Any suggestions on surgery in the DR and the "blue pill"? Additional sleep aid.

Question

Is it ok to take a flexeril (muscle relaxant ) or a Tylenol pm along WITH the infamous "blue pill " they give you before surgery in the Domincan Republic? My biggest fear is waking up mid-surgery. I'm asking because I don't want to take any meds that with interact negatively with the blue pill.

Richard H. Tholen, MD, FACS · Answer

You should worry more about waking up "dead" than "waking up" during anesthesia. Or having a complication that will have to be treated here in the USA by someone who did not do your surgery. THAT will cost you more than your savings via surgical tourism.Certainly, there are good doctors everywhere, but there is also a reason that you are getting such a "good deal" in the D.R. You should be asking the doctor you chose to do your surgery rather than us "also ran" surgeons here in the USA.Surgeons who operate and see their patients for a few days or a week at most are missing the bulk of the healing process, and any complications that might occur. How do they ever learn from their mistakes, if they bury them here in the USA or never see and change their practices to reduce these complications? Yes, we US plastic surgeons have complications also, but have to care for them post-operatively, presumably learn from these occurrences (or mistakes), and suffer the consequences (lawsuit) of truly bad or dangerous surgical choices.There is a reason that heads of state from other countries, as well as those who can afford it, come to the US for their care--it's the best, it's regulated and overseen, and our standards of training and residency/fellowship requirements for subsequent ABPS-certification are so stringent. Only the best need apply. And of those that pass, there is still the "lower half" of the class!So you're worried about "Blue pill" (what exactly is that medication?) interactions with Flexeril and Benadryl? Sort of like worrying about how cute your clothes look as you walk through a minefield. Just saying. Click on the web reference link below for information about D.R. and click on the health button (and others). Good luck--you may need it. Dr. Tholen

Larry S. Nichter, MD, MS, FACS · Answer

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another.  See the below link on some suggestions on finding the most qualified Plastic Surgeon for you.  Always insist on a board certified plastic surgeon.

Matthew Schulman, MD · Answer

I thank my colleague Dr. Tholen for saying what everyone else is thinking. If you choose to have your surgery in another country, and you accept all the risks, then you should direct all your surgery-related questions to your surgeon. Just give their office a call and ask to speak with the surgeon. Or better yet, stop by the surgeon's office to ask a few questions. They should be happy to see you.....

Robert Shenker, MD · Answer

As a plastic surgeon with 11 years in practice, the entire content of your question makes me tremble with fear...You are going to have an operation in a foreign country, you have no clue what medications to expect (knowing you will get a "blue pill" is not exactly being fully informed) and you have legitimate fears concerning the anesthesia.   I would strongly urge you to find a properly qualified and experienced plastic surgeon in your area. Have your surgery close to home, and most importantly close to your surgeon who can take care of you after your surgery.I hope this helps! Dr. Robert Shenker MD FRCSC

Robert H. Hunsaker, MD · Answer

I practice in Miami and see patients who have had surgery in D.R. You need to know that the U.S. Dept. of State makes a special point of warning US citizens to be "aware of the risk associated with cosmetic surgery in the Dominican Republic" including at least 19 deaths of US citizens after cosmetic surgery there since 2013 along with NUMEROUS cases of severe post-operative infection including a series of very rare Mycobacterial infections which generated a report by the  Centers for Disease Control. They also break down the other issues regarding access to emergency care, proper drugs, proper training of physicians, financial issues etc. All of this information is available drilling down in their web sites -   travel.state.gov.  and cdc.govThe attraction to the D.R. is price. Remember, there is always SOMEONE willing to do it cheaper but you may end up with exactly "what you paid for".

Joseph Franklin, MD · Answer

I was recently in the DR for a wedding.   The country is beautiful and the people were lovely and accommodating.  However, medical tourism is very risky.  If you undergo a medical procedure in a foreign country, there are huge problems with follow-up if complications arise.   Additionally, the risk of deep venous thrombosis is significant following tummy tuck and subsequent air travel back to your hometown in NY.

Thomas Crabtree, MD, FACS (retired) · Answer

Let me distill the answers below. Don't do it. Please. There are so many risks associated with medical tourism but the biggest is the lack of a longterm relationship. Your surgeon is your partner and guide during the healing process and even the simplest procedures may take weeks and months to fully heal. Not having your surgeon available during that time is simply not worth the risk or any perceived savings.Aloha, Dr C

Kemil Issa, MD - Account Suspended · Answer

Hello, Thanks for your question, any medications that you usually use or been planned to use before or after the surgery procedure should be told to your surgeon and anesthesiologist, medications like muscle relaxants or tylenol pm could interfere with other medications used during the anesthesia, the correct way is to speak to your surgeon and anesthesiologist about this ¨fear¨ that you have so they can explain you all about anesthesia during surgery. Regards, Dr. Kemil Issa

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