May 29, 2019July 6, 2020 Amy

Potty Mouth

Honduras, Travel Central America

Here in Tegucigalpa, we have been battling digestive issues for the past few weeks. Such is the is the unglamorous side of living as a diplomats’ wife in a developing country. The tropical climate means different diseases and ailments are lurking in the water, food and even the air we breathe. We must also navigate the disorganized health care system. Warning: Some may find this post a little gross. Those with weak stomachs are advised to abstain from reading any further.

Roaring Lions

It was as if two ferocious lions were competing for loudest roar in my stomach every morning. I would wake up at 3 am with excruciating cramps and then have to run to the toilet for some very explosive and liquid diarrhea. My husband also complained of acute stomach ache, feeling of nausea, loss of appetite and fatigue for days at a time. Then I noticed that we were throwing away leftover food. I had lost all my appetite. My stomach coiled at the thought of eating anything- even junk food! My husband had such frequent flatulence that our two-year-old daughter would wave her hand daintily in front of her nose – each time papa let one rip! Our oldest – who looks up to his father- exclaimed one day after school: “

-Papa, I did a pedo (fart) in class!

-No! What did the Miss say?” I exclaimed.

-“Smelly Tristan.” But I did a big pedo in class, just like papa!” he answered proudly.

It’s become a running gag with the children: “P.U. Papa!” they exclaim and we all move away from the strong odor. My husband tried to self-diagnose going online and asking “Dr.Google” for advice. He quickly fell into the Rabbit Hole of watching self-help videos on YouTube. It was 11pm and I could hear a young guy detailing how to self-diagnose a case of stomach worms. He then suggested various home remedies such as stomach cleansing, eating raw cloves with pineapple, and drinking lots of flax seed. I shudder and tell my husband to turn it off. Worms in my stomach, you’re overreacting, I think to myself.

Off to the hospital

After several weeks of persistent symptoms – we capitulate and decide to consult a doctor. They don’t have family physicians here in Honduras so we ask colleagues for their references. We get an appointment at the private hospital Honduras Medical Center (H.M.C), with a gastro specialist for 4pm the next day. After leaving the kids at home with the nanny; I pick up my husband after work (not my first choice or romantic date) and we drive in the pouring rain and heavy traffic to the big busy six floor hospital. The indoor parking garage is a maze of small dark spaces and it’s difficult to secure a spot. We arrive to our appointment on over 30 minutes late. However, the doctor has yet to show up for that evening appointments! (In the past, I’ve waited over two hours just to see the doctor – even for a scheduled appointment.)

After an hour of watching the lone fish in the huge empty fish tank and while waiting on hard plastic chairs in the sparsely decorated and deserted lobby, the secretary calls out my name and instructs us to room 5564 down the hall. We walk down a narrow corridor and stop in front of a closed door with the correct number beside it on the wall. We hear talking coming from inside the office, but we are not sure what to do. Should we knock, walk in, or wait to be called? Eventually we hear “Pase, pase” and enter the windowless space.

The middle-aged female doctor starts off with “Hola!” and then asks some routine questions in Spanish: age, past health record, number of children etc. She takes notes on a small laptop propped on a desk strewn with boxes of pills and samples. She seems nice enough and takes our series of complaints seriously. I get a little embarrassed describing the explosive liquid diarrhea which I’ve been producing but she does not flinch. This is her specialty after all. I remember watching a video “Let’s talk about poo” warning about the threat of bowel cancer. I swallow my pride and trudge on with the interview. As the doctor listens to our list of ailments, she hones in on my complaint of acid reflux and disregards our suggestion of worms or parasites we might have ingested from eating contaminated food. But she suggests an endoscopy, I shudder: “Yikes! What did I do wrong to deserve a camera up my bum?”

Next, I undress and change into a hospital gown. After climbing onto the plastic covered examining table, she places another cloth over my abdomen and begins to palpate my stomach. We both observe that it very swollen and painful to touch. “There is something wrong here, she says in Spanish, I am going to order some tests.”

