COVID Update Mazatlán 2

0a8e9588-fdf1-4599-aa96-304b31832dadI believe it’s time for an update on COVID-19 here in Mazatlán. I have been working so hard to help out and these posts take time, but I realize getting information to you is overdue. Our economies need to reopen; our people need to work to support their families. My hope is we can do so sanely, smartly, wisely, effectively.

Throughout this crisis, official figures and those reported on the ground by medical professionals have differed significantly. Doctors at our three public hospitals tell me they estimate 1000 people in Mazatlán are currently infected with COVID-19, and of that number 800 are asymptomatic. We need to take care, please; even if you are not sick, please shelter at home if you can, wear a mask when you are out and maintain a safe distance from others.

From the perspective of our public hospitals and their medical staff (ISSSTE, IMSS and the new General Hospital), we are in a horrendous crisis. The federal government has us at MAXIMUM RISK right now. While fortunately in Mazatlán we have had enough beds and equipment, the new General Hospital, for example, tells me they are running with only 30% of their normal medical staff! And during a crisis, when you’d think it would be all hands-on deck! Such under-staffing is due to some staff being infected, but more to people quitting, refusing to come to work, or taking leave and citing pregnancy or underlying conditions. There is too much work, the stress levels are through the roof, medical workers are scared, and they are dropping out in droves. The reason so many medical professionals refuse to work is because they do not have the personal protective equipment (PPEs) they need to stay safe and healthy. Their work also requires them to live separately from their families during this pandemic, if they are able, or to risk infecting loved ones if they are not careful.

The new General Hospital is running with only 30% of their normal medical staff.

Yes, I agree with many of you: the federal, state and municipal governments should be providing that gear to public hospitals. I suppose they are doing their best; it’s not my role to comment. The bottom line is that our medical staff do not have the protective gear they need. I ask them to take photos of the staff with the gear we provide them, as proof to all of you that your money goes directly to helping them. In nearly every photo taken there is at least one person without appropriate gear, risking his/her life for our welfare. It is heartbreaking.

So many of you have been doing amazing and wonderful work during this time to help out our local community. Local businesses are donating protective equipment, food and money. Many individuals have donated to Mazatlán Comparte, a volunteer position I’ve held nearly full-time for the past six weeks—100% of those donations go to buy either food for the Food Bank or medical supplies for our local public hospitals. Many of you are making masks, face shields or desk shields and donating them to those who need them, which is terrific. Others are helping out at shelters or feeding the needy. Whatever you are doing, bless you, bless you, bless you. And if you can do more, please do. Now is the time. Click any photo to enlarge it or view a slideshow.

This crisis has brought out the best and the worst in people. For each of you who is feeding the needy, we see a grandmother kicked out of her home because her family doesn’t want to nurse her or become infected, or a single woman forced to leave her own home in a wealthy community because, instead of offering to bring their neighbor food and medical supplies, her neighbors “want to be able to walk their dogs freely without fear of contagion.” Today the first baby with COVID is in IMSS Mazatlán, but she is fortunately doing well.

How much PPE (Personal Protective Equipment for medical professionals) is needed?
A few generous people who have donated money to Mazatlán Comparte ask me, “surely you have enough equipment now?” Let me try to explain the insatiable appetite of Personal Protective Equipment. EACH medical professional on a DAILY BASIS needs:

  • 1 KN95 mask
  • 10 pairs of nitrile gloves
  • 10 pairs of latex gloves
  • 1 surgical gown
  • 1 pair of boot covers
  • 1 coverall (now we are buying reusable ones which can last up to 5 days)

Obviously, that’s quite a bit of needed gear. In one week, a medical professional will need six KN95 masks, 60 pairs of gloves, six surgical gowns and one coverall.

But the real problem comes in the quantity of people at each hospital who interact with COVID patients and thus need PPEs. At our IMSS General Hospital Zone 3, for example, on a daily basis 199 medical staff interact with COVID patients and need PPEs! That number includes 43 doctors, 97 nurses, 10 assistants, 11 social workers, 15 janitors, 12 stretcher-bearers and 11 triage doctors. That means that just ONE of our THREE main public hospitals here in town on a DAILY basis requires:

  • 200 KN95 masks
  • 2000 pairs of nitrile gloves
  • 2000 pairs of latex gloves
  • 200 surgical gowns
  • 200 pairs of boot covers
  • 200 coveralls

The new General Hospital tells me they need PPEs daily for 110 professionals who attend COVID patients. ISSSTE hospital needs PPEs for 190 professionals daily. That’s a total of 500 medical professionals who DAILY need PPEs to treat current COVID patients here in Mazatlán; the quantities are untenable.

Every day in Mazatlán’s public hospitals, 500 medical professionals need PPEs to treat COVID patients.

To put this all into perspective, with your very generous help, in April and May Mazatlán  Comparte supported local medical staff with donations of:

  • 820 KN95 masks
  • 190 coveralls
  • 37 pairs of boot covers
  • 36 boxes of 250 nitrile gloves (4500 pairs)

Today we will purchase 500 additional KN95 masks at the miraculous price right now of 104 pesos each. These donations are wonderful! There is no doubt they have saved lives. And yet, from a larger perspective, they are a sad drop in the bucket. The longer this pandemic continues, the more PPE is needed; it’s insatiable. That’s why we need to keep the curve from spiking by reopening wisely and doing what each of us can to prevent the spread of the virus.

Difficulties/Challenges with Personal Protective Equipment (PPEs)
Last time I shared with you how challenging it has been to help. Prices of many PPEs have skyrocketed, due both to demand and to greed/price-gouging (surgical gowns normally cost 30 pesos and now are up to 160 pesos each with IVA). Many of the PPEs for sale are counterfeit and won’t work properly, so we require vigilance at every step of the purchase process and verification of every shipment upon receipt by medical professionals. Finally, the PPEs can be very difficult to find, though thankfully over the past weeks that has eased a bit. We now have a stable of trusted providers who are dedicated to selling us verified protective equipment at fair prices; let’s hope that continues. The problem is that prices of some needed items can skyrocket, or become unavailable, so it’s always a challenge. And the needs vary, too, as material is received from federal, state and municipal authorities. At Mazatlán Comparte we give the PPEs that the hospitals most need at the moment to the hospitals that are most in need. During a week ISSSTE might receive a shipment of coveralls and not need them for a couple of weeks, while IMSS might be in desperate need of masks that we can provide.

