Doctors & Dentists

My wife and I bid a fond farewell to January, which saw us cooped up in the casa most of the month, not due to weather, but due to a variety of maladies. It started January 2nd, when I caught a very fast-spreading cold (sore throat, fever, lethargy) which put me down in bed for a week. Just a few days after I recovered, Judy encountered an ensalada contaminada–she literally “et something bad” as we used to say. Food poisoning lasted a good ten days and necessitated a few visits to the doctor/lab, some testing, and verged on a trip to the emergency room for treatment before she got better. And when she got better, I went in for a routine teeth cleaning. I mentioned some dental pain, and that led to two root canals and crowns. Here we sit in February, now returned to health. So what was it like, being sick and out in expat land?

For all the experiences, the costs were much less expensive, as I have noted before. For my over-the-counter (OTC) cold meds, we bought the same things we did in the States: Nyquil and Robitussin and the like, except generally at much less cost. If you’ve ever wondered why the same product is cheaper elsewhere, here’s the the secret. Most of the cost in any medicine is in the research: you need to recoup the cost of creating the medicine, and the cost of all the other medicines your company TRIED to make but didn’t work out. When you get to an approved, functioning medicine, generally the cost of production is low. So while you can set a profit margin of (let’s say) $5 USD on a medicine in the States, no one in a poorer nation will buy it at that markup. BUT, you can set a mark-up of 5 cents on it and sell it and still make money elsewhere. So that’s what they do. It works for all kinds of things beside medicine. As long as you cover your costs, you still make a profit.

Doctors are very approachable and easy to reach. Judy texted (WhatsApp) our doctor on Sunday evening when she had already been sick for three days without improvement. Our doctor responded quickly with a Monday noon appointment. She gave Judy a mild antibiotic and something to address the bowel symptoms (more on that later), but also a sample kit if we needed it later and promised a quick reaction if that didn’t do the trick. When it didn’t, she arranged (again, by text) another, stronger antibiotic. The doctor texted Judy daily to check on her improvement over the following days.

As I already knew, treatments really vary by nation. Here they try to go very light on the antibiotics (as our doctor did with Judy), but when it didn’t get quick improvement, the doctor went straight to ciprofloxacin, the nuclear option of antibiotics. While we use imodium in the States to battle diarrhea, our doctor suggested it was “too strong” and recommended Treda. Seems like Mexicans swear by it, and keep it handy when travelling. I had never heard of it. Turns out Treda is the brand name for a neomycin sulfate compound not used in the US (as far as I can tell). It’s an internal antiseptic used for bowel surgery, with a load of possible side effects. Yet it’s in every Mexican medicine cabinet. It worked for Judy, and was far less extreme than imodium.

In my limited experience, medical professionals here aren’t quite as used to explaining the why and how of what’s going on. I am used to a running dialogue about what they’re doing to me, what they expect to find, what they do find, and what it means. When I went for my teeth cleaning, the dentist told me my teeth looked excellent and she thought my mild tooth pain was probably due to a change in my bite causing two teeth to impact. She filed one down a touch and sent me on way way, with a reminder to come back if I felt any more pain. Two days later, the same teeth were more painful still, so I went back. A different dentist did a quick dental x-ray and told me that both teeth had serious decay under existing fillings. This tracked with what my American dentist had warned me, that someday those teeth, which he filled, would crack or decay and need more treatment, so I was prepared for it.

After some anesthetic, the dentist started drilling out the old fillings to see what she would find. As expected, one tooth probably needed a root canal, the other maybe just a crown. I scheduled a follow up for a day later with the endodontist, who worked on the better tooth but decided to do a root canal on it. He scheduled the other root canal for a week later. So I thought I would have two root canals and be done. But when I arrived in the morning the next week, I learned the endodontist had scheduled two afternoon sessions for crowns, too.

So three appointments in one day. But, at the end of the day, I had no tooth pain and two new crowned, root-canaled teeth. I wish they had been a little more communicative as they went along (all spoke perfect English), but the care and quality were still very good. Total cost for a cleaning, another visit to drill away the old fillings, then the two root canals and two crowns? $14000 MXP, or about $700 USD.

The technology still appears to me to be very advanced. The laboratory clinic sent us a detailed readout by e-mail within six hours. The dental x-rays were all the small hand-held kind with results on a display beside the chair, and saved to my records. The crown was 3D printed on site and installed the same day.

All things considered, pretty routine stuff, especially since we were out in expat land.