The doctor quickly writes down several prescriptions and hands over a free sample of probiotics. She insists that these are way more concentrated that the ones you find in yogurt. The physician also gives me something to ease the discomfort, to be taken 3 times a day for 7 days (Alevian duo, which Google says is for Irritable Bowel Syndrome, or IBS.) These instructions are scribbled down in the doctors handwriting on the medical prescription pad. I take mental notes because here the pharmacy will sell you just about anything – without a prescription- and you are left to your own devices to verify posology and contraindications with other medications. There are many pharmacies around town. Each one offers a variety of promotions such as two for one specials’, drive through windows, online purchases, home delivery, etc. But not once have I been attended to by a real pharmacist!

Soon, we are sent downstairs to the hospital laboratory for blood test and a feces sample. It’s now past dinner time and dark outside, the rain is pouring down heavily. But first we have to wait our turn in line to see the clerk who takes our information and laboratory requests. We hand in one form and are given two more in exchange. Then we are instructed to walk down the hall to a different teller in order to pay for the tests and receive three more carbon copies of the bill. Kafkaesque. Eventually, we are each handed an empty container to fill with our feces sample. The problem is, I’m hungry and exhausted, I don’t feel very shitty right now…

Stool Sample

We return home, put the kids to bed and try very hard to resist any more self-diagnosis or Google searches. Although I joke that my husband is “full of shit”; I’m not hungry and don’t need to go to the bathroom. The hospital and laboratory are open all night but we must bring in the fresh sample within two hours of collection. I manage to hold off the lions growling in my stomach until 5 am and my husband produces his own poo sample shortly thereafter. As soon as it’s light outside and safe enough to drive, I return to the hospital with two vials of the brown stuff stashed in my purse beside me in the car. The laboratory clerk does not skip a beat as I gingerly place the smelly samples in his “Inbox.” They will send us the results by email this afternoon he assures me.

And so, the waiting game begins. After three phone calls to the clerk who can’t seem to correctly spell my email, I receive the test results a day later. But to me these are just a bunch of numbers and complicated scientific words in Spanish! The blood work seems clear and the feces sample shows “no trace.” Except for Blastocystis hominis which according to the Mayo Clinic: “is a microscopic organism that sometimes is found in the stools of people who have ingested contaminated food or water.” The listed symptoms match perfectly what we have. As per her request, I send the test results via Whats App to our specialist. Within minutes, the doctor replies that I should take Ameoba, one dose, after dinner. “These are sold over the counter” she texts me back in Spanish.

Only when I relate the whole misadventure to our neighbors who are native Honduran, do I make the connection: We have parasites! Ameobriz 2 is in effect a deworming pill. It was sold over the counter and given to me without further explanation. I cringe at the thought that these little larvae, sorry the official term is “protozoans” are fighting for a place in my stomach and causing such awful flatulence, diarrhea and cramping. Even though we are extremely careful, we must have contracted the bugs from contaminated food or water. Thankfully the pills worked and within a few days my husband and I were feeling much better.

Lessons learned:

-Be very careful, especially when eating out, that the food we eat is properly washed and the water is from a reliable source.

-Also, Google is my friend, until I find a well-trained pharmacist.

We are lucky that this only happed once during our two-year posting. Here, school children are given deworming medication every 6 months at school as a preventative measure.

-Get travel insurance.

A perk of being a diplomat’s wife, we have international health care insurance which covers the cost of the doctor consultation at a private hospital, the laboratory tests and the prescribed medication.  For comparison, this would otherwise have cost us nearly 300$. As a native Canadian, I am used to free health care.

Unfortunately, the public health care system here in Honduras is riddle with problems such as mismanagement and corruption. Patients are attended in rudimentary conditions and are asked to purchase their own gloves and sterilizing kits before an operation. The doctors are presently on strike in hopes that things will improve.

Last Laugh

Since she is in the process of potty training; our youngest is now wearing big girl underpants and we regularly remind her to pee and poo on the potty. But, not one to be left out, that same night during the bedtime bath routine, little Bea poos in the bath and hands me the turd saying proudly: “Poquito mama, poquito.”

My new to do list:

1. Clean the bath

2. De-worm the kids

3. Stay calm