The second challenge has been in getting the PPEs to those in need. Unbelievably, especially in the beginning, there were medical professionals who resold some of the donations received (none of Mazatlán Comparte’s, thanks to careful teamwork), or handed them out to their friends at work rather than just to those working with COVID patients. At Mazatlán Comparte, we have team members from the IMSS, ISSSTE and new General Hospitals who are in charge of COVID professionals and who ensure the PPEs we provide are used for exactly the purpose intended.

Protect a Medical Professional for One Week: 2500 pesos. That amount will purchase everything that person needs for a week of work: hooded, reusable coverall, KN95 masks, nitrile and latex gloves, surgical gowns and boot covers.

How Can You Help?

  1. Please wear a mask when you are out and about, as the government recommends. This protects you and those around you. Please wash your hands frequently and use hand sanitizer.
  2. Please do not use medical grade equipment for non-medical uses! Using medical-grade overalls and KN95 face masks to spray bleach on the malecón or to sanitize cars is overkill and deprives our medical personnel of vital material. Neither is required for day-to-day use by normal people like you and me. If you have medical-grade material, please consider donating it to a hospital.
  3. Maintain social distance as the government recommends. Stay vigilant that the bank you go to, the restaurant you’re visiting, are following sanitary protocols and, if not, get out of there.
  4. Reach out to neighbors who are alone; offer to bring them what they might need.
  5. Stay calm and centered; don’t give in to fear. This is a virus; an infection is very painful, but what we are doing is trying to prevent the curve from spiking. We want to reopen our economies, resume our lives, but let’s do so smartly.
  6. Donate: Mazatlán Comparte has systems in place to ensure that the PPEs we buy are functional. We also get better prices, due to buying in quantity and coordinating amongst multiple hospitals and cities. KN95 masks, for example, have varied in price to us from between 121 and 71 pesos per mask, while they tend to be much costlier on the open market. We buy reusable medical-grade hooded coveralls for 350 pesos each; again, much higher on the open market.

Protect a Medical Professional Campaign
Mazatlán Comparte has a new campaign: Protect a Medical Professional. There are several options. The amounts below will purchase everything that person needs for a week of work: hooded, reusable coverall, KN95 masks, nitrile and latex gloves, surgical gowns and boot covers. Remember that just in Mazatlán’s public hospitals, we need PPEs for 460 medical professionals every week!

  • For one month: 10,000 pesos
  • For one week: 2500 pesos

Or, you can help by donating smaller amounts. A week of the following for one medical professional:

  • Surgical gowns: 1120 pesos
  • KN95 masks: 700 pesos
  • Reusable hooded coverall: 350 pesos

Or, one surgical gown and a pair of boot covers (for one professional for one day): 200 pesos

To donate for medical gear: Donate to Hospice Mazatlán, I.A.P. with the comment “Mazatlán Comparte” to distinguish that your donation goes to combat COVID-19. http://www.hospicemazatlan.org/donativos/

To donate food: Donate to Banco De Alimentos Mazatlán Iap with the comment “Mazatlán Comparte” to indicate that your donation go to COVID-19 relief. https://www.paypal.me/BAMXMAZATLAN

Other Ideas
Mazatlán Comparte is also thinking to do a series of online auctions. That could be fun for everyone involved. Might you have a skill that you could share? Say, cooking a gourmet dinner for four people, and we will deliver it to the purchaser? Or maybe your company could donate something it provides? Cases of wine, kilograms of coffee, boxes of frozen shrimp and scallops? If you do, please let me know.

Bless you all! I know many retired folks are on fixed incomes and find it difficult to help. Many of you help friends and family. Whatever you do, thank you! I pray you stay healthy and well, and that as a community we become stronger together!

Helping During the Crisis

Collaborators

The great news today? With your help we were able to purchase 50 sets of medical grade hooded and booted coveralls, along with N95 certified medical grade face masks and nitrile gloves. This is one month’s worth of gear for two doctors or nurses, and they will go exclusively to medical staff attending COVID-19 patients in our local public hospitals! We obviously have a loooooong way to go, but it felt soooo good to purchase these today!

A group I belong to, Mazatlán Comparte, is comprised of service organizations, associations and private businesses here in Mazatlán looking to help those in need get food on their tables and looking to get effective personal protective equipment into the hands of medical staff who treat COVID-19 patients. It is an amazing team of talented volunteers working llloooooonggg hours to accomplish these goals. We are doing our absolute best to make sure that the personal protective equipment we purchase is certified and authentic; that it serves its purpose. We are scouring for the best prices. I myself have spent full-time this past week since we organized making connections, getting bids and having medical people test samples, between running our social media.

Several times a day since I joined the Mazatlán Comparte team, I get a new video from one of our local public hospitals that brings tears to my eyes. These doctors and nurses are working without adequate personal protective equipment. They are using masking tape to close their gowns. Today I received video of a COVID-19 patient being transported through the hospital and the patient didn’t even have a face mask to prevent contagion! They ask us not to publish the videos, but I glimpse a bit of what they are going through and it pains me deeply.

As I’ve quickly learned, it is really difficult to help.

  • I’ve worked with suppliers for days, only to find out they are lying about the quality of their product once I get the sample.
  • Likewise, I’ve worked with suppliers who suddenly increase their price, or sell off to a higher bidder.
  • There is just way too much medical equipment on the market that is pirated and ineffective and knowing how to distinguish what is what is a steep educational curve.
  • There is too much equipment being sold at inflated prices, enabling vendors to profit off the pandemic. Sadly, even quite a few of our local vendors. We have tried our best to keep business here in our community, to keep the money at home. But people have to have the spirit of giving, not just profiting.
  • Worse, there are truly wonderful people sewing fabric masks and making face covers, yet many of them when donated aren’t making it into the hands of the personnel who really need them.
  • Some of the donated items even get sold.

What can you do? First of all, if you are out and about for essential errands, PLEASE wear only masks made for the average person, not medical-grade masks. At Mazatlán Comparte (Mazatlán Shares) we have been searching high and low to get certified, functionally appropriate personal protective equipment for the medical staff of our local public hospitals. The sad thing is that there is so little of it available. Now is NOT the time for average citizens to be using medical gear! Let’s save that for those working with COVID-19 patients.

