Medical Tourism Costa Rica Hip Replacement

Bones, joints and muscles
1

Hello All,

I would appreciate hearing from any members who have had hip replacement surgery in Costa Rica, Panama or any other Central American Country.  As an uninsured North American, getting the surgery done in the states is looking to be unaffordable.  Any details you are able to provide regarding type of procedure, hospital/surgeon, results both short and especially longer term, type of prosthetic, recovery experience, where you did recovery or any other relevant details you think to mention.

Best to All,

Jimbone

2

I'm afraid that I can't answer your query, but I was wondering if you had given any consideration to the ancillary costs and risks of having surgery in another country. For starters, I can't see you being insured - what happens if it all goes wrong and you are stranded, ill, in another country? It's common to be advised against flying and long distance road travel due to the higher risk of DVT. So where would you live  and what would that cost? If you return home, who does the follow up - and again, what if it goes wrong? If you add up all the costs, and factor in the risks you are taking, you might not find it quite so unaffordable. Just be careful that you don't turn a bad situation (being unable to afford your healthcare bill) into a worse one (being stuck in a foreign country with failed surgery and no money). Whilst hip replacement is a very successful op, and generally people recover ok, a read on these pages demonstrates that even the best of surgeons doesn't guarantee the results. Please do be cautious and think it through. Medical tourism is great if you want surgery and a sun tan, but less so if you are left picking up the pieces.

With that warning, you might add Cuba to your list. I know you aren't really supposed to go there, but oddly the place is packed with Americans who "aren't there". Contrary to the propaganda exercises, Cuba has the best health care in the world (according to the UN), and the highest proportion per capita of highly trained medical staff. My Canadian friends daughter went there for treatment, and she said it was absolutely first class. For her it wasn't a hip - she went for treatment of a condition that can't be treated elsewhere but Cuban doctors found a treatment, but because of sanctions there is some reason why they can't "export" it. And I've seen some of the medical facilities for tourists like you - I could easily be tempted myself! If you are thinking of this, just make sure that you have a payment method that isn't through an American bank, because they don't accept U.S. bank cards and dollars are highly surcharged. 

3

Hello Beth,

You bring up several good questions.  And yes, I have given these questions a great deal of thought and research.  Some of the answers I've arrived at are encouraging, some less so and others are unanswered, hence my post- to look for the real life experiences of those who've gone this route. One was the brother of a friend who had his done in Mexico, probably a decade ago.  He recently had a revision done, in the states I believe when things went bad.  Not encouraging.  However that was a decade ago, I don't have all the details for the replacement failure and don't even know if the facility he went to was certified by the internation joint accreditation organization, then or now.  I know there are Mexican facilities that are currently accredited but don't know if they would be my first choice.  There are a few accredited faclities in both Costa Rica and Panama.  From my reading, the bill recieved for the work is comprehensive: from surgery through anesthesia, after care, hospital stay, physical therapy during a period of recuperation.  Those costs, as I have been able to find them are between 50-60% of just the surgical procedure here in the states.

A factor of medical treatment most often overlooked by the medical community is cost.  This is so, I believe, because the insurance industry determines those costs through coverage limitations and renumeration to medical professonals.  The insurance industry is a for profit effort which in the end creates a for profit health care system.  In any profit determined economic system, economicaly stratified parts of the population will invariably be unable to access certain benefits of that system.  If you ar wealthy enough, no problem, if you are poor enough you can probably find what you need, but if you are average enough, well then you are likely to be on your own until you spend yourself into destitution in which case whatever the surgical outcome is it's less likely you'll live well enough to get to enjoy it much.

Not intending ot make this a political manifesto while realizing the question is part and parcel of the discussion.  I am not crying the blues about the unfairness of the world- I made my bones with that long ago and chose a lifepath of self sufficiency, self employment, self care and personal responsibility.  It took a mindset of thinking outside the box, determing my own values often at odds with societal norms and finding a way to accomplish my goal through self reliance.  I've mostly enjoyed the autonomy and don't find any good reasons to alter my approach to life because the insurance industry doesn't/won't provide for me.

