Sunday, May 19, 2019

A MEDICAL EMERGENCY IN MEXICO: New Lessons Learned

Be Prepared at All Times!

CMQ Premiere Hospital Puerto Vallarta
             It started as a simple, fun weekend getaway to Puerto Vallarta. It didn’t end that way.
Jon and I were only going to spend two nights in Puerto Vallarta, go out to dinner both nights, go to the beach for a couple of hours, and go to Kelly’s Pour Favor Saloon and Cookhouse to listen to music Saturday night. We never made it to anything fun before I became very sick.
Nothing contagious. Just my GERD (Gastroesophageal Reflux Disorder) that acts up once or twice a year. Normally, I take one of my metoclopramide (Reglan) tablets that I carry in my purse and ten or fifteen minutes later, I’m fine. Not this time.
Here’s the yucky part of the story, but (stick with me) necessary to understand the seriousness of the medical emergency that we found ourselves in. I started vomiting about noon on Friday and continued heaving acid for another twenty hours. My doctor in the U.S. gives me a prescription every year for four promethazine 25mg (Phenergan) rectal suppositories, just in case I need it to stop the vomiting.

First Mistake: I hadn’t brought my promethazine suppositories with me to Puerto Vallarta. They were sitting in the refrigerator at home, safe from melting at room temperature. I hadn’t needed to use one for over six years. Why would I need one for a quick weekend to PV?
First Lesson Learned: Take all medication with you wherever you go, even on a short trip away from home.
I was getting extremely dehydrated and couldn’t keep even a sip of water or half of a metoclopramide tablet down. I toughed it out through most of the night, wanting to let Jon get as much sleep as possible. Plus, I figured there wouldn’t be much staff on duty at any urgent care clinic or hospital during the night on a Friday.
But at 5:00AM, I knew it was time to get some intravenous fluids, electrolytes, and a medication to stop the vomiting into my system. I woke Jon and asked him to Google a CMQ Urgent Care nearby because I knew this health care company has a good reputation. He found CMQ Premiere was about a mile away and Google said they had an Urgent Care. I also asked him to call our doctor in Punta Mita to meet us there, but he wasn't answering his phone at that hour on a Saturday.
We grabbed all of the money we had brought with us for our weekend getaway, about 10,000 pesos ($500US), walked to the street in the dark, and lucked out. A taxi was just passing by. For 60 pesos ($3US), he dropped us at the front door of CMQ.
Only the Emergency door was unlocked, so we entered there and walked up to the admitting clerk, a young man who spoke English. Jon explained that I had been vomiting for over twenty hours and needed medicine. Jon said we knew what was causing it (GERD) so I didn’t need any tests done. The doctor, a friendly, professional woman who spoke perfect English, walked over to the desk and asked me a few questions about my symptoms and said she would need to admit me to the hospital for an IV and possibly some tests.
Second Mistake: We didn’t know that “Urgent Care” in México means Emergency Room at a hospital. We just wanted a walk-in clinic to give me some medication and maybe  IV fluids. CMQ wanted to admit me to the hospital with full services. Not really what we had in mind.
Sanmare Walk-in Clinic Puerto Vallarta
Second Lesson Learned: For an uncomplicated or minor medical issue, we should have Googled “Traveler’s Medical Service”. Here’s one I found that looks like a place that could have taken care of me, though we haven’t yet gone there: Sanmare Outpatient Clinic. Any comments or reviews about personal experience with this or other outpatient clinics would be appreciated.
Third Mistake: The clerk asked if we had medical insurance that covered my care in the hospital.
No, we don’t. We have chosen to pay for our health care out of pocket and, so far, that has not been a problem.
The clerk informed us that we would need to pay 50,000 pesos ($2500US) before I could be admitted to the hospital and receive health care. He said the cost might end up being less or might be more than that amount, but we needed to pay 50,000 pesos up front!
What? We didn’t have that much money with us!
The clerk asked if we had a credit card to pay the 50,000 pesos.
No. We had left our debit and credit cards at home, expecting that our 10,000 pesos would be more than enough for our weekend trip.
Jon complained. The doctor confirmed that this was hospital policy, that most hospitals require this.
Third Lesson Learned: Never leave home without a credit card and a debit card. And maybe we needed to consider Mexican medical insurance—a thought for another day. Right now, we needed to solve this problem before I passed out right there in the waiting room.
Jon asked the clerk and doctor for a recommendation on where to go. They recommended the Red Cross Hospital, Cruz Rojo Mexicana. Another taxi ride, another 100 pesos and twenty minutes later we arrived at the dingy building.


