Living abroad with a chronic illness: the part nobody talks about
No one tells you that living abroad also means choosing where your body gets taken care of.
We talk about freedom, flexibility and building a life on your own terms. What we don’t talk about is what happens if you have a body that doesn’t fully cooperate with those plans.
I came back to Italy for Christmas. A normal break, longer than usual but for good reasons only. And yet, in between family time and slow days, I found myself booking my annual medical check-up right before flying home. Luckily, my doctor had an opening during my stay!
That small decision says more about expat life than most Instagram captions ever will.
I live in Greece. My life is there now. However, when it comes to my health, I still organize some things around trips back to Italy. Not because I want to, but because access to specific kinds of health care is a privilege, not a given, and something you need to actively seek.
This is a part of living abroad we rarely talk about, but it doesn’t mean it’s less important – especially if you live with a chronic condition.
For me, that condition is endometriosis.
Putting a name to the pain
For a long time, I didn’t have the words for what was happening to my body. Only pain.
It began when I was still a teenager, particularly during my last years of high school. Sharp pains that sent me to the ER more than once, often mistaken for appendicitis. They never found anything (what a surprise). Years later, I would understand that those episodes happened during ovulation.
My periods were just as bad. I would wake up in the middle of the night in pain, faint in the bathroom, and spend entire days in bed, crying and cycling through painkillers just to get through it. And yet, no medical professional seemed particularly concerned.
Doctors didn’t take me seriously. One gynecologist told me I was a hypochondriac and that I should stop self-diagnosing online. I had Googled my symptoms and stumbled upon the word endometriosis. I didn’t even know what it was, I just asked her if it could be a possibility. She dismissed it immediately.
Years later, while I was living in New York, a severe stomach bug led to an ultrasound. That’s when they noticed a cyst that could be endometriotic and suggested I look into it further. It wasn’t a diagnosis – just a hint. But it was enough for me.
Back in Italy, I searched for the most experienced specialist I could find and traveled to a different region, to a center of excellence dedicated to endometriosis. The visit didn’t take long. Within minutes, the doctor told me there was a 99% chance that this was endometriosis.
It was such a relief! It had been at least six years since I first suspected it, and since I had been told I was imagining things.
Fast-forward to 2012, I had surgery in that same specialized center, which confirmed the diagnosis: stage III endometriosis. After that, I went back every six months for follow-ups and started continuous progestin therapy. Over time, the visits became annual. Eventually, I looked for a specialist closer to home – someone I wouldn’t have to drive three or four hours to see every time.
That’s one of the hardest things about endometriosis: it’s not enough to find a good gynecologist. You need someone who is specifically trained to recognize and manage it. Otherwise, it often goes unseen (again).
And bear in mind: we are talking about a chronic condition that you have to constantly monitor. This isn’t something that you manage once and then forget about.
When travel and healthcare don’t speak the same language
When you travel with a chronic illness, you always have to factor it into your plans. And quietly hope that nothing serious happens while you’re away – because, as it turns out, most standard travel insurance policies don’t cover chronic conditions at all.
It’s something you learn early on, especially if you move often.
You plan medications in advance (I always left with dozens of progestin pill blister packs to cover my entire stay). You carry medical documents “just in case”. You plan your follow-ups around trips back home. Freedom, yes – but always with a mental checklist running in the background.
Living abroad long-term adds another layer.
At first, it still feels manageable. You schedule appointments around home visits. You have your medication shipped from your family or find an equivalent where you now live. You make it work. But when temporary turns into permanent (when you register your residence, change your healthcare system and officially become an expat) the cracks start to show.
Not all healthcare systems are equal. And more importantly, not all of them are equipped to deal with highly specialized conditions. Endometriosis is one of those. As I mentioned already, it doesn’t just require a “good doctor”, but someone who is specifically trained to recognize and manage it. Someone who knows what to look for. Someone who takes it seriously. Without that expertise, there’s a high risk for the condition to become invisible again.
When I settled in Rhodes, I realized that finding this kind of specialist locally wasn’t an option. The system works for many things, but not for this. And suddenly, the question became where can I realistically take care of my health?
That’s when living abroad with a chronic illness becomes less about adventure and more about questioning and negotiation.
Changing residency changes the rules
As an Italian, when you officially move your residence abroad you have to communicate it to AIRE (the Registry of Italians Residing Abroad).
On paper, it’s simply a bureaucratic step. In real life, it reshapes your relationship with Italy – healthcare included. In my case, for example, it meant losing access (FREE access!) to the public clinic where my gynecologist in Ravenna works – the same doctor who has been following me for years and knows my medical history inside out.
I didn’t lose the doctor. I lost the system around her.
Thankfully, she also practices privately. So I can still see her – just not in the same way. And not without a cost. It’s a privilege I’m aware of, and one not everyone can afford. But, given everything we’ve talked about until here, it’s also the only realistic option I have right now.
This is one of the less visible consequences of expat life: you don’t just change countries, you change how (and at what price) you access care. Continuity – which is crucial in chronic conditions – becomes fragile. Familiar paths disappear. And even when you do everything “right”, you often end up patching together solutions across borders. Because of course I have a doctor in Rhodes too – but one that I go to only for minor issues, and that unfortunately I don’t trust much when it comes to endometriosis.
From the outside, it might look like a detail. From the inside, it’s part of a much bigger question: how sustainable is a life abroad when healthcare becomes something you constantly have to work around?
Basically, we’re healthy enough to live abroad but not enough to navigate it easily in every aspect.
The mental load nobody sees
Living with a chronic illness is already exhausting, but living with one abroad adds a layer nobody mentions: the constant mental load.
Planning trips around medication and appointments and moves that have to account for access to specialists. That tiny, persistent fear in the back of your mind that says: what if something happens while I’m far from home? And then comes the invisible guilt: feeling like you’re a burden, or that you need to “push through” so no one else has to worry. Cherry on top? When your chronic condition involves the reproductive system (like mine) and therefore it doesn’t affect only you.
It’s a type of fatigue you can’t see in a photo, can’t post a story about, and can’t measure on a calendar. Yet it quietly dictates decisions, big and small: where to live, when to travel, what commitments to take on.
For many expats with chronic conditions, this invisible labor is just as demanding as the physical symptoms themselves… and it rarely gets acknowledged.
What living abroad has really taught me
Living abroad, first as a digital nomad and now as an expat, has taught me many things. How to adapt. How to start over. How to feel at home in more than one place.
It has also taught me that freedom isn’t the absence of limits: it’s learning how to live well within them.
When you live with a chronic condition, you don’t get to separate life choices from health choices. They’re intertwined. Every move, every plan, every long-term decision comes with an extra layer of consideration.
This doesn’t make expat life impossible. But it does make it more honest.
And maybe that’s the conversation we need to have more often: not just about where we want to live, but about what we need to live well – even when that complicates the story.
Have you ever navigated life abroad with a medical condition? I’d love to read your story in the comments – and remember: you’re not alone.
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