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Author: Subject: What are your plans for a medical emergency in Baja?
Iflyfish
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[*] posted on 11-10-2011 at 11:10 AM


Quote:
If I lived further south and had a heart problem- I would be looking into a hone defib unit- not all that expensive these days considering the alternative.


Good one! It could be lifesaving for a community to have a defib unit available. They are real life savers and are indeed available to the public as a reasonable cost. If one of these were available in each Xpat community that could be a very valuable resource. I wonder also if there is someone you or other Nomads could identify to be responsible for having your medical needs attended to if you are incapacitated. Who knows of your current medications etc?

Thanks again for your contribution to this thread

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[*] posted on 11-10-2011 at 11:13 AM


Quote:
Originally posted by Skeet/Loreto
First: Learn to speak as much Spanish as Possible.

Second: Take a First Aid Course :

Third: Get a Good First Aid Kit;

Fourth; If in Loreto, constitutio, or La Paz go to the very Good General Hospitals.

Fifth: Do not depend on Air Vac as you may have to wait for many Hours when you could be already in the Hospital under Care.

Sixth: There is Good Care in Baja Sur, good Doctors, they just do not have as many of the Fancy Machines as the States.

Dr. Gustavo Moraila and the doctors at the General Hospital in Constitution saved my Wife"s Life when she only had about 4 hours to live. 1992


Thanks for this very helpful post. We are our own best protection against life threatening incidents. Knowledge is power. I appreciate your naming Dr. Moraila as a resource. These specifics can be very helpful in planning for a medical emergency.

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Iflyfish
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[*] posted on 11-10-2011 at 11:20 AM


Quote:
Originally posted by Mulegena
Quote:
Originally posted by DianaT
Good topic!

... Other friends have died from heart attacks and/or strokes and we have wondered if emergency trauma care had been available, if they might have survived, but who knows.

A major heart attack or stroke would not be a good thing---


This brings up tough points of reality and opens the floor for each of us to consider our personal philosophies and choices in how live.

As a 20-year Emergency Medical Technician in a rural mountain clinic I learned that time and Advanced Life Support are the two most important factors in survival. That, and plain luck and destiny.

Most heart attacks in the rural area I lived were picked up by an ambulance with life support equipment and transported less than an hour to a waiting Critical Care Team. I don't know the survival rate of those people. I know that not all lived, even with the finest of emergent care available to them.

Additionally, I saw many cardiac incidences come through the doors of the clinic, either brought in by family or as a last-ditch effort by the ambulance. Of these, only one patient survived and it was because of his presence of mind and good decision-making immediately prior. He came in complaining of "just not feeling right". I was in his room when he suddenly "coded", i.e. had a full-on heart attack. The doctor was called in immediately, he was stabilized and sent out by ambulance.

In my opinion, we here in rural Baja have a very slim chance of survival given sudden cardiac arrest.

As for me, I too need to get my house in order, make my desires known and formally put in place some Advance Directives, written in Spanish and English. Those I had in place in years past are no longer pertinent. After that, I'll continue to hold those I love dearly and get on with savoring this beautiful, mysterious experience called life.


Thanks for this very informative post. I hope other Medical Professionals will also chime in and help us understand what is important to the care givers when they meet us, unconscious in the ER.
You bring up a very important point, having our medical information in both Mexican Spanish and English. Who do you leave this with and how do you provide them with legal authorization to act on your behalf?

From your post it would seem to me that having a defib unit available would be very helpful. How about EpiPens? Allergic reactions can be a serious medical emergency and EpiPens can be inexpensive and life saving. Who in your rural community is capable of using a Defib or injecting an epipen?

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toneart
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[*] posted on 11-10-2011 at 11:28 AM


In Mulege there is a clinic with very good doctors but little in the way of equipment. The closest medical facility with good equipment is La Paz.

It is difficult to anticipate what type of medical emergency one might encounter, and also, where it may happen. So, unless you are aware of a medical condition that could blow at any time, it is kind of the luck of the draw.

