Tuesday, March 26, 2013

A different view on medical care overseas

Back in October, Alex started coughing. I don't know much about the first week or so, it happened while I was in Tver and the family caught a cold - which was to turn into more than a cold for each of them.

She hasn't stopped coughing. At first the teachers and other parents thought she was still sick and I was accosted and accused for bringing her to school. This continued even after a month - c'mon guys, anyone with an iota of reason knows than more than a month later you don't still have a cold. And she clearly didn't have tuberculosis.

We went through all the obvious things, bronchitis, allergies etc and the coughing never let up. We saw an ENT who diagnosed post-nasal drip. I cut dairy out of her diet in case it was causing the PND. And yet ... she woke up every morning coughing, and spent some time coughing every night before falling asleep. Sometimes she woke in the night coughing. Naptime at school was the same.

A couple of months into all this mess, she told me she had a tummy ache. She pointed pretty high up her chest. We gave her 1/2 a Tums. A few weeks later, it happened again. Then, constant tummy aches, and daily heartburn. I get on the trusty old internet and ... GERD. All the symptoms, none of the causes. The Consulate doctor is away. A friend hands me her bottle of Zantac 150, we look up dosage for children and haphazardly chop up a pill for Alex.

A week later Alex still coughs but not as much. She says her tummy hurts less, but it still hurts every day. I put her bed up on some thick books but I'm not sure it's high enough. We got to see the Consulate doctor, who wants her to finish dinner 3h before bedtime. Yeah, Russian kids go to bed way later than American ones - she's still at detsky sad 3h before bedtime. Doc agrees GERD but is concerned as to why Alex has it - she's not a baby, not an adult, not overweight, doesn't eat any offending foods, etc etc.

She first recommended an endoscopy. Here they are usually done without anesthesia as "without" it's 15 minutes, "with" you have to plan 24 hours in the hospital. So we got to stress out for a few days about whether that is something we want to do at post or if we can/want to medevac. Sounds ridiculous for a 15 minute procedure but the quality of medical care received at post, especially diagnostically, has been bad enough several people have had to medevac after tests in order to get better tests. I am not making Alex go through an endoscopy twice.

THEN we hear back, after the local doctor confers with the American doctor in Moscow, that she first recommends doing a test for h.pylori bacteria as it is the likely cause of this. Does this test exist in Russia? We don't know yet and thus need to continue to worry about Alex's GI health.

Just one more thing that would be so much easier if we lived in the USA. At least we can get broken arms set properly here - something not true at every post!
[note, this post was written in draft form, the last sentence included, before Alex fell and broke her arm again. Quel coincidence!]

1 comment:

Becky said...

Oh wow. I'm so sorry. GI issues are tough even in the US because it is so hard to tell exactly what the issue is. I hope you are able to find some answers for her poor kiddo. We eventually had to medevac for our kid's. Best of luck to you.