Chapter 6: just another hospital room;
So after almost two days, I was finally wheeled (on the gurney) to my room (which I will spend the next 8 days) It was in the wee hours of the night. This hospital (CSS) was very different in room layout than the one in La Chorrera. Each room had 3 beds which was located between the hallway facing outside (no other rooms on that side) and the outside on the room side. What was interesting was that each room had a large balcony on which you could go and view areas of Panama City. Not much of a view though, I was on the 5th floor, but you didn't feel locked into the room. My bed was situated on the side next to the hallway.
Again just like the other hospitals, the early morning daily routine started, so it was hard to sleep as there were many people moving about in the halls. At around the 9 o'clock hour a group of Doctors came into my room to go over the information routine with me. They had my chart and the head Doctor was an internal medicine doctor. He didn't speak English, but their was a young female doctor who was able to translate what I needed to know. I understood most but a little help was good. I was told that they were going to keep giving me the coumidin (warfarin) and do clotting tests every day to see what dose was going to be needed for me. The clotting tests determine at what point the blood will clot. They need to be exact with this because too fast or too slow a rate that the blood clots is not good. I was actually very happy that they told me this, because through my research I found out that this is the proper procedure. Well I was starting to feel that the procedures they were following gave me confidence in them.
Every day or sometimes twice a day they came to draw blood. My arms were really feeling sore as they had been poked so many time. The usual spot for drawing blood was the inside of the elbow area. Here is a picture of my right arm when blood is drawn incorrectly. The phlebotomist in the ER area caused this as he was moving the needle way too much trying to find a vein.
This bruise lasted for almost two weeks. From that point of they didn't dare take blood from this arm. Many other nurses came to get blood and 90% of them couldn't do it. Finally a young nurse named Magda who was very experienced came and felt that a smaller needle was needed. From that time forward I requested her as even when she couldn't locate a vein in the arm, she drew blood from the outside of the wrist. She was able to locate a vein, but damn did it hurt a lot more in that area. So I started calling her my blood champion!
The next 8 days was very boring as I was just waiting for the tests on the blood clotting to be completed. I watched a bunch of movies on my tablet, slept a lot and played on my cell phone. I did meet a man who worked at a gold mine in the Penemone area, which is about 80-90 kilometres from Panama City. He was originally from England, but said many of his family live in Canada. He said he has been in Panama for many years working in the Gold industry. He even showed me some gold dust, maybe 1 gram or so. Anyway we had many conversations throughout the week. He suffered some major heart problems and was waiting to get a triple bi pass. Funny thing is he had not heart monitor on and said he needed to wait at least six weeks for this procedure to be done. I'm not sure if that is good or bad based on his condition.
Every day Ruth made the trek from Panama City to visit and bring me food, through the heavy traffic of the city. One day she had to wait in traffic because of a protest going on (this seems to be common thing when groups want to be heard, they block traffic and inconvenience everyone) I don't know how effective this is but it happens in all parts of Panama. Its a real pain for people who just want to get to work or go home and are not involved at all in these groups of peoples concerns. It seems that quite often, sometimes daily there are road blockages caused by protesters who don't like what the government has proposed or should be proposing. Its all just part of living in a very bureaucratic country like Panama. As I have mentioned before, my wife is my gift from God. I kept telling here that she didn't need to come every day, but she felt that she needed to. I still wonder how many wives would do what she has done for me.
So on day 8 the Doctor said that all was good and that I could go home that day. I was overjoyed as I was finally getting some good medical advice. He explained where all the levels were and prescribed me the amount of blood thinners that I would need to take over the next 6 months. He also made me an appointment to come back in a week for follow up blood tests and an appointment with the clinic (the blood thinner clinic, not sure if that is the correct terminology) Ruth waited to come until the afternoon when I would be discharged (They told me about 3:00, but that turned into about 6;30) We got the papers and off we went for the ride home in the heavy traffic of the afternoon commute. I had to recline the seat down as I was feeling quit oozy. I however was quite happy to be going home, and hopefully not visiting a hospital for a long time, to stay anyway.
So for the next week anyway, I took it easy trying to get up and walk around a bit to gain my strength. It was a time that Ruth and I had a lot of time to reflect on what has happened since I first got sick. We read the bible a lot and reflected on our relationship and marriage, which at times has been a bit on the rocks, but we both realized that we always need to communicate and respect each other and we can get through anything. This is I believe why this all happened to us/me. God needed me to learn some valuable lessons which I probably would not have otherwise. I have become more patient with things (I don't scream at my computer as much anymore, haha) and now believe that my life is all under control by God. Some of you may think I am blind to think this way, but through my experience, I have grown and learned things. As the title of this entire mini novel is titled
“How a Mosquito changed my life forever! God does move in mysterious ways!”
I have learned how the power of prayer and faith has worked in my life and my wife's. The title was not an easy thing to come up with, but I believe it is very appropriate. For many of us, a tragedy or bad experience is needed for us to “wake up and smell the roses” , it did for me anyway!
