Tag Archives: hypothyroidism care in mexico

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 1

Blood, feces and urine accepted here!

Blood, feces and urine accepted here!

Six months after my last doctor’s appointment, it was time for another blood workup for hypothyroidism. That’s what I was scheduled for, that’s what I did, even though I had been out of medication for nearly a month and felt awful!

So Sunday morning, I was up and ready to go at dawn, even though the office wouldn’t open until 8 a.m., it being Sunday and all. Having learned from experience that it is a first come, first serve basis for EVERYTHING in México. I marched myself in, without having eaten or had my morning cup of coffee like a good girl, asked who was the last person to arrive, took mental note that I followed the guy with the blue cachucha (baseball cap) and sat down to wait.

At 7:40 a nursey-type person came into the waiting room and told us that we needed receipts from the payments office before we had our blood draws. What? I sat and pondered that a moment and then asked the lady next to me. She showed me a yellow receipt and said I could get it from the office behind us without much hassle. Well, since I didn’t have the receipt, it was a hassle. I had to get up and get in line at the window for the receipt along with about 20 other people.

The lab opened around 8:20 and those with receipts lined up. The payment office was still closed. I lost my place behind the blue cachucha (hat). The security guard kept telling us we were blocking the aisle and that important people couldn’t pass. So someone asked when the payment office would open so that we could get out of the hallway. The guard said sometime between 8:00 and 9:00 a.m. on Sundays. Gee thanks!

Some of those in the receipt line tried to hop back over to the blood draw line but were sent back, tails between their legs. Now it was 8:40 and the lab started calling out patient names and here I was still in the dratted receipt line. Finally, someone arrived, but didn’t open the window until he finished his morning coffee and bolillo (bread). So we waited.

The man behind me commented that it seems the whole purpose of this process was to get us to lose patience and go to a private doctor for our health needs since we (nearly all of us line) had Seguro Popular no contributivo (no co-payment public health insurance) and therefore, there wasn’t a reason to check to make sure our “insurance” would cover the lab work and get this receipt. I commented that if I had the money to go to a private doctor, I certainly would not be wasting my time standing here.

So we continued to wait. Eventually, it was my turn. I handed the clerk my Seguro Popular paper and the lab work authorized by Dr. J. He looked at the paper and looked back at me and determined I would be the spouse, not the primary beneficiary, nor the child. Good thinking on his part. Then we went through the “my last name is F not E and E is my second name” rigamarole. He typed it in and printed out a yellow receipt for me saying that Seguro Popular would cover the lab work.

So I went to stand in the lab work line, which was much shorter now. When it was my turn at the window, I was pleased to discover I was nose level with the feces and urine samples lined up there. We went through the “my last name is F not E and E is my second name” rigamarole again here. The lab tech guy gave me a paper that didn’t have a date stamped to pick up the results but said that I should come back in 15-20 days for them since the TSH test was “special”. I pointed out that my doctor’s appointment was in 2 weeks and he said that maybe it would be in before then. Okie Dokie.

Then I sat down near the other door to wait to be called.

Meanwhile, my long-suffering husband had been waiting outside. He snuck in, past a distracted security guard, to see what the hold up was. I gave him the Seguro Popular paper and his little pink cita (appointment) book and told him to get himself an appointment with the surgeon who did his hernia operation a couple years ago and a physical appointment for our son who needed a medical release form to start secondary school in August. My husband trotted over to archivos (archives) to do just that.

Blood draws done assembly line style!

Blood draws done assembly line style!

All good things come to those who wait and eventually I had waited enough to be called into the blood drawing hallway. The normal seats were taken so I was herded to the way back part next to the freezer full of samples. The guy looked at my arm and seemed taken back. He squeezed and prodded and couldn’t seem to locate a vein he liked. He asked where blood was usually taken–well my arm obviously. Did he think the jugular would be a better spot? More poking and prodding. He wrapped a rubber glove around my upper arm and jammed that needle in. Then flipped off the rubber glove tie which smacked me in the face. I had a bruise for a week from that prick.

He asked for the labels and I told him I didn’t have any and that the vial should be marked “especial” which he did. Then I was free to go.

Cruz Roja in Moroleon

Cruz Roja in Moroleon

My husband also accomplished his mission and had an appointment the following week with the surgeon, however, archives said our son’s physical would need to be done at CAISES. (See Seguro Popular –getting started )That did not happen. We took him to the Cruz Roja, paid $100 for the physical and $50 for the blood type analysis instead. The process took less than 15 minutes. The amount of time we saved was well worth the money.

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