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Surgery / Hospital Stay
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Are
there any special requirements for surgery? |
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Is there an age or
weight limit or any other requirements that need to be met to be a candidate
for surgery? Will it affect the cost?
No. Dr. Perez
does not have a weight restriction for the surgery. You will
let the doctor know in advance during your consultation (and by
filling out a pre-op evaluation)
what your weight and height are, and if you have any pre-existing
illnesses or allergies in
case there are other preparations that must be made ahead of time.
A routine examination will be performed prior to surgery and an
extensive exam on anyone meeting certain criteria.
There are additional fees for additional exams and services, so please
see costs page for more
details.
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What
can I expect during my hospital stay? Who should I bring?
What should I bring? |
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How long is the
hospital stay? When will I be discharged? When should I check into the
hospital? Do I need a hotel room?
Hospital stay is typically around 1.5 days (at least 24- 30 hours post
op). You will check into the hospital at least 4 hours prior to
surgery, (or the night before
for a morning surgery). You can stay in the hospital the 2 nights
with no additional charges if
space permits. A hotel room may
be needed if space does not permit but this is a rare occurrence. A hotel room is always necessary if you are staying
additional days in the area or you have a flight time that conflicts
with our shuttle schedule. You will be charged for any additional
nights (more than 2) if you must stay in the hospital.
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Can someone be with me
in the operating room?
Yes,
spouses (only). It
is preferred by the doctors that your spouse be with you during your
reversal surgery. Your husband can take
pictures or video tape your surgery as well.
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If we fly in, how soon
after their surgery can we fly again? What if I need to leave early to meet
our flight? How soon will I heal?
You
will stay in the hospital a minimum of 24 hours post op. You
can fly immediately after being released if you are doing well.
Please note that most airlines are becoming strict on making sure you
have a doctor's release before they will allow you to board, and if
you appear to be having problems, they may refuse you. So
waiting the proper amount of time (24 hours) and obtaining a release
form before you leave the hospital is mandatory.
Your
flight should be scheduled so that you will not need to leave earlier
than 24 hours post op.
All return flights should be scheduled for afternoon or later on the
day you are released from the hospital. You can return to
work in 14 days. Depending on your job, there may be a 7 day
exception. Please ask for more details regarding resuming activities.
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Can my husband or a friend stay with us at the hospital the whole
time?
Yes,
you must have another person, at least 13 years old or older, stay with
you in the hospital room. Your guest will be provided
with meals if you are admitted prior to meal time. If you check
in after meal time, there are places to eat near the hospital or
someone from the staff will be willing to assist you with getting
food for your guest. No more than 2 additional people can stay in your room, one is preferable
since the rooms are only equipped with one extra sleeping space for
your guest to stay in your room.
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Can we
come alone?
(updated)
It is preferable that you not come alone.
You should have a friend or family member with you.
Your spouse is preferable. This is for the benefit
of the patient as well as our staff. It is very risky for you to
travel internationally for major surgery without
someone to assist you and to speak for you when you are not able (under
sedation or in the event of an emergency). You will also need
assistance
while you are recovering from the epidural and during your travel home
(to drive, carry luggage, etc).
You may bring
anyone of your choice, if they are 13 years or older. If your guest is
under 21, you must fly and
use the shuttle - you cannot drive after your surgery. Again we apologize for the inconvenience, but it is necessary.
Meeting with and/or traveling with another patient is not the same
as having someone with you, each person that comes will need to have
a family member or friend accompany you. There are some minor exceptions for couples having surgery, so please email for more details.
If you come alone
or refuse to pay for private nursing,
you will be sent home without surgery. There are no exceptions to this rule.
Private care
nursing may be an option. Please discuss this with us in
advance. Private nursing fees will be $200 for the duration of
your stay.
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What about children, can we bring them?
No. Children
under 13 are not allowed in the hospital. This is hospital
regulation.
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Is there anything special that we need to bring for our hospital stay?
What will we do with our valuables during the surgery?
Yes, please
see the tip page for more details on what to bring.
A
secure place for you to keep your money and valuables during your surgery
can be provided if you ask Dr. Levi when you arrive, or your guest/spouse
can hold them for you while you are in surgery. BUT! As
with any hospital, in any country, we cannot be responsible for items lost
or left in your room or unattended. All unnecessary valuables
(jewelry, electronics, etc) should be left at home. Never leave cash
or valuables in your room, your hotel rooms, or your vehicle at anytime
during your travel; and please be especially careful with your
valuables at airports.
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What type of surgery
is it? How is it performed? When should I have it done?
What about complications? Is there pain? |
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What form
of procedure is used during surgery?
Dr.
Perez uses a microsurgical procedure using surgical loupes (magnifying
lenses) which is the recommended method for microsurgical procedures
of this type. The surgery is performed through a small incision
(appx 4") just above your pubic area (bikini cut). You will be
mildly sedated after entering the operating room and prior to
surgery, so you will not feel the epidural or catheter being inserted.
The tubes are repaired (method is determined by the type of ligation)
by removing the damaged portion of the tube, and reconnecting the
healthy ends. In some cases, more extensive reconstruction may
be required. Please be sure to speak to the physician in advance
about your surgery.
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Does he check to make
sure the tubes are open? Does he cut through the muscle?
Dr. Perez uses
saline to flush the tubes after stitching to make sure that the tubes
are connected properly and that they are flowing freely.
He does not cut through the abdominal muscle, which helps make healing
quicker and less painful.
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How many layers of
sutures does he use to repair of the tubes? Does he use a stent? What type
of sutures does he use?
Each
layer of tube (3 layers) is stitched using a non-dissolvable
micro-suture. He does not use a stent because stents can cause damage
to the inside of the tubes.
