Oh crap. I'm in the ER, in a Foreign Country.

Everyone always talks about the wonderful things that happen to a person when they are living and traveling abroad.  In fact, if every travel post on social media were true, one would believe that expat and wanderer life is a utopia where everything free, everyone is friendly, and all the food tastes good.  Instagram shows us that climbing mountains, rafting down powerful rivers, or jamming precariously into a van does not carry safety risks; Vine gives you 15 seconds of bliss as you sneak a peak into beach side concerts, bungee jumps, and safaris; and Twitter tells you that everything is #fun and #amazing because those who have the ability to travel are #blessed.

But you know what, sometimes sh*t happens and you end up in the hospital; I was reminded of this harsh reality just a few days ago when I got emergency surgery in Mexico City.

On Thursday morning at about 4 AM, I woke up with a pain in my left side.  I thought it could have been a result of not eating lunch or dinner the day before (I have been working fourteen hours at my real job) so I had some water and went back to bed.  By 5:30 the pain had intensified to a point beyond discomfort, no position gave me relief from the stabbing sensation.  At 7:30 I was shaking, sweating, crying, and doubled over in pain - I knew I needed to to get to a hospital, quickly.

I jumped into a cab and went to Hospital Español, a private hospital in the posh neighborhood of Polanco in Mexico City, and hobbled into the emergency room.  Not missing a beat, the staff quickly got me into a wheelchair and checked in (which includes a deposit of 5,000 MXN - approximately $326.00 USD).  Residents and nurses buzzed around taking my vitals, administering pain medications, and setting up IVs; orderlies were my personal taxi service - wheeling me around for X-rays, CT scans, and ultrasounds; doctors asked me about my medical history and if I was alone in Mexico City.  The pain medications were so effective that I was actually tweeting my ordeal and joking with the staff; I naively thought that I was cured and would be sent on my way.  This all came crashing down when a representative from the administration office came into my ER cube and informed me that I was being admitted to the hospital.

Pardon me? Admitted? Like, this is not optional?! No. This cannot be happening.  I envisioned my first hospital admission to be associated with me bringing life into the world, surrounded by friends and family, and speaking in my native language.  But, the universe had other plans thanks to a very swollen kidney working overtime and three impressive kidney stones.  Sh*t just got real and I was admittedly freaking out.  The doctor explained that I would need surgery because my kidney was nearly three times its normal size, and the stones were causing some significant issues and damage.  Despite the clear need for surgery, I began to negotiate with him and the residents - asking if there was any chance things could improve on their own or if we could wait 24 hours for one of the stones to come on its own.  The answers to both of these questions was no, and a surgery was unavoidable.  I did score a minor victory - I asked to have the surgery the next day versus the same day because honestly, I was frazzled and wanted some time to think and do a little online research; the doctor and his staff obliged and my surgery was scheduled for Friday evening. 

View from my hospital room at Hospital Español // Mexico City, MX

View from my hospital room at Hospital Español // Mexico City, MX

Thirst. Hunger. Boredom.  This is how I spent the morning of my surgery day as I was being slowly starved and deprived of liquids in preparation for the general anesthesia.  In retrospect, I think the idea of anesthesia in a foreign country freaked me out more than the surgery itself.  As the time for surgery came closer, I began to question if I had given my correct metric height and weight; I wondered if I had unknown allergies to the drugs used in Mexico; I started to think about what would happen to my dog if I didn't wake up.  Luckily, the handsome anesthesiologist came by beforehand and put me to ease thanks to his excellent bedside manner, perfect English, and mention of U.S. education and training.  I was ready, let's do this.  I was wheeled over to surgery at around 7 PM, greeted by the smiling face of the anesthesiologist who assured me that everything would be okay; he even joked a bit - asking if I wanted tequila, rum, or vodka as he administered my tranquilizers.  As I began to relax and ask nonsensical questions (ie: I'm not dead, right?) I finally let go of my fear and put my trust into this team of medical professionals.

Obviously my surgery went off without a hitch as I'm writing this blog entry on my couch as I recuperate.  I learned a lot about myself as a result of this medical adventure, like my Spanish is stronger than I thought it was and I have a pretty upbeat personality - I mean it takes a special type of person to tweet and Instagram their hospital stay and take hospital selfies.  Since I know so many folks who travel and live abroad, I wanted to provide a few tips and suggestions that could make your life easier if you end up in a situation like mine while away from your homeland: 

- Check with our country's embassy for medical information.  If you find yourself in a medical lurch, check the website of your embassy for a list of providers or call their consular section to request one.   While most embassy officials cannot recommend a particular doctor or hospital over another, they can give you a list of decent health care providers in the area - when you're sick or injured, this in itself can be a huge help.

- Keep emergency contacts handy. I keep a little slip of paper in my wallet with the following information on it: my full name / DOB / foreign address + phone number / email; and the names, phone numbers, and email addresses of my parents and a couple of local friends / contacts most likely to be helpful in the event of an emergency.  I always thought I was a nerd for doing this, but last week it paid off - it was far easier to hand over this paper to the nurses versus trying to fill out paper work while writhing in pain.

- Don't skimp on international health / travel insurance.  Get the insurance ya'll, I believe in better safe than sorry when you're thousands of miles away from home.  Medical and travel insurance can cover everything from routine visits, trips to the ER, and costly medical evacuations (MEDEVACS) - shop around for the plan that best fits your needs and itinerary.  BrokerFish is one of many online resources that allows you compare and shop for a variety of international health insurance plans.  

Travel with an emergency credit card.  I keep a credit card with a $15,000 limit that is exclusively for if I were to get injured or sick abroad.  Why is that?  Many hospitals abroad (my main experience is in Latin America) require that you to put down hefty deposits and / or pay all costs up front (then you file with your insurance and get reimbursed).  You do not want to be in a situation where you are denied care because of an inability to pay.

- Remember to request your medical records.  Once you're discharged from the hospital, it is  easy to forget this administrative step but it is super important to request your foreign medical records.  The reason for this is obvious, your primary physician back home needs to know exactly what happened that one time you were hospitalized in country X in the event that a possibly related condition emerges down the line.  Many private hospitals abroad will even translate them into English at your request.

- Don't freak out.  I know this is easier said than done, especially if you are alone in an emergency situation.  This was my first major health crisis abroad, and I did it all on my own.  Admittedly, there were times that I had to talk myself down in order to be a good patient that doctors actually want to treat.  Whenever I found myself getting anxious, I reminded myself that everyday people in Mexico have surgery and get sick, and they live.  I will be fine, and I was.  Remember, doctors are respected globally for a reason - they're pretty smart.

- Ask questions.  Just because you're abroad does not mean that you loose your patient rights; what it does mean is that you'll likely have to be more proactive in defending them due to language and cultural barriers.  I was not afraid to ask questions (ie: Could I please see the CT scans / blood tests / urinalysis? Are there any alternative treatments?) or ask for time to think about the course of action (hence my surgery being scheduled the following day versus the same day) because ultimately its my body and my health.  So go ahead, ask away - even if you need help from Google translator and WebMD.

Hopefully you won't need to use any of the above advice, but if you're a frequent traveller I encourage you to at least borrow a few tricks from my book - you just never know what will happen.  As for me, I have a second surgery in a few weeks and am much calmer going into this one...plus, there's that handsome anesthesiologist.