Going to Mexico

[Aggie85]

Does anyone know how to go about getting INR checked when traveling to Mexico, specifically Cancun? Despite being careful, we've still had problems with getting intestinal buggies while visiting there. We love it but always prepare for something to get us, because it does. Not always me and not from same place.

The AC clinic warned me about the runs and vomiting causing fast changes and high INRs. But, I'm the person here on forums that can't use a POC machine to home monitor INR. So, I am wondering if anyone from the States has had to get INRs drawn while on vacation and what you needed or how you did it?

Do I need a prescription from Dr. and would one from a US Dr. work? Do I just go to ER at a local hospital, explain what I need and get tested or just find a lab, show script and get blood drawn? My clinician said I could text or call her results and then she could let me know what to do with Warfarin dose.

Anyone have suggestions on what is good or safe to take with Warfarin OTC or script wise if I do get a GI bug? My pharmacist just kept saying diarrhea was really bad but wouldn't say what to do to combat it. I'd think she'd know better than my GP but she was pretty useless.

Thanks,
Linda

 

[Aggie85]

Lots of folks taking a look, but I guess no one has had to do this while in vacation. Roughly, my plan is to NOT Get sick. But if that fails, I plan to go to the nearest hospital ER and ask for an INR test. I'll then text the result to my pharmacist and let her text me back plan.

It's not for a couple weeks yet, so maybe I'll get a better plan by then (aside from the not get sick plan).

Linda

 

[dick0236]

Linda, it's been a looooong time since I was in Mexico(Mexico City), early 1980's for about one week with no problems that I can recall. Have been on several cruises that stopped in many caribbean ports with no problem. How long will you be there? I doubt you should have any problems unless you really get crazy. Try not to eat/drink too much from the sidewalk vendors and drink only bottled beverages when outside of a major resort.

I would not look forward to going to a local hospital. Many years ago, also in the 1980's, I was in the Spanish "Costa del Sol" and had my INR go thru the roof(blood in urine).....scared hell outa me as I thought I would have to go to a Spanish speaking hospital and I don't speak Spanish. Stopped Coumadin and drank a lot of water until urine cleared up. Flew back to USA after a couple days and had INR checked......OK. While on vacation, use a little extra caution in food or drink.

 

[Aggie85]

Hi Dick,
Yeah our plan is to basically just hang out at the resort. It's one of those ALL INCLUSIVE so no need to eat on the local economy as it were. This is our 5th time going there. Once I got sick from something I ate at the resort and another time, Mike got sick we suspect from something he ate while on a tour. My worry was if I do get intestinal issues, the clinician said vomiting and diarrhea can raise my INR through the roof very fast and she'd want me tested. The resort is kind of isolated, about a 30min drive out of town, and Mexico isn't like the States (or DC area) where there's a hospital or clinic on nearly every corner.

We're only going to be there 6 days but I'd like to have a plan just in case. What I was wondering if anyone knew how scripts or insurance worked when out of country. I'll be calling my insurance company, but wondered if others had insight.

Happy summer plans (or spring plans for our down under friends) ALL,
Linda

 

[Aggie85]

Just for any who might be following this or looking to see if I found out anything....
I talked with my insurance company yesterday and found out at least how coverage for this sort of thing works. This is the retiree military coverage, so may differ with yours, so ask to be sure. I have to pay up front whatever is charged. I then turn in the invoice to the Overseas Coverage department and will get reimbursed. It didn't occur to me until today though, to ask if full, direct reimbursement or that "what insurance pays" rate we always see on those summary of coverage statements. I'm crossing fingers that I won't get sick enough to worry about it, but at least have one more piece in the trip puzzle.

Linda

 

[Duffey]

No helpful advice from me, but I will say that if the possibility of getting intestinal buggies existed, I'd consider changing my travel plans. Have you considered buying travel insurance in case you would end up hospitalized?

 

[yotphix]

No helpful advice from me, but I will say that if the possibility of getting intestinal buggies existed, I'd consider changing my travel plans. Have you considered buying travel insurance in case you would end up hospitalized?

The possibility of getting 'intestinal buggies' exists pretty much everywhere. Mexico might be particularly well known for it, but the fact is that you have particular critters in your water at home, and they are different from the particular critters everywhere else.

