GringoPost | Ecuador: Are you prepared for medical crises in Cuenca?

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Are you prepared for medical crises in Cuenca?

Are you prepared? It is challenging anywhere in the world to care for a husband whose health has deteriorated to the point that he cannot speak, one side of the body is completely paralyzed, and he has no sensations in his core. In Cuenca, Ecuador it is beyond challenging. When that happened to us, one of my major early discoveries was that all the hospitals here are designed around the assumption of large family groups, with a male at the helm. My Ecuadorian-American husband used to be at the helm. Without warning, one morning I became the one at the helm, armed with my high school Spanish and a will of steel: to keep him alive, safe, and improving. I was alone. I was not prepared for this. Think minefield.

My late husband was hospitalized for a massive stroke, followed a week later with a failing bladder. Then 4 weeks after that because of a mistake I had made, the huge, infected gall bladder was discovered, and a surgeon saved his life. All of these medical emergencies occurred within 10 weeks. It was a shocking explosion of stress and fear. By week 10, I was beyond burned out. 
Without medical training, I learned new things every day about medicine and about the emergence of new medical problems. I learned how to clean a wound that would never heal. I made mistakes. It was always something. My medical Spanish grew with each problem. I invented the wheel every day as I climbed the steep learning curve that had become our life. I was perpetually scanning the horizon line for problems and heading off catastrophes. And it would have helped if I had known things and been prepared. Stress, fear and burnout became my everyday reality. Dark gallows humor became my best friend. “Now what?” became my mantra.
I learned many things from the day of my husband’s stroke through the finality of his peaceful death a year later. After he was gone, I was overwhelmed with grief. And in that fog, I realized that no one would want to go through what I had experienced. Knowing this, I began making notes and organized everything I had learned. I developed a to-do list, check lists, a Medical Spanish list and a list of useful and reliable healthcare resources. All of my notes eventually evolved into a book and ½ day seminars which I offered during 2015-2018 for expats who wanted to prepare a structured support system for themselves.

There are several things I would like to stress to the reader. Get to an Ecuadorian attorney and draw up the Declaracion document, Poder for Healthcare (Power of Attorney for Healthcare), two general Poders, and a Testamento (Last Will and Testament). Hire a US trained registered nurse on a consulting basis to manage your care within the healthcare system. Complete a medical history form and review it with your nurse. Find primary and specialty care physicians who are top notch. Don’t select doctors or attorneys because they speak English. That’s dumb. Hire a translator. Complete the 5 Wishes form. And form your very own large expat family group which I call a “Care Community” in the book. In order to survive medical emergencies, incapacitation, and end of life in Cuenca and insure the best possible outcomes, we need to prepare our own personal systems. I go into detail of what you need to know in the book, “Expat Medical Emergency Preparation, the 2020 revised edition”. Be wise and prepare! Now you have the tools.


Miriam Drake: