Happy gorgeous Sunday! Final #healthcareMX update.
Check in last Friday - tons of paperwork, including an odd questionnaire regarding my opinions about religion, Dios and the afterlife. (It is a Catholic hospital system in a Catholic country, they want to do right by me if I exit this earthy vale unexpectedly).
The nice lady in admissions charges my card for 30K pesos / $1500 USD, the minimum overnight fee. We are escorted to the room. I'm here for bilateral hernia repair that I've been putting off for too long.
Private modern room. Gorgeous view - see photo above for view the next morning! Attentive competent staff. I change into the lovely gown (open to the back), they take my vitals and start the IV. I like the sedatives!! Can I get some to go?
Surgery is scheduled for 12 noon. At 11:45 they come and wheel me down. This is oddly punctual for this part of the world.
However, in holding area outside OR, I wait for 30 minutes, answer same q's for several people. My doctor, Dr. Joaquin E. Guarneros, comes by and says Hi.
I don't think I introduced him in previous Facebook updates. He completed his residency at the top private hospital in CDMX (ABC Hospital), his Laparoscopy training at Baylor College of Medicine, has an active private practice and teaches at UNAM here. He speaks English really well. His favorite word is "excellent!" in all forms.
I also meet my anesthesiologist, a short, no-nonsense woman who inspires confidence and bosses the med students around in a good humored way. She makes one of them hold her expensive large purse while the other one takes notes.
She calls them niños (they are both young men in this case). They straightened up abrubtly (one was leaning back on a gurney on one elbow, checking his phone) when she barreled through the swinging double doors like a fire marshal. I like her. If anybody is going to put me to sleep that day, I'm glad its her. She reclaims her bag from its sheepish keeper and exits to go suit up.
I congratulate myself for navigating the Spanish without Sergio; the sedatives mix up some verbs in my brain but we get through it. One of the "niños" speaks a little English and is happy to chime in. After that, a bit more waiting. I focus on an image of walking in the forest and try not to get anxious. I miss Sergio.
Dr. G shows up again, this time in scrubs, he squeezes my hand in that warm Mexican way, its like a cultural specialty with them.
He says, "Everything is going to be Excellent!" and in we go.
They hook up the heart rate monitor. A nurse holds an oxygen mask above my face, the anesthesiologist says "OK cuatro whiskeys!" They start the drugs and after that I don't remember much more.
I wake up in Post-op, feel groggy but not nauseous, which is good. After a bit they wheel me back to my room. I ask Sergio what time it is, he says its almost 5. What?! I was in surgery for about 3.5 hours.
Dr. G visits and tells me that my tissues are very delicate, he had to be really careful on one side, where the hernia was difficult to close cleanly as it had probably been there since I had my daughter Jessie. He checks my abdomen and nods in approval. He says he'll be back in the morning.
Here's a ding: the A/C was not working, this was probably due to renovations happening in other areas of complex, I don't know. It wasn't unbearable but it was stuffy and hard to sleep. The room had big windows that opened - for better or worse, something you don't see in new hospitals in the US. where our buildings are so tightly sealed that we have issues with air quality.
That evening the niños (med students) visit me again, to take some patient history. We revisit my previous answers to the questions about death and dying.
One of them is really curious how its possible to not be affiliated with a religion yet still believe in God, although not the angry old man version with the flowing beard and robes in the sky. I don't have the energy to explain so I let them think what they want to; probably they made a note that I'm an atheist. I can tell he's worried about me.
They leave, nurses come and go, I sleep poorly. There isn't alot more to tell - the next day was normal post-op - rest, sit up, eventually get up, pee and then you can go home. The pain drugs were good in the IV that when I left the hospital, I felt better than I expected.
Day 1 and 2 at home were not fun. I've got 4 holes in my gut, it feels like someone used my abs as a punching bag. I also am healing fast, no infection, no complications, NO complaints!
Sergio has been a life saver. I "could" have done this without him but it would have been much harder. Just about every effort except blinking my eyes hurt for the first couple of days and he was very supportive and attentive. This also would also be more difficult if I didn't speak Spanish.
If you are considering a medical procedure in Mexico and don't speak Spanish, look into one of the facilities that specializes in expat and US / Canadian patient care. They are located in Yucatan and Cuernavaca, to name a couple places. Baja California likely has some good options too.