Second, quite a few of you have contacted me to tell me you are making fabric masks or face shields you would like to donate. That is awesome!!! THANK YOU! Mazatlán Comparte is working closely with doctors and nursing staff at our local public hospitals: General Hospital, IMSS and ISSSTE. We will make sure your donation goes to those who most need what you have donated, depending on their patient load and current hospital supplies of equipment.

mazatlan comparte inglMost importantly, you can DONATE MONEY. Yes, I know most of us hate to part with our hard-earned money. But if not now, during this crisis, when? We will make sure your donation goes to buy NEEDED and FUNCTIONAL equipment for those who ACTUALLY TREAT COVID-19 patients in our public hospitals. Instructions for donating are below. If you want your money to buy medical supplies, donate to Hospice (information on the left). Be sure to indicate clearly on your donation that it is for “Mazatlán Comparte,” so they can distinguish the purpose of your gift, or send us a copy of the receipt. You can pay via PayPal, too; just scroll down to the bottom of the page and click the “Donate” button, adding in your comment during the process. If you want your money to go to buy food, please donate to the Food Bank (information on the right). They can buy much more food for the money you donate than you as a citizen are able to buy retail.

Bless you all! Thank you for all the help you give this community. Take care of yourself, each other, our neighbors. We will get through this. Share this post widely, if you would.

 

Please Help Your Home in Mazatlán!

MZT Comparte

A terrific group of organizations and individuals in Mazatlán has organized an ad-hoc non-profit called “Mazatlán Comparte” or “Mazatlán Shares” to help us make it through this pandemic as effectively as possible. Participating organizations include:

  • AMPI (Mexican Association of Realtors) Mazatlán
  • Canacintra (National Chamber of the Transformation of Industry) Mazatlán
  • Coparmex (Confederation of Employers of the Mexican Republic) Mazatlán
  • Hospice Mazatlán
  • IMSS Hospitals in Mazatlán
  • ISSSTE Hospital Mazatlán
  • Mazatlán Food Bank
  • Mazatlán General Hospital
  • Mazatlán Hotel Association
  • Scouts (both Mazatlán groups and the retired Scouts)
  • Sharp Hospital

More are joining everyday. Thus far Mazatlán has been blessed with very few cases. But our medical staff do not have the supplies they need to work safely, despite a new shipment of PPEs received by the Governor yesterday. As one of our members, the daughter of the head of the General Hospital and a lawyer here in town told me, “My father is 63 years old and suffered a heart attack a few years ago. We begged him to retire. He said, ‘No, my dear, this is when our people most need me active and helping out.’ Right then and there I committed myself to get them the protective equipment they need to get us through this crisis safely.”

Mazatlán Comparte is based on the successful effort in Culiacán, though fortunately we are a bit ahead of the curve here. We are cooperating with other municipalities in the state of Sinaloa to buy in bulk—cheaper and better quality!

We are collecting food and monetary donations via the Mazatlán Food Bank. The Food Bank has been experiencing huge demand due to widespread unemployment; on Thursday they served 580 families! They are able to buy food in bulk at good prices, so if you are a grower or producer, please donate in kind. If not, your monetary donation will make the most difference. If you are not easily able to donate to a Mexican bank account, you can use Xoom (a division of PayPal). Please help if you can!

Banco de Alimentos Mazatlán IAP

PayPal: 6692407916

Calle Río Pánuco 400
Col Ferrocarrilera
82013 Mazatlán, SInaloa
BAM-110101-EHA

Bank: BBVA/Bancomer
Account # 0199934960
Cuenta CLABE/Code: 01274400199934960 4

Tel: 669 981 2457
Email: info@bamazatlán.org.mx

The Food Bank is in the process of setting up a PayPal account to make it easier to donate. The medical supplies most in need are:

  • Tyvek-type waterproof, long-sleeved coveralls with boots (like veterinarians wear)
  • NIOSH-certified N95 masks
  • Face shields with goggles
  • Nitrile or latex disposable gloves

0c88ca4b-c1ea-4cc5-bd7f-1f5a6b89f32aHowever, each overall costs over 500 pesos! If any of you have a contact at the manufacturer (DuPont) or access to a provider who could make these for us here in Mazatlán or México—they don’t need to be Tyvek, just waterproof—please help us out. They want XXL sizes so they’ll fit everyone. If not, please donate via Hospice Mazatlán, and we will bulk purchase PPEs with Culiacán and other municipalities in Sinaloa. Below is Hospice’s bank information. They are also working on setting up a PayPal account. Apparently since they are IAP organizations it’s not as easy as it would be for you or me.

Hospice Mazatlán IAP

PayPal account (BE SURE to indicate in “Comments” that it is for Mazatlán Comparte, so we can distinguish money for emergency medical supplies.)

Privada Intl. 208
Col Palos Prietos
82010 Mazatlán, Sinaloa

Bank: BANORTE
Account # 0279959328
Cuenta CLABE/Code: 072 744 002 799 593 288

Tel: 669-182-1486
Email: info@hospicemazatlan.org

In addition to the donation efforts above, we are working with the hospitals and our local hotel associations to obtain temporary housing for doctors, nurses and other medical care providers, in case of need during this crisis. We do not want them potentially infecting their families, despite their best sanitary efforts. We are also working on transportation between the hospitals and those temporary residences.

Please, everyone, our unemployed families and our first responders really need your assistance. Thank you so very much if you are able to help. It is my privilege to be able to help coordinate some of this, and I will do my best to get your questions answered.

Covid-19 Update Mazatlán

DSC_7218©

Despite—or perhaps because of—our concern about Semana Santa and COVID-19, things are finally getting quiet here in Mazatlán: no RAZRs running up and down the malecón at all hours, almost no motorcycles revving, and very few pulmonías or aurigas blaring their music in the middle of the night. It has taken a while, but Mexico is on board.

This pandemic to me is Mother Nature’s way of sending us all to our rooms and telling us to reflect on our actions while she cleans up her air. I do hope we will listen, but looking at the number of single-use masks now polluting our global waterways (photos below from the internet–not from Mazatlán), it seems we are not learning.

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Governor Quirino Ordaz first closed schools and massive events; then casinos, discos and cinemas. Next bars and restaurants were ordered to scale back seating 50%. Despite all this, we went a couple of weeks with loads of fireworks going off around town periodically and banda music blaring—showing that, despite the cancellation of loads of parties and events, others continued. Even now El Muchacho Alegre seems to have a party crowd in the evenings.

