Mikey Goes to the Hospital - Round Two

Prologue

Okay.  So we all know that Michael has the knees of a 92 year old and they need to be retooled.  Plan One is that he will go to the hospital and have them both done at once.  He is thrilled with this plan while I am contemplating how I will carry him to the bathroom with two incapacitated knees.  I am assured that he will be able to bear weight on the left, less compromised leg.  Hmmmmmm.  But, says Dr. Gus, if the right leg is worse than we initially think, we will only do the right leg.  They will not know until he is on the table.  I LOVE suspense.  Well, of course, Michael's right leg IS worse than anyone could conceive so, to your delight, you will be treated to Mikey Goes to the Hospital - Round 3 -- but not right away.  But I'm getting ahead of myself.

Before leaving for vacation we scheduled the surgery for the end of August.  As before, we had to select the hospital in which Michael would have the operation .  Dr Gus suggested Santa Margarita because it had a brand spanking new operating room and was less expensive.  We were on board with that because, obviously, Margarita became a Saint after inventing the drink which, to this day, bears her name.  No, wait.  Jim, our theology expert, says that isn't true. But I don't care because I want to believe my theory.  And it's all about belief right?

The Event

This hospital is right in the heart of Guadalajara and has a definite retro, hacienda ambience.  It is the cosmic opposite of the hospital Michael had his angioplasty in.  Plush real leather sofas give way to turquoise plastic benches. Canterra tiled walk-in showers give way to a bath the size of that on a DC-3.
You get the idea.  But the operating theater is brand new and top of the line and that is what we are here for.  Everyone is super nice.  Do you know that they have nuns in Mexico that are younger than 80?  I swear it is true.  And there are many of them and they are solicitous and smile and make me wish I were a better person.

So, at the appointed time, we arrive and check in to our room.  NOBODY here speaks English. Which, after all, makes sense because it is Mexico and why should they.  It is clear that I will have my work cut out for me in communicating Michael's various needs but I am up to the challenge.  Men come and put him on a gurney.  I am fairly confident that they are taking him to the operating room but by the time I formulate the question in my mind in Spanish they are gone.  Oh well, he'll turn up.  Dr. Santiago (AKA Dr. Hernandez) comes to talk with me and gives me a rundown of what's going to happen.  Dr. Gus arrives and it's showtime.

I now have the surgical math correct based on Michael's unique anatomy.  Whatever the average duration of an operation is for a normal person, double the amount of time for Michael before you waste precious energy worrying.  This one was supposed to go 1 and 1/2 hours or tops 2.  It came in somewhere between 3 and 1/2 and 4.  At around three hours into it, a surgeon came out and approached me.  He wasn't  Dr. Gus but he DID come out of the operating room area.  He asked me in Spanish if my husband was having an operation.  I said yes.  He said that it was over and he was fine.  I thanked him and he walked halfway up the stairs.  He paused, turned and came back to me.  He stared at me.  Really stared.  Once it registered on him that I truly was a Gringa, he smiled and said that he was sorry.  He was sure that wasn't my husband he'd worked on.  I'm sure glad the guy hadn't died or I could have had several very bad moments.

At long last,  Dr. Santiago came out and told me the boy was fine.  Of course, the leg was a total, horrific mess.  It took them an hour just to get the junk (a medical term) out before they could get on to the real work.  Dr. Gus eventually emerged and described in detail what they had done.  Somewhere around the part where he drilled the holes to screw in the cadaver ligament and bone he noticed that I was growing pale and dispensed with further graphic descriptions.

Now Michael had read extensively about the procedure on the internet (I know, I know, we're not supposed to do that) and he said that he would have three small incisions stitched or maybe just with butterfly bandages on them.  He would be able to shower in 48 hours.  Imagine my, and his, amazement when he exited the operating theatre wrapped in ace bandages from his groin to his toes.  Good God!  What could lurk beneath all those bandages?  How would we know if "the site" were inflamed?  We were settled down by our Docs and told that it would all be fine.  I don't get it.  I usually have a very hard time getting over it when my preconceptions are violated but we both just shrugged and said "OK".  Trust is an interesting thing.

There was still one hurdle to surmount.  The checkout.  The bill thing.  I steeled myself for a totally Spanish financial transaction.  She handed me the bill.  $19,000 pesos (yeah, they use the $ sign too).  That's about $1,600 USD.  Even I knew that was too little.  So whipping out my best phrases I said "OK, I know that I pay the Drs. separately.  But then I have to pay for the room.  And I see that there.  And then I have to pay for the operating room and everything that goes into or out of my husband.  Right?"  Yes she said.  "Are you sure that is enough?" I asked.  I can assure you that is the first time I have ever asked ANYBODY if they wanted more money.  "No, es bueno."  OK.  Fine.  We're out of here.  Later we get a call from Dr. Santiago who is having dinner with Dr. Gus.  It seems the hospital forgot the $30,000 (pesos) for the cadaver ligament/bone. Two things.  We are VERY excited that we are probably the only people who have ever exited a hospital in Mexico without paying every, single dime owed.  I mean, it is just not done.  Two.  Times are rough everywhere.  If you are thinking of being entrepreneurial,  I would suggest going into the cadaver resale business.  I mean, one measly ligament and some peripheral bone and you're talking $2,300 USD.  Extrapolate that out over an entire body and you are talking some serious money.  I guess that's kind of dark.  Sorry.

We had been told by friends who have had knee surgery to start taking pain meds as soon as you can -- prenatally if possible.  Stories abounded of leaving surgery feeling fine and waking up about 6 hours later in mind-blinding pain.  Here's the deal.  Michael has not had ONE moment of pain.  Not one.  He took the pain meds but got rid of them about five days in.  No pain.  Actually, that is a little fib.  Last night, 8 days after surgery, he rolled over and got his foot tangled in the sheets and felt pain.  Duh, yeah.  I can do that without surgery.

