Through the Looking-Glass: Healthcare in Ecuador

Through the Looking-Glass:  Healthcare in Ecuador

After Alice falls down a rabbit hole in Alice’s Adventures in Wonderland, she steps through a mirror in Through the Looking-Glass into another fantasy world filled with walking and talking chess pieces and animals. Moving to another culture in a new country sometimes makes one feel like Alice.  Things appear in reverse and upside down, for better or worse. Except that for Alice this was all a dream and for the rest of us it is real!

On Monday of this week, I felt like Alice. Surely this was a world in which things were upside down. I walked into a medical professional building next to Santa Inez Hospital around 11:30 am, saw my second medical specialist in three weeks and, as before, got an appointment the same day, an examination the same day, and paid for both with cash on hand. In both cases the amount paid for healthcare services would have been about the same I would have paid WITH health insurance in the US. (I do not have my residency visa yet and; therefore, I am not signed up for Ecuador’s national healthcare.)

After a scope of my esophagus & throat ($30), an ecogram ($40), a pathology report of stomach fluids ($25), and an endoscopy ($240), medications for 6 weeks ($160) and 2 follow-up visits at end of week, I’ve spent a little more than my $520 monthly charge for health insurance in the US.  Doctors’ visits were $30 each.  The result of the two follow-up consults, with the ENT and the GI doctors, is that I have two confirmed diagnoses, substantial relief from symptoms, path to recovery, knowledge nothing major is wrong, and an end to guessing what was wrong.

I now know what healthcare feels like when doctors are able to freely focus on the patient’s needs and not have to deal with insurance companies, billing, and administration. It feels wonderful!  I have no bills from anesthesiologist (yes, I had one), no bills from hospital for use of room, no letters or bills from insurance company, no waiting to get approval from insurance company, and NO waiting to see a specialist. Typically I have had 3 to 5 month waits for specialists in Chicago. Yes, it’s like Alice talking to the Caterpillar! It seems like a fantasy, but it’s real.

The Details: What Was My Health Problem?

My symptoms were persistent, episodic coughing, especially in the evenings and difficulty catching my breath. I wondered if I was allergic to something in Cuenca or perhaps reacting to diesel fumes or having difficulty with altitude? Would I be able to live in Cuenca?  I wasn’t sure!

For someone with many airborne and food allergies, coughing from post-nasal drip was common for me; however, the episodic nature of the coughing was not. For someone who was never diagnosed in the US, but believes she had whooping cough twice, this was a worry. For someone who was very sick and coughed for 2 months after attending a DC conference (others had same symptoms), this was a concern. For someone who had visited the ER in the US with breathing problems within the year but never received a diagnosis, this was a concern. With no previous diagnoses by doctors in the US except allergies, I was guessing I had yet another allergy and had been selectively eating; however, this did not stop the coughing.

After a bad weekend of coughing and catching my breath, I walked into the medical building at Santa Inez, with no hope of getting a diagnosis but thinking I had to DO something and START somewhere. Receiving a confirmed diagnosis of acid reflux after a 25 minute visit to an Ear-Nose-Throat doctor was like a fantasy. I could immediately focus on doing everything to alleviate this problem, and stop wondering what was wrong. (How long did I have this problem? I will never know. I don’t have the typical heartburn symptom.)

Within 3 days I was breathing normally and the coughing, though still episodic, lessened considerably. As time went by the coughing didn’t disappear and I wondered what was happening in my stomach that might be related, since the esophagus and stomach are connected at a sphincter and the sphincter was part of problem (making “reflux” possible). (I also had a chance conversation with an expat doctor suggesting a look at stomach.) Despite pro-biotics and other home remedies, I continued to have a bloated, gas-filled stomach. A visit to a GI specialist seemed appropriate.

I walked into the medical building Monday around 11:45 and asked the gastroenterologist’s assistant to schedule me. Instead she walked me

right into the doctor’s office and sat me down. Forty five minutes later I left his office with a request for an “ecogram” of my innards later that day, in the adjoining building, and a list of things to buy at the pharmacy for tomorrow’s endoscopy with the same GI doctor at 9:30 am. Wow!

After Tuesday’s endoscopy and with the results of the ecogram, the GI doctor said my only problem was indeed an inflamed stomach: gastritis. As a side benefit, I now knew that my liver, gallbladder, kidneys, intestines, and uterus appeared fine. This is what preventive medicine looks like. Great! The only thing remaining was a lab test of fluids extracted from the stomach during the endoscopy, which happened Friday, the same day I had follow-ups with both the ENT and GI doctors.  Fortunately, the pathology report (of fluids) was negative.  Both doctors were happy to know the other had been consulted — the first doctor saying he would have likely recommended the second doctor after seeing me on Friday.

The same drug had been prescribed by each doctor, in a different form and name.  Fortunately,  I figured this out and didn’t double up on that medication.  In fact, I learned that someone with osteoporosis, like me,  should not be taking this medication long-term.   So, no, the doctors were not perfect — they had no medical history form for me to fill out, as is typical in US doctor offices.  Nevertheless, the Ecuadorian healthcare system has given me an excellent, quick result at far less cost than in the US.

 

Tags: Healthcare in Cuenca, Healthcare in Ecuador

Category: Expat Life in Cuenca, Healthcare