I had a couple ideas for a video this week, swimming around in my head, but then something happened and it made the decision for me. 

This is just a short video about what you might do, or how you might prepare, for having an unexpected accident or injury while traveling in a foreign country, especially if you are alone.

If you are not alone, like you’re traveling with a friend or partner, these are still good things to consider if something unexpected happens.

This is NOT legal, financial or medical advice! These are simply some questions you might think about if something unforeseen should happen to you.

I was walking towards the back door to the house to let the dogs out when I got tripped up on Viggo, my dog, and took a hard fall to the ground. I was in forward motion and I fell hard and hit my head on the hard floor tile.

I knew right away that it was a significant bump, but my knees felt the impact too. I laid there for a minute in a silent panic and the first thing I said out loud was “please let me be ok. Please God don’t let me be injured”

The dogs knew something significant was happening. Normally if I was on the floor they’d be jumping on me, sniffing me, and being goofy. I didn’t open my eyes but I could feel they kept their distance.

After another minute I got up, testing my knees for injuries, but mostly holding my head. It’s funny that your brain sends your hands to your most significant injury even in something like that, that happens so fast.

I stood up. All good. My knees were working and I didn’t feel very dizzy. But I could feel the swelling and went to a mirror and saw the large apple sized damage on my forehead. No open wound, just a big bump.

I didn’t lose consciousness and I seemed to be moving around ok. My pupils were equal and seemed reactive. I got on the phone to text a friend, in Mexico but far away, and asked her to check on me every 30 minutes and if I didn’t respond or I wasn’t making sense, to call my landlady immediately and tell her to take me to the hospital.

Then I went outside to speak with Alex, my landlady. She was busy with the plumbers who had come for some issue but could see right away that I was upset and holding my head.

I told her what happened and showed her. It was a big ugly bump and she recoiled a little.  

I asked her to do the same: check on me every 30 mins to make sure I wasn’t passed out, or confused, or anything different like that. She hugged me and told me that we were in this together and she would be making sure I was alright for the rest of the day, and race to the hospital if I needed to go.

If either of these friends had shown the slightest hesitation I would have called my driver Adrian to come and get me to take me to the hospital right now. If I was really hurt it might not show up for a few hours and I needed to be watched. If I got confused or passed out without support… that would not be good.

But I felt a lot of trust for these two friends and they both checked on me and assessed my mental problems (jk, there weren’t any) regularly.

I felt shaky for the first couple of hours after the accident, but I knew I was experiencing a lot of adrenaline in my system. I’m going to blame that for my heightened emotional state.

It’s rare, I think, but it’s possible to have a head injury, seem normal for a while, and then die from cranial bleeding or the resulting hematoma. It’s called “talk and die syndrome.” The person may appear fine initially because the mass of blood in the head is expanding and there isn’t too much pressure on the brain yet.

I had read a post by someone about a month before who lives nearby. Apparently he had to go to the hospital for, I think, a minor surgery and he was upset at the way he was treated at the hospital. (I’ve also heard glowing reports of medical care here at the local hospitals and clinics)

But I think he mentioned rudeness, no respect for privacy, and theft of his money.

A lot of the comments below indicated that people just don’t go to the hospital alone here. You need, they said, someone to go with you to prevent such things.

I had this in mind when I took the trip to the Morelia airport a couple of weeks ago. I mentioned it to my driver Adrian. This is not a large area and Adrian immediately knew about the post I was talking about.  I said “I would have hired someone like you if I had no family or friends around.” Meaning I’d have him with me at the hospital.  Adrian agreed and said that would be a good idea.  He also offered to show me some good shopping spots around town that I didn’t know about.

🚙 Adrian the Driver (all over central Mexico) : 52 434 128 4524

Not being fluent in Spanish yet, I would think it’s very important to have someone who could translate medical speak if nothing else. You don’t want any miscommunications in the hospital!

So, because I had these two friends looking out for me, and I didn’t have any symptoms of a subdural hematoma or anything serious like that (yet) I did not seek to go to the hospital.

If I had any doubt about my friends taking care of me, I would have seen if Adrian was available. The other good thing about that is that he’s been to my house and knows where I live. It’s not always easy to find. And he knows other drivers in case he was out of town.

(Adrian has a stellar reputation and I think I can trust him. I have reason to know that if something goes wrong, he will make it a priority to see that his customers are taken care of.)

