Tuesday, February 12, 2019

Ron's weekend: "You'll fall and break a hip!"

Late Friday afternoon, Ron was preparing to drive to Los Angeles to pick up his new boat. He'd packed a bag. Filled his med box. Then went to clean out his truck.
While wrestling the newly-filled big propane tank out of the back, it rolled and knocked him off his feet and he fell out, landing on the gravel on his left hip.

I was over by the clothesline next door at the guesthouse. I didn't hear him calling for me, maybe 10 minutes. In the interim, Ron somehow managed to crawl over to the bottom of the roof stairs and sat there. When I came back, he said "I think I need your help".

He couldn't put any weight on his left leg. Didn't want to go to the hospital, wanted his recliner. Took us 45 minutes to get him there. Sat there an hour, pain worsening. Decided to go. I packed ME a few things, and we thought if they said it was broken we'd drive on up to Tucson to the VA. Stopped at Panchos where our friends were dining and arranged pet care in case we didn't come back.
The 90 minute drive to CIMA Hospital in Hermosillo was a nightmare, Ron moaning and writhing, wanting to stop and lie down. I refused, drove faster. It was full dark then. All I knew was he probably had sharp bone tearing up the meat in his hip, and was a prime candidate for embolism. Faster.

The ER there was efficient and  competent. XRays and Fentanyl. Enough English speakers to get the job done. Yes, he'd broken off the head of his femur, the thigh bone, the ball that fits into the hip socket. The orthopedic surgeon Dr. Javier Baidon Romano was called, came right in. He walked with a cane. Startled, I said "An orthopedic surgeon using a cane?" He laughed, explained a recent skiing accident, spiral fracture of his femur. A four hour drive to Tucson's VA was not an option.
Surgery was scheduled for Saturday at 1 PM, papers signed, and he was up in his room by 1 AM.

Mexico hospitals:
  • You pay as you go. They wanted $7500 US before they'd admit him, stated that was just the low estimate for the ER, surgery, doctors, and the 3 days expected stay. I talked them into 1/2 that, hoping to get the VA to pony up before discharge.

  • If the patient is elderly or a child, the family must be there 24/7. They don't have extraneous staffing like nursing assistants. I knew that before from friends' experiences. There's a couch in the room, rather firm cold vinyl. No extra pillow, no blanket. The cafeteria's only open 8 AM to 5 PM.

  • Most of his nurses were men, all terrific. They'd let me run outside for a smoke, or get coffee from the cafeteria whenever I wanted. Once a nurse made me a cup of their instant coffee in their breakroom. I bought them a huge jar of Nescafe at Walmart.

The Fentanyl was keeping Ron's pain level to a dull roar. He was pitiful alternating with zonked. I slept maybe an hour on that couch. Karen and Jim Benson drove in and brought my laptop computer I didn't take time to pack up. My phone suddenly wouldn't dial toll numbers out of Mexico.

They took him down promptly at 12:45, the surgeon would call my cell when he was done, maybe 2-3 hours. I made a fast trip to Walmart and got a few things (gin, bottled Starbucks coffee, chips, and pistachios.) Used that time to assess our financial possibilities on the laptop. Notified the kids.

4 PM he was in recovery, they let me right in. No pain. All better. They'd placed a catheter in his spine for anesthesia, like an epidural for labor. He said he heard saws, grinding, a hammer. Doc said minimal blood loss and tearing occurred. Prosthetic hip:

I went to the cafeteria and ordered a burger and fries. Inedible. Not sure what that meat was. Fries slick with grease, limp. No salt anywhere. I ate Cheetos later.

Ron was brought up to his room at 6. Slept. And I slept maybe 5 hours off and on. I stole his blanket, he said he was hot, and used my rolled up hoodie for a pillow.

Sunday the surgeon came and personally got him up to walk with a walker. He held Ron's gown closed in back, walked him around the room. Can you imagine a US surgeon doing that? Still had the catheter in his spine, pumping anesthesia in. He had no feeling in his left leg/foot, and walking was slow. He slept in a recliner the rest of the day. And that day just crawled. SO slow, the passage of time when you just want to leave.

I ordered scrambled eggs, bacon, and toast from the cafeteria. Don't know what those eggs really were, inedible. Bacon was OK, and the toast and jelly were great. They brought Ron chicken soup for both lunch and dinner, but he never ate a thing. I ate one of the soups for dinner. It was OK, lots of zucchini in it.

They made Ron take a shower that evening. It took all the remaining strength and life out of him, totally exhausted him. The nurse stayed the whole time. Then he brought me towels and I took a shower too!

Monday morning, they took out Ron's IV. Discharge instructions were given, then they sent me to the business office. Total price for everything $9,000. Comped the parking.

(It's still unknown if the VA will cover this. Couldn't talk to anyone there til Monday of course, and the first woman at VA Choice said sure, it's covered. Vacationing in Mexico, accident, emergency, blahblah. Transferred me to their business office where they said it wasn't covered  because it's Mexico. Called the first woman back and got a different one. She's gonna work on it, will get back to us.)

AFTER I paid, they took out his spinal catheter and let us go. We stopped for beer and pain meds on the way. Friends met us at home to help Ron get inside. One friend had arranged to borrow a walker, raised toilet seat, bedside commode, and crutches from Club Deportivo's stash and had them all there already. Ron went straight to bed, and the dog (who never gets on the bed), jumped right up and wouldn't leave him.

Ron still hasn't eaten anything. Says he has a bad taste in his mouth he THINKS is from a forkful of those awful eggs he tried. I'm thinking maybe anesthesia. Very little to drink, just wants to sleep.Walking with the walker saps his strength utterly, gets all sweaty.

So. Impressions of emergency medical care in Mexico:

  • Modern, efficient, clean but no frills. Very low cost compared to USA. A total hip replacement in the US is $65,000-80,000. I had to pay the prosthetic rep separately. He came to the room with a portable credit card machine. The doctors speak English. Most of the nurses speak some English, and with my minimal Spanish, there were no problems. There were no egos on display like you see with US doctors. Courteous, caring, they listen. The food there sucks. Bring your own food, pillow, blanket. Lots of restaurants and fast food nearby, but I could only leave long enough to smoke a cigarette and fix a gin/tonic out in my car.