Recuperation

Thank God we had hired a driver to take us to and from the hospital.  I didn't want to drive in Guad with a cripple in the car because I just KNEW that would be when I would have an accident.  Michael thought I was a chicken but I insisted.  We rolled Michael out of the hospital and managed to get him splayed across the back seat of Heriberto's van.  Upon arrival chez Searles, he hobbled on crutches into the hacienda.  We then promptly installed him in his wheeled desk chair which has been the single most useful item we have EVER owned.  Better than a car.  Better than a computer.  Better, even, than a corkscrew.  Because the house is all tiled, he can wheel himself between office, den, living room and the fish bowl (guest room so named for it's huge window that looks out to the front yard).

Now, at first, it wasn't all that easy.  He had this drain for removing the blood from his knee.  He had this ice machine thingy that you attached to his bandaged area.  So every move involved decoupling him from the ice and carrying his blood on his lap (not appealing, I know).  But things would improve.  After two days we could clip off the blood drain.  Sounds easy eh?  Well, the Docs thought I could do it (they have such faith) but I knew that I could probably kill him in some manner.

That's What Friends Are For

Lucky for us, we have friends who are RNs.  Jim and Chris (actually both RNs AND theological experts) showed up at the house with a hemostat (they look like plastic scissors -- why don't they just call them plastic scissors?), clean hands and that "can do" spirit.  And they did it. Ron and Wes attended and deemed the procedure a success.

The next step was a follow up with Dr. Gus.  Tuesday afternoon (5 days post op) we met Dr. Gus in Dr. Santiago's office in Chapala.  Yes, he drove from Guadalajara to see Michael on his own turf.  Eat your hearts out NOB friends.  It was like unwrapping a mummy and the suspense heightened as a football field's length worth of ace bandages and the shearings of a flock of sheep were removed from Michael's leg.  And there they were!  Three small incisions looking perfect.  No swelling.  No bruising. No infection.  Perfecto!  After we all smiled and shook hands and stared adoringly at the incisions, they were once again bandaged and aced (but just a little).  Gone was the ice machine (mostly) and life could go on.  We were instructed to change the bandages in 3 days.

Luckily, Jim and Chris' friend Angel (another RN who does A LOT of knees) decided to drop by for a visit on just the day the bandages were to be changed.  There is that Santa Margarita working her magic again.  I REALLY didn't want to change bandages.  Once more, the incisions were inspected and deemed marvelous.  We go tomorrow to have the stitches out.  One and a half more weeks of no weight on the leg.  Then rehab.  Then full function.  Then Michael starts waiting on me.  As it should be.

The Bottom Line -- or what you have been waiting for

I'm not sure that we can do a direct U.S./Mexico cost comparison on this one.  It's like angioplasty is angioplasty is angioplasty but knees.... ah, so many ways they can go wrong.  None of the numbers I looked at took into account the cadaver ligament/bone thing - which we now all know is pricey.  There was a calculator that I thought was weird on one web page.  You just put in your zip code (I used Wellesley, MA) and pick the operation you want and it spits out a price.  It spit out $15,000.  Which seemed pretty in line with the other numbers I had seen.  So let's use that $15K even though we know it is low because it doesn't include a bunch of snazzy things that Michael's knees got.  And, in the States, they send you home that same day so there are no hospital room or  famous incidental costs figured in.  Here goes -

Hospital Room:                                                 $    78.54
Operating Room Expenses and Incidentals       $1,427.93
Surgical Teams Fee:
--Dr. Gus, Anesthesiologist, Nurses et al           $3,799.57
Dr. Santiago's Fee                                              $   303.53
Cadaveric ACL                                                  $2,278.01
Total Cost:                                                          $7,887.58

One Last Santa Margarita Note:

As I mentioned, Jim sent me exhaustive notes on the canonization of Santa Margarita which I am ignoring mostly (Sorry, Jim).  However, there was an interesting section on how Santa Margarita still visits the hospital and many report finding her at bedside or chatting with them or walking the halls.  I LOVE that kind of stuff.  Had I known, I would have realigned my aura (maybe I have been living in Ajijic too long) to make me more approachable.  Well, there's always next time during Round 3.

The House Psychodrama Continues

Okay.  You've been following along so I won't go through it all again.  House was sold.  We have to get out.  We buy new, lovely house.  Phone rings.  It is the realtor.  Can she show the house the next day?  What, the house is sold!  No, maybe not... I tell her it is not funny because we would have just kept renting.  She is most apologetic.  But the buyer is sick.  And may go back to the States.  So they want a backup.  Sigh!  Here we go again.....

Take care.  Don't know when the next blog will be.  All kinds of great stuff -- Globos Festival, Independence Day etc -- takes place in the next two weeks.  All depends if I can get out and grab some photos without my trusted photo ace.  We'll see.  Take care.  Have fun.

The entrance hallway at Santa Margarita.

Mosaic in the hallway at Santa Margarita.

Painting in the hallway (presumably depicting Santa Margarita & Jesus attending to the sick).

Interior courtyard of Santa Margarita.

A poster (very retro) in the waiting area on Michael's floor.

Deirdre's couch & bed in Michael's room.

Michael with the anesthesiologist prior to his release from the hospital.

Michael with Dr. Gus (the orthopedic surgeon) & Dr. Hernandez during the unwrapping ceremony.

Dr. Gus removing the final bandages to finally reveal...

Michael's unwrapped knee.

 Nice job guys!  On to Round 3.  Michael's sister Patricia will probably have to have the same kind of knee surgery that Michael will have in Round 3.  While we are truly sorry that she must endure this, we are salivating at the opportunity to have direct price comparisons.  This may be getting a little sick....