As it is up north, here it’s difficult to find hand gel, good sanitizer (bleach seems readily available), and face masks. We worry if medical staff will have the equipment they will need. A week or ten days ago people in Mazatlán started to make fabric masks. First they passed them out to family and friends, and now many locals are selling them, including ones made by the domestic-violence-surviving young women at Floreser. If you need homemade masks, they are my go-to source. Call Ely Cucurumbe at 669-123-1669 and she’ll deliver some to you (50 pesos each); she speaks great English.

Many restaurants have now voluntarily closed or have cut back to pickup or delivery only, including the Panama chain. This week the governor closed all beaches in Sinaloa: ocean, river, lake, stream. We have watched all day today as the lifeguards on 4-wheelers chase down anyone walking or gathering on the beach and make them leave. Banks, doctor’s offices and many stores are practicing the social distancing promoted by cartoon super-heroine “Susana Distancia” (“sana distancia” is “social distancing”) by marking their floors and setting chairs at a safe distance. This sadly does not prevent people from crowding around on top of each other. Below is a photo of the sign on the Cuban place, Carlos and Lucía’s, in the Golden Zone.

DSC_7287©

All but essential workers have been asked to shelter in place, as we accustom to a new normal of food and grocery deliveries (stores remain open). Of course workers who are accustomed to living paycheck to paycheck are suffering horribly. President Lopez Obrador has promised relief, and Mazatlán’s mayor has done so, as well. It’s not enough, but it’s something. Most foreigners here have paid their housekeepers to stay home and not work, and I believe most foreign-owned businesses are doing the best they can by their workers, too. These are challenging times, to say the least. Yet, there are those who continue kissing, hugging and drinking on the malecón, and others who insist on partying. It breaks my heart, as so many of us are already indoors for three weeks in order to help minimize the effect of this virus on the community.

Click on any photo to enlarge it or view a slideshow.

Wednesday the governor ordered the closure of all hotels. The AquaMarina Hotel had been one of the first to close, it seems a couple of weeks ago already. The photos above are of workers putting up a fence to prevent access to the Olas Altas Inn on the malecón, plus photos of the Hotel Playa Mazatlán, closed for the first time since its founding, the Decima and the Playa Bonita.

Several of the hotels have lit hearts using the lights of their empty rooms, as a sign of hope to our fair city, I suppose. I do love the gesture. The Hotel Hacienda, of course, has a tradition of lighting up for the holidays. Sadly, this time it’s not a celebration.

Below I throw in a pic of tonight’s sunset for those of you who are up north.

DSC_7242©

Be well, dear readers, whether you are here in Mazatlán or you have returned to your families up north. Stay home, stay safe. Help out anyone you know who is alone, has special needs or underlying medical conditions. I hope you can use the time to read, learn a new skill or try a new exercise. Take care of yourselves and reach out to others; creativity is key as we tread this new territory.

Hip Replacement in MZT

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Dr. Mario Castellanos Gonzáles, Mazatlán’s foremost joint surgeon, IMHO, with me post-op

In February 2020 I had a full hip replacement (received a prosthetic), here in Mazatlán. The surgery has fortunately been a 100% success and completely pain-free. I can’t sing the praises of my surgeon more highly—Dr. Mario Castellanos González and his team. I have received world-class surgical treatment, hospital care and physical therapy in an exceptionally professional, kind and caring manner. The surgery, prosthetic device and hospital stay cost about US$12,000, 100% of which was paid by our insurance company. I spent one night in the hospital and am now on week five of my recovery. I am still walking with a cane, but very much able to walk without it.

I am over the moon pleased to be out of pain and increasingly mobile! My family and friends up north were scared for me to have surgery here. Yet I completely believe it was better here than it may well have been up north, for various reasons I’ll outline below. I share my story in hopes it might help some of you who seek a similar procedure here in Mazatlán or elsewhere.

Click below to jump to the section you want to read.
Context/Background
Note on Foreign Helpers
Best Joint Surgeon in Mazatlán
The Surgery
Recovery in the Hospital
Heading Home
Physical Therapy
Financials
Friends, Family and the Community at Large
Key Learnings

Context/Background
I have had two hips bone-on-bone for many years. I am tough and very tolerant of pain; birthed my son with no drugs. I am active: hiking the lighthouse several times a week, swimming 35 km/month, walking and taking dance lessons with my son. I tried everything to help my hips get better. I changed my diet, going gluten- and lactose-free; avoiding nightshades and processed foods; and having a homemade vegetable, ginger and turmeric smoothie for breakfast each morning. I took a rotation of supplements like collagen, glucosamine and chondroitin. I have done yoga since my teenage years, spent a couple years in physical rehabilitation, tried acupuncture, homeopathic medicine, ozone treatments, massage and anti-inflammatories.

The pain got so bad in my left hip that there were nights I’d cry in bed, despite the CBD oil. I had trouble sleeping. We’d have to plan our road trips around how long I could sit in the car without severe pain. And, increasingly, my husband had to walk and hike while I stayed back, at the bottom of the hill or the base of the trail. Heck, one evening we walked the malecón to Valentino’s, and I was overwhelmed with such pain we had to get a pulmonía to take us home! Active me, still in my fifties! I neither wanted to live with excruciating pain, nor did I want to become increasingly immobile! I was too young for that!

I asked my friends, locals and foreign, to recommend a traumatólogo or orthopedist. Of course, I’d met with a couple over the years, but this time I was more serious; something had to be done. I met with about five specialists and can’t say I was blown away by any of them.

