Note to self: don’t Twitter when upset. I realized later that my tweet about the hospital might have scared you. And it wasn’t entirely accurate, I actually did get some good out of it. So here is a more thorough update on my health as I struggle to end this month-long bout of travelers diarrhea:
A friendly local who works in my favorite cafe offered to take me to a doctor and help translate. Excellent. The clinic turned out to be a hospital – quite modern and sterile, rivaling anything in the U.S. I’m impressed – Santa Marta is not that big a city.
Mom rightly insisted on signing me up for health insurance before I left on this trip. I actually have two – one for life-or-death emergencies should I need to be airlifted out of somewhere (although it says in big print on the card “Services not arranged or pre-approved will not be reimbursed!” which kind of goes against their name of Traveler’s Emergency Network.) Then I have regular health insurance through Kaiser Permanente, an HMO. But that’s more for long-term care, should I get cancer or something. So neither of them help me in this situation. I guess there is a chance Kaiser might reimburse me, but somehow I doubt it. They’d probably say, “what are you doing leaving the U.S., anyway?!”
Back to the hospital – I had an initial consultation with a doctor in which I explained the mild symptoms and how I’d been treating it with different antibiotics, but none of them seemed to be working. He gently reminded me that one of the side-effects of all of these antibiotics is… diarrhea! Good grief. So I’m a dog chasing it’s tail.
He then gave me a physical, pronounced me fit and fiddle, and sent me off for blood work and a stool sample (I was particularly excited about this part). And then we waited… for the lab.. and waited for some more for some internist.. and waited for the shifts to change.. and waited some more. I read the entire newspaper cover to cover, even at my 5 seconds per 1 word reading level!
Finally another doctor comes along and shows me that the lab found zero parasites, eggs, ova, protozoa, worms, bacteria, or other baddies in my stool. Huh, this really surprised me. The blood and glucose work also came back normal. So.. what did this leave? This is where we leave reality as we know it. First, the doctor suggests that I stay there in the hospital for two to three days.. as in, overnight, just to make sure everything is all right. When a doctor tells you this, you think, shit, really? Something really must be bad. But then I caught hold of the reality he had lost and told him what a cockamammie idea that was. Next? His next try would have been laughable if it weren’t so tragic. He dramatically drew the curtain which cut off sight, but certainly not sound from the rest of the busy ward (which of course were all paying attention to the gringo desperately trying to understand the doctor and my restaurant buddy who it turns out is not that great a translator), leans in close, and explains that I may have AIDS. You know, he says, not everyone with diarrhea has AIDS, but everyone with AIDS has diarrhea. Yes, and about 47 other symptoms, none of which I have. I’m really freaked and irate at this point, so I begin forcefully explaining why he’s full of shit: a) I was tested six months ago, before leaving for this trip. Negative. b) In the ensuing time (and the 6-month window previous) I have not engaged in any risky activity. c) Even if I had, and it’s unlikely that enough time has passed for symptoms to begin showing, I would surely be exhibiting more common symptoms such as fever, rash, loss of appetite, swollen lymph nodes, aches, none of which I have. So he proceeds to give me another physical, perhaps to confirm my assertions.
I mean, I know this doc must have been taught Occam’s Razor in med school, so why he didn’t use it is beyond me. Unless of course he was using it and that’s the likeliest explanation around here, which would be pretty scary. Anyway, he gave me a prescription for probiotics (not cheap!), rehydration formula, and something in case I have abdominal pain. Also a list of foods to eat and avoid, some of which surprised me. Coffee is fine, he said (against everything I’ve read, since it’s such a diuretic). Papaya and bananas are not good, contrary to received wisdom which states they’re great for healing from TD. Mango, guava, and peach are good, while all dairy is out. No sodas, gatorade, or beer. That’s going to be the tough one.
The hospital gave me an initial estimate that it would cost $70, which turned out to be a lie – it was $120. Damn. I wish they had asked me first before doing some of the stuff. One thing I really appreciated, though, was the stack of paperwork they gave me upon exiting – all the lab results, doctors notes, etc. It’s always frustrated me that the U.S. medical system hides all the patient records from the patients themselves – as if we’re too stupid to comprehend our own medical charts. This was a pleasantly straightforward transaction – I paid to consult with some specialists and have lab work done, and they gave me all the results, nicely formated and presented. Although parts of the process frustrated me, ultimately I think I actually received better care than I would have in an average city in the U.S.
The other great thing to come out of that day was the guy from the restaurant who sat with me all day (from 3:30 – 9pm), putting off his wife and job. Surely, I thought, he’s going to ask for a tip or something at the end of all this. Nope, he just wanted to help out a traveler in need. Well, I am certainly going to buy him a very nice present. This seems to be a common trait in Colombia – friendly, gregarious, generous people that aren’t trying to scam you. It’s hard to get used to after all those months in Central America.
The good ending to this story is that in the two days I’ve been off the antibiotics, my shit has almost returned to normal. Wouldn’t it be ironic if I was perpetuating the diarrhea with medication that I thought was treating it.
This is one of the most personal posts I’ve written, so please do tell me if it’s TMI territory. I certainly don’t want to scare off any of my dear readers.
