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#1 marlinfishing

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Posted 28 September 2013 - 01:57 PM

I'm David & my wife & I plan to retire in Cozumel in a few years.  My wife, Lorrie, had a back surgery to stabilize her lower back about (8) years ago and the surgeon cut a major nerve.  It can't be fixed by more surgery until a way is figured out to regenerate nerves.  As a result she has chronic pain & we've worked closely w/her pain mgmt. Dr. here in TX to get the right dosage of pain meds so she has the best quality of life possible.  She's active and we'd like her to stay that way.

 

My question is this: Does anyone in this forum know of a pain mgmt. Dr. in Cozumel?  If we have to go to the mainland once/month that's OK.  She's on low dosages of several controlled(here in the states) drugs & if I can't keep her pain level down I won't consider moving her.  This is something that has really concerned us.  ANY help is appreciated!


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#2 Carey

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Posted 28 September 2013 - 02:18 PM

I can pretty well guarantee that there is no such thing as a pain management doc here or in Playa del Carmen.  We haven't even got a decent dermatologist if that gives you any indication.

 

Ibupropen is often prescribed for pain by doctors here.  And they warn you very seriously about not taking too much of it (!)

 

If the drugs your wife needs are available for sale in Mexico -- and that could be a big 'If', it should be an easy matter to get a local doc to prescribe whatever your wife needs.

 

Give us the names of the drugs she uses and in what form and we can check and see if they can be purchased here with a scrip and at what price.


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#3 Charles

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Posted 29 September 2013 - 12:21 AM

Pain management, in Mexico? Trust me on this, I have researched this with real passion for decades. Controlled substances are very highly regulated and in practicality, they almost don't exist. Manufacturing is tightly controlled, then distribution to pharmaceutical wholesalers and the entire chain leading to the public is beyond over-regulated. In a conversation with an owner of Famacia Dori years back, "you know Spanish, another word for inspector is extortionist in Mexico"! 

 

Dori is the only pharmacy in Cozumel licensed to carry controlled substances. They are the only drug store that uses multiple wholesale providers and often are the only source for more expensive, exotic, newer to the market brand name drugs. They can and will order directly from the source for medications not widely distributed. It was in the late 1990s that common schedule III narcotics began to be listed in the Mexican version of the Physicians Desk Reference (drug Bible). Light weight compounded versions of assorted hydrocodone and oxycodone did not appear on their wholesale availability to order lists for close to ten years later. They had included them in their orders for years, but have never been able to obtain them. Inspector = Extortionist in Mexico. Again from the point of manufacturing, each and every level of the distribution chain will have to abide by complex, strict inventory and control documentation. No matter how strict, preciseness in inventory and accounting for every single unit, they are left wide open to simple extortion during inspections. Gee, everything appears to be in order, but maybe I need to take your entire inventory, all your documents and give them a more complete and thorough examination. But maybe we could avoid that hassle with a few thousand pesos for this time.

 

Narcotics available on the island and only at Farmacia  Dori would be: Tylenol 3s (Tylex CD 30 mg of codeine with acetaminophen. I have seen too a codeine compound containing 50mg of a codeine salt imported from Argentina. Propoxyphene (Darvon) was sold under the brand name of Percodan Demi which many, many tourists bought over the years thinking it actually contained oxycodone. I don't know if that has been removed from the market following the U.S. FDA action. The only other "significant" pain medication would be buprenorphine sold under the brand name Temgesic  both sublingual and for injection.

 

The "strong" easily available pain medication without prescription would be Tramadol and assorted Ketorolac versions, the most popular, but seldom suggested, Sinergix sublingual 25mg tramadol/10mg of keterolaco.

 

When I researched actual pain management doctors a few years back, there were THREE in Guadalajara that were properly licensed to prescribe real schedule II medications such as hyromorphone or even Oxycotins, larger dose versions of oxycodone. But the tricky part was that In the entire Guadalajara metropolitan area, there were only TWO pharmacies properly licensed to dispense these medications. Guadalajara is Mexico's second largest metropolitan area with a population over 4.5 million people! 

 

Good news regarding Merida, I have seen some Internet reports that I deem credible that there is a pain management doctor in association with Clinica de Merida who can write and one drug store licensed to dispense hydromorphone.