The next week Ruth called to confirm our appointment, which the woman at the clinic did. We went to the CSS hospital in Panama for the blood tests and then to see the doctor. As Ruth went to register me, I waited in line to get the ticket that I needed. All these procedures need tickets and you have many pieces af paper to submit (the smooth flowing system, NOT). As I was waiting, I felt very nauseous and kept waiting for Ruth to return. I didn't think I could make it to the counter (there was about 6 people ahead of me). Finally when there was only 1 person ahead of me Ruth returned much to my delight. I gave her the slips and went to sit down. Ruth received the slip and went to another line to wait for me to be called in the blood clinic. When they called my name I got up from the seat and went in and waited maybe 5 minutes for the first available technician. When Ruth gave her the slip she informed us that we were supposed to come in the next day and should. We were there and there was no way that we were going to return on the next day and go through this procedure. So the technician got the approval to draw the blood that day. She was going to us a normal sized needle and I told her that a small one would be needed (only after she had tried using a regular needle), so she went off and came back wit a small needle and all went smoothly. We went up to the clinic where the results would be discussed with the doctor. We were told that it would be at least 2 hours to see him as the results needed to be brought up. OK no problem, but that 2 hours eventually turned into 5. When we finally went in the the doctors room, he said that he didn't have the results, but that was a load of crap, because Ruth was told that the results were done and have been sent to the clinic. The Doctor there didn't want to discuss with us because he too said our appointment was for the next day. We were already there and couldn't understand why he couldn't take 5 minutes to discuss the results. He said that we needed to come back the next day. This was not acceptable at all..
The next day Ruth called and went to get the results. He took like 2 minutes to tell her that the dosage of warfarin was good and to come back in a month for the same crap. She received a prescription and came home. The doctor could have advised us the day before of all this, but bureaucracy stopped this from happening. I don't think that he realized or cared where we were coming from and the difficulty in doing so. I even said something about the outdated procedures and how streamlining things could alleviate some of the backlogs. His response was “this is Latin America”. I don't think it matters what country you are in, if new more efficient procedures can help the system shouldn't they be looked at. I was told that this is how it has always been done, and probably always will be. I not not a Panamanian citizen, only a resident, but I feel for the people here that I guess have accepted that is is the way it is. Even a few Doctors have told me the system will never change. Immigration is the same convoluted process.
So after 6 chapters and app 8 weeks since this all began, my story will end. Even though I am still on the process of recovery and gaining strength (I still have an issue with my leg, PTS, post thrombosis syndrome) all is progressing well.
My writing of this was to do a few things 1: to inform people of the episodes that I went through 2: to give a little insight into the healthcare system that I encountered in Panama, and 3: to tell about my spiritual revival and understanding of the powers of God and how he can affect our lives if we allow him to.
Here is something to think about. It may be simplistic, but to many it will be clear.
My final part of all this will be to explain a little about the different healthcare systems here.
So that is my view and experience of panama's healthcare from someone who went through some things. Its not perfect but did help me. I hope in the future things can get better for Panamanians, although its hard to access when this is what you only know.
I hope you have enjoyed reading my story and for all those on Steemit, I hope you will follow me and up vote my stories.
Cheers and God bless
Panama’s health care system is characterized by a large public sector, composed of the Ministry of Health (Ministerio de Salud, MINSA) and the Social Security Fund (Caja de Seguro Social, CSS), as well as a small but expanding private sector. Each operates separate coverage schemes and facilities.
The CSS coverage is the largest, operating both as a health care provider and a pension fund (like the Social security in the US or CPP in Canada) administrator. The CSS’s health coverage is financed by contributions from employees, who pay a percentage of their wages to the system, entitling them and their dependent family members to coverage. Employers are also required to pay the fund a monthly percentage, contributing to the employee’s pension plan. Prescriptions are also sometimes covered at no cost.
Foreigners working in Panama are entitled to coverage under CSS, provided they pay taxes. Tourists were previously entitled to free medical insurance for 30 days for accidents and unforeseeable illnesses, up to a maximum of $7000. However, to curb rising costs, this was eliminated in June 2014.
Panama's unemployment rate is quit low – 4.8% in 2014 according to the National Institute of Statistics and Census – the reach of CSS within the country is extensive. In 2013 an estimated 3.47m people (of a population of roughly 3.9m) were covered by the CSS; of that total 1.6m were contributors, while the remaining 1.8m were dependents.
While MINSA services are not completely free, they remain the least expensive option available to low-income groups. MINSA has the most extensive network of health facilities across the country. In 2014 MINSA operated 830 health facilities, significantly more than CSS’s 80 facilities.
In addition to being an important service provider, MINSA is also the entity in charge of overseeing the national health system and as such, formulates policy and acts as the regulatory entity.
The private sector comprises four large hospitals – Hospital Nacional (HN), Centro Medico Paitilla, Hospital Punta Pacífica (HPP), and Clínica Hospital San Fernando (CHSF) – and a limited number of smaller health establishments, which provide services to the upper echelons of society, including a growing percentage of the population with health insurance, in exchange for direct payment.
National Heath Care – “Salud” – you see these white, yellow and green buildings in almost every Panamanian community. It is a basically “free” or “low cost” – 50 cents to see a doctor, $1 to see a specialist – system designed mainly to treat the enormous and poor Indigenous population and those without Social Security health care. It is underfunded, understaffed, and plagued by inefficiency and bureaucracy.
Social Security – Everyone who works in Panama must by law pay into the Panamanian Social Security system. Basically the employer pays half and the employee pays half. For our Indian worker I think we pay about $4 a week. Long lines, understaffed, and plagued by inefficiency and bureaucracy. Often doctors prescribe drugs that are supposed to be “free” but the Social Security system doesn’t have them, so users must buy them at pharmacies. Pharmacies sell drugs here by the pill. So if your doctor prescribes something, you buy only as many as you can afford, when you can afford them!
Private System – Is the system used by many middle and upper class Panamanians, by expats, and by the increasing number of people who are coming to Panama to have procedures done, a growing industry called “medical tourism.”
THE END