Chapter 4: Really! Something else!
As the last chapters events culminated, I start this chapter. I was saying that I had no strength and spent most of the day lying in bed (about 2 weeks). After being home for about 4 days I started having a pain in my right leg, a sort of cramping which was very strong in my calf and a bit in the back of my thigh. I was thinking it was Sciatica, as years ago in Canada I suffered 3 or 4 bouts with it and each time had to go see a friend who is a Chiropractor. I had not had any pain from it in over 6 years, so I felt that is what the problem is. It sure felt the same. My calf was swollen and a lot of pain. My wife massaged it and I thought it would get better, but to no avail. Every time I got up to walk, the pain was unbearable and I again felt like passing out. I could not even stand in the shower to clean. I had to sit on a chair (oh ya, In Panama it is not typical for most people to have a bathtub, only a stand up shower, us included). So again my stubbornness kept me home, even though my wife kept insisting that we go and seek treatment.
During this time at home, we needed to get me put on Ruth's CSS medical care system. The CSS system covers all workers for medical treatment in Panama. Dependents (husbands, wives and children to the age 21 are covered). If you don't work you are not part of the system as it takes premiums from both the employer and the worker to be included. Self employed people can be part of the system, however they need to pay both premiums. Many people who are not on the system are either on a very basic system or they pay out of pocket for everything. Ruth knew that we should have added me on soon after we were married, but we never did. So we went to the CSS office here in La Chorrera to add me on. The procedure is pretty much like all the rest, you go in, get a number and wait through a mirage of people to be called, which could be hours. So we sat and waited, all the while my leg killing me and I couldn't find an position where there wasn't any pain. We waited and waited and waited and were only like 5 numbers to seeing the person to register. At this point I was ready to pass out, my blood pressure had dropped because of the pain and I was turning white. I just couldn't wait any longer. I had to leave and found refuge on a bench outside until Ruth retrieved the car. I went home and was hyperventilating and lying on the bed for quit a while until I regained my composure. Ruth knew that I needed to get registered in case of future events, which could cost us a lot of money that we didn't have, So the next day she made a plan to mitigate my chances of feeling nauseated and get in quickly. First thing in the morning when the office opened she arrived and picked a number. I stayed home and waited for her call to as when the numbers were getting with 5 or 6 of our number. Her son was home, so he drove me to the office and when I arrived I was within 2 numbers to register under her insurance. So I finally got registered and I had a CSS card. At that time we didn't know how valuable it would come to be.
The time that I stayed home and suffered was not good as I will explain later, but it was a time that Ruth and I became closer than we ever were in the time that we met (2 years). Ruth is a very devout Christian and has opened my eyes to my faith as well. In Canada I never really believed. Anyway Ruth and I prayed, we cried and brought our relationship and marriage to a new level of understanding. It was truly a blessing in disguise. I knew how much she loved me to endure all that she did with me and will endure in the weeks to come. It was very hard for us financially as I was not teaching and only got payed when I teach, but through the grace of God, we made it through. Many people all over were praying for my recovery and as I have learned, the power of prayer can work wonders. Also many people in the weeks to come gave us some financial support, not a lot but enough so as we could pay the bare necessities. Another one of Gods blessings!
After maybe a week of my obstinate behavior, I gave in and went to another doctor whom Ruth knew that helped her with some muscle problems that she had in her back after an elevator accident years ago. Again the same procedure to go through as we did before and then saw the doctor. We explained the situation with my leg and he looked at both legs to compare and told me that I had “deep vein thrombosis” which was a clot in one of the deep veins that supply blood to the lungs and heart.
He wanted to make sure he was correct so he sent us over 2 doors to see another doctor which happened to be Dr. Juan, who seen us before and was the one that recommended I go to the hospital regarding the “Dengue”. He was very concerned and called the hospital to arrange to get me admitted ASAP. So we rushed to the hospital and Ruth registered me (again) and had a note from Dr. Juan and had them check with the administration that I would be arriving. We still had to go through the ridiculous procedure of the emergency. This time though it wasn't a long wait as they only needed to verify what Dr. Juan send. Dr Juan is an attending Physician in emergency after his day clinic is finished, so he has a certain amount of pull. So as I waited in the emergency area, I was feeling nauseated again and after maybe 1 ½ hours I couldn't stand it. I was anticipating another long wait as they were checking to see if a bed upstairs was available. I knew I could not sit there for much longer, so I told my wife to tell them that I was having a hard time breathing and felt like passing out. (a bit of overcompensation was needed on my part) Immediately they found me a bed in the emergency area and gave me oxygen. They did an EKG, a heart ultrasound and hooked me up to a heart monitor. As the saying goes, The squeaky wheel gets the grease.
Dr Juan came into the emergency and saw me and Ruth and explained what was going to happen. My leg was elevated to keep the pressure at a minimum. He said that I should just try and relax and that hopefully in the morning they will do an ultrasound of my leg. So I laid in the bed until about 6 in the morning when a bed was ready for me. At that time I was wheeled up (on the gurney) to the 5th floor which I was on before. I was in another room and again lucky enough to be beside the window and the bathroom. Ruth again was a mess and she went home to rest and then returned later in the day with some things for me, a pillow, toiletries, a towel, a fan (Panama's patient room areas are not air conditioned and can be very hot as I experienced before). So another stint in the same hospital with a different set of problems. A few of the nurses remembered me and greeted me, probably wondering what I was doing back. Again in the morning all the Doctors etc started to come around with student Doctors asking me my history ( I was quit pleased to find that a good majority of them spoke English). I had many good conversations with them. Everyday a different Student Doctor asked me the same questions. It was getting tiring, but I realized that it was all part of their training, so I obliged them. My resident Doctor Ulloa, Doctora (female) was a 3rd year resident who spoke perfect English. She is Lebanese by descendants . Her parents had come to Panama before she was born. She is about 29 years old from my estimate. Ruth and I developed a very close relationship and still maintain a good relationship with her today. Ruth chats with her via “WhatsApp” quit a bit. She is a very caring and forthright professional. She has answered many queries from Ruth and I and has helped us with some scrips.
The ultrasound that was ordered did not happen the day I was brought up to my room which was on the Thursday. They were hoping it would be done on Friday, but because of the weekend etc, etc, etc, it was not done until Monday when the technician was available. (all part of the system and culture here, manana, manana, manana). Nothing seems to be urgent on its own. I spent the weekend sleeping most of the time lying on my back as they had the foot of the bed elevated so high for my leg. I am not a back sleeper and this was for me not a comfortable position. I tried to shimmy onto my side to get a better rest, even moving my body all the way up to the head of the bed to get a better side position.
Blood tests and more IV's were done on a daily basis. Ruth came in every day in the morning and in the late afternoon. She would bring eatable food for me to eat as I believe the french chef in the hospital kitchen must have been on holiday's, haha. Hospital food is usually not very good, but at this hospital it seemed to be ultra bad and so not good for patients. White bread, processed cheese slices, starchy vegetables, white rice 2 times a day and very greasy chicken with absolutely no flavour. The only things that I would eat were vegetables like broccoli, cauliflower and the likes. I was told by the nutritionist that I shouldn't have food brought in. I told him my history and what I would and wouldn't eat, but I guess the kitchen didn't get his notes. He said he would be back, but never returned during the time I was there, what a surprise! Too bad!, Ruth continued to bring food in. It was a lot of work for her, but as I said she is more than special.
As I remember, I was in not bad shape compared to some other men in the room. The man next to me was stung by what seemed to be thousands of bees. He had welts all over his body and kept going into shock. He was also heavily sedated for the pain and whatever else the stings were doing to him. According to my doctor, she said his entire immune system and organs were affected, poor guy! Another guy was not good as well. I believe he had very bad diabetes and one foot was amputated while the other leg to the knee looked like a dead tree trunk. According to my doctor diabetes is really getting bad in Panama. Over the last 10-20 years the diet here has gotten bad with the proliferation of fast food restaurants and the ease of them, along with the traditional foods here that are fried (tortillas, empanadas and (Hojaldras) Fried bread (pan frita) as I call it. You can see many people of all ages are obese. The North American lifestyle is certainly here. Diabetes is not good to have and if you do have the disease, you need to monitor things and always be diligent.