  • Two local doctors told me quite sternly that I was a “typical American” who wanted a quick fix and couldn’t tolerate pain. These two told me my hip was shot, desgastada, bone-on-bone, no cartilage left and would never get better. They recommended I lose weight (but wouldn’t refer me to a nutritionist; “just close your mouth”), take narcotics for several years and use a cane and then eventually a walker. Their advice was to delay any hip replacement as long as I could, so that the prosthetic wouldn’t wear out before I’d need another one. While I could see their point, I knew I’d already lost a lot of muscle and fitness due to not being able to hike, swim, dance or walk long distances. My quality of life had suffered terribly, and my extremely bad left hip was negatively affecting my knees and right hip—the domino effect. Plus, I hate taking drugs, and years of narcotics plus use of a cane and walker? No, I guess I’ll claim my “typical American” birthright.
  • Three of the doctors recommended hip replacement to me. Surely there must be another way? A prosthetic was so drastic. All three said yes, replacement was the recommended option. One of the three gave me an interim option of Synvisc shots—a synthetic version of the fluid that surrounds the joints. He said it might give me another six months to a year. I researched this, and found that while it’s proven effective with knees, most studies show it doesn’t help with hips. Studies and experience with friends had shown me that hip replacement has gotten amazing, that it can really bring people a new lease on life. While I surely didn’t want it, I did want my life back. I didn’t want to see my health continue to deteriorate due to lack of activity. So, I bit the bullet.
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Note on Foreign Helpers
Like most of you, I imagine, I had heard about a Canadian woman who is voluntarily helping foreigners here in town with their medical needs. I speak Spanish, so language is not really an issue, but navigating a medical system in one’s home is hard enough; in a foreign place it is nearly always a challenge. Her medical training could be helpful. I called a couple of my doctor friends to ask about her. One knew nothing about her, the other said she had called him and made an appointment, and then never showed. I figured meeting her to discuss couldn’t hurt.

Speaking with her by phone, she was absolutely in love with “her” hip replacement surgeon, the one she recommends. He is a retired military doctor who, she assured me, takes time to “align both legs.” She also connected me by phone to one of “her” patients, who told me she’d had several joint replacements at Hospital Marina with this lady’s help, with great success. I made an appointment to meet with her and the surgeon. When we showed up for the appointment, neither she nor the surgeon were there. I texted her, as we had been doing, but she did not respond. After some confusion in the office, a nurse asked me in and spoke to me in English, explaining that the lady does help foreigners voluntarily, that she works with the surgeon she told me about, but that neither of them were available today. He didn’t know why she hadn’t cancelled, and she never contacted me again. So, I don’t have great things to say about her, and am absolutely over the moon happy to say I went with Dr. Castellanos.
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Best Joint Surgeon in Mazatlán
I finally decided it was time. I’d do a replacement of my left hip, the really bad one, and hope to get a few more years out of my right one. I researched, networked and interviewed, and finally decided to ask Dr. Mario Castellanos González in the Polimédica to operate on me. He seemed to be the surgeon with the most experience with hip replacements here in Mazatlán—he’s been replacing joints here in Mazatlán for 30 years! Dr. Castellanos trained at Tacoma General Hospital in the USA in 1990, at the Institute of Orthopedic Surgery in Latina, Italy in 1999, and spent time at Houston Methodist Hospital in 2009 to learn a new post-operative pain management procedure for knee and hip replacement. He was able to operate on me in Sharp Hospital, close to my home, or in his own clinic. Dr. Castellanos has his own surgical team, including a dynamite anesthesiologist, Roberto Sandoval. He was not set up to work with my insurance company, which is based in France, but Sharp Hospital was able to arrange for all billings to go through them and agreed to interact with the insurance. His patients include locals and foreigners, as he is bilingual.

When we met the first time, I voiced my concern that two doctors had cautioned me not to get hip replacement too early. He explained to me that mobility was important to overall health and that technology was improving all the time. He showed me a hip prosthesis that he had removed from a patient after 25 years, and the prosthetic was still in mint condition! He’d had to remove it only because the patient had fallen and broken her pelvis bone. I found the endurance of the prosthetic extremely encouraging and hoped I might have such luck. Dr. Castellanos told me about another patient on whom he has replaced two knees and two hips, and the guy still regularly plays tennis—against doctor’s advice. He also pointed out that a younger person recovers more quickly and more fully and by doing it sooner rather than later, the bones he works with are in better shape. I knew that one of my foreign friends here in town had her hip replaced with Dr. Castellanos and was very happy with him. So, all in all, it felt like the right decision.

Dr. Castellanos has a beautiful modern office on the eighth floor of the Polimédica Building. The receptionist’s name is Maribel, and she is charming but only speaks Spanish. The space includes a well-equipped gymnasium and physical therapy facility. In his free time, he coaches American football. He told me my wound would be closed with staples not sutures, that I’d need a walker and an elevated toilet seat post-op, and that I’d have six weeks of physical therapy beginning two weeks after surgery and full recovery from hip replacement would take about six months.

Dr. Castellanos gave me his cell phone number, and I was able to call or WhatsApp him whenever I had a question. There were times he even answered me late at night, and without fail he answered quickly. What a blessing to have a talented surgeon who is also so accessible and caring about his patients’ welfare! He is amazingly dedicated.
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The Surgery
I had fasted from 10 pm the night before my 9 am surgery—not even a sip of water. The morning of the surgery I of course first had to check into the hospital. That was less than ideal, as I’ll describe in the Financials section below. For some reason they took me to my room on the third floor, rather than directly to the operating room. No big deal. In the room they changed me into a hospital gown, put a cap over my hair, and rolled my bed down to surgery.

Once in the operating room I was dumbfounded. The only other time I’d been in a hospital surgical facility it was MUCH smaller than this—in an oncology ward in Kansas City, MO. This room was huge, had gigantic overhead lights, loads of space, and it seemed like about ten professionals attending. I was lifted from my rolling bed onto the table and rolled onto my side. They cleaned my back and my leg. Tears welled in my eyes. I said a prayer out loud and invited those in the room to pray with me. One lady kindly held my hand and calmly prayed with me. Dr. Sandoval inserted an IV or drip into my lower back; from there down I would have no feeling whatsoever for the remainder of the surgery and post-op recovery. I was awake, but Dr. Sandoval gave me a whole lot of happy medicine; I was very much one with the world! There was no mask over my nose and mouth and no tube down my throat, which I very much liked.

The leg to be operated on was hooked up into a sling. I remember panicking to think that my privates were uncovered, but no, the lady nearby assured me that no one could see anything. I guess I went in and out of sleep during surgery, because I definitely heard the electrical saw. I even happily joked with Dr. Castellanos, “You promised me I wouldn’t hear anything, yet I hear you cutting my bone…” I woke again from the jerks of the hammering (of the prosthetic into my leg), and a third time with the pushing of the screwdriver as the cup was inserted into my hip. It sounds awful, I know, but I was so high that it was actually kind of cool. Each time I stirred Doctor Sandoval leaned over and gently whispered in my ear, asking if I was ok, reassuring me that all was well.