             Fourth Mistake: I took one look at the dirty white walls in the Red Cross waiting room that probably hadn’t been painted in ten years and the wooden backless bench seats set six inches off the ground that looked like they could double as gurneys and I told Jon that I hoped the examination rooms were cleaner than this. He spoke Spanish to a Mexican woman in scrubs with a scowl on her face and her arms crossed. She said there was no doctor until 7:00. I told Jon I didn’t want to be there. We walked out with relief.
Fourth Lesson Learned: I never want to go to a Red Cross Hospital in Mexico.
By this time, I could barely walk due to weakness. I said, “Let’s go to Farmacia Guadalajara (Guadalajara Pharmacy) and see if I can buy promethazine suppositories or the equivalent.


Another taxi ride, another 80 pesos ($4US) and we arrived at an old Guadalajara Pharmacy in the hotel district. They usually have a good inventory of prescription medications. But the pharmacist said Dramamine suppositories were the closest thing they carried. That wasn’t going to do a thing for my vomiting, I was pretty sure. We bought 2 bottles of Electrolit® solution and left. 


          Fifth Lesson Learned: Don’t assume pharmacies in México will stock the prescription medication you use, or even a therapeutic equivalent. Bring your medications with you.
There was only one thing to do at this point. I said, “Let’s go get Bella, our dachshund, and go home. I have my promethazine suppositories there. Once I use one, I should be able to drink some of this electrolyte solution. If not, we’ll take another taxi to the Unimed Urgent Care Clinic in Sayulita next to the Pemex gas station.”
Another taxi ride from Puerto Vallarta to Sayulita that seemed to take forever because there was a massive organized bike ride, over 750 bicycles and many police cars bringing traffic on Hwy 200 to a crawl. An hour later, I asked Jon to give our taxi driver a generous tip since he had to tolerate the sound and smell of my vomiting into a plastic bag every five minutes. I was so embarrassed, I mumbled, “Gracias,” and ducked into the house.
Yes, I was able to treat my illness at home with my own promethazine suppositories. It required two of the precious four my doctor in the U.S. had given me before I could start sipping chicken broth. We were so happy that we saved at least $2500US by keeping me out of the hospital!
Another Lesson: Bring eight promethazine suppositories from the U.S. when we return in November. What if I had run out before my GERD settled down? I would have ended up in the hospital eventually.
Summary of Lessons: Bring plenty of money, debit and credit cards, all medications, and consider obtaining a “Traveler’s Medical Insurance” for visits to Mexico or “Mexican Medical Insurance” if you live here. Some expats use the IMSS public health system, but I am hesitant for multiple reasons.


We have obtained some Mexican Medical insurance quotes, but they all appear to have that treacherous “Preexisting Conditions” clause. We are still of the belief that we will continue paying out of pocket for health care in Mexico and if we need expensive care for serious conditions, we will return to the United States where Medicare will cover Jon’s health care and my private, high deductible plan will cover mine.
This is an ongoing dilemma for those who decide to move to México. Age and current health will factor into each person’s decision. For us, at the age of 62 and 69, we’ll continue as we have been, but travel more prepared financially and with our medication container well stocked.
I invite you to SIGN UP for my "Healthy Living and Traveling in Mexico Newsletter", published monthly with stories about our latest adventures, my recent blog articles, and news about my books.


Check out my NEW RELEASE, "Life in Mexico: Never a Dull Moment" available on Amazon worldwide. This is the #4 eBook in the "Healthy Living in Mexico” series.


