Wednesday, February 8, 2012

My Personal Experience in the Health Care Industry in Cuenca

First, just a little background for me.  My mother had breast cancer in her 50's (which she survived), but then she passed away of ovarian cancer at the age of 65.  This was in 1994.  So, ever since that time, I have done the necessary tests to try to prevent experiencing those diseases in myself.  Every year (without fail), I would get a mammogram to detect any potential breast cancer and an ultrasound to take a look at my ovaries to make sure everything was good.  So far, so good.

I usually had the tests done in December in the States, so I had been asking several Gringo ladies that I knew if they knew of a female gynecologist in Cuenca.  It is amazing to me the number of women who do not get these tests done on a regular basis.  I could not get the necessary information that  I was looking for.  Finally, I contacted Noshy Pinos (a Cuenca interpreter who helps alot of Gringos) for this information.  She gave me the name and phone number of her doctor.  Unfortunately, she did not provide the address of the Clinic.  So, after several phone calls to the clinic (of which the answering machine messages are ALL in Spanish---I sure wished I could have pressed "2" for English), I gave up temporarily.  Then I finally called the doctor's cell phone and got her on the phone, but she only spoke Spanish.  After several frustrating minutes, I was able to get the address of the clinic from her.  It is amazing how nerve wracking it is to speak Spanish with someone on the phone when you feel like you only know about every third word that they are saying.

Well, this last Tuesday, I decided to go and try to find the Clinic.  It is located on the street next to Feria Libre (Avenida Carlos Arizaga Vega).   Here is a picture of the corner where you turn:

Juan Eljuri Store is on the corner

There are alot of green busses that drop off people for Feria Libre

You go pass several booths that sell food every day

Until you see the front of the Clinica Humanitaria

This sign is on the side of the building

The first day that I went there, I was just looking for the building.  I wanted to make an appointment with Doctora Norma Cordero.  I went up to the Recepcion and told them that I wanted to make an appointment with the doctor.  They asked me if I wanted to see her that day.  Well, I was not prepared to see the doctor that day because I needed to type up my medical history on Google Translate so that I could tell the doctor in Spanish.  So I asked her if I could come back the next day.  I thought she told me to be there at noon on Wednesday.  I also talked to a worker who entered my personal information into the computer and gave me a clinic card with my account number on it.  When I came back the next day at noon, I was told that the doctor had been there earlier (muy temprano) that day and was no longer there.  I guess I misunderstood when she told me that my appointment was at noon.  She told me to return on Thursday at ten (diez en la manana).

I came back the next day at 10:00am.  The first thing I did was go to the receptionist and she told me to pay for the doctor visit at the cashier next to her (caja).  And I kept the receipt ($9.00 for doctor visit).  Then I went to the left side (where the doctors are) and a woman took my height, weight and blood pressure.  After that she showed me where to sit to wait for the doctor to call.  After about 30 minutes, I went in to see the doctor.  She was very nice and she took down my medical history (which I had written in Spanish).  She then told me to change my clothes for my exam.  The rest was just as it was in the States.

The doctor then wanted me to get a mammagram and an ultrasound.  I had to pay for the mammogram ($20..00) and I got a receipt.  I was told to come back that afternoon at 2:00pm for the mammogram and to return at 7:30am in the morning for blood work and the ultrasound.  When I returned at 2:00pm for the mammogram, I was told that the technician would not be there until 3:00pm.  So I waited.  I did make a new 81 year one friend, Blanca.  She did not speak any English, so we stumbled through communicating in Spanish.  I thought she looked really good for her age:

She was SO sweet and very helpful.  She helped me to know what was going on.  I did finally get out of there by 4:00pm.  If I hadn't had to wait so long for the tech to show, it wouldn't have seemed so bad.

The next morning I returned for the fasting blood work ($42.40 total for blood work) and the ultrasound ($25.00).  First, I had to stand in line at the "Labratorio" to get a bill for the blood work to be done.  Then I had to return to the receptionist to pay for the blood work and the ultrasound.  Then the new wait began.  The nurse who drew my blood called my name in the order that I paid.  It took about 30 minutes.

Then I went to the next area for the ultrasound (I think it was called the "Ecocardiogram" dept).  Again, we had to wait.  Supposedly, I had an appointment for 7:30am, but the technician didn't even show up until 8:30am.  And again, I made a new friend, Germania.  She had lived in the US for a number of years, so she spoke very good English.  She even helped to explain to me what the technician was trying to say to me.  I really appreciated it.  And I told her that I would take her to lunch.

Germania was a real godsend.

Now I have to go for a followup visit this week with my doctor to go over everything.  After it was all over, I realized that it wasn't so bad.  It is just when you don't really know what to expect, everything seems more difficult than it really is.  And not feeling comfortable with the language doesn't help.  If anyone living here in Cuenca would like further information or would like for me to help in any way, please contact me here.  Sorry for the long post, but I felt it might be helpful to some of the women living here.  Hasta luego, Sue


  1. I think this was a very good post Susie. Hopefully some of your local gringo friends will benefit from your learning. Amazing that no one had experienced this. Do they do their routine medical work when they visit the states? I wonder.

    Grace has a new brainstorm on what she'd like to do after high school (before college starts). She is now thinking she wants to do three different volunteer stints, all in Ecuador. And in between the volunteer things, she will visit the sites, including your town. We are at least a year away from this great adventure, so I fully expect some changes in the plan. (It has already changed several times already.) But, so far, I'm liking this plan more than most. She definitely has an adventuresome spirit. At 18 I thought going to Florida was an adventure! Anyhow, when and if things start to become a reality, I will definitely be calling.

  2. In fact, a new study just presented at the annual meeting of the Radiological Society of North America (RSNA), concludes the low-dose radiation from annual mammography screening significantly increases breast cancer risk in women with a genetic or familial predisposition to breast cancer. This is particularly worrisome because women who are at high risk for breast cancer are regularly pushed to start mammograms at a younger age -- as early as 25 -- and that means they are exposed to more radiation from mammography earlier and for more years than women who don't have breast cancer in their family trees.
    "For women at high risk for breast cancer, screening is very important, but a careful approach should be taken when considering mammography for screening young women, particularly under age 30," Marijke C. Jansen-van der Weide, Ph.D., an epidemiologist in the Department of Epidemiology and Radiology at University Medical Center Groningen in the Netherlands, said in a statement to the media. "Further, repeated exposure to low-dose radiation should be avoided."

    Dr. Jansen-van der Weide and colleagues analyzed peer-reviewed, published medical research to investigate whether low-dose radiation exposure affects breast cancer risk among high-risk women. Out of the six studies included in this analysis, four looked at the effect of exposure to low-dose radiation among breast cancer gene mutation carriers. The other two studies traced the impact of radiation on women with a family history of breast cancer. The researchers took the combined data from all these research projects and then calculated odds ratios to estimate the risk of breast cancer caused by radiation.

    The results? All the high-risk women in the study who were exposed to low-dose mammography type radiation had an increased risk of breast cancer that was 1.5 times greater than that of high-risk women who had not been exposed to low-dose radiation. What's more, women at high risk for breast cancer who had been exposed to low-dose radiation before the age of 20 or who had five or more exposures to low-dose radiation were 2.5 times more likely to develop breast cancer than high-risk women not exposed to low-dose radiation.

    Bottom line: any supposed benefit of early tumor detection using mammograms in young women with familial or genetic predisposition to breast cancer is offset by the potential risk of radiation-induced cancer. "Our findings suggest that low-dose radiation increases breast cancer risk among these young high-risk women, and a careful approach is warranted," Dr. Jansen-van der Weide said in the press statement.