Dr. Andrés Alejandro Medina Gutiérrez   http://www.youtube.c...h?v=0R2eMOlGTEs

 

All general medications are sold without prescriptions in Mexico despite having the words "requires a physician's prescription: printed on the label. Only written prescriptions are required to buy certain controlled medications like Valium or codeine. No documentation is required to possess these drugs, but I have always kept a copy. Written prescriptions are returned to the client with the exception of controlled medications. Real drugs, anything that would be Schedule II in the States, like Dilaudid or oxycodone REQUIRES another written medical permission to CARRY or possess. Or this is what I have been led to believe.

 

This in a nut shell is what you're up against. Such extreme regulation that doctors don't want the hassle of expense of obtaining proper licenses to write. My guess the specialized prescription forms to write would cost several dollars alone and then few to none pharmacies able or willing to participate and go through all the hassles involved. The out of control pain medication market in the U.S. of assorted "pill mills" and their associated mayhem have caused U.S. physicians to limit their involvement and from situations of robberies, it is a growing problem for patients to find drug stores willing to inventory their meds. I have seen signs on the outside of drug stores boldly stating they do not carry Oxycotin. A very sad state of affairs. In Mexico, untold thousands, millions of people have had to suffer through chronic conditions and cancer patients are denied quality of life that proper pain medication can provide. Given the deteriorating situation in the States, I have lost any limited hope that the situation might improve in Mexico sooner than the distant horizon.


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#4 Kandy

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Posted 29 September 2013 - 11:44 AM

I would also recommend doing some research of your own. Given recent experiences of my own, I'd suggest checking Cancun to see if there is a pain management doc there. It's an easy trip to make, even if you have to do it once a month.


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#5 marlinfishing

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Posted 29 September 2013 - 09:16 PM

Carey, this will answer your question.  Thank you so much for the reply.

 

Charles, thank you so much for the thorough response!  Sadly, it's what I was suspecting after our last trip in May when we went to the farmicia & I looked around closely.  Granted, it was a small one, but I had a bad feeling about our ability to acquire the proper drugs my wife requires on a daily basis to be bed-ridden.  Monthly plane trips to Miami are about $550.00+ to renew & pick up her meds I estimate(that doesn't include co-pay for the meds).  That being said, I refuse to give up on moving to Cozumel so now is the time to get this worked out.  I've got 5-6 years(outside) to get this right.

 

My wife takes takes a cocktail mix (3) times/day of oxycontin(2x3 mil), hydrocodone(when needed for bad days), Neurontin &, Zanaflex.  It took years to find the right mix so that she doesn't "nod off", can drive a car & be like everyone else(OK, she walks w/a cane and will never win a foot race).  I guess I could change my plans to Key West or Key Largo, but that'd put a huge hit to my savings as it cost so much more to live there.  Besides, I knew a before I met Lorrie I was going to retire in Cozumel.  I just didn't tell her that for several years and waited until I'd taken her there to experience relaxing paradise before I brought it up.  She knew all along.  cr*p, I talk about the place all the time & we've met and been in the homes of many Cozulemnos she figured it out fast. 

 

Charles, you seem to have done very extensive research on this subject and I'd like to ask you more questions, but my wife's medical needs aren't necessarily  


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#6 marlinfishing

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Posted 29 September 2013 - 09:24 PM

I would also recommend doing some research of your own. Given recent experiences of my own, I'd suggest checking Cancun to see if there is a pain management doc there. It's an easy trip to make, even if you have to do it once a month.

Thanks Kandy!  May I send you a PM concerning the Cancun thing?  We'd appreciate any advice.

 

David


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"We live in a culture of simulation, in which nothing is what it seems and the image that reigns has no reference to the real world."  (The Art Of War, Sun Tzu)  It is what it is...  THAT never changes.


#7 marlinfishing

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Posted 29 September 2013 - 09:28 PM

Carey, this will answer your question.  Thank you so much for the reply.

 

Charles, thank you so much for the thorough response!  Sadly, it's what I was suspecting after our last trip in May when we went to the farmicia & I looked around closely.  Granted, it was a small one, but I had a bad feeling about our ability to acquire the proper drugs my wife requires on a daily basis to be bed-ridden.  Monthly plane trips to Miami are about $550.00+ to renew & pick up her meds I estimate(that doesn't include co-pay for the meds).  That being said, I refuse to give up on moving to Cozumel so now is the time to get this worked out.  I've got 5-6 years(outside) to get this right.