So if it goes wrong, what then?  Well I wouldn't have any insurance to provide a revision, unlikely I could sue anyone [or have the insurance compny do it for me] in a foriegn country and that's a factor in the equation.  But I'm asking myself how improtant is that really.  I mean if I'm permanantly disabled by the surgery I'd only be a little worse off than I'm going to be in a few years anyway and I think I've already made my mind up about that set of circumstances anyway.  Family is not a concern, I don't have any to speak of.

I've looked at Cuba and couldn't care less what the US govt. dictates regarding my destination.  The problem is that Cuba, while having the highest ratio of doctors per capita and universal coverage does not have even current technology for joint replacment.  In this respect they are pretty far behind the curve and yes, that is a result of the US imposed economic embargo.  If they were as advanced in this area as they are in others [they have a proprietary treatment for diabetic ulcers that has reduced amputation by an enormous factor and are working on a vaccine against HIV] I'd be on a boat or a plane to Havana faster than you could say "I'll have a Cuba Libre with lime".  My spanish is good enough.

I'm at a point close enough to retire, cash in my chips, and live out my days with the same level of frugality and comfort I've enjoyed until now. 40-60 grand for the surgery in the states would put a very serious ouch in those plans and as is my way, I am lookng for alternatives to the beaten track that might produce results equal to or even better than the ones we are presented for daily consumption.

Diatribe finished.

So, anyone out there had their hip done in Central America?  Wanna share?

4

Hi Jimbone, 

Hopefully there are members here who can answer your question ....

good luck and

big warm hug

renee

5

Hey hi bone,

i am 1 yr post thr preformed  in Ecuador, not Central America but Latin America still.  I had an excellent experience as far as hospital and surgeon go.  I was uninsured at the time of the injury and all cost would of been covered in the public hospitals but I opted for a private institution to fix it "the right way".  If you want more details about my experience feel free to reply.

Kind regards,

Al

6

Hello Alan

Thanks for replying.  I think your experience and input to this discussion will be invaluable to many besides myself.  The question I asked here regarding Costa Rica/Central American hip replacement surgery is actually the second posting to the forum regarding surgery outside the US, but is more specific to the two countries mentioned.  There are so many millions of people here in the states who are either uncovered or undercovered by insurance I am certain there is a large interest in expatriat medical treatment.  Since you are the first person to reply to either of these inquiries that has had any experience I think that makes you the resident expert or at least the voice of authority, so please, if you would, share any and all of the details you can.  I have numerous questions myself that I would think are shared by others that are in the same boat:  What procedure/surgical approach was performed [anterior/posterior]?  How long were you in the hospital? How fast was your recovery? How successfull was/is yor recovery? Was your surgery a Total Hip Replacement? Was there a language barrier [my spanish is quite good but others maybe not]? Do you know if the hospital/facility is accredited by the International Joint Institute? How many suregeries had your surgeon performed? Your private institution- were you billed directly and can you provide the complete cost- surgery/anesthesia/recovery/physical therapy/hospitalization? How soon were you back on your feet and feeling back to normal?  How long ago were you treated? Which prosethis/hardware was used? Were/are you a resident in Ecuador and what kind of strategy/cost could be used by someone who was travelling there strictly for surgery to account for recovery time? Can you provide the details for the private institution?

I'm sure there are dozens of other questions that should be asked but I don't want to overwhelm you with too many or my own trepidations.  I'm still trying to wrap my head around becoming bionic.  Frankly, the surgery scares me- something I'm strugging with to resolve myself to,but that's my problem and will get resolved after sufficient research.

I am new to this sight and there may be rules in place that prevent you from addressing specifics on surgeons/facilities.  I have not figured out how to PM another member- it may be a requirement to have a cerain number of posts, not sure, but I hope you can reply with as many specifics as you can for the benefit of many others and feel free to contact me directly if that would be easier for you.

