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I just want to say that I have struggled with my weight for over 35 years. Some diets worked for a little while, but after spending more on all my diets, exercise equipment and pills I decide that I needed a little extra help. I will have to admit that picking Dr. Almanza was an easy choice. I did a lot of research on the internet and he was defiantly the best of the best. And of course the cost of the surgery was a lot less than I had previously spent over the last 35 years on other things to help me with my weight. My experience with Dr. Almanza was great from start to finish. The entire staff speaks English so there is no problem with communication. The night of my surgery the nurses were awesome! My nurse came every time I rang my bell, and he even rubbed my back to help with the gas pains. (Now who knows a nurse anywhere in the United States who would do that). I opted to stay at the Hotel Ticuan which, by the way was a beautiful hotel and all the people there were very helpful by keeping popsicles in the restaurant freezer for me and they also serve chicken broth in the hotel restaurant and I had my own personal bellman to go get ice for me when ever I needed it.(I did tip him a whole $10.00 which he was very happy to get for taking care of me). The hospital staff was always available when I called with questions from the hotel. they also picked me up everyday for my appointments. I have had no problems at all since my surgery. I would for sure do this all over again if I needed to, but luckily I don`t because Dr. Almanza is a miracle worker.