The sutures used
to close the abdominal fatty layers just below the surface incision
are dissovable stitches, and the stitching method used to close your
external incision is a cosmetic surgery technique which will minimize
scarring, and make the incision barely visible within a few months to
a year.
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What
type of
anesthesia is used? What if I want something different? Why do I have to
have an epidural?
Unless you have certain allergies, severe obesity, or are
medically unable - you will have an epidural because it is the
safer method for this type of surgery. You will not
feel the epidural being administered. Our anesthesiologist
is excellent and highly skilled and the doctors will make the best
decision based on your individual needs. If general anesthesia is
required there will be additional costs, please see the costs
page. We understand the fear of the epidural, and
nearly every patient we see has those fears. But we can
safely say that nearly every single patient we've served has left
feeling completely different about the experience because of the
way we administer the procedure.
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What if I
want to be asleep for the surgery? What if I want to be awake?
The anesthesiologist will use a mild sedative to help you relax or
sleep (equivalent to the US drug, valium) while they prep you for
surgery and do your epidural so you will not feel a thing. If
you want to be awake, let the doctor know and they will decrease the
sedative dosage. If you want to sleep, they will increase the sedative to
make sure you sleep through the whole procedure (there are additional
fees for this). Above all, remember
that you can have an open dialogue with the doctors here; they are
receptive to allowing you to be involved in your care.
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Is there a particular
time that my reversal surgery needs to be done? If I
start my period, do I have to cancel?
Of course it is
preferable to try to do surgery at a time other than the time of your
cycle but we also understand that the stress of travel and pending
surgery can often cause even the most regular patient to start
unexpectedly. It happens often and will not keep you from having your
surgery. It will not pose a problem (unless you are prone to very
heavy bleeding). Just be sure to let Dr. Levi know if you are on
your cycle and at what point (beginning, middle, end) and/or if you
are experiencing any other problems. You will want to bring a few pads
from home (for travel). You cannot use a tampon during or after your
surgery (the next cycle is fine) but we can provide you with pads
while you are in the hospital; but you will want to have some of your
own for your journey home.
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Are they able to deal
with any complications? What about emergencies that could arise?
Dr.
Perez. has seen about every conceivable complication or emergency that
can arise in his many years as a surgeon and ob-gyn, and he has had
success with some very difficult cases. He has everything from simple
reversals to major reconstructions. He and the hospital are equipped
to handle emergencies that may arise. Dr. Perez has been in practice for 30 years.
The Hospital de
las Americas is also a Red Cross hospital so they are fully capable of taking very good care of you.
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Will I be
in pain? How do I get help when I am in pain?
Your pain
will depend a lot upon your tolerance for pain, most people are not in
extreme pain. Some patients compare the pain to being similar to that of a
c-section, though not as intense. If you are having trouble
sleeping, or are in any pain, please tell the nurses. You can reach them by
picking up the phone and dialing 107 for the nurses station or sending your
spouse to the nurses station. The nurses are
very intuitive to your needs, and language barriers have not been a problem
so far, for the majority of patients. They will also check on you
frequently. A Spanish/English dictionary, or note
cards, with a few words in Spanish - pain, hungry, can't sleep, sick, need
doctor, and so on could be helpful to take along.
There is a nice free
tutorial in the links section of
this website that is very helpful for making note cards.
Will I get
pain meds to take home? What about antibiotics?
Dr. Perez will
supply you with the necessary antibiotics and pain medications that
you will need to take home after the surgery. There is no cost for
this. Your travel methods and distance afterwards will also be a
factor, but if you take your meds at the times prescribed, your pain
should be minimal. You can bring additional over the counter
medications (Tylenol Pm is highly recommended by patients) for
your travel, but you must check with the doctor before taking any
additional medications to make sure there will be no reaction with the
medications you are being given in the hospital or taking home with
you.
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What about after my
return home? Who will remove my stitches? Who will take
care of my incision? What about pregnancy? |
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Who will
remove my stitches, and when should this be done?
You
(or your spouse or a friend) will be able to remove your stitches
after 10 days. The doctor will give you instructions for removing the
sutures or you can view them using the link below. (..it's very
simple and generally painless if you follow the instructions.) You can
also email for instructions. Your regular physician will be able to do
this if you are unsure or unable to do it on your own. Or you can
follow the instructions listed on the following page:
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How do I care for my incision?
You will
spend the 24-36 hours post op under the care of the nurses and
doctors at the hospital, and they will tend your incision during
this critical period of time. Once you are released from the
hospital, you will be given antibiotics, and taking care of your
incision should not be a problem if you follow the doctors
instructions. See the page below for detailed instructions
on how to take care of your incision.
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Will I be guaranteed a baby?
No. While it would be our greatest blessing to be able to do
so, it simply is not possible. There is no doctor, surgeon,
fertility expert etc.
who is able to 'guarantee' you a pregnancy /baby...no matter
what they may tell you. No two patients are the same and
while surgeons can restore the fertility 'tools' your body needs,
they simply cannot guarantee or force a pregnancy to happen.
What we can do is guarantee you that
you will have the 'best outcome possible' with your surgery, and
that we will do everything we can to make sure that your tubal
reversal is successful and your fertility is restored. Still, not everyone will conceive, and often there is no
explanation as to why. There are many factors that determine
the ability to conceive following a reversal, including but
not limited to following the doctor's instructions exactly. Dr.
Perez has the highest success rates for successful reversals /
pregnancies, especially among those who have been told
previously that a
reversal/ pregnancy is not possible.
No matter what doctor you choose, and there are fine doctors in
all countries, you cannot go wrong with by restoring your
health or by giving yourself the opportunity to at least 'try' to
conceive a child of your own.
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