I got up Monday morning with stomach cramps and, without going into gory details, the marina bathroom seemed light years away. (You just don’t do THAT in your boat head if at all humanly possible. I mean you’d (Brian) have to clean it afterward and well, that’s just disgusting. I’d have to be literally dying (…or drunk ;)) Well, luckily I made it there and back to the boat to sleep for another couple hours. I thought I was fine, drank some water, and as I walked down the dock to the bathroom again, hurled all over the dock. Dizzy, I sat there, back against a dock box and rested. It just took too much energy to move.
Costa Baja actually has a small medical clinic. Brian helped me back onto the boat and went to see if it was open. I can see it from the boat; it is literally the equivalence of walking 1 city block, but it felt like a mile. I had to sit down half-way so I wouldn’t pass out. When we arrived, the on-call nurse only spoke Spanish, so I was forced to utilize my newly-ingested (no pun intended) 2 full weeks of Spanish lessons on her. To my surprise and relief, despite my woozy brain, I could actually understand. It was 10:45am; the doctor could not get here til 11:30. She said I could come back, but the boat seemed so far away, I just wanted to lie down. She sensed my apprehension and said I could stay and wait. Whew. I told her that I think if I tried to walk back to the boat, I would pass out on the floor. At this point she understood, called the doctor again, did some tests and started a fluid IV.
After about an hour, Doctor Salvador walks in looking like a young 30-something Oregon hipster, complete with flannel shirt and bushy beard, speaking perfect English. He apologizes for his attire; he was doing something else when he was called. I imagined him constructing a barn… or a website, could go either way. But he was great and after asking me some questions stated that it’s probably a bacterial infection and would like to transfer me to the hospital for tests. He wants to do blood tests and a stool sample to make sure I don’t have any parasites. Eewww. Apparently they can’t do tests at the clinic; I have a feeling it is there simply for minor first aid for hotel visitors and as a perk of ownership for the expensive Costa Baja condominiums. The clinic seems to be an arm of a local private hospital called “Medical Center” (doesn’t get any more clear than that), as the doctor and nurse both work there.
At this point, a hospital bill sounds like yet another crap-ton of money. Ching, ching, cha-ching. He can’t even estimate what it would cost but assures me “it’s not like in Cabo San Lucas, which would be way worse”. Great, I guess I’m glad I’m not in Cabo then. But I don’t have any dollar reference except what I just shelled out for eye surgery. So, if I paid $400 for 10 minutes of specialized laser surgery, several hours in the hospital might run over $2000 is what I blindly estimated. Jesus.
But I don’t want to go back to the boat. I am still dizzy, but the IV is helping. Last May, I got sudden food poisoning, actually passed out twice from the massive fluid loss and almost stopped breathing my blood pressure was so low. Had to be ambulanced to the hospital and given IV for a few hours. So I did not want to go back to the boat, have it get worse, and put Brian into that emergency fiasco again. Plus I just want this alien in my stomach to go away. Begrudgingly I decide we should go, but refuse to stay overnight. I can’t imagine the cost of that.
They were about ready to call a cab, but to save money, Brian ran and asked our new friend (who has a car) to see if he could drive us. We then found out that Mike, our double-dinner comrade, had awoken with similar symptoms. In his case, after the initial bout, he had felt better. This confirmed the doctor’s suspicions of food-related bacteria (and proved to Brian that I wasn’t a hypochondriac). We all basically had the same thing to eat both nights, but Brian only had a few cramps. Must be made of steel, that stomach.
The team closed up the clinic, Mike and Brian pulled the car around, and I kid you not, the nurse and her assistant went with us, all three squeezed in the back seat, holding my IV. That would NEVER happen in the US. EVER. What a memorable ride. I spoke with my nurse, Angelica, (Ahn-HAY-lee-kah) most of the way. She was the complete opposite of “Miss Frosted Flakes” from a week ago. Calm and steady, she spoke very slowly and when I didn’t understand, she tried to say it in a different way. She was so kind she even would pet my hand in comfort whenever I winced in pain from the alien. Angelica truly was an Angel.
Typical US emergency rooms are not rooms at all, but 6ft x 8ft spaces enclosed by a microscopically thin curtain. They are disconcertingly loud, activity is constant and you can hear the diagnoses of the adjacent patient. I expected that atmosphere, or way worse.
But I was pleasantly surprised. The hospital was very clean, spacious and undergoing renovations, with freshly painted walls and new tile floors. Activity-wise, there didn’t seem to be much going on. I was wheel-chaired into a real hospital room, one twice the size as normal with only one patient bed, a flat screen TV, a couple chairs + table, couch, puffy lazyboy recliner, another long lounger to sleep on and its own bathroom w/ shower. There was even an Eddie Bauer crib. More like a surgical or post-baby recovery room. Great, I think. They take the gringo here to get the big bucks. But I was told all the rooms are that big. Well, it is what it is.