If an air evacuation is needed:

1. my neighbors will know I have credit cards with high limits.
2. I have a AAA Premiere Card. That plan will reimburse you for sure, but you must pre-pay on your own.
3. Celia Diaz, of BiNational Emergency has all my personal data on file as I am a member. She is in Chula Vista, CA and responds 24/7. It has already been stated in other threads how good of a job she does. She is so well connected that she can get the best services possible in any area of Baja...immediately. She also has my family contact numbers on file.

I have covered my bases, am cautious, and prepared as well as one could be. Having said this, I do not live in fear of what could happen. I live each day as though it were my last, enjoying every minute and do not worry in the least Try it! It's Free!

To answer another Nomad's question, yes, you can be buried in Mexico. Personally, when I leave my body, I care not whether the worms or the fish get it, or whether it fertilizes the trees. Oh, you could give me a wake. Freeze my body and put it in a tub to keep the beer and the champagne cold. Sing and dance! :saint::biggrin:




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Iflyfish
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[*] posted on 11-10-2011 at 12:34 PM


toneart

"1. my neighbors will know I have credit cards with high limits.
2. I have a AAA Premiere Card. That plan will reimburse you for sure, but you must pre-pay on your own.
3. Celia Diaz, of BiNational Emergency has all my personal data on file as I am a member. She is in Chula Vista, CA and responds 24/7. It has already been stated in other threads how good of a job she does. She is so well connected that she can get the best services possible in any area of Baja...immediately. She also has my family contact numbers on file."

So BiNational Emergency is a resource for keeping medical information etc. and by being a member one can have this information available in case of an emergency.

http://www.binationalemergency.org/index.html

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David A.
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[*] posted on 11-10-2011 at 12:37 PM


Within the last 30 years of visiting relatives in San Quintin, I have taken two of my kids and my wife to the hospital/clinic. Each time they accepted my HMO card with no questions asked, including the perscriptions. After the three individual visits, we had our home doctor check them out again. They said the work performed was excellent and don't worry.
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[*] posted on 11-10-2011 at 01:22 PM
2 cents worth...


Set and pin broken arm in mex, 900 dollars, quoted 39,000 pesos for operation. Returned to calif, HMO performed operation worth almost 70K dollars. I would get either IMSS or Seguro Popular in Mexico.
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[*] posted on 11-10-2011 at 01:26 PM


Don't forget -- opioid analgesics are almost non existent in mexico. Tylonol 3 or tramadol are THE strongest anything available. Made a big difference in how I think about where to have an operation done or where to recuperate.
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[*] posted on 11-10-2011 at 02:24 PM


David - you're not saying you paid the 70K in the U.S., right? What was your payment out of that amount.

Also, when you say opioids are almost non-existent. Are you saying doctors can't write prescriptions for them? My understanding is that after the new regulations were passed, the number of controlled-substances grew and that is now enforced, whereas before you could get a large number of "controlled" substances there. I know I personally purchased Valium without a prescription more than once.
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[*] posted on 11-10-2011 at 02:30 PM


Personally, my plans are to get the hell out as fast as possible, however possible. There is no doubt there are good doctors in Mexico - the problem is the system and the facilities. A good doctor is helpless in an emergency situation without the proper equipment.

There are also some good hospitals, no doubt, Angeles in Tijuana is an example, but if an emergency happens somewhere you are not intimately familiar with, and with the system - good luck. My family has clear instructions - if I get hurt, put me in the truck and head for the border, pedal to the metal.
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[*] posted on 11-10-2011 at 02:31 PM
Medical info


How does the medical system work in Baja?

…………I’m not sure. It seems to be different depending on where you are, and the type of medical problem you have

Do you have Mexican medical insurance? How does that work?

………………No

Do you have US medical insurance and how does that work in Mexico?

………………Yes, however not covered in Mexico. We have to be treated in the US, although I would submit any Mexican medical bills to the insurance carrier to start the clock running and for documentation purposes.

Who is authorized to advocate for you in the Mexican medical system if you are not conscious? Is there a Mexican Medical Power of Attorney for Medical and Economic issues if you are incapacitated?

