Recently I broke my collarbone on a biking trip in the Big Bend desert region of Texas. I lived in the desert for 13 years and had ridden that section of the trail hundreds of times. This time the rain had rutted the trail and I fell hard on a fast downhill section. I flipped three times, broke my collarbone, bruised some ribs, had multiple lacerations and a concussion.
I texted friends and started walking out. I was by myself. My friends found me after about 2 1/2 miles hiking back to the car and took me to the emergency room 90 miles away. My accident happened at around 10am. I got to the emergency room around 2pm. The X-ray showed a 100% displaced fracture with 3 fragments. The ER doctor told me I would need an orthopedic follow-up and probably surgery to put in a plate and screws. Friends who've also broken collarbones told me that it would heal on its own and since I didn't have health insurance I chose to believe that. After five weeks I had a follow up X-ray that showed the fracture was more displaced than ever and one end of the bone was poking me in the ribs and caused concern that when (for me it's not IF) I had another accident, the fractured bone could puncture my lung. So, I started thinking creatively about how I could get it fixed.
I had just been rafting in Mexico 2 months before and had made some friends there. I sent messages to ask if they knew an orthopedic surgeon who I could see. One friend, Enrique responded. He got an appointment for me with an ortho that had treated one of his family members.
I got hurt in August and had another rafting trip to Jalapa in September scheduled, which I had to cancel due to my injury. I changed my flight to September 19, a day before my scheduled appointment. This time I didn’t get to pack river gear, but nightgowns and pajamas that buttoned in front; nothing that had to be pulled over my head.
On the 19th while sitting in the Austin airport playing on my phone I saw that there was an earthquake in Puebla, Mexico where I was scheduled to land. I asked the desk workers if the flight would be cancelled. They couldn't tell me. I called my friend Marie who is a pilot for United and flies to Puebla and asked her if she knew anyone we could call to find out if the airport was damaged. She said she didn't know of any way to find out and encouraged me to continue on.
When my flight got to Houston for a short layover, I saw immediately that the connecting flight had been rescheduled for 7:00 the next morning. Sitting in the airport for 15 hours with a fractured collarbone was one of my worst fears for the trip. The airline's policy was to not provide housing in the instance the delay was related to natural disasters and anyway, there was not one hotel room in Houston available due to the population being displaced because of Hurricane Harvey.
Enrique and I had been communicating on What Sapp and I quickly told him about my flight. He was already on the bus from Jalapa to Puebla to get me but I caught him at a bus stop a short distance from Jalapa and he was able to jump off and catch a bus back home.
I was starving so I got some food and starting brainstorming. I put out a Face book plea to any Houston friends who might have an extra bed or couch and used ride share to get to my friend Victoria's house. She made me dinner and we drank wine and it turned into a lovely evening. I went back to the airport at 4:30am to make my flight.
The flight was smooth; I got a taxi at the airport to take me to the bus station, bought a ticket and headed to Jalapa where Enrique met me at the bus station.
My appointment with the doctor was that afternoon but due to the language difference I didn't fully understand if I was just going in for a consult or if I was going into the hospital for surgery that day.
The hospital was a beautiful stark white surrounded by palm trees. It's privately owned by a group of doctors and really clean and lovely. The rooms are like a luxury hotel and a creative luxury car dealership has cars for sale in the parking lot. The doctor looked at the X-rays I bought and said he wanted to monitor the injury for 2 weeks and then make a decision about surgery. Since it had been six weeks since the injury, he wasn't sure he would be able to do the repair. The bones may have calcified too much.
I was deflated as I took the elevator down to have a new X-ray done. I didn't want to have wasted the time and expense of traveling with an earthquake delay only to be turned away.
I took the X-ray back up to the doctor. He slid the film onto the viewer and the light came on to expose the break I was now really familiar with. It looked the same. He turned back to me and said, "Podemos hacer el cirugia Viernes" (we can do the surgery Friday).
The next day I had my blood work done and returned to the doctor's office for him to review it. Everything looked good and we were ON. I was scheduled to check into the hospital at 6pm the next day and surgery was scheduled for 7pm.
Enrique and I were out running errands in his sister's vintage VW Bug and at 10:30 I told him to pull over so I could eat. I had a window of 8 hours before surgery where I couldn't have any food or drink. At the last minute I got a cheese quesadilla a calabacita taco and a big glass of hibiscus tea.
At time to check in, we arrived at the hospital. San Francisco hospital is a private hospital run by a Catholic charity. I'd chosen it because to have the surgery in the doctor's private hospital would have cost $1,000 more. It was clean and the people were very nice. There is an armed guard posted at the door and the hospital is on a busy street near downtown. I filled out basic paperwork, paid a $280 (by credit card) deposit for the media controls for the room and headed up the elevator.
I changed into my hospital gown and had my legs wrapped to prevent thrombosis. My vitals were checked. The nurse had placed a tourniquet on my left arm and was tapping the top of my hand trying to get a vein to rise. She asked, "Estas nerviosa?" (Are you nervous)? I said, "Si, como no!" (Yes, of course). "Relajando", she said. "Right" I thought. "Facil a decir." (easy to say). She finally got what she needed and started the IV. I received pain meds, antibiotics and something for stomach upset.
When the anesthesiologist came in, he offered me "dos opciones" (two options), I could receive a cervical nerve block to deaden my shoulder for the surgery and remain awake for the procedure or receive general anesthesia. I asked what the pros and cons were and was told that the block was safer as there are always risks with general anesthesia. He went on to say that I was healthy and there was no reason to believe that i would have any problems with general anesthesia. As I couldn't imagine anyone staying awake for a surgery where your shoulder would be cut open, pried apart and screws and a plate drilled in, I chose the general anesthesia.