     Thank you for reading my books and blogs. I hope you enjoy them and learn something useful at the same time. I'm open to comments and suggestions for future topics. Every time I write an article, I learn something new myself!
Terry L. Turrell, Author

32 comments:

  1. Beside most pharmacies are a small doctors office. They will treat you on a weekend for 50 pesos.

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    1. Thanks, Carol, for reading my article and for your helpful comment.

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  2. So all these stories about "incredibly cheap and competent medical care" in Mexico are just that, huh?

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    1. No, Dick. I haven uncommon autoimmune disorder, polymyalgia rheumatica. I was able to see a US-trained rheumatologist here in Guadalajara for less than US$45, and for another $35 in lab tests, I had my diagnosis. Emergency care, particularly in expat centres like Puerto Vallarta, is a different issue. Routine medical care IS "incredibly" competent and affordable.

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    2. Dick, from the many comments I have received from readers, it seems the price of medical care in Mexico varies greatly by area and hospital or clinic. But one thing is for sure, I will always be prepared in the future to pay a high deposit to be admitted, just in case. My goal in writing this article was to inform readers of that possibility, though it is not always the case. Thanks for reading and commenting.
      Terry

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  3. It’s incredible you leave the credit cards at home!!!

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    1. Agreed!! That was extremely short-sighted. Any number of emergencies could have come up that required access to more money.

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    2. Hi Maruca20 and Dylan,
      I'm not sure I explained clearly that we live in Sayulita, just 25 miles from Puerto Vallarta. So, at the time, a two day trip to PV by taxi seemed like a quick trip that 10,000 pesos in our pocket should have handled. We have always paid cash for everything in Mexico and left our cards at home so we didn't have to worry about losing them. Now we know, never leave home without a credit card, even for an afternoon. I'm sure we aren't the only expats who have made that mistake:)
      Thanks for reading and commenting.
      Terry

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  4. I have found it helpful to go to each specialist I have needed directly. I normally can search the Facebook Page Puerto Vallarta Everything You Ever Need or Want To Know. 700p about $40 is the typical cost. We made the mistake of taking a young man who hurt his finger directly to the Medassist hospital and we were charged 9,000P, of which 5,000 was the doctor’s fee. They considered it an emergency despite the injury having happened two weeks earlier. So the lesson is don’t go to the ER, go directly to the doctor or contact Pamela Thompson for a recommendation. Yes care here is still much cheaper and in our opinion better than north of the border.

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    1. Thank you for your helpful comment, Holly. I've heard one good comment about the SanMare outpatient clinic I mentioned in this article. It's new in PV and Pam Thompson has an office there. That will be the place we choose in the future when we are visiting PV and need "Urgent Care". It's good to have these things planned out ahead of trips, because once I was that sick in the middle of the night, all I could think was to go to the Emergency Room. The middle of the night is a hard time to find a doctor available, so I'm glad to see PV has the new SanMare Clinic.
      Terry

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  5. I had to use the Red Cross hospital once in PV for stitches on my hand and I was very happy with the result and the price.

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    1. That's good to know, FGH. Thanks for reading and for your helpful comment.
      Terry

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  6. Thank you for sharing, I am sure it will be a lesson learned for many people. For most part paying out of pocket is affordable until you have a serious or critical emergency.

    If returning home in the event of a serious or critical medical emergency is important to you. Don't get hit with an unexpected $25,000 to $50,000 or more to get you home by air ambulance! In many cases insurance will NOT pay!

    Travel MedEvac insurance is not a replacement for travel insurance, it is a layer of protection not offered by most policies.

    Travel MedEvac insurance guarantees acceptance for all applicants through age 84 and there are no waiting periods for stable pre-existing conditions.

    Visit us at www.MedEvacGlobal.com

    However, accidental injury or sickness when traveling against the advice of a Physician is not covered.

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  7. CMQ is notorious for requiring a HUGE deposit before they will treat you. Not all hospitals are the same. We live in Bucerias and like to use the Medic-Aire Hospital in Mezcales. A few years ago, I was hospitalized there for three days with life-threatening cellulitis. I had continuous IV antibiotics, great nursing care and it was clean and modern. The total cost at discharge was 18,000 pesos, or about $1,000 US.

