I’ve been hospitalized in Puerto Princesa three times in
four years and am hoping not to see the inside of the ‘basic’ (choosing a euphemism
here rather than something slanderous) O.R. there again … although I have to
admit that it has improved dramatically in four years. However, they still practice some rudimentary
procedures and everything is no-frills – like the 5-foot tall industrial
canisters of oxygen that are wheeled into a room (by a large Filipino) for a
patient who needs oxygen, or the need to bring in your own eating utensils and
towel – and someone to help you during your time in the hospital. Note that this is the high class hospital –
Adventist – not the CoOp or the Provincial Hospital.
This is the only hospital qualified by the Peace Corps,
where I nearly died with blood clots in 2012 after a fall in Thailand (where I
also contracted dysentery thankfully - otherwise I would have been dead before
they would agree to admit me – as it was I asked them for 2 days to also check
my leg. After that operation, I passed a
clot and was evacuated to Manila for another 9 days in hospital before being
sent home). That time as I was rolled
into the O.R. I remembered that no one but the Peace Corps even knew I was being
operated on – some big tears ran down the side of my face while I lay flat on
my back feeling pretty darned alone and thinking of my daughters and loved ones
at home. And feeling worse when I looked
up at the peeling paint on the ceiling and the look of non-sterile operating
facilities – maybe it just looked dingy.
When I chose to return to Palawan on my own, I vowed not to
enter Adventist again. And oh – did I ever say that I was not welcomed back to
the Peace Corps; told not to come even to the send-off for my batch, and never
even received any sort of document or recognition that I’d ever served? Rather peeved at my lifelong dream of serving. Like a few of my dreams, that one didn’t quite
pan out. But, I digress. Along with some of my dreams, many of my
“never” statements have failed me….including never to check into Adventist
again.
As with the dysfunctional dysentery admission, October 12th
2013 (Ashley’s birthday) saw me writhing in pain from a gall bladder blocked
with boulders. I am usually quite
flippant and cheery at hospitals, but as the hours progressed, I morphed into
my version of Mr. Hyde – alternately pleading, threatening and moaning. Luckily, a new doctor had arrived recently – our
first laparoscopic surgeon – and was even on call at the hospital that
day. There is no way that I could ever
have made it to Manila and am very thankful that Dr Ronnie Dan Salazar
delivered me from evil that day.
Scroll forward 14 months to a December Skype call with my
‘sister’ Liz – telling her about a weird thing in my belly – no pain but a
bulge. She immediately diagnosed it as a
hernia (she had two boys and I had two girls – can I blame my ignorance on
that?)….and I of course immediately googled it and diagnosed it specifically as
an incisional hernia – caused by tearing of the abdominal wall from the gall
bladder incisions. I immediately (well,
after Christmas and the New Year), called my doctor - Dr. Posas, whose nurse
said – well, you are #52 today – can it wait until tomorrow? So, I made an appointment for 10am the
following day – got there and waited 2 hours – the explanation was, as people
kept cutting in line, that these people got their tests back and needed to find
out what to do next. Jeez. Finally got in and the doc didn’t say
anything about it being caused by the incision (as diagnosed by Dr. Pritchard),
but sent me upstairs to get a sonogram.
Walked upstairs to a closed, locked door. Finally found a nurse who laughed and said –
oh the doctor left for the day – he is at another clinic – can you drive
there? Sure. She told me the street name and said that Ultra
Med was just across from the Provincial hospital.
About 15 minutes and 2 wrong turns later (Puerto just put up
street signs on the major streets last year), I parked and got out to canvass
the area. I still hadn’t found the
place, which turned out to be about 2 minutes away from my doctor’s
office. I stopped first at a pharmacy,
who told me to ask the OB/gyn office across the street, but it wasn’t open, so
I walked up and down Malvar Street.
Finally, down a side street I thought I spied it. Not much of a sign, but a few older gentlemen
sitting around talking in the alley. One
was the radiologist.
We walked into a general purpose room where several people
were working on typewriters, or with vials, and I pulled down my pants and got
up on a table and waited for the cold goop to be squirted on my belly. He didn’t disappoint me – no warning, just
cold. He told me that there was ‘no
evidence’ of a gall bladder – I said that was a good thing and told him it had
been removed. He then told me I had a
fatty liver and asked me if I had diabetes.
No – we are looking for a hernia.
Nope – nothing there. I said,
“Look closer” and so he did – and found a “small, floating” protrusion. I was very confused – at times I thought he
was telling me something, but it turns out that he was calling out to one of
the typists across the room and was dictating the report to her as he examined
me. Luckily I am immune to privacy
issues anymore and it was just comical that people were walking in and out of
the office with me like a car with its hood raised on a mechanic’s rack. By the time I wiped off the goop, they had
handed me the typed report and the film.
No need for the lauded Asian Patience at Ultra Med (once you found it
that is).
Back to my doctor’s office (I now skipped to the head of the
list, having returned with my tests and wondering what my next step was), where
I quickly learned that the next step was surgery and an appointment at
Adventist to be examined by the surgeon.
