Pain Management in Mexico 101

In the planning stages leading up to my hysterectomy in Celaya, Guanajuato, I extensively researched pain management options online, in conversations with other expats and nationals, and during my many consultations with the multiple doctors 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 or their equivalents would be available and 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 managing my pain for the rather extensive procedure that I needed. 

Stoicism Has Its Place, But This was Not One of Them

Having gone through two previous abdominal surgeries in the States (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 Ketorolaco (for light to moderate postoperative pain) would be used. Light to moderate? Hmmmm….

I didn’t think that any of those options by themselves nor in combination with each other were going to be enough. I seriously contemplated returning to the States for this surgery, even though none of the logistics were convenient 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 an easy reality to wrap my head around. 

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 now vital detail of my life as an immigrant to Mexico.

Post-Surgery Pain

Waking up from general anesthesia after a total hysterectomy that included the removal of a large (thankfully non-cancerous tumor) and extensive endometriosis was something akin to an out-of-body experience. One of the surgeons said, and I quote, that “it looked like a bomb had gone off inside me”. Lovely. 

Life, always an adventure, isn’t it?

Screaming and crying through the haze of pain-induced delirium as they wheeled me into my recovery room, when I saw my husband Frank, I squeezed the very life out of his hand, begging him to help me–mustering all of my strength to tell him that what I was experiencing was “barbaric”. Poor guy, there was really nothing he could do, watching his wife in what surely must have looked like something out of a scene from the Exorcist.

I am strong, I am tough, but this was an otherworldly experience of physical pain. There were whispered discussions of giving me another spinal block but that was not an option I would entertain. Feeling and being able to use my legs was part of pulling myself out of this compromised state sooner than later. Getting home to my family asap was my laser focus and motivation.

God as my witness, had it not been for mi querida 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 long 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…”

Five months into my recovery from this abdominal surgery, 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 like a sack of potatoes. 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), 2015 was a bit of a rough year for me. 

MRI in Querétero

My first attempt at getting my MRI was a miserable fail due to the fact 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, which I was dearly thankful was even an option.

My Physical Therapist Dra. Rosario knew that the weekend ahead (while I awaited my surgery) would be a long and unbearable one for me without some type of effective pain relief. 

She personally escorted us–my husband and myself–to the offices of Dr. Paulo Gonzaléz of Querétaro–anesthesiologist, angológo and paliativista–a specialist in the management of advanced pain conditions that is licensed to prescribe opiates. I sure wish I had known about this specialty and Dr. Paulo himself 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 meds and for the first time in a very long six days since my spinal injury, I at last had a noticeable break from the unbearable 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 breaths 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 surgery and as needed for post-surgery pain. We needed to go to a Farmacia Especializada (specialty pharmacy) to get these prescriptions filled 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, put Humpty Dumpty back together again and allowed me to slowly but surely regain the gift of walking.

I am a pragmatic, look at the glass half full kind of person, and so I choose to look at these experiences as an opportunity to understand how to navigate the medical system here in my beloved, adopted country of Mexico and to pay it forward and help others if I am able to.

Is Effective Pain Management Available in Mexico?

So, yes, effective pain management is available here in Mexico, it is just a matter of finding the right doctor, and the right support team and pharmacy(s) to guide you through what could be an otherwise overwhelming, unknown path–most especially in the middle of a medical crisis. 

I do hope this information proves helpful to others–that was my motivation after all for sharing these personal stories of challenge, survival, and yes, triumph. 

In peace and health to you all…

Saludos,

Katie O’Grady

For the full stories on the two surgeries referenced in this article, click on the links below:

Hysterectomy in Mexico

Spinal Surgery in Mexico~From Wheelchair to Walking

Do you have your own pain management in Mexico experience? If so, please feel free to share in the comments section below. Thank you. 😊

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