Friday, Mar 9, 2018

Health Care

We had a health scare this week. Heidi had some blood work done and from the results…confusing results I must say…it appeared she had one or more tumors causing the lab results we were looking at. I’ll save the you the drama before I tell this whole story and say she is going to be ok. I appreciate the prayers and positive intentions of friends and family this week too. Thank you!

The problem with feeling generally “crappy” for months and or years is that when a potentially life threatening health issue is going on, it is hard to know which is what. Normal? Abnormal? Who knows? Such was the place Heidi found herself in these last few months.

Lab Results

She had her blood drawn last week, and this Monday we were given the results. From those lab values, it appeared she most likely had a prolactinoma, a tumor generally found in the brain on the anterior pituitary, causing her prolactin levels to be more than 100 times normal. She also had an estrogen level almost 3 times normal, and for a post menopausal women, this suggested a cancer somewhere in her pelvis.

So what to do? We have IESS, the government health insurance. We have never used it. I think it can be good, all procedures are free, but it can also take a long time to be seen. Who wants to wait with a potential tumor lurking about, right?

Trip to Guayaquil

The doctor we see here, Dr Guzman, is a very proactive and helpful Internal Medicine physician. He speaks English too by the way. He arranged for an MRI of Heidi’s brain and a full body CT scan this past Thursday in Guayaquil. Not only that, he drove us the two hours there to oversee the whole procedure. Wow. Can you believe it?

Also hard to believe was the cost of the MRI/CT scans. How much do you think a MRI of your brain, and CT of your lungs, abdomen, and pelvis would cost in the US? I don’t know for sure, but I imagine it would be well over $10,000 dollars. How much did I pay? Less than a thousand…$710 to be exact. Oh sure they don’t put you in a hospital gown, but when your own clothes will do, why bother?

CT Scan Logistics

Have you ever had a MRI or CT scan? They send you in that long tube and start taking pictures. They started at Heidi’s head and went all the way down to her pelvis. Along the way there were prerecorded verbal instructions given to her inside the tube. But guess what? They were all in Spanish of course! Not only that, it was Castilan, not Ecuadorian, Spanish.

Health Care Ecuador

Heidi Being Prepared For Her Brain MRI

I’m very proud of my wife for not having a total melt down inside the tube. Fortunately Dr Guzman realized what was going on and gave her instructions in English over the intercom. What were the instructions? Things like turn your head to the left, to the right, hold your breath for 15 seconds…that kind of stuff. Important stuff though if you want good pics!

Health Care in Ecuador

Dr Guzman Made Sure Heidi Was Properly Prepared And Ready To Go

Beautiful Brain

Health Care in Ecuador

Heidi’s Prolactinoma

I was watching the monitor as the technician took pictures of Heidi’s brain. Slices and dices of all its sections. It confirmed something I always knew was true about her…she is beautiful INSIDE and out. Her brain looked beautiful in all areas. It did however have a prolactinoma, a tumor on the anterior pituitary deep inside her lovely brain.

The good news is that it isn’t big, so no surgery required; it isn’t a malignant kind of tumor, so no chemo needed; and the prolactin production caused by the tumor can be shut off with medication. This was a huge relief for us.


The next concern was her increased estrogen levels. The CT showed no tumors of her ovaries or uterus. We had a vaginal ultrasound done as confirmation, and everything appears normal. Why the increased estrogen? Not exactly sure. Are all her hormones messed up from the increased prolactin? Yes. Does prolactin increase estrogen? No. Is there a secondary cause from the increased prolactin causing the increased estrogen? Maybe. It seems vague to me at this point. Hopefully we will have more clarity over the next few months.

Do You Know Your Health Care Strategy?

Why am I sharing all of this with you? No one expects to have a major medical problem when they come to live here. It can happen though. Have you thought about what your insurance options are, both here and in your home country? What about the language barrier? If you aren’t fluent in Spanish, do you have someone bilingual available to help you through the logistics of a major medical procedure? A hospital stay?

Think how a medical procedure or hospital stay in your own country can be confusing at times. Where to go, who to talk with, what questions to ask, what answers to get? Now think of doing this and not knowing how to communicate fully. Frankly it is overwhelming. I am very grateful to Dr Felix Guzman for helping us through the maze of this procedure. With the stress we were walking in with because of the unknown medical outcome, the language and logistics would have been too much to manage on our own for sure.

Celebratory Sushi Lunch Post CT Results

Dr Guzman practices in Salinas. His email is He can be reached on Whatsapp +593 98 414 3820. If you live on the coast he is a great doctor to know and see!

Some Fun

We did get some fun this week before the medical stuff happened. Our friend Teresa had a birthday and several of us met at Spondylus for some good food and good times. Of course Teresa seems to always have a good time whether it is her birthday or not. She was rockin’ out with Lennon while we sang Happy Birthday to her.

Happy Birthday Teresa!

The Chicken Bus

People often believe that I have moved to a country where chickens and other livestock ride the buses with the passengers. It isn’t like that here…except for this day. I heard a chirping sound and looked across the aisle. It appears this woman was able to get her small chicken on our bus…then she took a nap while the chicken kept watch.