Medical Tourism – Almost Always A Bad Idea

As you can probably guess, medical tourism is the name given to the practice of going to a foreign country for medical treatment, usually because it is cheaper there.  One of the most common treatments sought by medical tourists is cosmetic surgery and one of the most common places American medical tourists go is Mexico.  There are always risks associated with cosmetic surgery but they are much higher in Mexico.

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Americans are nothing if not cost conscious.  Look at this advertisement.  Who could resist?  Affordable health care with a nearby beach and margaritas to boot.  What could go wrong?  The answer is plenty.

Mexico is plagued by shortages of medicinal drugs and some medical equipment.  In response to these shortages, some clinics resort to purchases on the black market.  They may also resort to trying to stretch the medications they do have by using a single vial to medicate two or more patients.  Last year, practices like this led to the deaths of 12 Americans who went to Mexico for cosmetic procedures and came home with aggressive fungal infections that attacked their brains.  The Centers for Disease Control has documented 14 probable and 10 possible cases of fungal meningitis among people who went to Matamoros, Mexico last year for cosmetic surgery.

The fungus is one which is common in the environment.  Those who have studied this outbreak believe the fungus was probably introduced into the spinal column through the use of epidural anesthesia, a procedure in which anesthetic agent is injected directly into the cerebrospinal fluid that bathes the spinal cord and the brain.  Normally, the blood/brain barrier keeps intruders such as this fungus out of the spinal fluid and the body handles it without much difficulty.  That is not the case, however, if the fungus is introduced directly into the cerebrospinal fluid.  Its introduction through epidural anesthesia makes the most sense.  This is where the frailties of the Mexican medical system can cause these outbreaks.

When you go to a foreign country for a medical procedure, you place yourself at the mercy of whatever healthcare system that country has.  In the United States, we have strong regulation and are vigilant about drugs and medications used on patients.  It would be very unusual, although it does occasionally occur, that you would receive a counterfeit drug here.  This is far more common, however, in foreign countries, especially if the country’s regulatory agencies are weak or if the system is corrupt.  Sadly, both are true of Mexico’s health care system.

Because their treatment occurred in Mexico, when the tourists fell ill after returning home, it was hard for their doctors to get the information they needed to diagnose the problem.  Although the doctors were pretty sure they were dealing with a fungal infection, it was difficult to pinpoint the particular fungus and different fungi respond to different treatments.  To top it all off, this particular fungus is highly resistant to most anti-fungal treatments.

Victims would report a headache one day and have a stroke the following day.  Early treatment would have helped but doctors in south Texas, where most of these people were from, had no way to identify those who had received epidural anesthesia in Mexico and were most at risk.  Public service announcements brought some people in for treatment, but for many the realization that they were very sick came too late.

In addition to the risk that you will receive a medication purchased on the black market or that a needle or other instrument used in your procedure will be contaminated, there are many other risks associated with medical procedure in foreign countries even under the best of circumstances.  Here is a post from last year on some of the other risks of medical tourism in Mexico.

An epidemiologist with the CDC recommends that, if you do go to a foreign country and have a medical procedure there, be sure to tell someone on your return so that, if you fall ill, doctors will have a head start in trying to figure out what is wrong with you.

Posted in antibiotic resistant bacteria, blood infections, Doctors, Health Care Costs, Medical Costs, Medical Devices, medical errors, meningitis, Pharmacies, Plastic Surgery, science news |