 

My wife takes takes a cocktail mix (3) times/day of oxycontin(2x3 mil), hydrocodone(when needed for bad days), Neurontin &, Zanaflex.  It took years to find the right mix so that she doesn't "nod off", can drive a car & be like everyone else(OK, she walks w/a cane and will never win a foot race).  I guess I could change my plans to Key West or Key Largo, but that'd put a huge hit to my savings as it cost so much more to live there.  Besides, I knew a before I met Lorrie I was going to retire in Cozumel.  I just didn't tell her that for several years and waited until I'd taken her there to experience relaxing paradise before I brought it up.  She knew all along.  cr*p, I talk about the place all the time & we've met and been in the homes of many Cozulemnos she figured it out fast. 

 

Charles, you seem to have done very extensive research on this subject and I'd like to ask you more questions, but my wife's medical needs aren't necessarily  

Well, I'm new to this or it has some minor problems, but the last part of my post didn't get on.  "aren't necessarily" for public consumption.  If it's OK w/you may I PM you for more details.  Your reply is at your convenience sir.

 

Thank you,

 

David


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"We live in a culture of simulation, in which nothing is what it seems and the image that reigns has no reference to the real world."  (The Art Of War, Sun Tzu)  It is what it is...  THAT never changes.


#8 hillbilly

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Posted 30 September 2013 - 07:30 AM

Living in Cozumel is not as cheap as you might think. Certainly more than I suspected it would be. We carry a major medical policy which not exactly expensive helps to contribute to our monthly budget items. House is paid for and we do not really get out much. Still looking at 2k a month. Maintenance of property is killer on this island.

After looking at what Charles posted I would be really be second guessing a move here. You have to admit the guy does his research.


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#9 Kandy

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Posted 30 September 2013 - 07:48 AM

Thanks Kandy!  May I send you a PM concerning the Cancun thing?  We'd appreciate any advice.

 

David

Absolutely David. I only check here once a day, so it may be a little bit before you get a response ;)


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#10 ccannon707

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Posted 30 September 2013 - 03:57 PM

Most of the expats I've talked to go back to the States (or Canada) at least 1x a year. Some are on a regular 6 month rotation for visa reasons. I trust you will be coming down to rent and check it out thoroughly before plunging into a full-on move/homebuying. The quality of life for your wife is paramount... maybe she can bring 6 months of her meds with her.


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#11 crunch

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Posted 01 October 2013 - 11:42 AM

I sure feel sorry for Mexicans with cancerand such inadequate pain control.


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#12 Coz2wonder

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Posted 01 October 2013 - 05:08 PM

There may be some alternatives to add to your wife's drug therapy.

 

Cozumel can have a very calming effect for people, and perhaps your wife will benefit from that.

 

We have Yoga, water, and physical therapy, along with some limited physical strengthening.

 

Change in latitude can be a very positive therapy.


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#13 Charles

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Posted 03 October 2013 - 12:42 PM

Mexico does allow morphine as pain medication, but largely only in clinical situations. Under rare situations a doctor could administer it during a house call. There is no system for pain management allowing a patient to receive needed medication in a home environment. If a person had major (painful) surgery, they might receive morphine initially, but likely after the first day they would be switched to Tylenol.

 

Once IMSS (Social Security) offered me extra strength, 500mg of acetaminophen! They said it was extremely strong and to not take more than 1/2 tablet every 12 hours. That was for a ruptured kidney, bleeding, the result of a botched hernia surgery. I declined their two tablets offered.

 

Cancun has been radically working to catch up in their medical facilities in the last ten years. Merida, a larger town, a real town, has long had a high quality, state of the art medical reputation. They have had International "medical tourism" for decades. Many people from throughout Latin America and from Eastern Europe have chosen treatment there. My opinion, you could receive treatment for many things that would be equal or superior to what might be obtained in the U.S. and at a fraction of the cost.


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#14 TRAVELER89

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Posted 03 October 2013 - 02:48 PM

Contact Galenia Hospital in Cancun, let them know you are a Cozumel resident! 

 

http://www.hospitalg...m/eng/index.php

 

 

 

International Patient Department
Direct number: from US
011 52 (998) 891-5213

 

Merida, at the "transplant center"  would be another option.

 

Contrary to what Carey has said, there are several very good dermatologist in Cancun and Merida......, the economy here in Cozumel won't support this type of specialist!  
 


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#15 Coz2wonder

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Posted 07 October 2013 - 12:50 PM

If your planning on bringing those types of drugs in, I would do two things.

 

1.  Have a safe to store them in.

2.  Do NOT tell anyone these are the drugs you have.

 

Just like a home, these types of drugs are prized by addicts.   Oxyco is Hillbilly heroin with crushed, melted and injected.


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#16 Coz_Aholic

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Posted 08 October 2013 - 11:24 AM

..:: Chronic Pain Specialist::..
   