…………… Wife, daughter and our Mexico General Practitioner. It is important that you have a Mexican will in place so your wishes are known. Also would have a medical directive in Spanish available to GP

What is the best clinic in your area? What do they treat, what can't they treat? What equipment do they have there? Xray, MRI, CAT? Where do they send you if your needs are greater than they can provide?

…………………Unknown about a clinic, but Velmar hospital is a short distance away. Very highly regarded and works with Sharp Hospital in Chula Vista

What is the best hospital in your area given your medical insurance/ability to pay?

……………Stabilized at Velmar then transported to Sharp Hospital in Chula Vista

Where would you go for a heart attack, stroke? How would you get there?

……………Velmar Hospital in Ensenada.
Cruz Roja and Dianamed ambulance service is dispatched from Ensenada, so driving time could be up to 20 minutes one way. Probably by private car.

How would an Emergency Room or Hospital know what medications you currently take?

…………We have a medical card on the refrigerator that lists doctors, meds, blood type and other info including directives and a copy of passport. Was told by Dianamed Ambulance service that they always look on refrigerator for info. Also keep a copy of the card in my Baja wallet. ALWAYS keep a copy of your passport in your wallet.

What other medical questions are not included here and need to be considered when in Mexico? If you work in the Mexican Medical System, what should we know that most of us don't know?

What would a Medical Action Plan for Nomads living/visiting Baja look like? Where would you keep it so it will be of use?

………………Obtain a quality medical evacuation insurance plan. Check your current US medical policy or life insurance policy (or call your agent) to determine if you have evacuation coverage included in your plan.

We have one through our health insurance plan. It is from Med-Ex (worldwide, 24/7):

http://www.medexassist.com/

We also have 24/7 worldwide Search & Rescue and evacuation insurance through SPOT:

http://www.findmespot.com/en/index.php?cid=104


Sharp Hospital in Chula Vista will at NO COST coordinate for medical evacuation worldwide 24/7 by calling:

(888)265-1513 or in Mexico, 001-888-265-1513

Sharp has bilingual and bicultural emergency service representatives who will:

Work with the Mexican hospital treating you to coordinate your evacuation

Arrange air and land ambulance transportation to San Diego

Coordinate arrival with one of the Sharp Medical Center group

Contacting and providing assistance to family members

Contacting and coordinating with your stateside medical insurance carrier, to include Kaiser and the VA system.

In addition to medical /evacuation insurance, you should have a high limit credit card for medical emergencies in Baja as the majority of private ambulance services and hospitals will not bill you or your insurance company.

[Edited on 11-10-2011 by bajaguy]




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Iflyfish
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[*] posted on 11-10-2011 at 11:46 PM


Good one Bajaguy, lots of great ideas in your post.

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[*] posted on 11-11-2011 at 04:22 AM
Local area


One thing for sure, you need to check out the medical services/ambulance service/evacuation plans for your specific area and situation BEFORE you need it............Luck favors the prepared!!!!!



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[*] posted on 11-11-2011 at 06:21 AM


Or, do as I did, and marry a Mexican doctora!!! Seriously though, a very good topic. My wife knows what can be done and where, here in La Paz. If the worst happens, she will do her best, if that fails, feed me to the fishes!!



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[*] posted on 11-11-2011 at 08:26 AM


In my pre-baja days I was an Insurance agent that specialized in Health Care policies. I can tell you that even with simple policies that not all of my clients knew how to get the best services out of their policies and very few, if any, bothered to read the details.

Now we come to Mexico, which works very well for the Mexicans, but we get all confused because it is not the same as it is in the United States. Some people think that the whole system is set up as a rip-off to snag unwary tourists into paying large amounts of money and providing no services. Others report that they have had some of the best care provided that they had ever experienced.

Because I got involved in a project with the local hospital in Santa Rosalia, I did learn quite a bit about the systems and what really goes on with healthcare in Baja. First, because of the way the system works, it is possible to get very good personal care in terms of the doctors, nurses, and staff because they are doing what they want and are not under the same treatment operations as the United States. Doctors and Nurses actually take the time to spend time on trying to help you and do not have to run off to the next patient in the same way that US doctors do. But the real deficiency is is Medical and diagnostic equipment. (The big buzz this week is a mobile Mammogram trailer that is making it's way through the small communities, where this is available in any moderate sized town in the US)

Second, is that if you live here part time, it is very reasonable and inexpensive to sign up for Seguros Popular. This gives you good treatment at the general hospital but do not think it is a full blown Blue Cross Blue Shield Plan. There are some very good plans available in Mexico but again, they are not the same as the US. I carry Seguros Popular , Medicare in the US, and a high deductible supplement ($2,500).

