Pesos, Kilometers, Milligrams, Liters.. ARGH!

When we were first making our decision to leave on an adventure, Dan suggested Panama because it would be a “soft landing”. The money was the same, the electrical current was the same and for the most part they used the imperial system of measurement. Indeed, at the butcher you could ask for your meat in kilos or pounds, and they were just moving away from gallons into liters. And using US currency was a huge piece that didn’t require adjustment when everything else did. That was excellent.

When we first arrived in Mexico it took quite awhile to get used to pesos. To this day it still doesn’t spend the same. The value of items is different when you aren’t dealing with your home currency. I’m sure it’ll get better with time but for now when I see something for 98 pesos, I still equate that to about 98 cents but in fact it’s about $5.40. Oops. So sometimes it’s easy to spend more than you realize. If it weren’t for our “you get one suitcase” policy, we’d probably acquire a lot more things simply because we don’t realize how much they cost. Well, Dan says he knows, so maybe it’s just me, and it’s definitely the kids. We call pesos “rainbow money”. It just feels fake!

In addition to adjusting to pesos, you have to get used to metric here (pretty much everywhere!). Distances are in kilometers, weights are in kilograms and there isn’t an ounce or pint or quart or foot to be seen. It’s a double whammy when you have to translate the money AND the quantity.

And then there’s the medicine. Oh, good times with high stakes. Here’s a recent example for you…

Zoe seems to have a weak stomach and picks up various bugs from places we’ve been. We’ve been to emergency rooms for her aching stomach once in Panama and now twice in Mexico. Zoe seems to complain communicate a lot about her stomach, especially when she is reminded to eat her vegetables or when she is anticipating doing something different or out of the usual schedule. So we don’t pay a lot of attention. But after 5 days of complaining, we decided something might be going on. Sunday afternoon I got out the children’s Tylenol and started trying to figure out the dosage. We bought it in Mexico so the box was in Spanish, of course. It said  “give 10-15 milligrams for every kilogram of the child.” Again, double calculations are SO hard and now it’s a range, to boot! First we have to figure Zoe’s weight in kilos (the easy part), then figure out how many milligrams she should have. Should be pretty straight forward, right? But then we notice the cup that came with the medicine is in milliLITERS. What!? We worked on it for awhile with the help of Siri (iPhone lady) and finally we gave up and gave Zoe the amount we used to give her in the USA, assuming the potency was the same. She felt better after a bit. Yay! We didn’t OD the child on Tylenol! Es bueno!

Then by 8:30 pm she was really hurting and actually crying so I decided we better go in to see the doc or it would be a long night for everyone. So off we went to the emergency room. I knew what to expect from the last time we went to this hospital. Unfortunately this time they did not have a pediatrician on duty. The ER doc said their policy states that he can’t treat kids under the age of 14 so he called the on-call pediatrician and said it would take him 60-90 minutes to get to the hospital. Geez, good thing it’s not an emergency! So we wait and, as it always happens, the minute Zoe hit the bed of the hospital she started to perk up. By the time the pediatrician arrived she was feeling quite peppy indeed. That’s a good thing but I’m feeling like a Gringa Helicopter Parent. I wanted to say “She’s sick! Really! I think so anyway! Well, no, I’m not so sure. Maybe she just didn’t like her dinner…?”. Ugh!!!!

The doc looked at a few things on Zoe and felt a few things and with nary a single test  – no blood pressure, no body temperature, no heart rate, no blood, no stool, no urine, no MRI or CAT scan or X-ray, he declared she had some kind of bowel or stomach infection. OK! I guess he’s the Stomach Whisperer. So he writes out the prescription and off we go. By now it’s 11 pm. Thankfully the pharmacy near our house was open 24 hours, but that’s not to say they let you go INSIDE during those 24 hours. We had to stand in the parking lot outside a small window in the door and do our entire transaction while standing outside. Meanwhile the inside of the pharmacy was lit up like a surgical center, just taunting us to come inside, but no. We were relegated to the parking lot for the 10 minutes our transaction took.

In addition, pharmacies are a little different here. You don’t have to have a prescription to get medicine (narcotics and some antibiotics, the exception). You just show them the note from the doc listing what meds you need and they give it to you. But that’s only to get the actual name of the medicine. They don’t care where the slip came from. They don’t even keep the slip! I have refilled the same prescription 3 times. They don’t even know, or care, who it’s for. Just… “what do you want to buy?” Pay. Done.