Anyway, around 9 AM or so on Monday my Doctora came and told me that sometime during the day they would be coming to get me for the ultrasound. Sort of like when you make an appointment for the cable guy, he will be there sometime between 8 and 5, lol. As I mentioned earlier Ruth came in every day in the morning hoping to see the doctora and also the main Doctor guy and ask him some questions. This main doctor guy was an older Doctor and had the bedside manners of Archie Bunker (if you know who that is). Anyway he was very rude and should retire and take his good manners with him. One time Ruth asked him a question and he acted like her question was not important. He started to walk away with the students Doctors and Ruth went after him to get her question answered. I cant say she tore a strip off of him, but made him recognize her and answer her question. At about 2 PM, the patient transfer guy came with a wheelchair and off we went to the ultrasound, X-ray, cat-scan area. After waiting in the hall for maybe 10 minutes, I was called into the ultra sound room. I was wheeled in and went onto the table. The technician positioned me in the way that was needed for her to do the ultrasound. She put on the gel and after maybe 10 minutes of scanning we were done. While I was in the room , the door was left open and 2 or 3 people came in to chat with her and her concentration was averted, also the patient transfer guy sat in a chair in the room and was chatting with her the whole time and was also chatting on his phone. I thought this whole procedure was very unprofessional and should have been done differently. I didn't say a thing as I am sure they would not have understood what I was saying. Another example of unprofessional conduct. I've had ultrasounds before and it was always only me and the technician with the door closed for privacy and concentration.
I was brought back to the room and awaited to find out the results (which didn't come for another 2 days on Wednesday morning) At that time, Wednesday, I was then seen by a cardiologist who told me that I had a large clot in my leg, so he started me on 2 different blood thinners in liquid form which were administered in a syringe in my belly. I was also given another blood thinner which was more costly. The name of this is Clexane. The cardiologist was leaning to have me use this for a period of 3 months when I went home. He also wanted me to stay in this hospital for an additional 2 weeks to monitor things. He also ordered a cat scan of my chest to see if the clot might have broken away and entered my lungs. The cat scan was done on Thursday morning which was something new for me, and the results came in rather quickly to my amazement.
A team of doctors, I believe they were all in cardiology came to see me along with my regular Doctora. They were going to transfer me to a hospital in Panama, A CSS hospital where there was a cardiac surgeon. They informed me that a piece of the clot had indeed broken off and went to my lungs, so now I had a pulmonary embolism (a clot in the lungs). A pulmonary embolism is where a piece of the clot from the thrombosis breaks free and travels along the femoral vein and through the heart and blocks a blood vessel in the lung.
So they arranged a transfer as soon as an ambulance could be ready. I knew this wasn't going to be quick, as in my room alone 2 other patients were waiting for a transfer as well. Later that afternoon they brought in a portable X-ray machine to do another X-ray. In about 2 hours after that the Doctora and Dr. Juan came in and told me that the clot in the lung looked fairly substantial and they put a rush on the ambulance transfer. Doing my research, I found out that if the clot is large and blocks the blood vessel enough, it could cause the lung to contract because of lack of oxygen and then a heart attack is likely to happen.
When he told me this I started to have pains in my neck region and started to have trouble breathing. I don't know if this was psychosomatic or real, so they did a EKG and a heart ultrasound and then hooked up the heart monitor. The pain in my throat area was coming and going and I knew it was real as I have felt this before. You see we live up on a hill from the main highway area. Everyday when I would come home from classes, rather than take a bus up, I figured to get some exercise. There are 2 different slopes to go up. Always near the top of the 2nd slope I would get this same pain. I thought it was just that I needed some oxygen, but at the hospital I wasn't doing anything physical other than lying in the bed. This pain came and went for a couple of days.I later found out through another doctor that it could be angina which sometimes you feel during exercise or with stress. The heart is in need of oxygen and causes this pain. To any that have Angina, you know what I am taking about.
To be continued!