If you have an upgraded health insurance plan, they usually cover private as well as public or general hospitals. You can also pay the tab for whatever you choose to have done and the rates are usually 1/4th or less than the same procedure in the United States. I think as the healthcare delivery continues to degrade in the United States, we will see more medical treatment take place south of the border. (I have a good friend who is going to head up the Shriner's Childrens Hospital in Tijuana since they are closing down the Los Angeles facility due to run away costs and figure they can operate for a fraction of the cost in Mexico.

Each person needs to decide what tolerance they have for medical treatment in a foreign country and if it is beyond their ability to understand or comprehend, then I heartily reccomend carrying a medical evacuation policy. When my wife had cancer, she felt it was important to come to Mexico but things could happen so quickly that in order to do that responsibly, we enrolled her with an evacuation policy and also signed up with Celia Diaz because she is the master at arranging everything. We had no problems setting up with a non-tower airport and they did have a King Air which would land on dirt strips. I do not know if that is still current but it was several years ago.

Finally, it is a good discussion to have with the locals as they usually have a good idea of the good doctors and services and the ones to be aware of. There have been numerous stories of the rip-off hospitals and doctors in both Cabo and La Paz and they seem to prey on the unsuspecting. So my hat is off to the FISH for starting this thread as information helps all of us.




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Iflyfish
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[*] posted on 11-11-2011 at 08:56 AM


Quote:
Originally posted by DavidE
Don't forget -- opioid analgesics are almost non existent in mexico. Tylonol 3 or tramadol are THE strongest anything available. Made a big difference in how I think about where to have an operation done or where to recuperate.


I was able to acquire Oxycodone in La Paz when I was on that very nasty drug. My prescription ran out. I obtained it through a Cancer Doctor in La Paz. They had to order it from the mainland. Only one pharmacy in town could order it.

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Iflyfish
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[*] posted on 11-11-2011 at 09:15 AM


Quote:
Originally posted by Pescador
In my pre-baja days I was an Insurance agent that specialized in Health Care policies. I can tell you that even with simple policies that not all of my clients knew how to get the best services out of their policies and very few, if any, bothered to read the details.

Now we come to Mexico, which works very well for the Mexicans, but we get all confused because it is not the same as it is in the United States. Some people think that the whole system is set up as a rip-off to snag unwary tourists into paying large amounts of money and providing no services. Others report that they have had some of the best care provided that they had ever experienced.

Because I got involved in a project with the local hospital in Santa Rosalia, I did learn quite a bit about the systems and what really goes on with healthcare in Baja. First, because of the way the system works, it is possible to get very good personal care in terms of the doctors, nurses, and staff because they are doing what they want and are not under the same treatment operations as the United States. Doctors and Nurses actually take the time to spend time on trying to help you and do not have to run off to the next patient in the same way that US doctors do. But the real deficiency is is Medical and diagnostic equipment. (The big buzz this week is a mobile Mammogram trailer that is making it's way through the small communities, where this is available in any moderate sized town in the US)

Second, is that if you live here part time, it is very reasonable and inexpensive to sign up for Seguros Popular. This gives you good treatment at the general hospital but do not think it is a full blown Blue Cross Blue Shield Plan. There are some very good plans available in Mexico but again, they are not the same as the US. I carry Seguros Popular , Medicare in the US, and a high deductible supplement ($2,500).

If you have an upgraded health insurance plan, they usually cover private as well as public or general hospitals. You can also pay the tab for whatever you choose to have done and the rates are usually 1/4th or less than the same procedure in the United States. I think as the healthcare delivery continues to degrade in the United States, we will see more medical treatment take place south of the border. (I have a good friend who is going to head up the Shriner's Childrens Hospital in Tijuana since they are closing down the Los Angeles facility due to run away costs and figure they can operate for a fraction of the cost in Mexico.

