What Happened?


David was driven to the emergency room at Star Medica by his soon to be landlords, Mary Chacon and Jorge Herrera.
A consultation resulted in the prescription of three pain relievers including Ketrolaco, xray of the hip and pelvic area, and ultrasound of the inner thigh muscles in the right leg.
The Xray and ultrasound both showed no sign of problems and the pain meds had no more affect than the 400mg Advil he had been taking. Morelia March 2018

David started a daily yoga, weight, aerobic, nutrition routine at 212 lbs; taking no medications or any apparent health issues Nashville 8.15.17
Many factors (cost of living and healthcare prime among them) led to his decision to move to Morelia, Mexico. Nashville Feb 2018
Uber picked him up on a dark cold winter morning. With his 175 pound self, a large check-in bag, backpack, computer case, and one way ticket, he boarded the plane to a totally new life. He knew one person in Morelia, spoke no Spanish, and had developed a love for the people, culture, and food in numerous vacation trips including one adventuresome drive through the interior from Nuevo Laredo to Acapulco and back in 1967. Nashville 2.27.18

He knew one person in Morelia, spoke no Spanish, and had developed a love for the people, culture, and food in numerous vacation trips including one adventuresome drive through the interior from Nuevo Laredo to Acapulco and back in 1967. Morelia 2.27.18


It happened that first week. The now full time pedestrian in the center city elevation of 6000 feet was led on guided tours by his host. While marveling at the sights, sounds, smells and architecture the stone and masonry sidewalks, curb cuts and street crossings was the unexpected problem. He pulled some muscles on the inner thigh of his right leg that run from the groin to just above the knee. The pain was acute. The following week a second pain arose in the sciatic nerve area of the same leg. Morelia 3.1.18

From the time of his move to Calle Aquiles Serdan 803 until mid-August this year (about 15 months) David pursued all the information and leads he could find about the rehab of his leg and medications to easy the pain. He and Ana gradually increased their time together from one day to five, Nothing had eased his pain or improved his mobility. In fact, both were significantly worse. To illustrate mobility during that same timeframe, he changed his immigration status from tourist to one year temporary resident to four year residency including a trip to Laredo, Texas and meetings with US immigration officials. Morelia 4.25.18

Ana’s search for a doctor was successful and on Thursday August 15th Fernando arrived at David’s apartment for an initial consultation. Next steps included comprehensive blood work and a pelvic Xray. Fernando went over the findings with David and Ana. Severe anemia needed immediate treatment. The first mention of cancer invokes a staggering sensation! David was stunned. Ana pushed back a tear. ‘Nada,’ she said looking at Fernando then me. C-scan was needed to determine the nature of the cancer. Morelia 9.5.19

The radiology clinic was about 15 minutes from his apartment by taxi. He managed to get down the stairs and out onto the sidewalk. Ana. The impacts of the anemia were in full display. Luis. David barely had the strength of stamina to get to the corner of the block and taxi. The C-scan results would be available to be picked up the next day. The half block from the taxi back to the apartment he experienced no strength in the legs to stand or move, acute dizziness, on the edge of fainting and passing out. Luis came to the rescue of David and Ana. Luis and one of the professors from the music school carried him in a straight-back arm chair the half block and twenty five or so steps up to his desk. The lingering question is with the severity of the anemia why the doctor would put his patients in that jeopardy. Aquiles Serdan 9.17.19

Urban Center with 1.5M Residents

Ana had a difficult time finding where to buy Fernando’s prescriptions to prepare for the procedure. David and Ana were left to their own devices to administer the enema. The next morning the ambulance arrived at Ana’s house. The infusion was successful but the colonoscopy was aborted because the prep failed to clean the colon. Confused and disappointed an ambulance delivered them back home. Hospital 10.28.19
Ana fixed the 4 liter water additive to clean the upper part of the colon and Fernando performed the enema to cleanse the lower. Casa de Ana 11.4.19
The ambulance picked them up and departed Morelos for the hospital in Morelia. The procedure was a success with the extracted biopsy and they were returned to Casa de Ana. Hospital 11.5.19
We anticipate the diagnosis, treatment alternatives, and next steps from the oncologist the week of December 2nd. Casa de Ana 11.25.19

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Cost Considerations and Healthcare Comps

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