Shoulder Replacement, Mexico Style

Walt has had pain in both of his shoulders for many years, and gradually has lost the ability to lift his arms much. Well, a month ago Walt found out the reason was that he had no cartilage at all in his left shoulder and has very little in his right shoulder. Our doctor sent us to an orthopedic specialist who immediately recommended shoulder replacement surgery.

This is how the process went. We tried convincing our doctor in the US about Walt's shoulder pains. He was not terribly interested, and told him to take Ibuprofen. Then our doctor here in Mexico tried exercise and medication almost to no avail (although we have to say that the medications available here are often more effective than some in the US, thanks to the FDA). We were both in for a regular checkup one day and Nancy said to our doctor, "This is only as far as he can lift his arms". He immediately said to see an orthopedist. The orthopedist is one of the many specialists that come down to our local clinic from Guadalajara on different days of the week, so two days later, Walt was talking to the specialist. He asked about arm movement and the like, then said, "Lets go across the hall to get x-rays", looked at the right one and said, "You should think about replacement surgery" then saw the x-ray of the left one and said, "Right away". This was all in the same 20 minute appointment, not waiting weeks and weeks for x-rays or permission from insurance to see a specialist! We then sought council from our regular doctor, mainly to see if Walt was healthy enough and whether we should do it with our Mexican government insurance, IMSS, or not. He said if we can afford to pay for it ourselves we can control who does it and when. So we did our internet homework comparing Medicare costs, out-of-pocket cost and IMSS, which would be no cost, since we are now fully vested (although it would be put off for many months). Since we had the money we decided not to go through IMSS. Then we looked at the cost difference between out-of-pocket and Medicare - if we had even kept up the policy payments. The specialist here said it would cost around $10,000 USD and it actually came out to be $9450 USD. Finding what we could about Medicare allowable expenses, deductibles and then including payment of a Medicare Part B and supplemental policy, we figured we easily saved $10,000 to $20,000 USD. This is based on that we saw that shoulder surgery in the US can cost as high as $40,000 and it looks like Medicare may have taken care of around $10,000. Then, of course, you have to add in the $5,000 we would have spent on the cost of a policy and, just like with IMSS, you don't know who you would get or when it would be scheduled.

Now here is the beauty of the whole thing. We went back to the specialist on his next Friday visit to the clinic and he said, "How about scheduling it a week from this Monday?" What? Not 6 months from now? Then the following Friday he called us in the evening to say only one of the two prosthesis parts had come in (delayed from the US) and he didn't want to operate twice and didn't think we would want that either (that is a joke, btw). A few days later he called again to say the part was in and rescheduled us for a week later. It was the surgeon who called us personally at home to apologize for the delay and to reschedule the surgery. It was not the secretary of the assistant nurse to the specialist's assistant. It was the specialist himself.

So, one may ask, who is this specialist that can give you this kind of attention? After all you are way down in Mexico and they just are not qualified.... Here is his own personal home page, in English yet. His "Curriculum" page is the most interesting.

We went to Guadalajara Wednesday morning, had the surgery around 11:00 am and apparently the surgery was about an hour and a half long. The socket was replaced with a plastic one, and the shoulder ball was replaced with titanium. The doctor came in several times after the surgery to see how things were going. Nancy stayed overnight in the room (she had a nice couch to sleep on), which is the custom here. The surgeon returned Thursday morning with the anesthesiologist in tow. With Walt's three previous surgeries he never got to see the anesthesiologist. In fact, he had chatted with Walt a little bit before the surgery. Walt's last words to the anesthesiologist, surgeon and nurses before he dozed off were "Hasta luego" (See you later)- that got a good laugh.

The clinic we were in is only nine years old and very modern. It is really a tiny hospital more that what one would call a clinic. In fact, the operating room looked like it was some space age place. Here are pictures of the clinic and of Walt recovering.

Walt began physical therapy the day after surgery and, when he was at the specialist Friday here in town, got some more exercises to do. Next Friday the staples will come out and we should be on a full road to recovery. Already the fact that there is no pain whatsoever in the joint is huge! God is good!! Work with a physical therapist should hopefully improve mobility in the muscles that have atrophied over the years.

So this is proof that in places where malpractice suits do not exist, affordable quality health care does exist. The next surgery will be scheduled around our missions trip to Israel at the end of October, plans for Thanksgiving and Christmas and our yearly trek to Thailand, depending upon how fast the recovery process is. So it may be the beginning of November or as late as February of next year.