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A Medical Emergency in Melaque

by Nancy Lennie
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We all hope that our time in Mexico will not include a visit to the hospital, but what if it does? What will that be like? What follows is an account of an actual medical emergency involving a Melaque, Jalisco, resident, Richard, as told by his wife, Nancy. Complicating this emergency was tropical storm Henriette, which had flooded the town and was continuing to bring more rain. Richard and Nancy are proprietors of La Paloma in Melaque.

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The whole place is flooded. We seem to get the worst weather from tropical storms. We can't drive anyplace without a row boat, and wouldn't you know, Richard was going down the stairs and slipped on the slippery tiles. He was taking it slow but all of a sudden I hear this scream and there he is. He can't move--thinks his hip is broken or his knee. So after about 30 minutes of trying to get ahold of someone as we are the only two in the whole place, I gave up and called Raul, who used to work for us. Raul came over and helped me move Richard. I called Sue, Richard's cousin who lives one block away, and she came but the Protection Civil, police, doctors in general, and our trusty workers can't get through. The whole of Melaque, San Patricio, and Villa Obregon is flooded up to 4 feet deep. No traffic is getting in or out of town and only one street open is ours because we are on high ground.

Finally Dr. Antonio came and pronounced that Richard broke his leg, the upper part between his knee and hip. It is a fracture. If I can get him to the hospital this afternoon, I will just as soon as the water goes down. He will need attention and X-rays to tell what kind of a cast to put on. So I have him laying down in the patio on the floor till I can move him.

Choko, our worker, just showed up. He finally found one place down by the new bridge to come into Melaque. He looks like a mud pie. His house is lower than the river and his house is flooded, so I won't keep him here.

At 11:00 am this morning the Lagoon has broken through and the water hyacienth, debris, caiman, are all floating in the ocean. There are mini islands floating all over the place and coming ashore. What a mess! I want to get Richard out of here as soon as I can drive him to the hospital but for now its wait till the water goes down. He is all morphined up and still in pain.

About 4:00 pm we just morphined Richard up and loaded him into the car on our board we have for just such occasions. The Hotel Association requires that we have it. My Honda Pilot makes a very nice ambulance. The springs in the honda are brand new and we took the pot holes and sand piles smoothly. Richard rode along with only a few ouches--it could have been worse.

We make our way through the flooded streets to the Echauri Clinic in Manzanillo in about an hour. Fortunately, there is no one waiting in the emergency room when we arrive. X-rays show that Richard fractured his femur badly and also his knee has multiple fractures. Today is Monday, but Richard must wait until Friday for surgery since he has been taking aspirin and he will have to wait for that to get out of his system so that the blood can clot normally.

The surgery will involve putting a plate in his femur and one in his knee. I will have to provide 2 units of blood and replace it with 4 units. So I need to take 4 willing donors down to the blood bank and get them to donate and then I get two in return. I guess it's a good return. The other way you can get blood from the blood bank is barter. You give them something they need and they give you units of blood in exchange. You can't buy blood. It's just one of the idiocyncries of Mexico's blood bank. I won't go into detail about what you are screened for to give blood--it's massive and they only want good blood. For one thing, a guy can't have a body piercing anywhere.

After one night in the Echari clinic in Manzanillo and a long conference with our doctor here in Barra and lots of pushing from various friends who have had similar surgery, we were strongly encouraged to move Richard to Guadalajara where his orthopedic specialist was located. It was tough on Richard, 5 hours more on the board and pretty well drugged. I hit the road with my trusty friend Raul driving and me being a nervous nelly for Richard who at the moment didn't much care as long as the drugs kept coming.

We checked into the Terranova Hospital in Guadalajara around 3:00 pm, and by 6:00 p.m. Richard was in a private bedroom, small but lovely, with a staff of nurses who were always at your call. The staff doctors also were very good. The Terranova Hospital is a teaching hospital and the surgeons are the top of the staff of the University of Guadalajara Medical school. Our team of doctors and nurses came and went all day long. You can't beat the attention to each patient you get in this particular hospital. I highly recommend it.

We spent 9 days in all in hospitals, 2 in Echauri in Manzanillo and 7 in Guadalajara. As is in all of Mexico the specialists did their mornings for the Fed. Medical IMSS, and then did their after hours on their own practice. So the poorest patient with the same problem as Richard got the same good treatment at the IMSS hospital for free that Richard got in the private hospital, from the top specialists in Mexico. The hospital bill for 7 days and nights was less than US$4000. This included the operating rooms and recovery and all the meds while at the hospital. We will not discuss the hospital food... But there are 3 great restaurants that do take out, so everything was hunky dory. Also they provide you with sheets if you wish to camp out in the patient's room for the night. I only did this for one night, the night of the surgery, then I found a hotel 5 minutes away from the hospital.

Now if you're an American from the U.S. you will think the bill was fantastic. If you're Canadian American you will opt for the IMSS plan that you can get here with your FM3 for about 300 dollars or 3000 pesos per year.

On Saturday, the nurse comes to prep Richard for surgery. He is anxious to get this over with as he has waited for the aspirin to leave his system and to be built up with his blood count to the level he needed for a man his age. He has grand plans for a huge breakfast the morning after surgery and a steak for dinner as he was not allowed to eat all day. And then he will be hobbling around on his crutches by dinner. That's his plan at the moment.

The nurses bring in the gurney and Richard is on his way to surgery. The doctor says they are just doing his leg, not his knee as he is in need of a knee replacement. That comes later. The surgery takes about 4 hours.

I spent the whole night with a very very wiggly fitful guy. He never stopped moving all night long. It took all I had in me to keep him in the bed. He is half awake but the anesthetic is not quite worn off. I would say be still, and he would say back God wants me to wiggle. So what can you say to that. But I am getting ahead of my story... The surgery was very good. Various plates were installed, one 36 cm long, and 58 pins and he is put back together very neatly. It is my belief that the doctors knew he wouldn't lay still so they really put him together in a way that he can't break again, at least before he leaves the hospital. After that he is on his own.

We left the hospital 3 days after the surgery. The long wait before the surgery had to do with the aspirin... moral of the story don't take aspirin of any kind if you are going to need orthopedic surgery.. take lots if the heart is involved. No one ever tells you the whole story about the meds we take. We sometimes have to find out the hard way. Also there is NO CAST. Not even a little one... The Doctor said to Richard "that leg is mine... don't you even put it on the floor" for 2 months. So now we are at home after three weeks have gone the stitches are healing just fine and the scar is going to be quite immense, from below the knee to way up his thigh.

San Patricio, Villa Obergon, and Melaque are also healing. You can hardly find a scar from the flood, except in peoples' minds. It should never have happened, and it was the first anyone can remember.. Poor planning some say, but at the moment I suspect the Mayor and Presidente of the community are praying for no more rain till they get a chance to figure it all out. Like Katrina, there is lots of finger pointing. I hope they figure it out so we don't repeat it. The best thing to keep in mind in Mexico in the middle of the hurricane is: BE SELF SUFFICIENT. BE PREPARED. BE CALM. BE OPEN TO GOOD PROFESSIONAL ADVICE. PRAY. AND THEN AFTER IT IS ALL DONE.. DON'T DO IT AGAIN.

Nancy Lennie
September 2007

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