Fly me to San Antonio

On By Alfredo LanierIn health care, Uncategorized
Medical evacuation seems frivolous until it isn’t

Five years after we moved to San Miguel, around the time we turned 65 and eligible for Medicare, Stew and I bought medical evacuation insurance with a company called SkyMed, based in Scottsdale, Arizona that promised to fly us back to the U.S. in case of a major emergency. It seemed a prudent move but after several years it looked like a frivolous expense we were never likely to use. Should we cancel?

The mere logistics of a medical evacuation make it seem far-fetched, considering the many pieces that have to fall into place. One of us would have to notify the insurance office in Scottsdale, which would arrange for an ambulance here to take us to the airport, 90 minutes away, to meet a waiting chartered plane to take us to an airport on the other side, there to hook up with ambulance for the run to the hospital of our choice. It sounded as iffy as paying in advance for a flight to the moon.

Yet with only one glitch at the San Antonio end of the flight, the evacuation proceeded with military-style precision both going and later returning to Mexico on a commercial flight, also arranged and paid for by SkyMed. We were left astonished how well it all worked out.

The emergency began late on a boring Sunday afternoon when we went to a grassy spot on the ranch to practice pickleball, normally a low-wattage sport now the rage among the AARP set. Stew tripped on something and fell and landed on his right hip, letting out a scream. I tried to help him up, and brought a small stool so he could help himself up, followed by my trying to pick him up, but neither maneuver worked. Lifting 180 pounds of dead weight is damned near impossible, particularly when the weight lets out a scream every time you try to move it.

First I called Gabriel, a young neighbor, to come and help us, but I got no answer and then dialed Félix who lives no more than one kilometer away, but got no answer either. Moments later he called back and said he’d be right over though his speech sounded garbled. Twenty minutes later he arrived with his wife and a friend who had given them a ride. Félix was barely intelligible and at one point fell to the ground himself: Indeed, he was plastered, a seemingly chronic condition that’s fodder for another blog post.

Then I called Hospital Mac, about 20 minutes from here, to get an ambulance and they gave me the number for SEETS, a private ambulance service. In one of several lucky breaks, an ambulance showed up in about 15 minutes, which still amazes me because my frantic directions to our rather remote ranch must have been barely coherent and by now it was dark outside. When the ambulance arrived, the driver and a young woman paramedic, with the help of flashlights, loaded and strapped Stew onto a stretcher and took off, emergency lights flashing. I followed in our truck ten minutes later, long enough to lock up the house. We still marvel how the ambulance arrived so quickly. The charge for the ride was $1,500 pesos or about $75 dollars, certainly a bargain.

At about nine o’clock two very young doctors greeted us at the emergency room of Hospital Mac, took X-Rays, confirmed the fracture, checked Stew’s vital signs and hooked him up to an IV that presumably included some pain-killers. Then they called an orthopedic surgeon who over the phone gave me a quick but somewhat dire summary of the various types of hip surgery, emphasizing the need that it be done right away. His enthusiasm seemed to wane somewhat when I mentioned I was going to investigate an air evacuation to a hospital in the States, but to his credit, said that was my choice and showed up the following day to see how Stew was doing. Two hours after arriving, at around midnight, Stew, who was calmer by now, was wheeled up this room.

Stew taken out of the ambulance at Querétaro Airport.

The day after the accident I contacted a SkyMed rep in Scottsdale who began the paperwork for the evacuation. After some back-and-forth over forms that the orthopedic doctor here had to fill out, I faxed them to Sky Med, along with a copy of my passport. At around three o’clock, I received a call back that an ambulance would be waiting at the hospital for me and Stew two hours later and barely long enough to do some haphazard packing and get a hold of Félix, by now sober but still bleary-eyed, to take me back to the hospital.

As advertised, a seemingly well-equipped critical care ambulance, staffed by a paramedic and a doctor—as opposed to the more basic SEETS ambulance designed mainly to move patients, was waiting and we took off for the airport by around six o’clock, siren wailing. Heavy rains apparently had disrupted the expressway to the airport, so the driver opted for a bumpy detour through landscapes I didn’t recognize.

The patient being entertained by Dr. Raúl

By around eight-thirty, we arrived at a desolate corner of the Queretaro Airport apparently reserved for corporate jets, where we were greeted by uniformed airport security and customs officials, plus two pilots and another doctor and a paramedic that would accompany us. All those uniforms standing ready by the the plane made me feel a bit like a Latin American dictator fleeing a revolution the night before. About an hour later, pilots climbed aboard, and medical personnel personnel packed Stew, me and two pieces of luggage into the plane.

It was a Mexican-flagged Lear-type jet, which in its original life could have carried ten passengers but now was packed to capacity with Stew strapped on a stretcher and hooked up to several pieces of monitoring equipment, under the supervision of a chatty doctor named Raúl, whose prescription to calm everyone’s nerves was to talk and tell jokes non-stop. I sat at the back of the plane with my luggage, in between the two engines roaring just outside. From my vantage point the scene reminded me of the Titan submersible that went kaput while searching for the Titanic, though I tried to get that out of my head and listen to Raúl’s jokes instead.

Tight quarters in the medivac plane

About ninety minutes later we landed in San Antonio and were greeted by one of those multi-ton ambulances fire departments use in the U.S. that seem equipped to do a kidney transplant if need be. From there, we went to the emergency room of Baptist Orthopedic Hospital, where we encountered the one glitch in the otherwise flawlessly choreographed evacuation: Apparently the hospital wasn’t expecting us, although SkyMed said they had contacted it.