Money: This cost a little more than original estimates because my surgery time was about double what we thought it would be. That was reflected in the final hospital bill. Having said that, I'm definitely on the right side of the peso right now with conversion rate being lowest range in years.
Pre surgery Labwork (chest xray, EKG, full panel blood workup, including hormone panel, urine test): $140 USD
Hospital - 2 days, 3 - 4 hours OR time: 100,000 pesos - $5437
4 PostOp Drugs (antibiotic, anti-inflammatory, antibiotic cream, extra strength acetaminophen):
Doctors' fee - including anesthesiologist - $25,000 pesos = $1,370 USD. Includes my doctor's fee for surgery, 2 pre-surgery consultations, 2 visits in the hospital after surgery, and 3 follow up visits in his office.
Dr. Guarneros did not increase his fee over his original quote, even though the surgery was probably an hour longer than we originally thought.
Grand total: $6777.
Compared to my old insurance in the US, where I would have breezed through my 5K deductible in a flash and then been responsible for 20% of the rest, it is easy to imagine this could have cost at least 10k out of pocket and most likely closer to 20k. And I likely would have been discharged the same day. All that on top of a steep monthly premium for insurance.
(I have an expat policy right now for emergencies that works out to be $1200 for the year. Without the rider for emergency coverage while in the US, it would have been $700. )
I also factor in and appreciate that there won't be a trickle of confusing statements and bills from insurance and medical providers that goes on for months after any procedure in the US.
I left the hospital with a copy of my itemized bill and other paperwork, I'm paid up and done, with the credit card points to show for it.
Last thing, drug prices in the U.S. are obviously skewed by something other than market forces. The fact that you can't legally order drugs from Canada or Mexico if you live in the U.S. is a hint, too. My guess is that my post-op drugs in the US would have been at least $150.
It crossed my mind once, Damn, I could have bought a 5 star boob job for what this hernia is costing me. On the bright side of this shallow train of thought, once I'm all healed, the swelling is down and I can get back to doing planks, its going to be like a tummy tuck! LOL.
Final thought - I'm very grateful to have had this experience, have it go well, and have it behind me. It was mildly complicated and if I were not in good condition and normal weight range, it could of been worse and the recovery would be much worse.
Which leads me to....
I encourage you from the bottom of my corazon, it you are overweight and out of shape, deal with it NOW. Start slow but keep at it. NOW.
It WILL save your quality of life when you have to have surgery, and it may even save your actual life. You don't need a fancy diet.
You already know all this - this is what you do:
Cut all but one small treat sized source of sugar from your diet - for example, a square of dark chocolate, or your afternoon latte with a teaspoon or two of raw sugar. (A venti frapuccino or any other light colored venti beverage with whip cream on top is not a small treat. Sorry)
Cut all soft drinks, sugary drinks, and especially sugar substitutes. JUST DO IT. THEY ARE NOT GOOD FOR YOU. Some sugar substitutes and other chemicals in diet sodas mess with your brain, they can change your personality over time. google it. go ahead.
Do not eat "low fat" by cutting out healthy fats and dairy (unless you can't eat dairy). Women especially need some dairy in their diet. This is my opinion. Your brain needs the b-vitamins in small amounts of meat from healthy animals. Yes, happy meat is more expensive, but if your portion size is about a quarter of the usual side of beef your local steakhouse serves, it all works out.
Stop eating at restaurants all the time (if you do this by default you will be cook more),
Download a body weight workout from the web and start by strengthening your core. Go slow and enjoy feeling your body move. Its a friggin' miracle no matter what "shape" you are in, be in awe!
And walk walk walk. The gym is great but you have to move a little all during the day, not just 1 hour a day total out of the 16 or so we are awake. Here's a good one - walk to your local farmers market! Or at least park half a mile away.
Radical solution - get rid of your car. Since I sold my car and use public transportation, I average walking 3 - 4 miles per day and maintain an ideal weight range, about 10 lbs less than 3 years ago. Not to mention the 100's of dollars I'm not spending on a car.
(caveat - we did buy a used Toyota Avanza here, to monetize via UBER and private driver services. In Mexico the UBER numbers work out reasonably well if you don't spend too much on the car up front, and if you supplement with revenue from other driving services. We would not own a car here if we could not monetize it somehow.)
Thanks for reading!
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