In addition to carefully vetting the provider and hospital you plan to use, here are other important steps to take and things to know before you sign up to a have a medical procedure abroad.
Discuss your plans with your primary care physician or dentist, and arrange aftercare with this provider, a specialist, or both. If you have heart surgery, for instance, you’re not “done” once you come off the heart-lung bypass machine. You’re going to require follow-up care, including a cardiac rehab program, once you return home.
At least four to six weeks before your departure, consult a travel medicine specialist in the U.S. to identify health concerns pertaining to your particular case and find out which vaccines you may need for the country where you will be going. For instance, hepatitis A and typhoid vaccines are recommended for most people traveling to Thailand. Getting vaccinated against hepatitis B may also be strongly advised. In addition, make sure you are up to date on routine vaccinations such as tetanus and MMR (measles, mumps, rubella) and your yearly flu shot. The CDC provides vaccine and other key travel medicine information.
If you don’t speak the main language of the country, find out whether the health professionals who will be treating you speak English well or whether a translator will be available. This is important in order to minimize the chance of miscommunications and to make sure you will understand any pre-and post-op instructions.
Make sure to have a written agreement with the health care facility or the group arranging the travel so that everyone is clear as to what treatments, supplies, and care are covered by the cost of the trip and, very important, what is not covered.
Check what your health insurance plan covers regarding overseas care, if anything. In particular, if it doesn’t cover medical complications that may arise from the procedure or acute medical conditions or injury while abroad, you should buy a medical tourism insurance plan that does (about $500). These plans also typically cover trip cancellation or delay and emergency medical evacuation if needed. (Some credit cards also cover medical evacuation, but check the fine print.) Keep in mind that physicians in many other countries cannot be sued for malpractice. (Besides the lower pay of physicians and staff and lower operational costs, part of the reason health care tends to be so much less expensive overseas is that doctors don’t have to pay for malpractice insurance.)
Bring whatever medications you currently are taking (pack them in your handbag or carry-on luggage in their original bottles). The overseas medical facility will provide these medications (and any new ones needed) during your stay, but it’s a good idea still to have your own supply to last the whole trip, plus extra in case of delays. Check first with the foreign embassy of the country you are visiting (and that of any other countries you may be passing through) to make sure the drugs will be allowed in and to find out whether there are additional requirements for doing so (you may need a note from your doctor, for instance, especially for controlled substances). The CDC provides information about traveling with medicine.
Bring copies of all your medical records that are relevant for the procedure you are going to have. And before you leave the hospital, get as complete a copy as possible of all new medical records, including progress notes and, for example, any imaging studies and blood work done. When you get home and receive aftercare, your doctor will need to know, among other things, what risks you may have been exposed to in case you develop an infection or other complication.
If possible, take along a companion—your spouse, partner, or friend, for instance— who can act as an advocate in general and in case of complications (just as it’s a good idea to have an advocate with you for any major medical procedure you may undergo in the U.S.). In addition, that person can be good company in a foreign culture where many people responsible for your care may not be able to easily communicate with you due to limited English.
Be aware that you may have significant recovery time before you can go home and that you may not be able to fly even after you are released from the hospital. For instance, the CDC warns that anyone who has had chest or abdominal surgery should not fly for 10 days after the procedure, since the change in cabin pressure that occurs during flight can expand gas in those cavities (left over from the operation) by up to 25 percent, potentially causing pain and bleeding. Flying also increases the risk of blood clots and subsequent pulmonary embolism.
This article first appeared in the UC Berkeley Wellness Letter.