabetes, sleep apnea, obesity-related cardiomyopathy (heart damage) or severe joint disease may also be candidates.
• Have acceptable risk for surgery
• Have failed previous non-surgical weight loss interventions

Situations where people who should not have bariatric surgery:

• Untreated major depression or psychosis
• Recent history of binge eating disorders (Anorexia or Bulimia)
• Current drug and alcohol abuse
• Severe cardiac disease that poses a high risk for anesthesia
• Severe coagulopathy (blood clotting disorder)
• Inability to comply with nutritional requirements including life-long vitamin replacement (Some bariatric surgical procedures result in nutritional deficits that require life-long vitamin supplementation).

Potential conditions where Lab Band Surgery should not be done:

• Crohn’s Disease
• Large Hiatal Hernia
• Portal Hypertension (Seen in Cirrhosis of the Liver)
• Connective Tissue Disorders (Scleroderma, Lupus, Rheumatoid Arthritis, etc)
• Prior Ulcers of the stomach
• Chronic steroid use

Summary of Bariatric Procedures

Our physicians and health care coordinators have extensive, hands on experience working with doctors and hospitals throughout Mexico. We began developing our network of Mexico’s finest doctors and hospitals in 2000 by conducting personal interviews and educational background checks on more than 700 Mexican doctors and inspecting over 80 private hospitals. We spent 6 years researching the Mexican healthcare system before we referred our first patient for surgery in February of 2006. As a result, if you decide to let MedToGo coordinate your surgery or medical service in Mexico, you can be assured that you will be working with the country’s finest doctors and institutions.

You will have also hired a team of U.S. physicians and health care and coordinators that will oversee your care and serve as your advocate while you are in Mexico. You will not be alone. Unlike other cheap lap band surgeries, your safety and peace of mind are our primary concern. Furthermore, we can offer you complete healthcare packages with up to 75% off the price of a comparable experience in the U.S.-without a compromise in quality.

• Our physicians meet and hold personal interviews with all Mexican physicians.
• We verify the doctor’s educational experience and credentials, including board certification and licensing.
• We request and check professional references and assess a doctor’s local reputation through various professional and personal resources. Doctors must be in good standing with their community and hospitals. There must be no history of current or repeated legal malpractice.
• We review physician resumés and give preference to physicians who have been consistent with continuing medical education, who are active in their medical societies and who have been entrusted with leadership roles within their institutions.
• We examine evidence of their surgical success rates.
• Prior to including a surgeon or physician into our program, we attend his/her operations to evaluate competence and skill.

But if you hire MedToGo we will not only provide you with a selection of Mexico’s finest health care providers and coordinate your procedure, we will also be your advocates while you are abroad and not rest until have returned home.

Your Mexican hospital and doctor compensates MedToGo for marketing services, and MedToGo does not add additional fees to the cost of your package. MedToGo does not accept cash incentives or alterations in compensation from physicians or hospitals. This ensures that our recommendations are unbiased and based solely on our experience and quality assessment.

While performing my surgery, Dr. Joya discovered that I had a hiatal hernia, which he repaired for me at no extra cost. How many doctors do you know that would do this for you?

I cannot praise Dr. Joya and his staff enough – not only did I receive fantastic care while at the hospital, but even after my surgery Dr. Joya and his staff followed up with visits to my hotel and phone calls once I returned home. The hospital where my Lap band surgery was performed was immaculate. The staff and the care that I received was top notch.

When my neighbor found out that I was going down to Mexico for surgery, he said that if I (Deanna) could do it so could he. He went down 2 weeks later and had the same surgery. We are both doing great!

I would also like to thank Dr. Robert Page for all his phone calls to check up on me and my well being after my surgery.

I would be more than happy to talk to anyone who had questions about the surgery, the doctors, or the quality of care I received while in Mexico.

Sincerely,

Deanna
Home phone (360) 856-6331

TONIA MANN – PROCEDURE DATE: 11/05/08

I can’t tell you how pleased I am with my lap band experience in Mexico arranged through MedToGo International. Dr. Joya was wonderful and answered all of my questions. I traveled to Puerto Vallarta with my sister and took five days to relax and enjoy the Westin Spa following my surgery. Even with the vacation for two my expenses were about 1/2 of what I would have paid here in Atlanta, GA.

I have received my after care through Fill Centers USA and I have also been very happy with their services. Unlike most people, it took me eight fills to get to a significant point of restriction. I moved very carefully through my adjustments but initially my weight loss was not the 2-3 pounds a week that most patients experience. But, I am happy to say that about six weeks ago I reached my magical point of restriction and that scale is moving now.

My daughter’s wedding was the initial inspiration for making the decision for bariatric surgery — I just purchased a size 16 dress which will probably need to be altered before the event Sept. 5th. When I headed to Mexixo in November I was wearing a size 24 — that is a major change! But the best part is finally feeling good again — I actually enjoy exercise and going to the gym. I feel so much stronger and excited about being back in the game again.

