Dying to lose weight: The lucrative ties between border surgeries and U.S. middlemen

Jessica Ballandby was still groggy from fading doses of sedatives when she became conscious of sharp and aching pain throughout her body.She looked down at the gown covering her stomach. It was saturated in blood.At that moment, Ballandby deeply regretted her decision to travel to Mexico for weight-loss surgery. A single mother of two young boys, she began to doubt that she’d ever get back home to Arizona. “I felt like I’m dying the whole time,” Ballandby told The Arizona Republic. “I was in so much pain. I’ve never felt such pain. … I was just praying that I could make it home to see my mom and boys again.”Ballandby survived her ordeal in the Mexican border city of Tijuana. But she got an unwanted firsthand look at the risks of medical tourism, a business from which referral agents and aftercare businesses on the U.S. side of the border also profit, a claim letter submitted by several Arizonans alleges.The claim contends that companies and individuals with Arizona ties have made money by arranging patients’ trips to Mexico for weight-loss operations and by receiving referrals from Mexican surgeons to see patients when they return home.While website testimonials praise these transborder relationships, some patients who have had unhappy outcomes say they were misled by middlemen who minimized the risks.Nonetheless, it is a lucrative market, capitalizing on the desire of overweight people to undergo surgical weight-loss procedures that health insurers often do not cover, or cover only under specific circumstances.Mexican clinics tout procedures for as little as $3,599. That’s far less than a U.S. weight-loss operation that the National Institute of Diabetes and Digestive and Kidney Diseases estimates can cost from $15,000 to $25,000.But U.S. doctors also warn of hidden risks from operations abroad. Continue Reading

Nemours preps to move patients

After three years of construction with more than 100 builders on site daily, the Nemours/Alfred I. duPont Hospital for Children's five-story expansion is set to open in mid-October.Officials will show off the $272 million addition Thursday with invitation-only tours in the morning, and an evening celebration that will include blessings by representatives of nine faiths and and a chorale finale featuring nine youth choirs including those from St. Mark's, Sanford and Cab Calloway schools and the Wilmington Children's Chorus.To build the addition, nearly all of the hospital's surgical, medical and pediatric intensive care units were converted into 144 single, specialized patient rooms for an additional 450,000 square feet. The hospital's emergency room moved and doubled – to 44 bays. Neonatal care and cardiac care are the only two areas that will stay in their current space. All other units will move to new rooms.The hospital now spans over 2 million square feet, said Dr. Dave Bailey, president of the Nemours Foundation, which oversees operations in Delaware, Pennsylvania, Florida and New Jersey.The hospital wanted the new space to focus on what officials call the heart and soul of their operations: Patients and their families. Families were intimately involved with the design process, down to providing artwork in hallways, and even choosing the television for a room and placing the clock on the wall."It's the little things. Sometimes it's very small, but very important," said Kay Holbrook, an associate administrator for Nemours who headed the project. "They are living in there; we forget that."Holbrook said that as architectural plans were being designed, the staff enlisted the help of the hospital's Youth Advisory Council, which included some long-term patients.They started by laying out crayons and colored pencils on a table."We said go for it," Holbrook said. The kids gravitated toward greens and blues, she said, and the children's thoughts behind it Continue Reading

BAND SHRINKS & YOU DO, TOO These New Yorker decided to combat their obesity – one chose a gastric bypass, the other the less invasive lap-band procedure. Here are their stories, and a comparison of what each woman eats on a typical day.

It was the little things thin people don't even think about that drove Andrea Balmant to make the radical choice to undergo weight-loss surgery. Like people not even trying to squeeze into the seat next to hers on the subway. Like having only one choice of underwear - the shapeless kind. There were more serious reasons, too: Sleep apnea. Always feeling out of breath. And then, the sadness. "Deep down, you know you should change, but you go on with it and deal with it and you play like you don't care, when inside you really do," says Balmant, 30, of Queens. "I finally said, 'I'm not happy, this isn't me. I don't like to be big. '"At 5-foot-7 and 280 pounds, Balmant, an executive associate at a financial-services company, chose laparoscopic banding surgery, an option that appeals to many patients because it's reversible and causes less scarring than traditional procedures requiring large incisions. Of all the weight-loss surgeries in the United States (144,000 projected for this year), it's the second most common, behind the Roux-en-Y gastric bypass. An adjustable band is placed around the top portion of the stomach, leaving a pouch about the size of a golf ball with a narrow passage to the remainder of the stomach. As the patient loses weight, the doctor - either in the office or at the hospital - periodically tightens the band through a port under the ribs by filling it with saline. One big benefit: The procedure allows women to become pregnant after surgery. Doctors loosen the band by draining the saline, allowing the mother to satisfy the nutritional needs of the fetus and the uterus to expand as the pregnancy progresses. In the first year after surgery, patients eat 500-1,000 calories a day. After that, they increase their intake to 1,500-2,000 calories a day. (A moderately active adult should consume between 1,900 and 3,200 calories per day, according to the Food and Drug Administration.) The major limitation of their diet is not being able to eat Continue Reading

Top-notch local health care is available, but few know it

Queens is a special place with special needs when it comes to health care. As the population of this borough expands, further diversifies, and ages, we need to provide a wide range of health care services right here in Queens, and those services need to span the continuum of care. As I see it, within that framework there are several important issues that our community can focus on in order to benefit from access to the highest quality care, and expertise, close to home. The first issue is that the 2.3million residents here have access to top-notch care, but some people may not know how much is available to them. Excellent care is provided by doctors and nurses who could choose to practice anywhere and have dedicated themselves to the health of this community. Although Queens is considered to be "under-bedded" in terms of hospital beds available per resident, most people can find high quality medical services near where they live or work. However, the statistics on utilization of services tells us that too many of our residents do not take advantage of what is available right here. Approximately 30% of Queens' residents use a hospital outside of this borough. While it is important for people to have choices, this statistic representing out-migration from Queens for health care services is troubling. When people leave the borough for general or specialty treatment, they may lose the opportunity for their primary care physician to participate in that care, as he or she may not be able to travel from their practice and their other patients. As the leader of a hospital that provides virtually every type of care, we work hard to give people what they need close to home. We operate a Level One trauma center and repair some of the worst injuries imaginable. Our surgical expertise spans a wide range from vascular to bariatric (obesity), orthopedic, neurosurgery and many cancers - with results that stack up on a national level. We have one of only two cardiac Continue Reading