A male nurse redoes the IV. I have tiny veins, so I hate being poked again and again for blood, but he gets it done the first time. Then a swarm of 5 aides arrive to take temperature, blood pressure and whatever else. They speak in rapid Spanish that I can’t understand. At this point, I want them all to just go away so I can sleep. But they keep holding up the “cup” and gesturing at it. Both Brian and I think they want a stool sample as the doc had stated that earlier. She kept saying ‘Tiene que ganar’ which, as far as I know, means I must earn or win something. What? I must win you a stool sample? Agggh my brain hurts. Where is my Angelica? She doesn’t start work at the hospital until later that night though, I’m out of luck. How do I get across that I cannot ‘win’ you a sample as I am ‘out’ of samples to give? Finally we just say OK ‘no puedo ahora… luego’, or ‘I can’t now…later’. They give up and leave me alone. Finally, sleep.
Later, while waiting for the doc and the blood tests we watch Spanish TV. We’ll see bits and pieces here and there but never get to sit through a whole show since we don’t get a good TV signal at the boat. We land upon Animal Planet’s The Dog Whisperer. Watching Cesar, even dubbed in Spanish, makes anyone feel better. The subsequent program was the cat equivalent, starring an Elvis imitation in swoopy sideburns, carrying a guitar and wearing kooky glasses; we were not impressed. Listening to him blather in dubbed Spanish tired me out. So I nap again. Then the guy who runs the café downstairs brings me cranberry juice, tea and pineapple jello, pronounced “hay-yo” I think. Later, I begrudgingly “win my sample” and give it to the aide to keep them from bothering me again.
I also get a new male nurse who took the longest time fixing my IV after I bumped it. He was super careful not to peel the tape back harshly and reseated it much more securely. He told me my blood pressure is too low and that I need to be very careful getting up. He spoke pretty good English and we started talking to him, half English/ half Spanish. Aaron has two kids and has worked there for 8 years. He went to nursing school up In Tijuana to specialize as a therapeutic nurse and worked in Cabo as well. He was definitely good at his job - as calming and helpful as Angelica. I told him we never visited TJ due to the violence. He said TJ gets a bad rap but it’s a good town and if I ever go there to make sure and get tacos, they have the best tacos in Mexico. Noted. When we asked him when his shift ended he said 10:30pm, but he had started at 7am. Wait, what? Aaron works 2 jobs, but apparently that is the norm. All the nurses work 2 shifts a day he tells us, usually each at different hospitals or clinics, just to get by. We were shocked that a skilled professional would make so little here. (The controversial differences in employment practices and wages could be a whole blog, so I won’t comment further, yet). Anyway, Aaron was pretty interested that Brian was a helicopter pilot & had been to Iraq/Afghanistan. He also was shocked that we lived on a boat and didn’t own or rent a house. Loco? Yes.
Later, Doc came back and said I had a strong bacterial infection, 86 I think, on a scale of 100. He made it sound like it was a bit worse than standard; but no parasites. He declared I should take Cipro antibiotic for 10 days and I can go in a little bit after he tallies the bill, gets me some anti-nausea and anti-stomach cramping pills and I have some more IV fluids. After being there 7 hours (twice as long as the ER visit back in May when I actually passed out), I was released.
Ride to hospital: courtesy of our new friend Mike on s/v Impulse
Hospital bill: 6600 pesos. I was there for about 7 hrs (1pm-8pm). This included the cost of IV, Cipro and the other pills. Cipro is available at pharmacies here without a prescription. We plan on picking up some extra in case we are away from civilization next time. But getting the IV for my sudden dehydration made the difference for a quick recovery, I think.
Doctors bill: 3000 (includes both at the clinic and hospital)
Taxi back home: 200
Total: 9800 pesos/14.5 exchange rate = $676.
Yes, you are reading that right. $676 for an ER visit. My U.S. ambulance bill alone was $1900, for a 3 mile trip!
Interestingly, the doctor told us he would like to be paid separately as the hospital won’t pay him for over a month. That could be taken as either a scam or as fact; we felt he was trustworthy. In reality, his bill took place on the iPad much like a Square account, and was the first time I had seen anything so “high-tech” down here. We actually got an instant receipt via email. The hospital bill was a normal credit card receipt and I then must pick up the itemized statement in a couple days from the clinic. We rarely use credit cards in Mexico, purely for caution against identity theft. But after my cash laser payment, I decided I needed to make sure there was a credit card record of what we actually paid for any medical care, solely for potential Tricare reimbursement.
The experience, while a bit unnerving, was actually a positive one, enlightening us to the potential of quality Mexican health care at low prices. While visiting 2 doctors within one week was highly annoying, it significantly reduced our fears regarding further unforeseen medical problems. We were quite pleased with what we deemed competent and professional care (Miss Frosted Flakes from blog#2 was a bad apple). On top of that, we were pleasantly surprised at their efficiency and lack of bureaucracy. (Tricare & VA = bureaucracy + inefficiency.) Finally, I am truly thankful for two great doctors and my two nurse angels.
Where I was… Medical Center La Paz
Interesting link from an ex-pat about health care in Mexico.