In the planning stages leading up to my 2015 abdominal surgery in Celaya, Central Mexico, I researched pain management options online, in discussions with other feet-on-the-ground expats and nationals, and during my consultations with the various doctors that I was vetting. In addition to surmising their experience in the particulars that I needed professional help with, I asked each of the prospective surgeons if they administered narcotics like Morphine, Vicodin or their equivalent for post-surgery pain and recovery.
I was answered each time with a vague, “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, may we all keep our sense of humor!)
Having gone through several previous abdominal surgeries in the States (no, nothing cosmetic–we’re talking 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. Stoicism has its place, but this was not one of them.
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 cut it.
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.
My home was in Mexico, my family was in Mexico…my life was in Mexico.
I decided to stay, plan for and literally pray for the best.
To say I was disappointed and dismayed to discover that opiate-level medication was not the standard of care for post-operative pain management would be an understatement. 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 digest. I had visions of waking up from the surgery in agonizing pain and suffering through the recovery unnecessarily.
Some people would state, “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.
So, how did I fare?
Waking up from the general anesthesia after a total hysterectomy, removal of a large (thankfully non-cancerous tumor) and massive endometrial implants was something akin to an out-of-body experience, and not of the good kind. Writhing in my hospital 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 a scene out of the Exorcist as I screamed in agonizing pain. 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, I knew, was part of pulling myself out of this state.
God as my witness, had it not been for Doctora Margarita de Michoacán, who stayed by 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 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 still intact.
Doctora Margarita held my hand in hers and distracted me with tales of her mother’s Michoacán mole, helping to re-route my brain and its response to this all-consuming pain. Mil Gracias Doctora Margarita…para siempre voy a estar agredicida por su amistad, su compañía, su ayuda…para mí, siempre será mi ángel.
“That which does not kill you makes you stronger?” Well, wiser for sure, and in this case, it provided me a much-needed understanding of how to navigate the medical system here in my beloved, adopted country of Mexico.
Five months into regaining my strength 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 fully herniated and onto the floor I fell. I spent the next week and a half-paralyzed on the left side of my body, requiring that my husband carry me from point A to point B in all things necessary to get through the day, which in my case at this time, included from the bed to the bathroom and the bed to the car for my multiple doctor’s appointments. Yes, 2015 was a bit of a rough year for me.
Thanks to already being in the care of an amazing physical therapist and realizing in short order (after multiple failed injectable steroids and consultations with orthopedic docs who acknowledgment the severity of the situation at hand) that surgery itself was likely my only hope for being able to walk again, I scheduled an MRI in Querétero.
My first attempt was not successful for I was unable to lie on my back for the required 45 minutes due to the excruciating pain. The MRI was rescheduled for several days later, this time under sedation. My PT Dra. Rosario knew that the weekend ahead would be a long and literally unbearable one for me without some type of effective pain relief.
Dra. Rosario took me to the office of Dr. Paulo Gonzaléz of Querétero—anaesthesiologist, 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/or his specialty prior to my abdominal surgery! (Now I know the questions to ask and the provisions to be made. I hope the sharing of this experience and information helps you too.)
We arrived at Dr. Paulo’s office and even without any intake paperwork or 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 goodies and for the first time in a very long six days since my spinal injury I, at last, had a significant respite from the pain. The tears of relief flowed profusely.
Dr. Paulo monitored my vital signs throughout this whole process, asked me every few minutes how I was feeling, and adjusted the meds as needed. I think I was able to take my first full, deep breath since the discs had herniated.
Dr. Paulo 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 (a 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 procedure, who along with my neurosurgeon Dr. Salvador Galván, the amazing OR and recovery nurses and a fair share of my own grit and gumption, I regained the gift of walking.
Prior to and after my spinal surgery, both Dr. Paulo and Dr. Galván would check in with me via WhatsApp to see how I was doing, monitor my pain levels, and adjust my meds accordingly.
Yes, narcotic-like 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 am forever grateful to my earth-angel doctors here in Mexico who have more than once saved my life and returned to me the gift of health and freedom! Se lo agredezco de mi corazón...
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 you would like to share? If so, feel free to do so in the comments section below.
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