I researched a lot of companies prior to selecting MedToGo. The fact that you are doctors who have developed relationships abroad made the difference for me. I knew the doctor I would meet in Mexico had been truly evaluated — not just from a sales and marketing perspective. The hospital was great — the nurses were very attentive — and their patient/nurse ratio is much better than here in the US. I would encourage anyone considering surgery in Mexico to contact MedToGo International for no pressure, educated and caring advise on how to obtain medical services abroad. I would still be waiting if I had relied on self pay here in the US — instead I am back to living my life and feeling better each day. Thanks Dr. Page, Dr. Joya, and all the MedToGo staff.

KATHY HENDERSON – PROCEDURE DATE: 09/19/08

My name is Kathy and I had my lap band surgery on Sept. 19, 2008 through MedToGo in Tijuana, Mexico. When it was suggested that I go to Tijuana for my surgery, my husband was, to say the least very apprehensive. He had lived in Mexico several years ago and thought I had lost my mind…

After talking with Dr. Page and his staff, my husband agreed that WE would go to Tijuana. We decided to drive ourselves across the border as my husband had done this many times in the past. When we arrived at the hospital we both were immediately impressed with the cleanliness of the hospital and clinic grounds.

Upon entry to the hospital I thought we must be in an upscale US hospital. Actually it was cleaner and more modern than some US hospitals I have worked in. (I am in the medical field). We were immediately introduced to the MedToGo liaison and she brought me the remaining paperwork that I needed to complete. I had my labs drawn with minimal waiting time, even though I was 2 hours early for my appointment. (I was anxious to get there). As soon as my labs were drawn we were taken to my room, which was actually a suite. There were 2 rooms with a table and 4 chairs, a bath and a half and a couch/cot for my husband to sleep on as well as a modern hospital bed.

I met with the MD and PA as well as the Anesteologist and nurses in my room. The room was as clean and modern as the rest of the hospital. It had a large new TV with several English channels, Internet hookup and beautiful cabinetry.

The nurses were lacking in English and I was lacking in Spanish, but all the doctors and the PA spoke English. Everything that was going to happen to me was explained to both my husband and me. I felt very comfortable and was anxious to get this done.

My husband is not the patient kind of person and after I was taken to the operating room, he was kept informed as to my progress by the staff.

The operating room contained all modern equipment, including GE and Siemens which impressed me even more.
After the lap band surgery I was taken back to my room where I was kept comfortable with pain meds and not once did I feel any discomfort.

I got up the next day and started walking around the hospital with my husband. We went out to the courtyard between the clinic and the hospital and witnessed staff everywhere cleaning. One lady was actually scrubbing the pillars in the courtyard. I thought to myself, you sure don’t see hospital staff in the US working this hard.

My only suggestions for anyone going to Tijuana is to take your own pillow (as mine was rather lumpy), your own washcloths (I couldn’t make the nurses understand washcloth and they kept bringing me towels), Personal bathing items, and slippers (I forgot mine and had to walk in my socks).

As I said in the beginning my husband was very skeptical before we got there but by the time we left, he had gone to the dental clinic to have his teeth cleaned and X-rayed and said he would definitely go back there for any surgery either of us would need.

DR. ALLEN STOUT – PROCEDURE DATE: 7/31/08
I can happily recommend MedToGo to those patients who need bariatric surgery without reservation. My surgery and the subsequent hospitalization was of the utmost quality. I was pleased to see that the hospital uses state of the art equipment and the staff was excellent. The surgeon did a great job and the staff was well trained. I was also pleased to see that the hospital was properly staffed. I was never left waiting for a nurse and the staff was quite attentive. The hospital was quite new and the grounds outside were beautiful.

My LapBand surgery has been very successful. I have lost 40 lbs in about 6 months with little effort. I continue to recommend the MedToGo doctors to my patients on a regular basis.

Dr. Allen Stout

CLAUDELLE L’ECUYER – PROCEDURE DATE: June 2006
June 2006 found me in Hermosillo, Mexico, having weight loss surgery. This is a procedure I had hoped to have in the U.S. but when I researched the possibility I found it was far too expensive. The cost in Mexico was one half of the fee in Arizona.

I consulted Dr. Robert Page, my primary physician, because I knew of his familiarity with surgeons and hospitals in Mexico and I had read his excellent book on Medicine in Mexico. He agreed that this surgery was important to my health and began the process of arranging for the procedure.

Dr. Curtis Page accompanied my husband and me to Hermosillo. He introduced me to the surgeon, a fine man with a great reputation in Mexico. The hospital was wonderful. Much like our American hospitals, the staff was professional and the nurses were every bit skilled as those I had experienced in Arizona.

My surgery went off without a hitch and the next day we drove back to Arizona. Last month I returned to Hermosillo for my one year check up. Dr. Robert Page met us at the hospital and learned the “fill” procedure so that he can perform necessary fills for patients who have this surgery in Mexico.

I was very pleased with this experience, the hospital, staff, and doctors and the care and attention I received from both Dr. Robert Page and his son, Dr. Curtis Page.

Claudelle L’Ecuyer
June, 2006