I drove 5 minutes down the road to Adventist and my now favorite Palawan
surgeon, Doc Ronnie; lifted my blouse for him to look the bulge and he said –“oh
yeah – incisional hernia.” He took full
credit for it, saying that it happens, even with laparoscopic surgery – kind of
like keloids – which we tangentially discussed for a couple minutes, before
agreeing to check me in and do the surgery the following day.
Then I remembered that I wanted to support (emotionally) one
of the managers at PPS, by attending a morning meeting – so I asked the
admissions director if I could check in not later that night, but the
following. No problem - she took care of
all the paperwork and I paid the down payment of P2,000 ($40 US), went home and
had a couple of pieces of pizza for dinner.
The morning presentation was great and I got a call just before I was
leaving that was quite garbled – “….sorry no rooms available for your
dates.” I tried to remember where I had
reserved rooms since my vacation wasn’t planned until April – then realized it
was the Hospital! She promised that she
would call me back later….which she did, to say there still were no rooms and
to call her back at around 8pm. Wala pa.
(still nothing) I have become very
“bahala na” (meaning roughly, it’s up to god…or whoever is in charge of the
universe) for an American – certainly a far cry from the person who tried so
hard to be perfect for several decades - so, I enjoyed an evening with Happy
(my 4 month old dachshund puppy) and decided to check in on Friday evening
instead.
But, after several pleasant and calm chats with admissions
nothing came up for Friday either – I’d asked the admissions folks if they had
notified the doctor and they said they had, but….. I finally called the surgeon and he was
waiting for me to check in – well, I’d love to – but there are no rooms. We agreed to wait to do the surgery on Monday
morning, so I would check in on Sunday night.
Settled in for a nice sleep and easy weekend…. I was awakened at 11:15pm
– the hospital was calling to tell me that there was a room and to come
then. Told her it was set for Sunday
and I would see her then. After a nice
Saturday and Sunday, I called (you should always triple-sec I mean triple-check
in the Philippines ... Hilariously on Sunday afternoon, the same poor woman told
me that there were no rooms. I told her
to talk to Dr. Salazar (“which one – Doctora or Doctor?” – his oncologist wife
has joined him here on Palawan and they make quite the pair – a 21st
century team!). I responded “Doc Ronnie”…..and
I texted him as well. Within an hour she
called me back at 3pm very cheerily to inform me that a room was available and
to come check in at 4pm. I packed up Happy’s stuff and carted him to my friend Angie’s,
where I explained his care to her son Luke (although I knew Angie’s yaya would
probably do most of the caring).
On Sundays at Adventist you have to check in via the
Emergency Room. There was quite a bit of
howling when I arrived, although I never figured out what the girl’s problem
was; I also later found out a FB friend
and her husband were there…funny. So I
waited. With all the room mix-up, I
didn’t have current papers. Luckily, Doc
Ronnie arrived and got everything straightened out. We got me all fixed up with the plastic ID
band on the left wrist, and for $20US/night, I settled in to my suite –
complete with an extra cot for my kasama (a relative or friend who stays with
you in the room to take care of you).
AND an LCD television! One of the
best deals in Puerto if you can meet the rental qualifications. Around midnight they came in and hooked me up
to an IV (only 3 sticks to the vein…not too bruised). Being my independent, American self, I’d
packed a washcloth and towel and utensils, but hadn’t thought that a kasama was
necessary, so hadn’t asked anyone…actually hadn’t really told my friends that I
was even doing this.
Prior to the surgery, my surgeon said that Filipinos were
wimps after surgery, but Europeans and Americans were amazing, leaving just
hours after the surgery – sigh – of COURSE I took that as a challenge! Afterwards, he did say that the hernia was
larger than he thought, so I felt justified in staying one more night, but
competitively checked myself out the next day, and drove myself first to get
Happy from Angie and then drove myself home (but did call and ask my friend
Jane if she could open the gates for me – I was pretty owie by this point and
hopped up on painkillers and other things).
Thankfully Jane also got Happy and his crate into the house and kissed
me goodnight!
Scoring perhaps a 7 out of 10 for overall non-wimp performance,
but I thought at least an 8.5 for technique.
Yesterday made 2 weeks post op and Doc Ronnie agreed to take
out the drain that had been in me for 2 weeks, complete with 18 inches of
tubing (major eeew). Finally feeling
more human than plastic fantastic, although can’t lift much for another month.
For those of you curious on costs (I have no medical insurance): For the procedure, which took between 1-2
hours, the surgeon charged about $400 US for the operation and follow up visits;
my regular doctor who visited me twice charged about $50. The damned drain and tubing was $40 and the
medications about $10 (7 days of antibiotics, 2 types of painkillers and 30
days vitamins), with the room charge of $20/day. There were detailed charges for the IVs and
O.R. rental, but the total charge was $1,400 for everything. Pretty incredible.
Thankful once again to those who cared for me in
all the ways they do.
As long as this Humpty Dumpty can continue to be put back
together again, all is fine (although I’m hoping the 3rd time is the
charm!).
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