The next time I awoke I was in the surgical recovery room. I was so thirsty. I was initially given ice chips, then small sips of water. I waited there till I could wiggle my toes and feet, then got to go up to my room—again pushed on the bed.

Let me also mention here a bit of the pre-surgery preparation. I spoke with a couple of friends in the USA who have had hip replacements. They both told me it took them almost FIVE WEEKS of preparation before their surgery, as you need to get blood tests, X-rays and an EKG and cardiologist’s guidance. They told me it took that long for each of them to get appointments and receive the test results and reports. Here in Mazatlán, I did it all in a relaxed manner over two normal days!
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Recovery in the Hospital
My surgery started later than the programmed 9 am, due to the check-in issues I’ll describe below. Dr. Castellanos called my husband Greg when it was finished to tell him all went really well—I’m guessing surgery took about 2 ½ hours—but I didn’t get back upstairs to my room till nearly 3:00 pm. My husband Greg and friend Dory were going crazy up in my room by that time. I believe it was either miscommunication between the post-op and floor nurses, or the floor nurses just didn’t want to or have time to come get me.

Once I got to my room, I was REALLY thirsty, REALLY hungry, and I REALLY had to go to the bathroom. We waited almost an hour for a bedside commode. I finally said that I really had to go, so a nurse helped get me up and my husband and son helped walk me to the bathroom. That was a huge mistake. While I could walk fine, I was so drugged that I broke out in a horrible sweat and nausea and had to sit down—my son had to quickly bring a chair into the bathroom. All because the nurses hadn’t thought to get either a bedpan or a commode for a hip replacement patient! The toilet is too low to be used comfortably for a post-op hip replacement patient, but with the help of my family I managed it. Fortunately, food and drink arrived much more quickly and easily than did the commode.

Nursing service improved drastically with the evening and overnight nurses, who were absolutely wonderful. The food I ate was understandably bland but healthy and good. There was plenty of it. A foodservice person came before each meal to take my order. I was blessed with non-stop visitors, flowers and gifts. While I was in the hospital I was kept on a saline solution, an antibiotic to prevent post-op infection, an anti-coagulant to prevent blood clots, an anti-inflammatory and pain medicine. During my very short stay I got up a few times to walk around the room and down the corridor, and I flexed my feet and toes, tightened my leg and butt muscles in bed as often as I could. Greg spent the night with me, laying on the extra bed in the spacious room.

The biggest surprise post-op was that I had absolutely no pain. Never. Zero. Not during the surgery, not after, not during recovery (other than my two self-inflicted setbacks, see below). After suffering with so much pain in my hip for so long, this was a hugely welcome but astounding relief! Dr. Castellanos’ pain management method is amazing! They continued pain management drugs during my one-day hospital stay, but I didn’t take any once returning home, so it’s nice to say there was no pain.

In the morning the nurses changed my gown and my bandage. I was taken in a wheelchair downstairs to get an x-ray of my hip. Dr. Castellanos came in around 9:30 and reviewed with me how I was doing and showed me the x-ray. He was quite proud of how the prosthetic was at a perfect 45-degree angle in my pelvis. He reported that I was in no danger of osteoporosis, as my bones are so hard that he actually sweated while he hammered. The surgeon cautioned me to keep a pillow between my legs to keep them a good distance apart from one another. That scared me, as I had woken up after surgery with a pillow between my legs, but no one had told me what is was for. When the doctor told me, it was because he saw that I had my legs crossed in bed. He said for sure not to cross my legs for at least a year after surgery.

Before surgery Dr. Castellanos had said I’d spend two nights in the hospital, but the morning after my surgery he told me I could go home that day. I expect that was because he saw me walking with my walker already, and he could see that I had two terrific caregivers in Greg and Danny, plus my friends who’d visited. What a great Valentines gift!
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Heading Home
I was sent home with prescriptions for an anti-inflammatory, an anti-coagulant (to prevent blood clots due to limited mobility), a week’s supply of antibiotic (standard post-surgery to prevent infection) and pain relief (which I never needed to use), along with instructions to “walk as much as possible but don’t overdo it.” A bit ambiguous, but my body was pretty clear about what it could and couldn’t do. I was honestly never in any pain, no exaggeration. It amazed me after such a major surgery. I was very weak in the surgical leg, however, and especially in the evening for the first week to ten days I would need my husband or son’s help lifting it into bed or onto the couch.

At home we removed every throw rug in the house, as they are a tripping hazard when you’re on a walker. We stacked pillows on an armed chair to allow me to sit and get up more comfortably. I have the world’s absolutely best partner, who carried my stuff from one room to another for me, cooked and cleaned, and waited on me hand and foot. I honestly don’t know how people without a live-in partner or helper do it. I’d recommend getting help if you live alone. I will admit I was spoiled. You don’t have your hands free if you’re using a walker, so fasten a bag of some kind to the walker to enable you to carry things around. I would also move things from one flat surface to another, sort of like a bucket brigade, in order to get things from one place to another. Cups with lids are really helpful, too. Greg fastened an S-hook on my walker with a rubber band, and I used it to carry my drink with me in a sealed, handled bottle or cup.

I had been told to keep my wound bandaged until I saw the doctor again in two weeks. My wound oozed quite a bit for the first week, so we had to change the bandage, which we covered with a waterproof plastic, every morning. My surgery did not involve a drain, as I am told some do. Neither was it minimally invasive; my perhaps 8-inch wound was closed with 23 staples. By the second week we were down to changing the bandage every two or three days. Once my staples were removed, two weeks post-op, I no longer required any bandage.

I was instructed not to bend my hips further than a 70-degree angle—this makes sitting in many couches and chairs impossible and prevents you from bending over to pick up low-lying objects or anything from the floor. The surgeon said I could shower but be careful not to get the bandage/wound wet. I chose instead to sponge bathe and wash my hair in the sink for two weeks. If you will shower during the first two weeks, most people recommend a shower chair. I was able to sponge bath standing from the get-go, so I suppose the need depends on your mobility.

When I got home, I really had a hard time moving around; I could walk with the walker, but not for any length of time. I got tired very easily and needed to sleep a lot. Which, of course, is good as it aids recovery. Something I did not hear a lot about is the amount of core and upper body strength you require to recover from hip replacement: you need to be able to stand up, roll over, get into and out of chairs or bed without over-reliance on your legs, and you will be using a walker and then a cane for weeks on end. So, wise to start building core and upper body strength before surgery.