I was surprised that the surgery was scheduled for 7:00pm. I know the culture there is different with siesta in the afternoon and staying up later but the evening surgery was a novel idea, which really made a lot of sense. After my surgery I could just go to sleep.
As the nurses were prepping me for surgery, I heard a choir start to sing in the hallway. Of course I was scared a) I've never had surgery other than dental extractions b) I was in a 3rd world country seeking medical care. I was with my friend Enrique who I'd known for four months but was otherwise alone. It was a little scary. I'm a massage therapist, yoga teacher and life coach. I used all of the tools in my arsenal to calm myself; deep breathing, wounded child archetype work and meditation. My eyes filled with tears but I was proud of my ability to remain calm.
As I listened to the choir singing and with thoughts of my mortality, I was reminded of a conversation I'd had with my best school friend shortly after we got out of high school. We were raised in a small town with a strong Christian base. I moved to Austin and she was living in the Dallas area. We'd recently learned that some very normal people didn't necessarily believe in Christ. I remember our conversation was something to the effect of, "Who do the talk to when they get scared?" "Who do they ask for help?" And let's not be mistaken. I was scared but I took a minute to reflect. As an adult I consider myself to be a seeker but don't identify with any religion. We've all heard of people finding God on their deathbeds. Curious about my own fear because, to tell the truth, I had had a big glass of ice water in the middle of the afternoon and lied to the anesthesiologist when he asked me if I'd had anything to eat or drink in 8 hours. When I said, "no", he asked, "Not even water?” "No." I'd read online that you could have water up to 2 hours before general anesthesia but...hey, I was still a bit nervous.
Pema Chodron taught me that enlightenment by definition is the absence of fear. As they came to move me out of my bed and onto the gurney and rolled me down the hallway under dim lights to the sound of choir music, I was peaceful. Not scared. I've lived my life as close to my true nature as I possibly could. I've traveled to the places I've been curious about and introduced and empowered other women to try things that scared them. I decided that even if I died because of a glass of ice water, I'd be okay with that. I felt well loved by my friends and wrapped in pink cloud, rolling down the hall to what could have been the soundtrack of my funeral.
The anesthesiologist talked to me as he stuck monitors to my body as we waited for the doctor to arrive. When the orthopedic surgeon started to wash his hands, the anesthesiologist told me that I was going to relax as he put something into my IV. It was a great, happy feeling. As the doctor came close and asked me if I was ready, the anesthesiologist said, "Vas a dormir ahora." (You're going to sleep now).
The next thing I knew, they were moving me off the surgery table onto a gurney and I was mad because I didn't think they'd done the surgery yet. Time went by in a blip. I'm sure they're accustomed to patients who are out of it so they just ignored me. They couldn't understand what I was saying anyway. I finally understood that the surgery was over.
The doctor came by my room after I was settled and showed me photos he'd apparently taken of the surgery on his phone. They even already had filters on them so I'm pretty sure I'm on Instagram somewhere. I saw how the bones were glued back together and the plate attached. There was also an X-ray of the plate in position after the surgery.
A couple of differences between surgery in Mexico and surgery in the United States (besides the huge price difference and live Instagram pics) is that they don't use as much anesthesia during surgery so it's safer. I didn't spend time in a recovery room taking hours to wake up. I was awake before I was even off the operating table. Also, Mexicans must be a lot tougher than we are. Even though I have a pretty high pain tolerance, I was uncomfortable through the night and kept asking for more pain meds. They gave me a bit more but then told me I had had all the pain meds I could get.
In the morning, the nurse who came on staff asked me if I was uncomfortable all night. When I told her "yes", she left the room and came back with a bottle she attached to my IV. I finally felt relief. After she left my bed started moving. I looked over at Enrique and asked him if he felt anything (thinking maybe the drugs were messing with me). He said,” No," but then he pointed to my IV bag which was swaying on the stand. Another earthquake had hit nearby.
I got to go home the next evening. Worthy of mention are the bad streets in Mexico when you're going home from surgery in an old car with no suspension. But otherwise, I felt well taken care of and professionally treated.
I was on oral antibiotics for ten days. The pain meds they prescribed were pretty innocuous, but thankfully in Mexico you don't really need a prescription, even for narcotics. I coordinated with my US pharmacist friend who helped me get the right combination of pain relievers and muscle relaxers so I could be comfortable for the week of recovery.
I returned to the States a week later, had a friend remove my stitches after two weeks and started the PT exercises my friend had prescribed for me. I can't move my arm for another five weeks and will then need an X-ray to make sure the bone is healing with the support of the plate. If so, I can start strengthening exercises. I can't return to high impact activities like mountain biking for four months.
The breakdown? The surgery in Mexico, including the surgeon, hospital, anesthesiologist, hardware and diagnostic testing was somewhere really close to $3,000.00 US. I was able to pay the hospital with an American debit card, the doctor I paid cash in dollars and the hardware had to be paid for in pesos. My emergency room visit alone was $2500.00 in the States.
I feel really lucky to have a Mexican friend who was willing to guide me through this experience and take care of me and give me a place to stay during recovery. I'm also grateful that my US friends respected my decision for the most part and didn't add to my apprehension with the apprehension that they were feeling for my Medical Tourism Adventure. My shoulder is healing nicely and I don't anticipate any problems.