So that was my plan, assess for any mental or physical changes indicating a possible brain injury throughout the day. And put ice on it, which I did. I was a little shook for the first couple of hours, shaking a little. But I attributed this to the adrenaline flood I had when I realized I was hurt.

Everything went well. No sign of neuro or physical problems. My friends checked on me throughout the day. At night time one of them asked me to set my alarm to wake up and re-assess for any problems, which I did once in the middle of the night, but all was well and I slept well.

As the days went by it became apparent that my big bump would travel down to my right eye and appear as a huge and ugly black eye. No biggie! I’m grateful that that’s the worst of it.

But all this has led me to wonder what would happen if things turned out much worse.

This is NOT legal, financial or medical advice! These are simply some questions you might think about if something unforeseen should happen to you.

In my mind, the worst that could happen, short of actually dying, would be to be in the hospital for any extended amount of time, unconscious. If you were in the hospital with a big fracture or something but you were conscious, you could still arrange for your finances, your household and your animals. But if I was in a coma everything would be different.

So I thought about what you could do to prepare for the unexpected like that. No one really wants to go down that road in their head. I certainly didn’t and never really thought about it before this happened. But if you want to be prepared and take care of possibilities, These are things you could do when traveling, especially alone, in a foreign country.

If I was unconscious in the hospital I would want a family member to have access to my bank account. I would have them pay my rent for two months and the hospital bills, and any dog expenses, while, hopefully, doctors could estimate how long I’d be there (that’s a big hope with brain injuries).

I’m lucky that I have two friends in Mexico who say they would take care of my dogs if I was in trouble. I’m so grateful for this because, beyond my own recovery, the dogs are a main concern.  However, adding two big dogs to your life or your home is a big adjustment in space and lifestyle. While I have no doubt that these two friends mean what they say, the variable that really matters in this situation is time.  

If the dogs needed to be looked after for a couple of weeks: no problem. What if it turned into months?

I don’t have an answer to that. If worse came to worst and no one could take them, they’d be orphan dogs and either be on the streets or in a rescue. I don’t know what I can do about that. The fact is that whether I’m in Mexico or the United States the situation could be the same: orphaned dogs. I can’t ask family or friends to make a permanent commitment to take my dogs forever if something should happen to me.

So we hope that something like that will never happen! And chances are, it won’t.

But if I had a badly broken leg, for instance, and I was in the hospital for a few days and then needed help to recover at home, in theory I could arrange what I needed from my phone in the hospital bed.  To hire people to help with recovery at home, transportation, whatever, because I don’t know that many people, and even if I did I would not ask them to nurse me for days on end.

The question of money, of course, is important.  What I know is that in the US I would have to be on my deathbed before I went to the hospital for help, because it would most likely bankrupt me. In Mexico it is more affordable to seek care in an emergency, and even in a scheduled procedure or routine medical care. And for help at home, I’m sure it would be much more affordable as well.

I’ve heard of two visits to the medical establishment here that are informative.

One was my friend Jess who twisted her ankle and had to get attention. She was lucky it wasn’t a broken bone. See her amazing writings about Mexico here:

But the bottom line is that the Doctor, cab ride, x rays and meds added up to $52 USD

The other is someone I don’t know but had to have a serious surgery at the hospital in Patzcuaro. I don’t know what kind of surgery. This man was very happy with his experience at the hospital and the whole thing including surgery, anesthesia and a 3 day hospital stay cost $2600 USD. He said it was very clean and professional.

I have private medical insurance, which I hope never to have to use. The broker told me that premiums for insurance in Mexico are going up because some hospitals are known to extort insurance companies, not letting patients leave until they pay more.

I realize all this is anecdotal.

According to the U.S. Embassy & Consulates in Mexico website:

U.S. Government Responsibility

“If an American citizen becomes seriously ill or injured abroad, the embassy or consulate can assist in locating appropriate medical services and informing family or friends.  If necessary, a consular officer can also assist in the transfer of funds from the United States.  However, payment of hospital and other expenses is the responsibility of the traveler.  More information can be found on the Department of State site at Medical Information for Americans Abroad .
And…

Hospital quality in Mexico varies. While most U.S. citizens have acceptable  experiences in Mexico, some have reported hospitals failing to provide an itemized list of charges, withholding their passport, and/or delaying medical evacuation. Hospitals in Mexico usually require payment up-front for services and will place holds on credit cards when a patient is admitted. The U.S. government does not pay for medical care overseas. Some private U.S. insurance companies pay for overseas medical care, usually on a reimbursable basis, meaning you must pay first and request reimbursement later. Patients should contact their insurance company as soon as possible to understand what overseas services their insurance covers. 

