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All Around the Health Care Bush–the weasel chased the monkey

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Hospital Regional in Uriangato, Guanajuato

Monday found me up at the crack of dawn to make the 30-minute commute to the Regional. I arrived just after 6 am again and the waiting room was full–again. I asked the place check question and took my seat. Everyone queued up when directed and handed in our appointment slip (stamped of course) or the specimen sample. Then we waited. It was after 8 when finally my name was called. The blood draw took less than a minute. All in all, I had waited 12 hours for that blood draw. It doesn’t do any good to complain. That’s just the way it is–this time. Who knows what the procedure will be in 6 months when I come back?

I had no problem picking up the lab results a day before the actual doctor’s appointment. I just butted in line and handed the clerk my paper and she gave me the results. My TSH numbers were looking pretty good–so that dose modification Dr. J gave me last time around seems to have done the trick.

And the actual doctor appointment process has changed. I no longer had to arrive at the crack of dawn to get a ficha (number), but a mere 30 minutes before the scheduled appointment. I didn’t even have to check in at Archivos (archives) for them to pull my file. It was already waiting for me at the nurses desk where I checked in and had my blood pressure checked and weight recorded. The nurses sent me along to Consultorio 5–Medicina Internal (Internal Medicine Consulting Office 5) and I sat down. It was only a 2-hour wait from there–record time actually.

The new doctor seemed to be about 25 years old. I’m not sure he was a doctor, maybe just a body to fill the chair.  I was a little put off that Dr. J wasn’t there, but those with Seguro Popular (Beggars) can’t be choosers I suppose. Anyway, he verified that my TSH levels were good. He asked for my previous prescription sheet from Dr. J. Unfortunately, I had left that at home. He seemed put out. He asked what medication I had been taking. Unfortunately, I couldn’t remember. He seemed even more put out. I asked if that information wasn’t recorded in my file there in front of him. That seemed to bother him too. He asked me what I would do if my file were lost. My Spanish failed me here and I understood that my file had actually been lost. Confused, I pointed out that my file was in front of him on the table. So he repeated his hypothetical sentence in the conditional tense. Oh, ok. I said that I still had my previous prescription page only had left it at home. Then the name of the medication hit me–Levothyroxine–and I garbled out what I thought might be the Mexican Spanish name. He understood enough to write it down and give me a new prescription.

He didn’t check for goiters, or any other thyroid like symptoms just sent me on my way. My appointment lasted a little less than 8 minutes. I suppose it’s a good thing that I’m so familiar with my condition because this dude didn’t seem to be.

So then, I headed to Archivos (Archives) to make an appointment for 4 months from now. Four months? Well, as our Seguro Popular policy is up for renewal in 6 months, I suppose that will get me, at least, one more prescription in case we are rejected. Then I went to the Farmacia (pharmacy) to pick up my 4 month supply of medication.

Apparently it was Hypothyroid day at the old Regional.  The two ladies in front of me were there for their own supply of Levothyroxine boxes.  One of the women, an older woman carefully dressed and made-up, was asking the pharmacist about the pills.  The pharmacist didn’t know anything.  The second woman jumped in the conversation and told woman #1 that she shouldn’t take the medicine with coffee or juice or food.  Well, I knew the coffee bit. (See 11 ways coffee can impact your thyroid) Apparently it interferes with the pill’s absorption.  So I chimed in too.  The older woman said that would explain why she still didn’t feel better.  I betcha that kid in the doctor’s seat didn’t mention any of that, the weasel.

Well, I suppose it’s like anything else in Mexico–you need to be your own advocate.

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All Around the Health Care Bush–the monkey chased the weasel

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Regional Hospital in Uriangato.

I’m the monkey that’s doing the chasing of course. If you don’t remember, I have hypothyroidism which requires a blood test and doctor appointment every 6 months. Sounds relatively simple, but there’s a catch. We have Seguro Popular, (Mexican Health Care Insurance) and as such, must go to the Regional Hospital in Uriangato to have any and all procedures and doctor appointments.

It sounds like it would be a better deal right? After all, you’d expect the hospital staff to have better credentials than any Dr. Jose off the street (No offence meant to those Joses who are doctors). However, I’ve found it to be quite a frustrating experience overall (See Mexico’s Seguro Popular–A model of inefficiency). This time around was no exception.Apparently, there are now only 5 doctors during the week to attend to patients (Hay déficit de médicos en el Hospital Regional) which would explain the long lines and slow service to some extent.

Since my appointment 6 months ago, the rigamarole has been changed. In order to make an appointment to have a blood draw, you must arrive sometime after 6 am to wait for a ficha (number). The sign says that they only give out 30 fichas, but that isn’t true. The first attempt landed me number 43. The second attempt (I arrived a bit earlier) I received number 32. The first attempt was a failure. I was still waiting at 11 am–couldn’t wait any longer, and left the hospital without a blood draw appointment. The second attempt happened to be the day of the monthly teacher meeting (See Mexican Educational Reform and Political Wrangling) so I was determined to wait it out. I really didn’t mind that I’d miss the meeting.

