Being ill abroad

One of my biggest worries about living outside the UK, where healthcare is free through the NHS (OK, you have already paid for it in a lifetime of taxes!), though sometimes slow, is getting seriously ill. Many prescription-only medicines in the UK are available "over the counter" with little or no control in both Brazil and Peru, and pharmacists can pretty much hand out whatever they like! Simple painkillers, like Paracetamol, which in the UK you can but a pack of 16 for around £0.25 cost about £0.20 for 2, so I tend to stock up on these whenever I visit the UK.
When I first started living in Brazil I purchased "Backpackers" travel insurance, mainly because you could take out an 18 month policy whereas most others were short-term, and it covered emergency medical treatment, and even repatriation for serious injuries. I renewed a couple of times, but this was actually against the policy terms, and knowing that they would check were I to make a big claim, and refuse if I contravened these terms I eventually let it lapse (I was supposed to only take it out in the UK as well before travel!). I also looked into an overseas healthcare plan - but for over-60's these were astronomical, and would have cost almost as much as my total annual income. The cheapest one I found, but still not realistically affordable, was linked only to hospitals in the Sao Paulo area in Brazil, over 2000 miles from where I was living! So I decided to take my chances and return to the UK should I need to - bearing in mind that minor procedures would be a lot cheaper locally in Brazil or Peru than the cost of the airfare home!
I have been lucky - despite riding a motorbike out here, and having done some light walking in the Andes and in Brazil, I have remained injury free. That is, until this year! My annual trip between Brazil and Peru involves 3 flights each way, and carrying cabin luggage (laptop back-pack) and hand luggage between planes, often what seem to be ridiculously long and unnecessary distances, can be tiring, even with wheels on the holdall I use. Often by the time I reach my destination my arm and shoulder muscles are aching and take a few days to recover.
This year was no different, but exacerbated by the fact that the accommodation I had booked 5 months previously in Peru was not available, and the alternatives offered woefully inadequate. So after over 30 hours with no sleep I was on the street outside wondering what to do next! I knew of a restaurant nearby that had a couple of rooms, so started heading for there, now also lugging my heavy wheeled suitcase behind me, but then decided to call a previous landlord (who I also now consider a friend as I have known him for 6 years) to see if he had anything available. His wife answered as he was away (he works part-time as purser on a cruise liner!!) and she said they could probably help temporarily, so I should head there - and then I had to carry my bags up a further three flights of stairs! There was an apartment close by that they were managing, and that would be available from the following day, if I would like to look at it - it was having some maintenance done. We left my bags and walked round, and I decided to take it, though it was only going to be available for 3 weeks - so we went back to collect my bags, down three flights, up the road and then up the 5 flights to the new apartment - they were going to continue working and clean the place while I got some much needed sleep!!
By this time my shoulder and arm were hurting a lot, but I still put this down to the muscle strain of luggage carrying - and over the next few days it eased a little, but I had to shop for groceries and carry them up, so was not giving the aching muscles time to recover fully. After 2 weeks my shoulder in particular was hurting all the time, and one morning I reached back to rub the area ... and discovered a lump, about half the size of a tennis ball, on my shoulder-blade! Other than knowing it shouldn't be there I had no idea what t could be, so immediately went to the local health centre, where I had to wait almost three hours to see a doctor!
She examined my shoulder and suggested it was a muscular strain, but that the joint was inflamed, so prescribed pain killers and anti-inflammatory drugs, and said to return in 5 days if it was no better. The pain subsided considerably, but the lump was no different, so after 5 days I returned, but saw a different doctor this time, who sent me for an x-ray and an ultrasound. In Peru many auxiliary services like these are provided by private organisations, not the main health centres or hospitals, so I had to go to 2 different places, and then return later in the day for the results - both of which were inconclusive. I took these back to the same doctor, and he sent me for a tomography scan (at one of the places I had been to the day before), and I took the results back to him. The report said I appeared to have a "soft mass" on my shoulder-blade, and he said that the health centre could not really do any more as he felt I needed a biopsy so he referred me to a general surgeon at a local hospital.
This surgeon said he thought it was probably a cancerous tumour, but that the shoulder was a secondary location, so I needed a full tomography (chest, abdomen and pelvis) and referred me to an oncologist (with the results) at a private clinic! It was starting to get expensive with all these tests and consultation fees, and the oncologist suggested (since I didn't have insurance) that should cancer and chemotherapy be required that I should consider returning to the UK for the treatment there. I explained that it would cost me around £600 for the airfare alone so unless treatment was going to be more expensive, my best option would be to remain in Peru. The oncologist then referred me to a Traumatologist, as the scans were still "inconclusive" and she felt the "mass" was hard and possibly bony!
The Traumatologist also though the lump was bone, or possibly cartilage, and that a biopsy was needed (Hmm, where had I heard that before? Oh, yes, at the health centre before the second round of expensive tests and consults), so referred me to an endocrinologist and requested a load of blood tests first. I took them to her and my blood sugars were too high to risk the biopsy so was put on a course of pills to try and bring that down, and then, of course, more blood tests! They were still too high, so now am on more pills to bring it down (as well as my cholesterol!) and have two weeks before the next tests!
So far it has cost me more than the price of a ticket back to the UK, and I am still no closer to knowing what the problem is, and still have a large, occasionally painful, lump on my shoulder-blade - the lump isn't painful, but local muscles are. It is looking increasingly unlikely that it is cancerous, or malignant, but still needs dealing with - for me the sooner the better!