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    1. Thank you for this information, Karen and Jerry. This is the first comment I've received about the Medic-Aire Hospital and I'm glad to hear about this. Thanks for reading and commenting.
      Terry

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  8. Promethazine suppositories (Phenergan) are available in large Mexico pharmacies.

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    1. Thank you, ICU nurse living in Mexico, for your helpful information. Unfortunately, the one we visited that day, a large Guadalajara pharmacy, did not have them and I was too sick to keep looking. But I will look elsewhere and replenish my supply.
      Thank you for reading and commenting.
      Terry

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    2. I'm still checking large pharmacies for promethazine suppositories and have not found them. I'll keep checking. Any specific suggestions?
      Terry

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  9. My partner had a heart attack at home in December and six hours later was being wheeled into an ICU room with a stent in place for 100% blocked right main coronary artery. Two more days in ICU before being discharged - total bill $12,000 US which we negotiated down to $10,000. No deposit required to be admitted to the hospital. Paid $2000 on a credit card when leaving and the cardiologist took a promissary note for the balance which was paid a week later. Cannot say enough good things about the health care system here - if you are prepared and know who to turn to for your care. Our marvelous GP, Dr. Jessica Flores, in Ajijic, knew just what to do and said, pay me later, just get to the cardiologist's office (it was a Saturday at noon).

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    1. Hi Robbin,
      Thank you for your information. I'm always glad to receive health care stories that turned out well and where the price was reasonable. Yes, being prepared was the focus of my story, in hopes of helping others avoid the same mistakes we made.
      Thank you for reading and commenting.
      Terry

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  10. I’m happy you are well and estática you posted this for others - do your research people ! I’m living in CA and keep a stash for emergencies at all times. A list of known facilities or drs with cities be great. To pass around on FB Dentist too - my hope is to eventually get to Mexico - so I’m soaking in all the info.

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    1. Hi Grider,
      Thank you for reading and for your comment. Best wishes with getting to Mexico--it's a wonderful country!
      Terry

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  11. Hi Grider,
    Thank you for reading and for your comment. Best wishes with getting to Mexico--it's a wonderful country!
    Terry

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  12. Sadly, although I live on the border (El Paso), I won't even VISIT Mexico anymore. I have found other Latin American countries that are less problematic for relocation. But, buena suerta, Terry !!

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  13. Hi Marc,
    That is sad, that you won't visit Mexico. I find many Americans have fears of living here, but I feel most fears are caused by the scary media reports, which tend to show the negative side of this beautiful country. We feel we are safer hear than we were in the U.S.
    One of my main goals in writing my books and blogs is to show the brighter side of expat life in Mexico. The other goal is to point out mistakes we have made while learning to live here so others won't make the same errors we did.
    Thank you for reading and commenting on my article.
    Terry

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  14. I developed pneumonia in February and went to the local Ajijic Clinic where I was seen within 10 minutes, admitted and was put on a nebulizer and IV antibiotics. Three days in a private clinic, private room $750US. The next Friday my Mom fell and broke her hip. She was taken to the Red Cross in Chapala where they did xrays and stabilized her. Ambulance took her to a private hospital in Guadalajara where she was put in a private room, surgery to replace the head of her femur done the next day and she was home two days later...$2500US.

    The care i have had here has actually surpassed what I had gotten in the US because the doctors here LISTEN. They don’t keep one eye on the clock and the other on the mandated flow-chart of treatment with the drug companies hanging over their shoulder. It’s refreshing.

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    1. Hi CatLadyKnitting,
      Thank you for your comment. It's nice to hear positive stories about the health care in Mexico.
      Terry

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  15. Thanks for the report, much good information. But I would like to add my experiences with Red Cross have been good. I have used the one in Cozumel several times and also the one in Merida. Both clean, modern facilities with good , helpful staff and low prices.

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    1. Thank you for reading my article and for your helpful information about your own experiences. Best wishes.
      Terry

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