Sick and Alone in Mexico

I doubt many of us are really prepared for the serious medical emergency while we are traveling. No matter how well prepared or how seasoned a traveler, when the doctors say “surgery,” you quake inside.

One Saturday evening in my second week on Oaxaca, I became doubled up with intestinal cramps and pain that lasted all night. It let up a bit and so I waited till Monday to go to the doctor. He listened to my symptoms and said “amoeba.” I took the prescribed meds and nothing changed. The pain was acute.

I found another doctor who again treated me for amoeba, and still there was no change. Now it was getting worrisome, and I was getting scared. After a series of tested, including a colonoscopy which could not be finished because of severe and infected blockage, my doctor started mention “surgery.”

This is when the alone part of traveling alone became an issue. First, of course, alone is not the way to be for a medical emergency, especially one that takes you into the finer workings of a foreign medical system. You need someone to talk to and to go to the doctor’s with you, because in the circumstances, your judgement may not really be the best. Hand holding is called for, and someone to talk you off the ledge of extreme fear. Someone soothing who will both let you cry and talk you out of weeping.

Second, in many countries, including Mexico, you are expected to have someone at the hospital with you, and someone to care for you post-operation. Of course everyone back home is working, or if they aren’t, like say a young adult grandson, they don’t have a passport. I checked in with everyone. I got lots of sympathy and concern and apologies for not being available, but it isn’t the same and doesn’t help you with the practicalities of recovery.

So here I was alone and afraid. Between the pain fear, I was crying a lot. A neighbor helped me some with diagnostic appointments, which was helpful, but I didn’t really know her. I sure could not ask her to help me through the whole process.

But it ended up not being necessary to have help this time. My condition started improving, which seems to have had something to do with the total cleansing necessary for the aborted colonoscopy. Between the colonoscopy and a cat scan a few days later, I had started healing. It was then that the doctor told me he had been convinced it was cancer, but it wasn’t, and I was healing well.

This, of course, has been a learning experience. I guess the most important consideration is whether or not you are comfortable having surgery in a developing country. If my cat scan had shown the same condition that the colonoscopy did, then for sure they would have wanted to operate pretty immediately. To go to the US for the surgery, where I have no established relationship with a doctor or medical system, would have postponed things for too long. But everyone was encouraging me to do just that. My doctor assured me that the surgeon here was excellent, and I have been assured by many that the hospital is very good.

Insurance is another issue. For me, at least. I travel “bareback,” meaning I have no medical insurance except for Medicare in the US. Self insuring is good for doctor’s visits and such, but surgery is a different story. My doctor told me the whole thing would be under $2000 US. I have set aside savings with exactly this eventuality in mind. Fortunately all of the testing and the doctor’s visits came to under $300.

I was extremely lucky. First and foremost because I found a doctor who had trained in the US, and who had grown up there. He has practiced in Oaxaca for over 20 years, so he is totally integrated, and integral to, the local medical establishment. His English is spoken with no accent and he understands the needs of American patients. In case you find yourself needing a doctor in Oaxaca, his name is Alberto Zamacona, and most call him Doctor Z.

I was lucky beyond what I every could have expected by having recovered without having surgery. For that I am grateful both to the ministrations of my doctor, and to my excellent immune system. I have been stunned by my recovery.

So, that was my month in Oaxaca. Now I have a couple of weeks left to enjoy the beautiful city and get acquainted with more than the medical system.

I Beat Cholesterol. It Really Does Come Down to Diet and Exercise

Yes. I am astonished. I had no idea. For years my doctors have told me to take statins to lower my sky high cholesterol. I even tried once, about 12 or so years ago, and had a miserable side effect-Burning Mouth Syndrome. My mouth and lips were on fire. To add to my misery, I was living in South Korea at the time, and the good food there is spicy hot. I could only eat bland food, and I was still miserable. That was the end of my experience with statins. I figured with diet and exercise I could control the numbers, but I wasn´t disciplined enough about either. Well, I have spent long periods of time when I have swum a lot and hiking and biking, but the numbers only got worse.