 U.S. Mission Mexico recommends patients take the following actions regarding billing for hospital services: 

• Obtain a written estimate in advance of any procedure or proposed treatment. 
• Request an itemized bill daily. 
• Express concerns about billing with the hospital administration immediately. 
• If uncomfortable with costs, check with other hospitals and if medically possible, change hospitals. 
• Immediately work with your insurance company – do not assume the hospital will. 
• If it appears the dispute cannot be resolved, contact the U.S. Embassy, consulate, or consular agency for advice. 

There are different types of hospitals in Mexico:

• Public clinics where patients pay for medication and other basic items. 
• Public and private hospitals that generally provide a basic level of care, but may be unable to handle complex cases.
• Modern private facilities that provide high quality care at prices usually higher than in the United States.
• Lists of hospitals, doctors, and medical evacuation services are available at the Resource Navigator. 
• When the patient wishes to leave Mexico immediately and travel on a commercial flight is not possible, you may wish to consider air ambulance/medical evacuation services. A list of providers is available in the Resource Navigator. These services are expensive, and we recommend contacting multiple companies for quotes. 
• In Mexico, the Federal General Health Law (La Ley General de Salud) governs the rights and responsibilities of hospitals and patients. The key provisions of the law require the nearest medical facility to see patients with emergency medical conditions, that patients receive complete information about their diagnosis and care, and that patients authorize any treatment. Additionally, patients have the right to consent to treatment and where they will receive treatment. Hospitals may not retain or attempt to detain a patient, or his/her passport or body to guarantee payment of provided medical services. However, the patient, family member, or legal representative who authorized treatment is also responsible for arranging payment with the hospital administration and/or insurance company. 

https://mx.usembassy.gov/medical-practitioners/

Of course it’s important to have things like insurance contact info and family contact info close by. If you’re unconscious, having this information around you where someone can find it might be imperative.  My landlady asked for emergency contact numbers when I first got here and I’m glad. 

All of these issues and possibilities bring up more questions like What are the legalities of Mexico when it comes to making medical decisions? Would there be any issue with a family member talking to and working with insurance companies if you were unconscious? And have you thought about and made decisions about your care if you can’t speak for yourself?

I’ll be talking to some family members about what to do if they get an emergency call about me, how to get ahold of some of my money, and who else to contact if that should happen.  It’s not a bad idea to write down your wishes if something catastrophic should happen!

All of these things are also important to consider if you’re just thinking about getting old in Mexico. The questions of care as you get older or need help, and what options there are, could be something you want to consider.

We are all responsible for ourselves and the choices we make, but we can’t always do it alone. I’m very grateful for the friendships I have here and their kindness when I needed help!

See the beautiful writings, about Mexico and other things, of my friend Jess here:

Recently “heard” on the internet:

“Personally for me I have set myself up nicely with a small casa single level. I have a doctor who comes to my home. There are trained nurses that can be hired, also the same for cook/housekeeper aids etc. I have zero intentions of returning to the US. I plan on staying in my home and hiring the help I need. It is so much cheaper than a nursing home and the care is superior. The idea of laying in a nursing home waiting to die is abhorrent to me. Here I can be surrounded by my things, my pets, plants, hobbies, friends and I can choose to be around people I like and enjoy. There is nothing special about a nursing home that can not be provided in your own home. I recommend you do not buy a home here but rent. That will leave you capital to live your life as you see fit.”

See my article about getting old in Mexico here: https://moramargaret.com/2024/07/21/getting-old-in-mexico/

Head Injuries: What to look out for

• Pain: Constant or recurring headache
• Motor Dysfunction: Inability to control or coordinate motor functions, or disturbance with balance
• Sensory: Changes in ability to hear, taste or see; dizziness; hypersensitivity to light or sound
• Cognitive: Agitation; confusion; shortened attention span; easily distracted; overstimulated by environment; difficulty following directions or understanding information; feeling of disorientation and confusion and other neuropsychological deficiencies
• Speech: Difficulty finding the “right” word; difficulty expressing words or thoughts (which is my baseline) ; dysarthric or slurred speech

I’m so glad I had the support of my friends and that my head injury seems to be minor!  It’s a day and a half later and I’m going to have two back eyes, it looks like.

This is NOT legal, financial or medical advice! These are simply some questions you might think about if something unforeseen should happen to you.