Dr. Google and Cyberchondriacs


“Be careful about reading health books. You may die of a misprint.”~ Mark Twain

Without a doubt, the internet fundamentally alters all aspects of health care. Dr. Google has been my reliable internet physician since we moved to a small, isolated tropical island in Nicaragua. Online information empowers passive patients of the past, like ourselves,  where symptoms can be diagnosed with the click of a key, a bonanza of data appears instantly, and treatment options are dispensed freely.

Yet, sometimes, I feel like a cyberchondriac. I can find a wealth of worse-case scenarios for my symptoms, all leading to …You’re gonna die. If I have a sore throat…I’m going to die of throat cancer. Dr. Google diagnoses a minor stomach ache as an infestation of cyclosporiasis, the same rare parasite called Cyclospora cayetanensis, that sickened 466 people in 15 states. I’m sure this must create a major new headache for doctors throughout the world. A bit of information can be a dangerous thing.

I’ve decided that the only way to cure cyberchondria is to have regular health check-ups with real doctors. Ron and I bought the Silver Plan health discount for Vivian Pellas hospital last year. Health Care for Expats in Nicaragua  Since we’ve had the health discount for over 6 months, we received a 30% discount for extensive health exams. So, we made an appointment with Arlen Perez at Vivian Pellas for our super-duper exams last week.

IMG_3368We arrived in Managua at 7:30 am. Within a few minutes, Arlen met us in the lobby with a printed schedule of our procedures for the day. She took us to the lab where we gave blood and other bodily fluid samples. Then, Arlen’s new medical tourism partner, Maite Soto, filled out a questionnaire for us in Spanish.

Maite spent the rest of the day with us, translating, attending meticulously to all of our needs, and taking us from lab to lab. After our blood samples, we had EKGs and stress tests on a treadmill, then ultrasounds, chest x-rays, and I had a mammogram. What astounded me was that we could ask the technicians, “How does it look?” and “Do you see any abnormalities?” Try that in the states and you will get a response such as, ” You will have to wait until the doctor reads the tests and you’ll find out in a couple of weeks.” Instead, the technicians reviewed the exams with us and reassured us that everything looked fine.

At noon, we finished the major procedures. Maite took us to the cafeteria for our free lunch and COFFEE! Since we had to fast the night before, I missed my morning coffee. Then, we had an hour to wait for our consultations with the doctors, and my gynecological exam.

We walked around the well-manicured grounds, where I discovered the children’s burn unit. You must read the experience of Vivian Pellas and why she started the children’s burn unit. Love Without Limits: Health Care in Nicaragua

IMG_3369A friend, who lives on the island, took her small son to Vivian Pellas Children’s Burn Hospital for a badly burnt foot. Poor little toddler accidentally stepped on a ground fire. She was very impressed with the care and attention he received and all expenses were free.

Our private consultations with English-speaking doctors were held in the afternoon. They carefully reviewed all of our test results and gave us plenty of time to ask numerous questions. The only test result that wasn’t available was my Pap test because I had just completed my gynecological exam 30 minutes earlier.  But, not to worry. They would scan the results and email me within two days. ( AND…they did! )

Now, I know you are curious about the cost of these exams. What would be your guess?
The public price for the Male over 40 Physical is of U$ 350
With the 6 months discount (30%) is of U$ 245
With the 3 months discount (25%) U$ 262.50

The public price for the Female over 40 Physical is of U$ 420
With the 6 months discount (30%) is of U$ 294
With the 3 months discount (25%) U$ 315

We were at the hospital until 5:00 pm. All exams were professional and we received same day results! They sent us home with hugs and packets complete with our x-rays, ultrasound pictures, EKGs, thoroughly reviewed blood analysis’, and most importantly recommendations for improving our health as we age. Although, I am proud to announce that we are in excellent health for two aging baby boomers. :-)

Was it worth it? Absolutely! Would I recommend Vivian Pellas to other expats? Without any doubts! Their medical tourism program is growing rapidly. Many foreigners come to Vivian Pellas for hip replacements, cosmetic surgery, and other procedures at 1/4 of the cost of procedures in the states.

Does this mean that I’m abandoning Dr. Google? No, of course not. But, now I can make more informed decisions about my health care because of the thorough services I received at Vivian Pellas. Is my cyberchondria cured? Yes! Thanks to the attentive, caring doctors and staff at Vivian Pellas. It is very reassuring to know that we have an excellent expat hospital, same day results, and hospitable staff available in Nicaragua. Have I told you how much I LOVE this country?