I've spent a great deal of time in Mexico (it would total well more than a year, but usually for just a couple of few weeks at a time), and only been sick once, and that from a pretty dirty 'restaurant' at a fish market. I should have known better!

To Aggie: Make a point of talking to your doctor or pharmacist about anti-diarrhea/nausea medications. That way, if you contract something, you might still not have an issue. I used to keep a couple of lovenox syringes when I spent a lot of time at sea, in case sea sickness interfered with my ACT. That might not be a bad insurance policy too. Last, I don't know what your policy looks like, but I'd bet that an inexpensive emergency medical travel insurance policy isn't a terrible idea to supplement that.

Enjoy!

 

[Duffey]

Were you on Coumadin the one time that you became ill in Mexico? If so, did it disrupt your INR?

 

[Aggie85]

Where we go is a Five Star resort and quite well run. I'm not sure what got me sick the one time we went, pretty sure it was a restaurant on the resort, but I do feel comfortable going there. As Hotphix points out, you can get sick eating here in the States too (and I have). Problem there, is it's harder to get medical care because we're not in familiar environs and have limited transportation. I just want to have a plan in case.

I did talk to my pharmacist and she was NOT helpful. Told me not to get sick! She kept saying diarrhea was BAD for INR levels but refused to offer any meds to help if I got sick. I saw a new pharmacist the other day who just started at the clinic. She seems more open, so I'll ask her next time.

My insurance coverage is pretty good, but I'll look into supplemental coverage, it might not be a bad idea.

Hotphix, having been in Mexico a lot, have you ever had to go to a clinic for INR testing? Are they set up like here, where there are some labs run independently or should I plan on just going to nearest hospital? BTW not sure if you've seen my other thread, but I'm the one who the POC machines don't work on. So, I have to do vein blood draws.

THANKS,
Linda

 

[Aggie85]

Mexico trip update. I talked to the new pharmacist and she was much more helpful in some areas and just as unhelpful in others. She gave me a "travel letter" to take to show customs, airport security, hospital personnel, whomever is rightly concerned that I am on Coumadin Therapy and what dose, ect. Also wrote me out a script for INR testing if I should need it. This sort of thing is handy for ANYONE who is traveling. Ask your pharmacist about it. She made mine good for 3 years. As to what to take if I do get sick, her answer was "everything reacts in someway with Coumadin AND see you PCM for anything to have on hand profalatic wise. Not helpful. I'm going to take Immodium and an anti-nausea OTC with me and hope for the best (NOT getting sick in first place!) I've also borrowed NewMitral's INRatio machine to have with me. I know it reads higher than blood draw level but will give me an idea if I'm going terribly out of range up or down. If I do, then I can try getting a INR at a local clinic. Again, crossing fingers that none of this will be needed. Hope all are having good summers (winters for our down under friends)! Linda

 

[Protimenow]

With the InRatio, I wouldn't be too concerned with an INR that's on the high side of normal. However, anything below 2.3 or 2.4 would concern me. Of course, if you DID have a 2.2, I'm not sure how you could get your INR tested in Mexico.

 

[Aggie85]

Sorry to not have updated this sooner. For those who cared. LOL. Trip to Mexico was fun and relaxing, also got the sex drive re-engaged (hubby says WHOOT)! I did get sick for 24 hours after eating a fancy lobster dinner. I think it was the mushrooms as it was the only thing I ate that hubby didn't. INR on NewMitrals machine stayed in range (high as usual so I read as in range, LOL). I had a great talk with the chef of the resort about Vit. K and coumadin. I'd mentioned to our butler about problems with lunch buffet having too much on it I couldn't eat (or had to watch how much I ate) and he put me in touch with the chef. From that point on, they made me a personalized lunch each day, YUM! Also learned about some of the more exotic fruits to eat or not eat. Dragon fruit (hot pink bizarre looking outside, white pulp with thousands of seeds inside) is yummy and ok for us Coumadin users. Star fruit is like mangoes, stay away from. Also discovered capers are HIGH in K. I wonder if anyone has made up a K chart for non-American based diets? I like all sorts of cultural foods and do wonder about some of the foods and spices in them????? Hope all are well! Let's see if this will actually post. I've learned the hard way to now copy what I've written so I don't have to retype it if the load up doesn't work. Linda