Losing weight is really hard and my weight was in a range where I didn´t really feel a great compulsion to suffer. Besides, all my other heart and health factors have been good. I take thyroid medication and have for many years, but that is all. I´m fairly strong and fit, so I have just suffered the reminders every couple of years that my blood was fatty. And then I would forget and go get another of those lovely Thai sausages.

My only limiting issue has been my knees, which have endured every sort of insult from skiing accidents, 10 K races and daily runs till I was told to stop, falls, and even torn menisci from swimming (breast stroke with frog kick, bad news for knees). My orthopedic surgeon in Bangkok, treating my knees after some serious damage done in Nepal, which resulted in a fall and a broken foot, told me, many times in fact, that the best thing I could do for the knees was lose weight and strengthen my quads. But, I whinged, I am trying to lose weight, and I am always hungry, and I don´t seem to lose anything but my temper. Kindly Thai doctor that he is, he told me that suffering from hunger is a very good thing because it helps you sympathize with the hungry of the world.  I exercised more once I was back on my feet, but my knees hurt and my weight stubbornly increased.

I think most of us of a certain age have heard it: lose weight and all of your health factors will improve. It is good for the blood pressure, cholesterol, aging joints, yada yada. But there is no magic bullet to improve these things, right? It is just a matter of age, and I have felt lucky that my only real problem was my knees. Well, and those nasty cholesterol numbers.

So, what happened that my most recent cholesterol test came back with results in the excellent range, without the use of medications?

As my few darling regular readers know, I headed out at the end of January, with a back pack and a small pension, to explore South America. I have been traveling by bus and in the 4 wheel drive truck of some friends I met along the way. I have hiked my way around major cities and little villages. I have walked for hours every day. And meals have been what can be grabbed along the way, and what fit on my budget. In South America the big meal of the day is between about 1 and 3 in the afternoon. I fell into the habit of eating then and either skipping dinner or just having a snack. My evening meal shrank and disappeared. I accidentally fell into the habit of intermittent fasting before I knew it was a thing. The new diet science (fad of the day?) suggests that if you limit your eating to a 8-12 hour period each day (there is disagreement on exactly how long) you will lose weight even if you eat the same as you would in a normal day. New research indicates that it can be as long as 12 hours. I was doing my eating most days within a 6-8 hour time period.

Last month in Cuzco I started having tingling in my lips when I walked for very far, and soon it spread to my whole right side. It got gradually worse, and finally in Antigua, Guatemala, I went to see a doctor. I was convinced that my high cholesterol had finally caught up with me, and I was going to have a stroke or a blood clot. I was scared to get on my next flight. The doc ordered up lots of tests, and I went back to the hotel and skipped eggs at breakfast. I figured I was going to have to give them up anyway.

The doc and I went over the results. Blood pressure, slightly high but okay, as I was stressed and my BP is normally a bit low. Clotting factors, okay. All other blood work, just fine. Sugars, fine. Cholesterol levels? In the mother fíng excellent range! Damn. I haven´t ever, since having it checked for the first time, had such good numbers. Oh, and I had lost almost 30 pounds! I knew I had lost weight, as my clothes were really not fitting and I had had to buy a new belt to hold my pants up, but, wow! I had not been on a diet. I had just changed my habits to accommodate constant travel.

The immediate problem, the tingling and right side numbness, seems to be my thyroid, and that medicine has now been adjusted. So I am still only on thyroid medication, and I am not taking statins. I am so thrilled I never started them.

So, my friends, it is possible to get cholesterol under control with diet and exercise. I personally think the weight loss and exercise are the most important aspects, because I have been eating eggs and pork all summer, but only in that 6-10 hour window of time. I would highly recommend taking a year off and trekking the world. But of course, that is not practical for everyone, and it is not practically as a lifelong life style. Going forward I will have to manage the exercise and diet while not traveling. But at least I now know that it works, and that I really must make that commitment.