Health Care for Expats in Nicaragua


 

 

One of the biggest challenges of living abroad is health care. When we opted for early retirement, we could have continued our group health insurance, but the cost of the insurance would have reduced our pension checks by half. Plus, when we retired, our health insurance was not accepted in Nicaragua. We are too young for Social Security and Medicare. Medicare is not accepted in Nicaragua either. At the time, our only option was to take a risk, self-diagnose, and live cautiously on our tropical island.

Fortunately, Hospital Metropolitano Vivian Pellas in Managua is committed to providing healthcare with international excellence. So, we made an appointment with Arlen Peres, the Medical Tourism Manager, called our faithful taxi driver, and visited the hospital to explore our insurance options.

                                                Arlen Peres, Medical Tourism Manager

Arlen met us in the lobby of the hospital and attended to us like newborn babies. She took us on a tour of the immaculately clean and modern hospital, answered all of our questions with the honesty and professionalism of a Supreme Court Judge, and spoke fluent English. Impressive!

She explained the two insurance plans for the hospital: the Silver Plan and the Gold Plan. When we were trying to decide which plan would be the best for us, she recommended the Silver Plan because it cost less and it would meet our needs until we are 65 years old.

                        The Silver Plan

We filled out the health insurance application for the Silver Plan. It was three pages of general health questions..all in Spanish, which Arlen patiently translated for us. Ron’s Silver Plan is $21 a month. Mine is $18 a month. We could pay monthly or annually. We chose to pay annually and we charged $468 on our credit card for a year of health insurance for both of us!

The Silver Plan offers discounts for emergency room services, medical and physical rehabilitation, laboratory diagnosis and tests, annual preventive health check-ups, intensive care, and operations. The discounts increase after 24 hours, 90 days, and 180 days of insurance coverage. The discounts range from 15% to 70% depending on how long one has had insurance coverage.

Next, we had to have blood tests and urine samples tested for health insurance coverage. Arlen sent us to the lobby where we waited for about 10 minutes while she set up the appointments.

                                                  Ron and one of our friends

                                              The reception desk in the lobby

Arlen returned and took us directly to the admittance booth, where we paid $25 each for all the laboratory tests. Then, she took us to the laboratory for our tests…no waiting! Top notch service! We went to the emergency room for general physicals: weight, height, blood pressure. While we were in the emergency room, Arlen toured us through the offices and operating rooms. They have a kidney dialysis room, where we heard soft music and the TV behind the closed-door. She said the kidney dialysis room is open 24 hours a day and is always busy. I don’t know why so many people in Nicaragua have kidney problems, but it is prevalent.

We met with the doctor for a few more questions and prodding and poking. Then, on to the cafeteria where we had lunch while we were waiting for the results of our lab tests. Thirty minutes later, after we had delicious cappuccinos and chicken burritos, we met Arlen in the lobby with our test results. The best news was that the test results indicated that we had no parasites. Ron had just completed a round of parasite pills because he had a bad bout with parasites the week before. I know the parasites were the result of him eating mangoes that dropped to the ground!

We were finished for the day! Our lab tests and physicals would be reviewed by the insurance director and we would be notified of our acceptance within a week. I have never encountered such personalized attention. Where in the states could one have a personal attendant, who tends to every health need? Not to mention immediate test results hand delivered the same day. Before we left, we asked Arlen how much each operation or procedure cost. She said, “Email me with the specific procedures and operations you may need and I’ll send you a list of the all-inclusive costs.” Can you believe that? No hidden costs? A list of all the costs of the procedures and operations? I’m amazed! Why can’t they do that in the states?

My expat friends from Granada went to Vivian Pellas hospital two weeks ago for their annual check-ups. While they were doing the stress test, they discovered that J had a serious heart blockage. They operated on him that evening and placed 2 stents in his heart. He did not have the hospital insurance, and he had to pay upfront for the operation. He charged $16,500 on his credit card for the total bill. His wife had the same operation seven years ago in the states. She only had 1 stent placed in her heart. Total cost for her? $50,000. What is wrong with the health care system in the states? I won’t rant here, but something is terribly wrong when the same operation costs 3 times as much in the states.

Vivian Pellas Hospital has a website, but when we checked for information, the website was outdated. I talked with Arlen about the website and she told me that someone had hacked into the website. They had to put up the old website until October when the new website will be completed. Here’s a link to the old website: Vivian Pellas

If you are an expat living in Nicaragua, or a potential expat, please feel free to contact me for more information about Vivian Pellas Hospital. Nicaragua is advancing daily in health care for expats. It is reassuring to know that excellent, affordable health care is available in Nicaragua.