I worked on my computer from a lounging position, being careful to get up and around every hour minimum. I had found some basic exercises on YouTube designed for hip replacement patients, to keep the blood flowing and prevent clots. I did these every day, some of the exercises every chance I got, and found they really helped me feel I was doing something during the first two weeks. The exercises start at 11:45 in the video embedded below or via the link just above. I took a couple of walks outside with my walker; the fresh air and being out in nature really cheered me up.

I experienced significant swelling and bruising in the first few weeks post-surgery. Moving around helps with that, and I kept my feet and legs elevated above my heart when resting. I went to the bathroom a LOT, but I also drink a lot. About a week into my recovery I had my first self-inflicted setback—my fault for not thinking before moving. My leg was swollen, so I laid on my bed and put my feet up against the wall. Fine, no problem. Though at first you will need someone to help you lift your surgical leg. Well, when it was time to put my legs down, I forgot to ask for help. I just basically forgot I was wounded. I rotated my hips and legs down onto the bed, and pain shot through me. The sharp pain was short-lived but walking on my surgical leg and moving it around was very sore for the next two days. Oops.
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Physical Therapy
Two weeks post-op I went into the surgeon’s office; he checked out my wound, removed the staples and reviewed my mobility and pain. By then I really did not need the walker, though I did use it. I was told I was doing great and could graduate to a cane. I was also given a prescription for six weeks of physical therapy. Normally, Dr. Castellanos’ patients would go to his facility for therapy. My son’s girlfriend, however, is a physical therapist, and she designed and supervised an exercise plan for me to do in my home, based on the surgeon’s parameters. He instructed me to return to his office after two weeks of physical therapy.

Sofia Soto from ST Physical Therapy (fully bilingual and VERY talented) spoke with my surgeon to ensure her plan was appropriate for me. She gave me exercises to do every day in the privacy of my home, building from 5 repetitions to 15 over the course of a couple weeks, and doing the full set of exercises once followed by a second round. I really liked this set up, as it helped me build strength gradually and never overdo. She came to supervise three times a week. If I had the energy, on the days she didn’t come I could do the exercises twice/day. I used a Pilate’s ring, a resistance band and “core sliders” (small foam pad that you step on and then slide your foot on the floor) to strengthen my hips/thighs/glutes and restore hip mobility, and an inflatable wobble cushion to strengthen my ankle, foot, leg and hip muscles while building flexibility.

During the first week I had to lean against a piece of furniture for stability, as it was challenging to put all my weight on my surgical hip. The exercises I had were so very simple, yet they were amazingly exhausting. Especially at first, I had to rest between exercises, and definitely between rounds. Friends joked to me that the “PT” of “physical therapy” stands for “pain and torture” or “physio-terrorism.” I won’t deny that. The surgeon does the work during surgery; your recovery is all you.

By the end of the second week of PT (one-month post-op) I was able to stand unsupported to do my exercises, and Sofia added new exercises to my program. Now I would also lay on the bed and do pelvic lifts, leg lifts while laying on my side and face down, as well as bicycling using a portable pedal exerciser. When I returned to my surgeon’s office for my one-month checkup, he had several medical students observing our visit, and spent the time bragging to them what an ideal patient I was and how quickly I was progressing. He reviewed my physical therapy plan and advised me to continue and to graduate to doing some of the exercises in the swimming pool.

I guess his encouragement went to my head, as that evening I experienced the second self-inflicted setback of my recovery. We planned to go out to a nice dinner with our son, and I was in a hurry to do my PT and get ready for dinner. I rushed through my full set of exercises, rather than taking the time to listen to my body. And, for the first and only time, rather than doing the full set followed by a second round, I did a second round of each exercise as I went, to save time changing out equipment. I felt the strain in my muscles, but nothing major. Then, as we went out the door for dinner, I held our heavy door with my body for my two men. As I stepped away from the door, I believe I twisted my surgical hip a bit weirdly, and combined with having overdone my exercises, I again felt a very sharp pain shoot through my hip and leg. I could barely walk, even with my cane! That setback cost me three days of progress, during which time I couldn’t do my therapy. Live and learn. It’s a delicate balance between pushing oneself and overdoing it.

As I write this, I am on my third week of PT (five weeks post-op). I can walk around the house without my cane, and often do so inadvertently. I’ll walk somewhere to do something without thinking, and then later I’ll wonder where I left my cane. I do still use the cane when I go outside, as I find that people can be pretty pushy, and the cane helps them realize I am not currently fleet of foot. Plus, it provides added help on uneven surfaces. My new hip is in many respects already stronger and more flexible than my other, natural hip (which is bone-on-bone and also needs replacing). For example, I can lift the leg with the prosthetic hip higher. Due to my setback and some chilly weather I haven’t yet done exercises in the pool, but plan to start soon.
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Financials
You’ve probably heard the horror stories of foreigners feeling like they are held hostage in Mexican hospitals, as they have to pay the bill before they are released. We are in Mexico, and the customs here can be very different than where we come from.

In my case, this was not emergency surgery. I had time to plan and schedule it. I got pre-approval from our insurance company, MSH International. We are enrolled in a group plan available through our membership in AARO (Association of Americans Residing Overseas), but they have plans available to individuals as well. MSH assured me they had an agreement with Sharp Hospital. They approved the quote from Sharp for a total of $250,000MXN, which included payment for the surgical team, the prosthetic and a two-night’s stay in the hospital. I believed all was good. My girlfriends arranged a dinner for me the night before surgery to wish me well.

During that dinner I got a call from the administrator of the hospital, telling me I’d have to pay US$10,000 cash the following morning or I wouldn’t be able to have my surgery. Seriously? The evening before my surgery and now they’re telling me this? I felt very abused, and he was amazingly confrontational. My local girlfriends assured me that if their insurance pre-approves surgery, they do not have to pay cash to the hospital out of their pocket. This was obviously a thing for foreigners. And it felt very ugly. I called my surgeon. I called the hospital’s head of Medical Tourism. Neither could help; money is in the hands of the administrator, I was told. It ruined our nice dinner among friends.