Each person needs to decide what tolerance they have for medical treatment in a foreign country and if it is beyond their ability to understand or comprehend, then I heartily reccomend carrying a medical evacuation policy. When my wife had cancer, she felt it was important to come to Mexico but things could happen so quickly that in order to do that responsibly, we enrolled her with an evacuation policy and also signed up with Celia Diaz because she is the master at arranging everything. We had no problems setting up with a non-tower airport and they did have a King Air which would land on dirt strips. I do not know if that is still current but it was several years ago.

Finally, it is a good discussion to have with the locals as they usually have a good idea of the good doctors and services and the ones to be aware of. There have been numerous stories of the rip-off hospitals and doctors in both Cabo and La Paz and they seem to prey on the unsuspecting. So my hat is off to the FISH for starting this thread as information helps all of us.


Thank you very much Pescador. This is the very sort of post I hoped would emerge from this discussion. I appreciate your thinking and experience.

It can be difficult to sort out the Mexican Health Care System. There are a number of levels to it.

My brother has lived on the mainland for the past 18 years and he has a private health insurance policy and his care has been EXCELLENT. As identical twins our health care issues, including surgeries, have been exactly the same. My care has been in the US, Kaiser, and his in Mexico. We both have had OUTSTANDING care. One of the main differnces is the one you noted. Doctors in Mexico have time to really engage with you and they care. If you have a personal doctor in Mexico you have the absolute best health care advocate you can have.

My brother carries a Private Mexican Health Insurance policy. It costs less than mine in the US and has provided him with excellent care. A key componant of his Private Mexican Health policy is that he has an agent who brokers his care for him. This agent acts somewhat like a Mexican Auto Insurance Agent, who must be on the scene to negotiate a settlement for any accident you are involved in. His agent is intimately involved with the health care facilities and providers in his community as he must deal with them on an ongoing basis. I hope that perhaps a Private Mexican Health Insurance Agent will chime in on this discussion and help us better understand how that system works. This might be an option for those of us who have resources and live full time in Baja.

In discussing medical care with locals or anyone for that matter it is important to remember that people have varied levels of knowledge of the medical system and medical care.

I have traveled in Mexico for nearly fifty years now. I have traveled in most of the states in the Republic. In my experience a typical Mexican that I have met will first go to an aunt or curendaro for suggestions on what to do, then perhaps to a pharmacy where they will ask the clerk, who may have no medical training, what they should take, then they will order one tablet of the drug or if they order a full regime may only take one of these tablets. Of course better educated peope of more means will usually have better knowledge of a wider range of medical options and those which may be most helpful for an extrajeno.

Thanks again for your very thoughtful post.

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Iflyfish
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[*] posted on 11-11-2011 at 09:19 AM


Quote:
Originally posted by bajabass
Or, do as I did, and marry a Mexican doctora!!! Seriously though, a very good topic. My wife knows what can be done and where, here in La Paz. If the worst happens, she will do her best, if that fails, feed me to the fishes!!


We have had the very great pleasure of sharing a memorable Thanksgiving dinner with you and your lovely wife. You are a very lucky man!

I wonder if you might provide us with a run down on what medical resources you might recommend to Nomads who live/travel near La Paz? Do you have any information on Private Medical Plans in Baja?

Thanks

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[*] posted on 11-11-2011 at 09:22 AM


Quote:
Originally posted by bajaguy
One thing for sure, you need to check out the medical services/ambulance service/evacuation plans for your specific area and situation BEFORE you need it............Luck favors the prepared!!!!!


This is a very good point. Luck does indeed favor the prepared!! This is the point of this thread. In the middle of an emergency is not the time you will want to be scrambling for information, papers, names/addresses, list of current medications in Spanish etc. I hope that out of this thread specific information will emerge to assist Nomads in making their emergency medical plans.

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[*] posted on 11-11-2011 at 10:00 AM
Thanks bajaguy


One of the most thorough posts on the subject I have seen posted here.

Ken
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