You mention an injury.  Was your hip surgery a result of trauma? I've got OA- not bone on bone yet [still 3mm clearance] but we all know where it's heading.  My quality of life is alread seriously impacted and not going to improve.  At 62 years old and still in very good health otherwise I am not prepared to go gently and pretty damned resentful that a fairly well planned retirment is going to get gutted without the surgery or because of the cost of the surgery here in the states, so your reply here is like a beacon to a floundering vessel on a fog bound sea.

Thanks again for your reply.  I am looking forward to everything you can communicate and hope you are doing very well.

Best regards

Jim

7

Thank you Jim, yes I am very well, physically at least.  My injury was due to the earthquake and subsequent house crumbling around us, so trauma is the word.  Dislocated and fractured hip socket and the femur ball was shattered on my right side.  Fortunately that was the extent of my major injuries besides the on going battle with cPTSD.

So, first question...about surgical approach... I was not aware of different methods btw until I began following this forum 👍...I had a posterior approach with General anesthesia (I was out cold) six days after my injury.

I had ball and socket (total hip) replacement with ceramic on ceramic(20 yr hip) as I was 51 at the time and longevity was critical for my choice of hip, and they did offer choices. 

More to come,

Alan

8

Secondly, my hospital ( Hospital de Los Valles ,not sure of accreditation ) surgeon(orthopedic trauma specialist with a focus on hip and shoulder) and post surgical care were top notch.  I was in the hospital about a week after but more due to other issues.  The hip responded well and I was up on my feet 24 hrs after surgery and was in good enough shape to leave the hospital in four days.  I stayed in the local Cumbaya area (just outside the capital city Quito) for a week and had my staples removed in the surgeons office before traveling to meet my wife in her hospital in Guayaquil 

9

Alan,

Surviving a catastrophic earthquake with your life must be a truly soul changing experience.  I can imagine the emotional impact it presents.  I'm truly glad your hip surgery went well and your physical recuperation is proceeding.  Having to deal with the additional pain/frustration of a less succesful procedure would only add to the more encompassing trauma, so it's good you were spared that.

I've had a few close calls although nothing as severe as your own.  A few, I've decided, are a little too gruesome to relay here in detail [think chainsaw accidents] and yes, the emotional/psychological after effects can shake us deeply for a long time after the physical healing has occurred.  We are a vigorous species- one of the reasons we have survived for so many millenium.  It can be difficult to regain our sense of security after certain events and a confident outlook toward life is a valuable asset to live with.  When life puts some chinks and dents in that sphere of personal outlook it can leave us feeling exposed and vulnerable in a way that is uncommon to us.  But like I said, our species tendency is a strong survival instinct; those chinks of exposure tend to grow back, maybe not as smoothly as the original surface, but sometimes stronger.  Having to wait 6 days for surgery after such a damaging occurence can effect the psyche deeply- the uncertainty and the pain is very challenging and can take a few years for the full recovery of emotional stability and recovery.  Maybe the  brightet sight from such an experience is a new won appreciation of living.  Upright and taking deep breaths is a gift some more fortunate can overlook.

Thank you for your reply.  I will research the facility you referenced.  Are you still residing in Ecuador?  Wherever you are, I wish you all the best in your full recovery which I would expect will happen as the days go by.

Jim

10

Thank you for your kind words.  We are currently in Vermont tending to some medical issues, both mental and physical.  Not hip related what so ever.  We will be returning to Ecuador at some point to attempt to "get back in the saddle" sort of say.  Rebuilding our dream of beach bar ownership and tour company.  When we do we will be located on a beautiful stretch beach in the small surf town of Canoa, Manabi.

If you ever do make it to Ecuador look us up at our place...Surf Shak in Canoa, Ecuador.

Good luck to you also...affordable hip replacement for all who need it!