The two paramedics and doctors from Mexico and the San Antonio ambulance arrived a bit later and they all joined Stew in a lively argument with the admissions nursing staff, to the effect that emergency rooms, by definition, should be ready to handle the unexpected, no previous notice required. Finally they took Stew to a separate corner of the ER where he received more IVs while waiting for a hospital bed to come available, at around 2 a.m.

From there, it was back to the airport and the medivac plane for Raúl and his paramedic, this time to pick up someone in Oaxaca.

Stew was scheduled for surgery the next day, Tuesday, at 6 p.m. but it was delayed until about 8.30 p.m. The surgeon, a trim 30-something, with a slight German accent and a bone-crushing handshake, came down to the pre-op waiting area to introduce himself, along with the anesthesiologist, though both were all-business, with no time for chit-chat. Surgery finally began at 9 p.m. and didn’t end until midnight, when I met the surgeon briefly in the lobby as he was rushing home.

I went up to the room, very pleasantly furnished if you forget you’re in a hospital, including a couch that would be my sleeping berth for the next six days while I kept Stew company. .

24 thoughts on “Fly me to San Antonio”

  1. mollyandlukerich@gmail.com's avatar mollyandlukerich@gmail.com

    WOW. We have SkyMed so it is good to know they are reliable. Ment to ask you when we saw you ate the Vivero, how is he doing?

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    1. kateagreenaway's avatar kateagreenaway

      What an ordeal for you guys! So glad it worked out well. Best wishes for a continued recovery to Stew, and thanks for writing it up Alfredo!

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  5. othmarsingen's avatar othmarsingen

    Glad to hear that the entire journey went relatively smoothly, and that Stew makes a speedy recovery. As someone who is very soon going to make the move to Mexico, SkyMed is something that I will have to look into.

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    2. It depends where you move to, and other factors, such as whether you are eligible for Medicare, and your financial situation. Medical care in big cities like CDMX, Guadalajara, Monterrey and even Queretaro, is good but the problem is that all medical attention is cash-on-the-barrel, which can get pretty expensive. Some people we know have signed up for Mexican medical insurance and say they are happy with it. Good luck.

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  6. Mary Jane Harvey's avatar Mary Jane Harvey

    We, too, have SkyMed and have wondered if it was worth it. Your post is very reassuring. What made you choose San Antonio? I’ve wondered where we would choose since we no longer have a home in the US but would probably opt for somewhere near family because of the rehab afterward. Hope Stew is recovering nicely!

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    1. As I mentioned in the blog, we also had our doubts and I’m glad we kept the policy. We picked San Antonio because we have friends there and are pretty familiar with the city. San Antonio also has some very good medical facilities. We originally had designated Chicago, our previous home, but after so many years we’d lost contact with most friends. If you have relatives somewhere, it would make sense to pick that city. Good luck. Al

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      1. Dee Tillotson's avatar Dee Tillotson

        Al, so glad that Stew is back home recuperating; great to see him on the SkyMed plane with a smile; he must have been on some “happy juice.”

        Just a few questions, if you have the time (being a caregiver can take a lot of time, but we do it with love). Do you and Stew have to return to San Antonio for Stew’s post-surgery visits and therapy? Did Stew have to get a new hip or was the surgeon able to repair his “God-given” hip? When Beach and I get our travel insurance (for insurance out of country because we are on Medicare in USA), the company we use includes medical evacuation with an upper limit on the policies; however, I do not see the name of the evacuation company in our policies. Therefore, do you buy a SkyMed policy separate and apart from your regular medical insurance?

        I hope everything continues to go well, and it’s great that Felix is there to watch over the ranch while you and Stew have to be away.

        Dee Tillotson
        Summerville, SC

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        1. Yes, I think they had given him some “happy juice” in an IV because he didn’t complain on the way to San Antonio. They repaired the fracture, which I think it’s preferable to a hip replacement which is more painful and takes longer to recover. I’m not familiar with the type of insurance that covers you while traveling; it might be informative to look on the internet for people’s experiences and recommendations. Our insurance company is SkyMed, and I’m not sure if they would cover us while traveling outside of Mexico. That would be useful to know. I’ll post the answer when I check. SkyMed is separate from Medicare. al

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  7. Glad it all went well for you. Well…as well as the situation allows. Have you recommended this line of insurance to Steve Cotton? Sounds just the sort of thing he could use from time to time…

    🙂

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    1. Steve disappeared from my radar screen about a year, for reasons unknown. On another topic, how’s the Hon. Mr. Sunak working out for you? It sounds as if the Tories might soon be taking a well deserved vacation.

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      1. I think Steve’s limited his online social circle to a more local group thesedays. But I did used to enjoy trading bards on the merits (or lack thereof) of insurance. I have no doubts that he’d prefer to hop several hundred miles, with a severed leg in a backpack, to get over the Rio Bravo than pay an insurance premium.

        Sunak is toast. It’s just a matter of whther he can keep his job till the election is due towards the end of next year.

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  8. Dee Tillotson's avatar Dee Tillotson

    Gary, if you remember, while Steve was flying back and forth spending time with his aged mother and helping settle her worldly issues, he acquired eye problems and had to have surgery. He has mentioned that his eye issues have not made it easy to be on-line for long periods. You will also remember that Steve has a hobby of composing new food recipes, and even when some are a great success, he had this rule he would only prepare and cook them once (I wrote them down as he prepared them and use them today, maybe with a slight variation.). I hope he is still able to continue his cooking hobby—he seemed to enjoy it so much and I did too. Yes, I do miss Steve on-line and reading his points of view and debates. The world would be boring if all people thought alike.

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