 

health-quality-services.jpg

 


Dr. Andrés Alejandro Medina Gutiérrez 
Algólogo | Anestesiología | Medicina Hiperbarica y Subacuática

"DIAGNOSIS AND TREATMENT OF PAIN "

Gral Postgraduate Hospital "Dr. Manuel Gea Gonzalez" and the "Angeles del Pedregal Hospital" Mexico. Df.

e-mail: aamg_98@yahoo.com

Behind Altabrisa Mall
Torre milenium Altabrisa 5th floor
Office # 507 Calle15 N°491 x 22 

Phone:(999) 313-01-58 Emergencies 24hrs Cel: 999 218 2826

 

 

 

http://www.buscatan....n-2668-504.html


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#17 Coz_Aholic

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Posted 08 October 2013 - 11:35 AM

from www.rollybrook.com/health.htm

 

 

 

Pain Medications

Chronic pain suffers should be aware that getting Class 2/Schedule II pain medication (either natural or synthetic narcotics like Oxycontin and Methadone) is difficult in Mexico. But it is not impossible, and with a little preparation, you should be able to get the medication you need.

Generally, only doctors specializing in pain management and having narcotics certification can prescribe such drugs in Mexico, and they are not that common, even in cities. For example, there are only three in Guadalajara as of this writing. So it would be wise to locate one before arriving, or at least to establish that there are some in the area you’ll be visiting. This may not be as easy as it sounds as local doctors do not always know of the existence of such narcotics certified doctors. When you do find one, be prepared to show proof that your need for the drugs is legitimate - these drugs are dangerous and have a history of abuse. Mexican doctors, like their US and Canadian counterparts, are duly cautious. Recent prescriptions and medical records should suffice.

Finding pharmacies that carry the drugs is also a challenge – again, cities are the best bet. Your US prescriptions will typically not be accepted in Mexico, so you will need to get prescriptions from a Mexican doctor.

Class 2 drugs tend to be more expensive in Mexico than in the US. The premium over the US will likely vary by Mexican state and drug; however, experience in the Guadalajara area is indicative – Methadone is about 8 times more expensive there than in the US. If the drugs need to be shipped to you from a major city, the premium will be higher – there is the case of someone in Puerto Vallarta paying $300 to have a 30-day supply of Percocet sent from Guadalajara.

A short list of Schedule II drugs: Cocaine, Codeine (standalone), Morphine, Oxycontin, Oxycodone, OxyIR, Percodan, and Percocet

If Codeine is mixed with either aspirin or acetaminophen (as in Canadian 222’s), it is a Schedule III drug.


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#18 Coz2wonder

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Posted 08 October 2013 - 12:39 PM

The only question I have is in what quantity  are these types of medications dispensed in?

 

I have only seen medication dispensed in boxes.  No pharmacist behind the counter (do we even have pharmacists in Mexico?).  I have only seen medication (non scheduled drugs) in boxes of  5, 7, up to 30 pills at a time.  

 

I am limited on my knowledge because I have never taken the types of drugs being discussed.

 

Flying to DF, or Guadalajara will add quite a bit of expense to what may be a very expensive medication.


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#19 Carey

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Posted 08 October 2013 - 12:59 PM

Merida is a very pleasant city although you must stay in an AC'd hotel if you go there any time besides the winter.  The trip is pleasant also.

 

You can opt to take Maya Air and get there in an hour or less but in a small plane so if you are a squeamish flyer....

 

Or you can take the ferry to Playa, bus to Cancun and then the first class UNO from Cancun to Merida.  The UNO from Cancun, very comfortable bus, takes I believe 3.5 hours.

Definitely a full day trip each way to Merida.  But it is a VERY nice town.

 

That pain management doc in Merida would definitely be one to contact and his email was kindly provided.  I would use translate.google.com, however, and translate the questions you want to ask into Spanish.  50/50 or less this doctor speaks very much if any English.  Which is another problem you are very likely to run into.  Quite a lot of Mexican docs speak English beautifully but probably a whole lot more don't have any.  We've been to a hernia surgeon and a dermatologist in Merida neither of whom spoke a word of English, for example.


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#20 CZMDM

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Posted 10 October 2013 - 06:51 AM

Due to the massive abuse of Vicodan in the USA it is nearly impossible to get here. However it is false that you cannot get pain relief if you are injured. I have been given morphine (injected) and Dilauded 5 oral. However the days of going to the pharmacy and going on a dopers shopping spree is a thing of the past (not implying that anyone wants to do that).


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