Dateline: A Medical Consultorio in Guadalajara

When I got to Ajijic a little more than a month ago, I thought I was about to die. As in “much sooner than expected” going to die. Of course I’ve never had illusions of immortality, at least not since my 30’s. But shortly before leaving for Mexico, I wrote my first will, designated a pair of executors, and handed a copy to a friend.

During November and December I had been suffering from some mysterious intestinal malady which left me very tired, and with a host of vague and varying symptoms. (Most of which are too gross to detail here.) My oldest and dearest friend, “W” whom I’ve known since about 1975 is a nurse, and had become my personal consultant on the problem. The symptoms were puzzling and didn’t lend themselves to any quick diagnosis. We discussed various possibilities, but easily-cured problems seemed to be ruled out. According to the web searches I did, the most likely things all seemed to be horrible — colon cancer, pancreatic cancer, and bowel obstructions, though the latter felt instinctively wrong to me. From research, it seemed like even arriving at a proper diagnosis could be a long and expensive process. This all happened over a fairly extended time frame, and my condition waxed and waned. Some days I’d feel fine and start to think that whatever it was was improving. Other days I’d have little energy and would spend the day in bed watching YouTube videos.

Worse, in late 2017 I let my health insurance lapse. It was a calculated risk. I was one of the healthiest people I know, with normal weight, normal blood pressure, good blood chemistry, regular exercise, good diet, and not on any maintenance medications at all, this despite being in my late 50’s. And frankly, at $650 USD per month, my Romneycare didn’t strike me as a particularly good deal, given my up-until-then good health. Also, no one in California had ever heard of my Massachusetts-based insurance company, much less were set up to bill it. I also figured that if something went badly wrong I could always fly to Mexico and get treatment, and not be bankrupted. Which was precisely my plan in December.

But because I was moving my mother and lots of details still needed to be worked out, I couldn’t drop everything and fly right away either. And the symptoms, while tiring, weren’t debilitating. So I got sicker and sicker. By the time I got to Ajijic, I had lost 22 pounds, and was down to a scrawny 148, way too light for my six-foot frame. Fortunately my friend, Lisa, had found a gastroenterologist in Guadalajara, (Dr. Antonio Orozco Gámiz) and I booked an appointment immediately. Fortunately he could see me the next day.

When I arrived in his office, he ushered me in and we talked about my medical history and symptoms. He poked and prodded me, then we talked some more. At this stage he resolutely refused to speculate about what might be wrong, and was very clear about not even thinking about ruling out cancer. To me, this seemed quite professional. Speculation is never a good thing, when you can get real information in a matter of days.

As we spoke, he wrote up orders for a battery of tests — blood work, stool samples, chest x-ray, ultrasounds of my abdomen, among others. My fears of a complicated diagnostic process were indeed confirmed. He strongly urged me to go to his favorite lab the “Unidad de Patología Clínica e Imagenología,” which I would later learn is a world-class operation, accredited by the College of American Pathologists, and full of friendly, professional, and efficient folks. And then, seemingly almost as an afterthought he wrote me a prescription for anti-parasite medicine, which he urged me to take as a low-risk, cheap way to rule out parasites. Oh, and he also gave me his cell phone number and said I shouldn’t hesitate to call it. Has such a thing even once ever happened in the annals of U.S. medicine? They (and their myriad assistants) won’t even do email in my experience. By the way, Dr. Orozco charged me $1,000 MXN, about $52 for a 40 minute consultation. Such a deal!

A few days later, I had my most amazing medical laboratory experience ever. With a branch located in Guadalajara’s “Ladrón de Guevara” neighborhood, I arrived at 9:00 AM for my tests, somewhat grumpy due to the fact that I had been told to neither drink nor eat after midnight the night before. Within a few minutes, I was registered, and whisked away to have my blood drawn. From there, I was taken to have my X-ray. After that, I was brought to a room where I’d have my ultrasound. A pleasant nurse got me ready, and then the doctor came in to do the ultrasound. Afterward, I was handed a one-liter bottle of water, told to drink it all plus another half-liter of liquid (coffee, in my case), and not to pee under any circumstances. They also suggested I go eat breakfast, and then to report back at noon. By then it was about 11:00, and I didn’t need much urging to either eat or drink. I found a restaurant across the street and ate with gusto.

When I returned, they made me wait some more, then did another ultrasound, this time to measure my bladder’s capacity. Then I was allowed to pee, and they did one last ultrasound to see whether I was retaining urine. Finally, when I went to check out, the total for all of this work came to $7,090 MXN, about $1,050 MXN more than they had initially quoted. So I complained, and guess what? They honored the initial quote after a quick call to the woman who had made the original appointment. So my total cost came to $314 USD. Compare that to my last HIV test done at Mass General which cost me a princely $287, and you can see what an amazing deal I got. I shudder to think what an uninsured person in the USA might have paid for this battery of tests, never mind the cost of the specialist visit.

Battery of Tests Ordered

And the best part? I got my results within a day, via email. Everything inside of me looks fine: stomach; kidneys; liver; spleen; prostate; bladder; lungs; and general viscera. Not only that, but within about six hours of having started the parasite medicine, I began to feel better. After I completed the medicine, four days later, I felt like myself again. Woo hoo! I was going to live after all! About a week later I had my follow-up with Dr. Orozco.

By then it was pretty clear that my problem had been parasites. Since taking the medicine I had been eating like a newly-released prisoner, (“comiendo como un huérfano” in Spanish) and I had regained my former energy level. Dr. Orozco basically gave me a clean bill of health, but wanted me to do another blood test a month later, along with another stool sample. Though my blood work had been more or less normal, my lipid levels were all ridiculously low, due to the parasites’ having blocked my absorption of fats, as well as having blocked my bile ducts. Bile is a key ingredient in fat digestion, and it turns out that being bilious is a good thing, haha.

All this happened during the third week of January. Yesterday I went for my second set of lab tests. Let’s hope they look good. At this point I feel great, though I’ve only managed to regain about 8 pounds. And my knees are a little sore from all the running I’ve done lately. But I’m now pretty sure I don’t have any form of cancer, and have regained my former excellent health. And I’ve found an excellent gastroenterologist in the process. I couldn’t be more thankful.

Saludos and thanks for stopping by!

Speaks Fluent English — Did a year’s sub-specialty post-doc at Los Angeles County+USC Medical Center.