When I moved from Canada to Saudi Arabia I never imagined that the quality of health services would be at a similar standard, let alone superior. Unfortunately, the lack of health care professionals combined with increasing government cuts to health care budgets in Canada has impacted access and delivery dramatically. In Saudi Arabia, on the other hand, it appears that both financing and trained health professionals are in abundance.
I have two chronic autoimmune diseases, diagnosed in my twenties. The first disease, Type I Diabetes Mellitus, is usually juvenile onset, but may occur at any age. It occurs when the body’s own immune system destroys the insulin-producing cells of the pancreas. The second, Hypothyroid disease, is a condition in which the thyroid gland is considered underactive. I had no known relatives with Diabetes, and although Hypothyroidism runs in my family, I wasn’t aware of it at the time.
Having a chronic illness like Type I Diabetes is manageable. There is no cure, nor is it easy to try and mimic what the pancreas does automatically, but insulin therapy is available. To manage it well requires diligence and hard work. The support of health care professionals, particularly a skilled and knowledgeable endocrinologist, can be very helpful.
I’d like to say I’ve had amazing support from the health care system as a Canadian, but that would be a lie. I happen to be one of the fortunate people who, when initially diagnosed, had health care coverage from both my husband’s employer and my own that rendered my insulin, test strips, and other diabetes supplies free. Other people aren’t so lucky.
When, for other health reasons, I had to stop working, I had to pay for all my prescriptions until I reached a deductible of $2500. I managed, using money I’d saved over the years. I’ve met other people less fortunate who don’t fare so well. They end up choosing not to test regularly because they don’t have coverage and with each test strip valuing at a dollar, testing frequently can soon become a financial burden.
The biggest challenge for me has been in receiving supportive care. When I moved to Victoria from Calgary, it was almost impossible to find a general practitioner, whom you need to see first to procure a referral to any specialist. There was only one doctor accepting new patients, and once I met her and had to endure her patronizing, unprofessional attitude, it became clear why she had vacancies. I had no other choice. She made the referral to an endocrinologist and it took over four months just to book an initial consultation.
At the time, I was having considerable difficulty achieving what has been determined to be a healthy range of blood sugar, or A1C. Upon reviewing my health journal, the endocrinologist in question made a few suggestions to alter my regimen and dosage of insulin shots. There was no discussion involving diet or exercise what-so-ever. None. Lucky for me I have the self motivation and initiative to research nutritional recommendations on my own, but the information available is highly diverse and often conflicting. I felt alone, confused and unsupported.
I have felt chastised for my lack of achieving blood sugars within goal instead of helped to improve them. Some doctors referred to me as noncompliant, which confused me more. After all, who is to benefit from good control and who is to suffer the complications if not me? I have battled on with my own unwavering determination, pretty much on my own.
In December of 2012 I started to suffer from a range of debilitating symptoms. I was teaching in a new position that was very stressful, which I’m certain contributed to the problem. I fainted during yoga and proceeded to have various vasovagal episodes. I had an infection in my knee that required intravenous antibiotics followed by an oral dosage, for a total of three weeks. I started to experience chronic fatigue and generalized weakness. Holding my arm above my head to write on the chalkboard became impossible and writing up report cards on my computer caused deep pain in my hands.
I made an appointment with my general practitioner, the one I described earlier. She intimated that it was all in my head, that I was a hypochondriac. When the blood tests revealed high levels of cortisol, she suggested I might be developing another autoimmune disease, perhaps lupus. And when she informed me the referral to a rheumatologist would take four months, she told me it was just as well because I would only be put on a regimen of extreme pain killers for the rest of my life anyway. She completely missed the result indicating I had a urinary tract infection and it was left untreated for over two weeks.
Within a few weeks, I had to go from teaching full time to part time and a few weeks after that I had to, somewhat stubbornly, resign. At this point, I decided I had to take matters into my own hands. Since there wasn’t an alternative western doctor in Victoria to choose from, I took it upon a recommendation to seek help from a doctor in Nanaimo who practices integrated, functional and alternative medicine at his clinic. It was tedious driving the two hours each way, once a week, for IV infusion treatments for high levels of mercury and lead in my bloodstream, but at least I was finally hopeful.
My challenges persisted. Eventually I was diagnosed with Lyme’s disease. Even that diagnosis was fraught with difficult to determine blood testing and medical doctrine in BC suggesting that chronic Lyme’s disease did not exist at best, and if it did, there was certainly no cure. It took determination and a miracle, but I ended up in the care of a doctor who practices Homeopathic and Naturopathic medicine. After two and a half years of intense and expensive treatment, not covered by health care, I am cured of Lyme’s disease. I’ve started taking my life back, living each day with greater vitality and overwhelming gratitude.
Which brings me back to my current feelings of being fortunate. Before arriving in Saudi Arabia, I was required to undergo a thorough, in-depth medical, including a battery of tests and forms. Upon arrival, I had to have another medical, in Riyadh, before being issued residency. My Mister introduced me to the Medical Clinic on our compound right away, and the level of service ever since I arrived has been nothing short of exemplary.
A few months back Mister and I were packing up to leave on holiday when I started having spasms in my leg. The clinic was closed and we were leaving in a few hours. I couldn’t imagine having to endure the long flights with the pain I was in. Mister called the emergency line and the nurse on call agreed to come by and have a look. He came to our home and examined me, then gave me a shot of magnesium to relax the muscle, along with several pain medications and a detailed prescription of how to follow a successful pain management regimen. It made our trip doable and I was beyond grateful.
Earlier that year I developed a severe pain in my tooth. It was a Friday, the religious day when the dentist and medical centre are both closed. But again, the nurse on call met us at the clinic and gave me some temporary pain medication. I called my dentist at Smile Dental and could get in immediately. Upon examining me it was clear I needed a root canal. I had to follow a week of antibiotic therapy for the infection, and right away I was scheduled for the procedure. My dentist, a pleasant and professional Saudi woman, did an amazing job and I was thrilled with the result.
Smile Design professionals
When I need to make an appointment to see one of the two doctors practicing at our clinic it usually takes a day or two to get in to see them. If I have an issue that requires a specialist, they make a referral, and the appointment is scheduled within a week or two. All my supplies are free, either given to me at our clinic, or purchased at a pharmacy in Riyadh and then reimbursed directly to Mister’s pay. I have seen a gynecologist from Greece, an ophthalmologist from Jordan, and I’m going to see an endocrinologist from the UK in a few weeks.
What really blew me away was the access to diagnostics. I’ve been having difficulty with pain in my neck and shoulder, including numbness in my right arm, for several months now. When I asked my doctor if I could be referred to a Chiropractor, she agreed, but suggested I get an MRI first to properly diagnose the situation. I was stunned. I called Kingdom hospital and was given an appointment for the next week. And so I had my first MRI and the results were emailed to me the next day. Meanwhile, back in Canada, people like my mom and mother-in-law are waiting four to six months to receive an MRI for chronic and painful conditions.
MRI @ Kingdom Hospital Radiology Department, Riyadh
I don’t know enough about the politics and regulations of each country to quote cold, hard, facts. I can only speak of my experiences, then and now. I guess what has impacted me most, besides the superior service, is the feeling of being treated with respect. The medical community here assumes I am doing my best and that I want to be as healthy as I can. They support me in achieving my health goals without being authoritarian. We work together, as a team, to review my observations and discuss possible treatment. The care I have received has been thorough and my concerns have never once been dismissed.
So yeah, I’m feeling fortunate for the health care I am receiving in Riyadh, Saudi Arabia.