In our book and on Planet-Boomer.com website we have extolled the virtues (high quality and low cost of care the main ones) of private hospital care in medical tourism hot spots such as Kuala Lumpur, Penang, Bangkok, Chiang Mai, etc.

On our little island of (Penang) with 700,000 people, there are 7 private hospitals and every expat has a favourite.  The better the private hospitals in these markets get, the more the public and not for profit facilities step up.  In our travels we met expats who actually don’t carry insurance coverage, as they believe that putting a fixed amount of money aside is sufficient to cover the cost of any medical issue they may have.  Good luck with that if you leave the country.  Although only the very confident (or foolish) would ever do that without at least having good travel insurance.  

Our recent Spanish holiday in Marbella did not go as planned, far from it.  We learned first-hand about costs and quality of medical care in Spain and we expect that Spain is reflective of France, Germany and most EU countries.

At La Cabane Beach Club

At La Cabane Beach Club

With Jay at Trocadero Arena

With Jay at Trocadero Arena

Bertrand in Condo pool

Bertrand in Condo pool

Five days in to our gorgeous beachfront condo rental, I woke up feeling rather poorly.  No good reason and not red wine driven in case you were suspicious.

But, we had friends from France and a full day of touring planned so I soldiered on.  By that night I was much worse.  I had some sort of urinary infection that was more painful by the hour.  I thought it would pass, drank lots of water but the next day was as bad or worse.  Not sleeping, I had time to do Internet searches of private hospitals in Marbella.  I found Quironsalud Hospital close by, just 70 rooms and 3 operating theatres on the beach a 5-minute drive away. 30% of patients expats, English spoken and excellent reviews.

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Into emergency we went.  They immediately installed a catheter and sent me for a battery of tests.  As they did an ultrasound of kidneys, prostate, bladder etc. they paused and called two doctors in.  They had found something else, unrelated but much worse.  

Doctor Gallardo, a cardio vascular surgeon, came to see me.  I had an AAA; an Abdominal Aortic Aneurysm.  In the abdomen, below the heart an artery takes blood to a junction who then directs it left and right to the lower body.  That artery is supposed to be 2 cm’s, mine (confirmed after a full scan was done) was 5.2 cm’s.  5 and over is bad, so bad you shouldn’t fly they said as with a rupture due to pressure change you would simply bleed out before they could land the plane. They needed to install a stent to wrap the aneurysm, contain it and shrink it.

We then consulted all the doctors we know around the world.  Fantastic people we have befriended in our travels.  They all agreed the ‘no fly’ issue was overkill but what I did have was a “ticking time bomb“ in my abdomen.  We met with the surgeon again and decided to have the operation right there and not risk the 20 hours in the air to fly home.  Ellen managed our health insurance people who were fantastic.  They agreed immediately and dealt 100% directly with the hospital after the first phone call.  The initial estimate for the operation and treating the prostate infection was €30,000 euros ($45,000 CDN).  I think we jumped that number by a good margin as time wore on.  

Before operating they needed to kill the infection. That took 8 days in hospital extended a few days by the fact they only operate on Tuesday’s and Thursday’s. My private room had a view of Morocco across the water.  The hospitals roof terrace had a cool boutique restaurant/coffee shop, couches and coffee tables and lounge chairs with a lovely view of Gibraltar just an hour’s drive down the bay.  If you have to be in a foreign hospital, this is the one you want.

The operation was state of the art.  Laparoscopic, no cutting, no stitches, 2 days in ICU recovery.  The ‘stent’ went up a vein in my groin and a tiny camera went in on the other side.  They ‘wrapped' the aneurysm and even installed a cool little rig to ensure it wouldn’t slip when the thing shrunk.  The infection has proven harder to tame and I had the catheter in for another 7 days, as antibiotics were slow to shrink back the infected prostate.  Doctor Gallardo was simply fantastic.  He visited me every day to provide updates, even on the weekend.

View from Jim's room at Quironsalud

View from Jim's room at Quironsalud

Roof top bar restaurant at Quironsalud

Roof top bar restaurant at Quironsalud

With dearest Matt in old town Marbella

With dearest Matt in old town Marbella

Ellen was magnificent too. She managed our private insurance, extended villa rentals and found new ones, changed rental cars and extended contracts, brought me fruit and drinks, prescriptions and ate my hospital food (which was very good).  She took care of our stream of guests while making sure we always understood what the medical team was doing to and for me.  In the last week she found a condo in the same complex as our close friends from Penang and they took wonderful care of us, in particular taking Ellen out to parties and dinners while I moped about peeing into a bag.  She was getting more than a bit stir crazy by then.

7 days after leaving hospital I had the catheter removed and to my great dismay I still couldn’t go.  But, according to the urologist I hadn’t drunk enough water so they left it out and we went home.  5 hours later, prior to walking to the beach for dinner, I had about a 60 second, unassisted pee; a very happy urinary moment.

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Shortly after, we decided to come home.  It was a desperately long trip; Malaga-Frankfurt-Singapore-Penang, but I made it and very, very glad to be here.  I have to see an urologist here and have the stent checked by scan in a month.  So far, daily ultrasounds in Spain indicated it was working perfectly. 

I was very, very lucky.  AAA is the #3 killer of men my age and the fact they found it by accident while looking for something else is simply bloody kismet.  I am not 100% yet; maybe 85% as the infection is just now winding down I wasn’t sleeping well.  I was on sleeping pills for almost 10 straight days and have been off them 100% for the last 10 days, but better every night.  I have, as of this morning, lost 20 pounds.  However, it is not a diet I would recommend.  You lose as much muscle mass as you do fat.  Horrible to drive by those fabulous Marbella golf courses on release from hospital and feel you couldn’t even muster the strength to swing a club.

By sheer coincidence a friend in Penang had exactly the same operation a week later.  His aneurysm was being monitored every few months and had grown to 6 cm’s, a very dangerous condition.  If you accept that my operations cost, reduced by having to treat the infection as well, was about $40,000 CDN, his was just $8,200 for exactly the same procedure.  Five times less.  Testimony to just how efficient and effective medical tourism is in Asia compared to Europe (and, North America).

As we have mentioned in our book, Canadians should be aware that their Provincial medical coverage might NOT cover this kind of procedure when offshore.  Never, ever venture out of the country without travel insurance.  It is cheap as chips, the best protection you can buy for the unexpected.