In the planning stages leading up to my 2015 hysterectomy in Celaya, Central Mexico, I researched pain management options online, in conversations with other expats and nationals, and during my consultations with the doctors that I was vetting for a rather complicated surgery.
In addition to assessing the expertise of the prospective surgeons, I asked each one whether or not narcotic pain management like Morphine, Vicodin or their equivalents would be used for post-surgery pain and recovery.
Each time, I was answered with a “no” or a “well, not exactly”, that there was a “concern of addiction” with meds of that class, but that narcotic type medications would be available and sufficient for my procedure–which ultimately turned out to be a rather involved and complicated one not foreseen via pre-op imaging.
Life, always an adventure!
Stoicism Has Its Place, But This was Not One of Them
Having gone through several previous abdominal surgeries in the States (no, nothing cosmetic–we’re talking about bringing life into this world and then saving mine), I knew firsthand how important adequate and appropriate pain management would be in those first few days post surgery.
I did not want to be uninformed, unprepared nor suffer needlessly.
When I asked what these “other options” were, I was told that a combination of paracetamol (Tylenol), non-steroidal anti-inflammatories and other non-opiate analgesics, such as Ketorolac (for light to moderate postoperative pain) would be used.
I didn’t think any of those singularly nor in combination with each other were going to be sufficient and I seriously contemplated returning to the States for the surgery, even though none of the other logistics of traveling there were convenient, affordable nor logical.
Mexico, My Home
I decided to stay, plan for and literally pray for the best.
The thought of going forward with major surgery with what seemed like nothing more than slightly stronger versions of Tylenol and Motrin was not easy to comprehend nor digest.
I would read online, “oh, narcotics are available in Mexico, you just have to find the right doctor”, never really quite understanding what that meant, where to go, nor who to ask for. I hadn’t yet cracked the secret code on this component of my integrated life in Mexico.
How I Fared
Waking up from the general anesthesia after a total hysterectomy, removal of a large (thankfully non-cancerous tumor) and multiple endometrial implants was something akin to an out-of-body experience, and not of the good kind. One of the surgeons said, and I quote, that “it looked like a bomb had gone off inside me”. Lovely.
Writhing in my bed, squeezing the very life out of my husband’s hand as they wheeled me into my recovery room, I’m pretty sure I resembled something out of a scene from the Exorcist as I screamed through the haze of pain-induced delirium. I begged my husband to help me, telling him that what I was experiencing was ‘barbaric’.
I am strong, I am tough, but this was other-worldly. There were whispered discussions of giving me another spinal block but that was not an option I would entertain, as feeling and being able to use my legs was part of pulling myself out of this state sooner than later.
God as my witness, had it not been for Doctora Margarita de Michoacán, who did not leave my side for those first 24 hours– seeing to it that I was being administered the maximum amount of approved non-narcotic meds and that I was at last paid a midnight visit by the anesthesiologist himself to authorize two single-use injections of morphine (finally!), who knows if I would have survived the night with all strands of hair and my sanity still intact.
“That Which Does Not Kill You…”
I am a pragmatic, look at the wine glass half full kind of person, and so I choose to look at this experience as an opportunity to understand how to navigate the medical system here in my beloved, adopted country of Mexico– specifically as it pertains to pain management–and to therefore, help others.
Five months into my recovery from this hysterectomy, whilst doing yoga of all things at our home in San Miguel de Allende, two of the discs in my back herniated and onto the floor I fell. I was instantly paralyzed on the left side of my body, unable to care for myself and needing to depend on my husband to carry me from point A to point B in the days leading up to my spinal surgery (and many after). Yes, 2015 was a bit of a rough year for me.
MRI in Querétero
My first attempt at getting my MRI was unsuccessful because I was unable to lie on my back for the required 45 minutes. Embarrassed, frustrated and feeling both defeat and surrender, I rescheduled for several days later, this time under IV sedation.
My Physical Therapist Dra. Rosario knew that the weekend ahead would be a long and literally unbearable one for me without some type of effective pain relief.
She took me to the office of Dr. Paulo Gonzaléz of Querétero—anesthesiologist, angológo and paliativista—a specialist in the pain management of advanced conditions that is licensed to prescribe opiates. Thank God! I sure wish I had known about him and this specialty prior to my abdominal surgery! Live and learn!
We arrived at Dr. Paulo’s office and without any intake paperwork or a long office wait, my husband and both doctors lifted me up onto the treatment table. Dr. Paulo began an IV concoction of morphine and some other godsend meds and for the first time in a very long six days since my injury, I at last had a noticeable break from the pain.
Tears of Relief
Dr. Paulo monitored my vital signs throughout this process, asking me every few minutes how I was feeling, and adjusted the meds as needed. I was able to take my first full, deep breath since my discs had herniated.
He wrote me a prescription for a variety of pain and anti-inflammatory medications, including morphine, to use while waiting for my Tuesday surgery and as needed for post-surgery pain. To get these prescriptions filled, we needed to go to a Farmacia Especializada (specialty pharmacy) where my husband Frank was required to show his ID and sign several pages of paperwork.
As luck and design would have it, Dr. Paulo ended up being the anesthesiologist during the six-hour spinal surgery, who together with my neurosurgeon Dr. Salvador Galván, the amazing OR staff, recovery nurses and a fair share of my own grit and gumption, allowed me to regain the gift of walking.
So yes, effective pain management is available here in Mexico, it is just a matter of finding the right doctor, support team and pharmacy(s) to guide you through what could be an otherwise overwhelming, unknown path–especially in the middle of a medical crisis.
I do hope this information proves helpful to others.
In peace and health to you all…
For the full stories on the two surgeries referenced in this article, click on the links below:
Do you have your own pain management in Mexico experience? If so, please feel free to share in the comments section below.
For more stories about our immigrated life in Mexico: