Wednesday, June 18, 2014

Ecuadorian Health Care

Cynthia and I have been paying into Ecuador's Social Security health care system for over two years. Locals adamantly warned us that the care is substandard and advised that they would never use it, but then again these are the same people who say how unsafe the buses are when they never actually ride one themselves.

Since the cost is so low (less than $100/month for both of us), we had always regarded our monthly investment as insurance against unforeseen health catastrophes. But when our primary care physician, in whom we have the utmost trust, became part of the system we decided to explore the possibility of using it for our ongoing care.

I've been bothered by a condition known as Dupuytren's contracture for over ten years. A thickening in the fascia of the hand causes a finger, normally the pinkie or ring finger, to bend inward toward the palm. Left untreated the finger can eventually curve to the degree of making a permanent fist.

That wasn't an acceptable outcome, so our doctor referred me to a specialist at the Social Security hospital. He examined my hand and confirmed that corrective surgery was needed. Another warning we'd received was that long delays for treatment were common, so I had low expectations when I asked when he could do it. "I'm going to the States tomorrow night," he said. "Can you be here at 6:30 in the morning?"


I left his office and a few minutes later was having blood drawn for pre-op testing. After that I went straight in for an EKG. Finally I met briefly with the anesthesiologist. All within an hour--so much for delays!

The doctor said I would be held overnight for observation and pain management. What? This procedure in the States would be performed in an outpatient clinic and you would be sent straight home with some pills. I haven't been in a hospital since I was born, but what the heck---OK.

Cynthia and I showed up bright and early the next morning. After a brief wait I changed into one of those ultra-flattering hospital gowns (and a shower cap thingy for my "hair"), hopped on a gurney, and off I went. No paperwork--everything was already logged into the system.

A couple of hours later I left recovery and was taken to my bed. Most of the rooms hold three patients, and I was happy to be assigned a "window bed" with a beautiful view of the mountains that surround Cuenca. Per doctor's orders I hadn't eaten since 10 the previous night, and I'm a guy that needs to eat something about 6 times a day. I'd already devoured a banana Cynthia brought along and was starving when the lunch cart came around.

Sorry--no food for you, Senor Staton. Possible nausea from the anesthesia. The hell you say. Good thing I had Cynthia pack other snacks just in case. I proceeded to dine on cookies, an apple, and Cheetos the rest of the afternoon.

My overnight was uneventful. They had me on an IV drip so I was pretty groggy, and the nurses were attentive but not coming around bugging you all the time.

After picking up some free medication at the pharmacy I went home the next morning. Again, zero paperwork. Just goodbye, thanks for taking good care of me. Two weeks later I went back to the doctor and had my stitches removed. Now I'm the proud owner of ten perfectly straight fingers, and the scar is so clean that it will look like just another line on my hand when the redness subsides (thinking about bamboozling a palm reader when that happens).

I can't recommend our health care system here highly enough. The care I received was top notch. For sure the speed of my treatment was an anomaly. Cynthia yesterday made an appointment with an ophthalmologist-- for mid-September (but this too is an exception--there are only two of these specialists working for Social Security in Cuenca). If you can be a patient patient, you'll be rewarded with caring practitioners and great results.

Tuesday, June 17, 2014

Baby, I Can Drive Your Car

Well, I did it. I finally got my Ecuadorian driver's license.

I mentioned in an earlier post that I had been to driving school here. My US license has expired--we're going back to the States next month--and I needed to be legal.

After waiting several weeks I received notification that my paperwork had come back from Quito so I went to the school to pick up my packet of info. The good folks there wanted to set up an appointment immediately to take my exam (it happens the next day) but I declined because I hadn't even studied yet.

All 103 possible multiple choice questions (in Spanish) are published online, so I went through the whole list once to refresh my memory. Twenty are included on the test--ten verbal and ten road signs. You can also take as many practice tests as you need online. Each time a different set of questions appears, but I quickly noticed that there was a lot of duplication. You are always asked about driving on the right, passing on the left, the colors of a traffic light, and several others.

The signs are a breeze. You don't even need to know Spanish to understand what a person on a bicycle with a diagonal line through it means. After several run-through's of the practice test convinced me I couldn't miss more than the four wrong answers allowed, I set up my appointment on the website and showed up the following morning.

When you live in Ecuador awhile you come to understand that anything involving paperwork rarely goes smoothly the first time. This time proved to be no exception. I waited in line for my turn, took a quick vision test, then sat down with one of the processors when my number came up. She went through all of my documents and discovered that the administrator of the driving school had failed to sign my diploma.

Sigh--no test for me today.

Four years ago I would have been highly upset about this. I'd gotten all geared up mentally and ridden clear across town to take the test. Now I just got up and said, "OK, see you tomorrow."

The following morning I walked to the school, got the document signed, took a taxi back to the transit building, stood in line again, received a number, got processed, and sat down at a computer. I got the first 19 right and missed the last one on purpose just for the hell of it. Ten minutes later I walked out with license in hand.


To reiterate, we love our pedestrian lifestyle and have zero plans to own a car in Cuenca. I hope to never even drive someone else's vehicle here. But the US suburbs beckon and now I'm ready.

Monday, June 16, 2014

Birthday Celebration

My beloved wife Cynthia's birthday was Saturday and I wanted to do something special for her. A card, flowers, and box of chocolates wouldn't cut it (although she got those too), so I made reservations at Noe, a new sushi restaurant that we had heard so much about.

With seven locations in Quito and four in Guayaquil, Noe is no stranger in Ecuador's largest cities, but a restaurant like this brings a whole new level of dining to little Cuenca.

For starters, the space itself is dramatically designed with a contemporary feel totally different from the traditional interiors usually found in other restaurants here.

Service was impeccable throughout the evening. Our champagne glasses were always refreshed before they were empty,

and anything we needed was anticipated before we could request it. Impressive!

The menu is literally a glossy magazine (with BMW and other high end ads) offering an overwhelming number of choices. Having been forewarned of this fact and that it's totally in Spanish, we studied the selections--in English--online and pretty much knew what we wanted upon arrival. Doing so allowed us to relax and enjoy the evening without over-ordering or being flustered and perhaps disappointed with what came to the table.

So what about the food? Honestly, it was outstanding. We shared a cold appetizer of grilled shrimp and vegetables in Oriental rice pancakes.

I chose a steak and langostino teppanyaki dish

while Cynthia enjoyed two half rolls--one with crispy salmon and the other filled with shrimp and avocado and flambeed table-side with sake.

The staff brought out a complimentary tiramisu for Cynthia and sang a heartfelt "Happy Birthday" in their best English. So sweet.

I highly recommend Noe for a superb dining experience.

PS. Happy Birthday to my forever girlfriend.