Tough Old Broad By Michael

I am pleased that the staff here seem to have taken
a shine to my mom, making this paciente feel good. 

The kids were falling asleep Saturday night and I was downstairs writing a post about the work we’d accomplished on the boat and reflecting on our eminent move aboard, when my sister called me from her room upstairs. I heard a distress in her voice unlike anything I have ever heard. I ran upstairs while she continued calling for me. I heard her yell that something was wrong with our mom, here visiting for a short time.

The door to the upstairs bathroom was closed and my mom was inside, lying against it, blocking it from opening inward. She was conscious and in extreme pain, unable to move. She could hardly communicate her belief that her hip or leg was broken. It was difficult to listen to her agony.

Windy called 060 (the Mexican version of 911), corralled the kids in front of the TV in the other bedroom, and went out to the security gate guard to alert him and direct the ambulance. While my sister kept a dialogue running with our mom, I ran out to the boat to retrieve the tools needed to break into the bathroom. I returned, pried the trim off from around the door, and pulled on the door until the hinges ripped out of the frame.

My sister covered my mom in a towel and the paramedics arrived very soon after. My mom was in extreme pain while the emergency personnel did the necessary manipulations to remove her from the bathroom and strap her to a back board. It was extremely difficult to watch. They carried her downstairs and to the ambulance. I followed behind in the car while my sister rode aboard for the five-block trip to the Amerimed hospital.

My mom with her surgeon, Dr. Plantillas.

X-rays revealed a fractured femur, just below her hip. She had successful surgery late last night to install a rod down the length of her femur and some screws top and bottom to hold it in place. She returned to her room from post-op about 1:00 a.m. this morning, conscious and feeling good. In fact, she was feeling a bit too good and this morning we've had to repeat all of our post-op conversations. Today we’re expecting a visit from her surgeon and will hopefully get a sense of how she is expected to progress over the next few days.

During the ordeal, she never lost consciousness, enduring unimaginable pain and the fear of an unknown situation. She is going to have to delay her return to the States, remaining here until she is fit enough to travel, likely not before August 23. She will not be able to return to the villa we rented and we’ll find a ground-level hotel room nearby where she’ll be able to recuperate following her discharge.

How did she break the largest bone in her body? We don’t yet know. She did not fall. She says her bone simply snapped while she stood on that leg while drying the other (it literally threw her for a loop in the small room). For the past nine years, she has been taking a bisphosphonate-based drug called Zomata for her multiple myeloma. While this drug is intended to strengthen her bones against the debilitating effects of the disease and the chemotherapy she is taking to combat it, studies over the past year have increasingly and ironically linked it to spontaneous upper-femur fractures.

On first blush, it seems like her body picked the worst possible time for her bone to snap, assuming it was destined to happen. She was trapped alone in a small bathroom up one narrow flight of stairs in a foreign country. In retrospect, these were the perfect circumstances.

That the room is tiny was a blessing. When her bone snapped, she said she felt catapulted, out of control. In a larger space, she could have gone anywhere and caused more extensive injury. Worse, she could have been on a flight of stairs carrying a small child. In the small bathroom, she fell back onto the door immediately behind her before winding up contorted on the floor.

That we three adults were there to coordinate an effective response was a blessing. Had she been alone at home she may not have been able to summon help, instead waiting in agony for assistance. Even she wasn't alone and my dad was able to assist, she would have faced a much longer response time in the rural community they live and then an uncomfortable ride down the long dirt road to their house.

My sister and I are impressed with the level of care she’s received in this small Mexican hospital (maybe 20 rooms). From the time she arrived we have felt assured she would receive excellent care and confident in the knowledge and skills of the doctors and staff. That said, it’s fascinating how things are different from the U.S. hospital culture. Everything is much more casual. The care is often participatory in that my sister and I have been enlisted to help transfer my mom from one bed to another. Characteristic of Mexican culture, time and schedules in the hospital are quantified in precise terms (viente minutos!), but with an imprecise actual meaning (dos o tres horas, mas o menos…). Her two-hour surgery scheduled for 6:00 p.m. did not happen until 8:45 and it was five hours before they wheeled her back into her room. When my mom decided a sample of her bone at the break might be of value to her cancer doctors back home, she asked her surgeon to remove some. After the surgery last night, Dr. Plantillas walked into her room and handed my sister and me small containers, one containing a marrow sample and the other containing a piece of her femur. We didn’t sign for them and there was no mention of a pathologist or anything else, just super casual. Visiting hours? I don’t know. My sister and I have come and gone at all hours without restriction. She spent two nights on the couch in my mom’s room. (Yet the kids are not allowed upstairs to visit Grandma, a big disappointment.)

And the room is really nice. It is the standard room, yet private and includes a leather couch, a leather recliner, a table with four chairs, a refrigerator, a big screen TV, and a window. The building is new, completed only this past June. It turns out this hospital is private and does not serve the working class participants in Mexico’s nationalized health insurance program. It is intended for U.S. tourists and upper class Mexicans or those with private insurance. Mom’s HealthNet coverage should absorb all of the costs—or my credit card is on the line. Either way, I am eager to learn the actual costs of her care here in Mexico, I suspect they will be comparatively low.

She is supposed to check out of here manana…we’ll see.

--MR

A view of last night's sun setting from my mom's hospital window.