When I arrived in the hospital waiting room, I gave out the customary holler–Quien es el ultimo para sacar citas para el laboratorio? (Who is the last to arrive to make an appointment with the lab?) I took note of the woman who claimed to be the last and her brown rebozo and sat near her. Others arrived asking who was the last for the laboratorio (for the actual blood draw or specimen deposit), who was the last for x-rays (the line was short for that) and for picking up resultados (lab results pickup). So there were several lines we all were trying to keep track of.

The blood draw and specimen deposit line formed at 7 am. A bit of pushing and shoving ensued, however as these people already had their appointment, it wasn’t too desperate. Once the 50 odd people were taken care of, the line for the appointments formed. The second line forming was more desperate since everyone knew there was a limited number of numbers available. I had to shoulder my way into the line and ended up pressed up against the back of the woman with the brown rebozo until the line advanced.

When we reached the window, each person received a laminated number. Real high tech here. Then we sat down again. The lady at the window called the numbers and set up the appointments. This process was slowed down as she attended those who had come to pick up lab results. It was now 9 am. Lab result pick-ups are from 9-10. You don’t need a number for this–you just head to the window and butt in line in front of those with numbers waiting to make their appointments. It’s a nice change to the routine when it comes time to pick up results, but while you are waiting for the appointment, it’s a bit frustrating.

So it wasn’t my turn until a bit after 11 am. As my appointment with the doctor was less than a month away and my blood work results take 2 weeks to come back from the lab in Leon, my blood draw was scheduled for Monday. Halleluiah!

Since my lab appointment was the next working day (no blood draws on Saturday or Sunday) I headed to the caja (payments office) for their approval. Last time around I was given a yellow receipt that verified that I this procedure was covered through Seguro Popular. This process has been streamlined with a rubber stamp instead of the yellow receipt. A bit of paper-saving here that shows an improved concern for the environment possibly?

Once I received the official stamp of approval, I was free to go for the day. It was now nearly noon, and I wasn’t in a hurry to head to the teacher meeting, so I set about my second health quest of the day–new glasses. (See I can see!–Getting glasses in Mexico)

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Mexico’s Seguro Popular–Back for more–Round 2

Archivos at the Regional Hospital in Uriangato

Archivos at the Regional Hospital in Uriangato

The following Sunday, we were back at the Regional Hospital for my husband’s doctor’s appointment. We arrived at the crack of dawn to get a ficha (number) and wait in the Archivos waiting room until the doctor arrived. Well, my husband waited inside, I stayed outside. Those security guards are sure on top of things. And I waited and waited.

At 9:30 my husband came outside and said that the doctor was scheduled to arrive at 11 a.m. and he was hungry. We scrounged around for change and he went and bought two cups of watery arroz con leche, it should have been advertised as leche con un poco de arroz and a hard as rock bollillo (roll). He went back in at 11 a.m. and was told that the doctor would arrive at 2:30 or so. He asked to have his appointment rescheduled, which was written in his little pink book or so he believed.

My doctor’s appointment was scheduled for the 30th. Fortunately, my lab results were in by the 28th. On the 29th, I was organizing my paperwork for the doctor’s appointment and happened to look in my little pink appointment book. To my horror, my appointment had been crossed out and rescheduled for some point 2 months down the line. The way I had been feeling, I knew I wouldn’t be able to make it until then without a refill on my prescription. I freaked out. Seems like my husband had given the archivos lady my little pink book instead of his. Therefore, he didn’t have an appointment and mine had been changed.

Well, nothing to be done but try. We dragged our sorry butts at the break of dawn to the Regional the next day and took note of whom we would be following when the time came to line up. When the desk opened, we lined up. When we arrived at the desk, we explained the situation. The archivos lady made my husband’s appointment and gave me a ficha (number) to see the doctor that morning. Whew!

I checked in with the nurse’s desk, was weighed and measured, checked for diabetes, and had my blood pressure taken. The nurse didn’t think that a doctor would be coming as there were some urgent cases in the hospital. We sat down to wait anyway. Around 10 a.m., I got tired of waiting. A doctor had arrived and was seeing patients, but I didn’t think he was the doctor I was supposed to see. He most certainly wasn’t Dr. J. (See Seguro Popular–Dr J.) So I got up and went to the nurses’ desk to ask, but there wasn’t anyone there. So I went further up to the nurse’s station to ask. I showed my pink book—however as the appointment for today had been crossed out, I had to explain what happened. I was getting a bit cranky. As it turns out, while I was up at the nurse’s station, my number had been called.

Discovering that unpleasant fact when I returned to the waiting room, I rushed the door to the consulting room when it opened the next time, darting in front of a large elderly man. Near tears, I told the doctor that I was number 3 but had been at the nurse’s desk when he called. He nodded and sat down. I told him of my condition and that I felt terrible and here were my lab results. (My TSH level was 40. Normal is under 4.) He asked some questions. I answered. He checked his email on his phone. He told me to sit on the examining table. He checked his phone again. He came and checked my heart and neck. He went back to the desk and checked his phone again. He looked at my chart. He told me I had gained weight. I responded that it certainly wasn’t because more food was available. He checked my lab results. He told me that my TSH levels were bad. He gave me a prescription. Told me to take 2 pills, not 1 and come back in November for another blood test. I left. The entire consultation took less than 10 minutes. I had been waiting 6 hours.

I went and had the prescription filled at the pharmacy at the hospital. Took 2 pills immediately. Went on about my day.

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