Fortunately, in the morning the administrator showed up in a much more human mood. They wanted a security deposit of 75% of the 250,000-peso estimate. My husband talked to him, and they finally agreed we could put the amount on a credit card, and the charge would be reversed once payment was received from the insurance company. We have a US credit card, so the charge was just over US$9000.

In the end, the hospital bill for one day’s stay was significantly higher than the estimate that the insurance company had agreed to pay, so the insurance company and the hospital negotiated for a couple of weeks. We were blessed in that the insurance company kept their promise to us and paid 100% of everything— MXN$326,835, and we weren’t to be out even one peso. God bless MSH and AARO! They paid the hospital as soon as the final agreement was made, about three weeks after my surgery. I can’t fathom how the bill came out higher than the estimate, as the hospital stay was shorter and there were no complications. Greg says it is partly because of IVA being added to the final bill and not included in the estimate.

At this point, we still have not been reimbursed by Sharp, but I am counting on it. I don’t understand the medical field. It’s only the second time I’ve been interned in a hospital. I don’t like knowing that the hospital was able to make money off my money for at least a month now, nor do I like that the surgeon and his team have to wait three months to be paid their professional fees. But I am thrilled with my good fortune on the cost—or at least I will be once the charge on my credit card is reversed.

My advice to you is to be sure to meet with the administrator of the hospital with plenty of time to spare and clarify how much money you will need to deposit (and how and when) in order to have your treatment. I do not believe this is something unique to Sharp. I’ve heard similar stories from people who use Hospital Marina, Clinica del Mar, El Centro Quirúrgico and other hospitals around town. My surgeon told me that in his clinic he would have wanted payment up-front, and we would then work directly with our insurance company to get reimbursed. My upset was due to the last-minute surprise; better to know going in. You may remember we did a hospital comparison late in 2017; hopefully someone might update that soon.

My in-home physical therapy with Sofia is 350 pesos every time she visits.
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Friends, Family and the Community at Large
Your community of friends and family love you, and they will no doubt be very supportive. I know I was and am completely blessed. And, people say the darnedest things, so be prepared with a smile. I figure people want to be supportive and encouraging, but it can come out insulting or discouraging, especially if you get tired, as you probably will, or discouraged. I had a lot of people tell me,

  • “You’re too young to have hip replacement!”
  • “Hip replacement is so quick and easy nowadays!”
  • “I/my cousin/my best friend was walking, good as new, three weeks after surgery.”
  • “Are you sure you want to do this in Mexico? Wouldn’t you rather come home for the surgery?”
  • “My friend’s body rejected the metal” and other horror stories.

In reality, hip replacement is not the exclusive domain of the elderly. There are loads of young people who need hip replacement due to reasons as diverse as injury, genetics and arthritis. Yes, the surgery is a technological, medical marvel, but it remains major surgery and is definitely not to be taken lightly. The bragging about record-time recovery? This can easily become a danger if you start to second-guess yourself or compare your progress with others. Each of us is unique. Our recovery needs to be at our own pace. The last thing we need to do is beat ourselves up mentally. And, honestly, I heard such amazing stories that I’m pretty sure people’s memories become incredibly rosy and they remember recovery as much faster and easier than it actually is. The racism you might experience, the talk about medical care in what some might call a “third world country” (which Mexico is not), my best advice is to hear the love behind the doubt; that person wants you to be well. Kudos to you if you’re able to educate regarding stereotypes and biases prior to or after major surgery. Personally, I left that battle for a time when I was feeling stronger. If you are a friend or family member, I’d suggest listening, empathizing and asking questions as safer and more supportive options than offering an opinion. Before the person has made their decision, share your horror stories if you feel it will help your friend make a more informed decision. If not, hey, maybe best to keep that story to yourself.

The final point I’d like to make in this section is how people in the community respond to the physically handicapped, in my very limited and fortunately temporary experience. I was astounded how even when I was on a walker or a cane in a medical building, some people would push me out of the way as they rushed to an elevator; people would step right in front of me as they passed me on the sidewalk—thinking I could quickly stop or jump out of their way, I suppose; and some drivers would actually speed up in their cars, trucks or pulmonías as I was trying to cross the street. It was discouraging; I naïvely imagined the general public would be more considerate of those with impaired mobility. And then, fortunately, there are those strangers who are total angels and go above and beyond your wildest dreams to be of assistance.
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Key Learnings
Prior to Surgery

  • Lose weight if you can.
  • Talk with the hospital administration regarding payment and insurance, in addition to your surgeon and the medical staff.
  • Obtain a walker and install an elevated toilet seat.
  • Build your core strength as well as upper body muscles as you will need them as well as your glutes and quads for recovery.

In the Hospital

  • Make sure the nurses bring a bed pan or portable commode into your hospital room before you return from surgery.
  • You will need a walker immediately post-surgery, so bring it with you to the hospital if you have it.
  • Hospitals are very cold. Bring warm socks, slippers and your favorite blanket to keep warm.

At Home

  • If you live alone, I would recommend you have a friend stay with you for a while or hire help. I have friends who’ve done it alone, but it’s hard for me to imagine how.
  • Remove throw rugs as they’re a tripping hazard while you’re on a walker.
  • Clear walking paths in your house so you don’t trip as you go between rooms.
  • Install an elevated toilet seat (from a medical supply store) for use at home. Toilets are too low for recent hip surgery patients. A grab bar is not a bad idea, either.
  • Do basic exercises to keep your blood flowing during the first two weeks of your recovery.
  • Put pillows in an armed chair so you can sit and get up without bending your hips over 70 degrees the first few weeks. And keep one in the car so you have one wherever you go—chairs here tend not to be the most comfortable, and with a metal hip that’s healing, less so.
  • You will graduate to a cane from the walker, so you will need to get one of those as well.

Physical Therapy

  • I loved having equipment at home so I could do exercises anytime I was able. I felt it aided my recovery. Follow your therapist’s advice.

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Summary
It has taken me quite a bit of time to write this all up, so I most sincerely hope that it will be helpful to some of you in some way. I know I got world-class care during surgery, recovery and therapy. I feel I’ve experienced a miracle, a second lease on an active life, and for that I thank God, Dr. Castellanos, my family and my insurance company. I did not have to wait years on end to get my prosthetic, nor lose my overall health or mobility in the process. My healing is not yet complete, but you will be seeing me at the pool soon. After that, see you at the lighthouse!