But they also do not measure it out for you. Last night I bought 1/3 of what I needed for Zoe for the length of her treatment (cost: $11.65). The last time she needed meds they sold me the box that was 4 times what I needed. So you just never know. Frankly I think the pharmacist doesn’t care, or they don’t price these things in smaller quantities so you don’t get to buy them in those quantities.

It’s also funny how much they make you do the work. Zoe can’t swallow pills yet so we had to get an antibiotic in liquid form. We had this in Panama too and I totally messed up the first time I tried to add the right amount of water to the powder substance. So this time I kind of knew what I was doing, but the pharmacist had given me a generic so I wasn’t sure if the dosage was the same as the medicine the doctor told me to get. Again, it’s done differently here. The doc lists the dosage and the treatment time and the pharmacist just gives you the meds. No further instructions, no pretty little label with expiration dates and names and descriptions. Just the meds straight from the container. I’ve started writing on bottles with sharpie to remind myself what it’s for.

The pharmacist said I’d need 3.5 bottles of this medicine to complete her treatment. I decided to not buy them all at once. But then when I got home I was unclear. Do I still give her 14 ML of the generic liquid like the doctor said to do for the brand name stuff? If so, why is there only a dropper that holds 5 ML? Do I give her 3 times the 5ML? But what if I didn’t add enough water and now I’m giving her stuff that’s way too strong? I honestly didn’t know what to do so I gave her about 5ML and sent her to bed. I worried that I had given too much, both in quantity and potency. But she slept well and seemed to make it through the night OK. Again, we didn’t kill the child with meds. Es bueno.

This morning I decided to go to a different pharmacy and try to figure this out and see if I was doing it right. I took all the meds and the prescription and off I went to ask all my questions. The pharmacist and I worked on it for awhile, probably slowed down due to my Spanish. We determined that the liquid antibiotic should have been more liquid-y and less frozen (it says to put it in the fridge but I guess my fridge is pretty cold). And it turns out I should have given her 14ML, not 5. OK, so perhaps we won’t see improvement quite yet since the first dose was too small. But this was also bad news because the taste of the medicine made Zoe gag and now she has to take 3 times the amount that made her gag! Daily! For 10 days! Four words, Zoe: Learn.To.Swallow.Pills.

So I then asked about the other medicine, the brand name stuff. It was about 4 times more expensive ($41.40 a bottle) but I tried to figure out if I’d have to buy 3.5 bottles of it as well. I never really figured that out but I think the answer is yes. But the pharmacist said it tasted better. I didn’t commit but said we’d see what Zoe wanted to do after we were out of the first bottle. I decided at that moment to bribe Zoe into learning how to swallow pills. She needed to get a move on with that growing-up thing. Mommy can’t do all this math in Spanish.

So then I took this opportunity to ask the pharmacist about the Tylenol dosage. The pharmacist read the label and said I should have give her 5 milliliters. What? I had given her 15 milliliters. This medicine is for 2-12 year olds so if that small amount is for an almost-10 year old, what kind of microscopic amount do you give to a 2 year old??? Who knows. But it didn’t seem right to me. I left the pharmacy with the understanding that I gave Zoe 30% of what she needed of the antibiotic but 300% of what she needed for pain. At least percentages are not in metric. And at least she’s not on the floor convulsing. Not convulsing es bueno.

So I come home and decide to consult another expert: Google. Turns out Tylenol.com has a nice little handy dandy chart that gives dosages in both milliliters and teaspoons, by age and weight in pounds. Bueno! And I was almost right. I was supposed to give Zoe 12.5 ML. So neither I nor the pharmacist really got this formula right. But now I know. And I also know to use Google not the pharmacy.

I also think it’s funny that the medicine manufacturers want you to do so much of your own work on the meds. This “add water to powder” stuff for liquid meds is really a major pain and there’s so much room for error, I just don’t get it. This is the result of a non-litigious society, not caring if you mess it up cause it’s all on you, not them. And selling me way more meds than I need? Really? But that’s the way it is here.

So this is just part of the adjustment that it takes to live in a foreign country. Most people realize that they’ll have to adapt to a different language and culture, but you don’t realize that you have to adapt to not knowing what you pay for gas or how much medicine you give your kid. At least I know how to get her to the hospital if I mess it up. I just hope the pediatrician is on duty.