NORMAL! NORMAL! — Mi Aventura Médica

That is what the wonderful young Tico doctor almost shouted to me at the conclusion of my angiogram. Normal! Normal! (Fist Bump!) He seemed as pleased as me that I have no blockages or other problems. Now I will try to summarize my gran “Aventura Médica” as I am calling it. Totally using the national health system which means my only expense was the taxi fares!  🙂

WEDNESDAY, 23 AUGUST

Hospital San Rafael de Alajuela
Alajuela, Costa Rica

My friend Jason Quesada goes with me on bus and taxi to Hospital San Rafael de Alajuela for a 1:00 pm appointment for what I thought was going to be paperwork to take with me to the bigger Hospital Mexico in San Jose on Friday though Jason thought I was going to be checked into Hospital Alajuela, which I knew couldn’t be two days before a test. I was wrong again. In short they were full and one day in advance is enough said Lorenzo in Admissions. (See my last post) So he promised me he would have a room the next day because the test was pre-scheduled.

THURSDAY, 24 AUGUST
Jason & I get back there a little before 3;00 pm and wait about 30 minutes to start the process. One of the first things they did before taking a group of us upstairs to our rooms was snap on the usual hospital bracelet with my hospital ID number & name. Note that most Latin Americans use 3 names like mine shone here but with slightly different meanings. Of course the “first name” or “given name” is the same. But what I call a middle name “Everett” would be a Tico’s father’s last name and the one most commonly used for shorter names. My Dr. Hernandez is using his father’s last name as his primary family name. Then the third or last name in a list like this is their mother’s maiden name, which is what some here may think about my last name of “Doggett.”

Jason snapped this of me eating soup in hallway.

We had one delay because my hospital file (started earlier) was lost.  🙂  But they found it and up we went to the fourth floor which includes cardiology. Then we sit in a hallway while that nurses station gets me checked into my room 414 which was really my bed number in a room of 6 old men with heart problems, beds 413-418. We are sitting in a hallway with a TV playing a horrible Mexican Comedy Channel for maybe another 45 minutes. No TV in rooms, so you come out here to watch. They start serving the dinner trays and I get my first hospital dinner in Costa Rica while waiting in the hallway for my room preparation. It is very healthy and mostly tasteless bland! Vegetable/chicken noodle soup, beans & rice, mixed tropical vegetables you Tennesseans wouldn’t recognize, a cold beet and carrot salad, cup of fruit juice, and an apple for dessert. This was typical lunch & dinner with varieties and even a pear instead of an apple the next night. I would recommend those planning on a hospital visit to pack salt, pepper, herbal seasonings, hot sauce, catsup, or whatever you like to give more flavor.  🙂

My roommates were all nice and interesting gentlemen, all speaking Spanish of course. 4 of them were bedridden.  One came there after a massive heart attack and the following night or at 1:15 am this morning he had another attack and nearly died while I watched, but was still alive and on machines when I left today, but his son told me he had been given only 30 days to live by one doctor. Another commentary on Costa Rica: almost every bed had a family member sitting in the one chair by each bed. Family First here! And the heart-attack guy is why my angiogram!

They kept working on me to past 8:30 pm with things like blood for tests, shunts for catheters, x-rays and the constant blood pressure checks, etc. It was a very noisy night as was the second night with one roommate talking (hollering) in his sleep, nurses in every hour with whatever services and of course turning on lights, and the hospital has all kinds of buzzers, bells, etc and a PA system for announcements and paging of person, and the very friendly and happy crew at the nurses station, right outside our door, laughing and carrying on all night. If planning on a hospital visit here, I suggest you bring ear plugs!   🙂

And we all wore something like hospital sweats or whatever you call the buttoned shirts and tied pants. The only hospital gown I got was for the surgery room test Friday.

FRIDAY, 25 AUGUST
This was the big day and the part I had the most uncertainty about, cutting into my leg at my crotch and running something up the artery. Ugh. By 5:00 am the nurse was getting me ready with two stents for drips as needed and shaving parts of me, etc. We left a little after 6 am with a crew of 4 in an ambulance for the normally 21 minute drive to Hospital Mexico, but in rush hour it was probably 30 to 45 minutes (didn’t time it). Most of my attendants were in their 20’s it seemed, the doc maybe 30, a nurse, orderly, and some kind of helper. The driver was very professional as I learned on the return trip.

The ambulance pulled up to a side door of Hospital Mexico and I was rolled into the second room

Hospital Mexico
San Jose, Costa rica

where of course I waited at least 30 minutes while the crew enjoyed themselves! The happiest people in the world just love to be together! Laughing, talking, beautiful digital music and occasionally giving me attention. Someone was having this procedure ahead of me and course another gurney rolled in right after me; a regular assembly line! I was surprised at how quick it was having been told from 30 minutes to two hours if a lot of blockage. After he stuck me with the needle for the local anesthesia (the only part that really hurt), I would guess 15 or maybe 20 minutes before he shouted “Normal! Normal!” with a great big smile on his young face. Then gave me a fist bump. Made me feel good! Even though one of the Mexico nurses whispered in my ear in English, “You still need to avoid KFC and cheeseburgers.”  We smiled and chuckled at each other.

They quickly rolled me back in the waiting room where the next person was waiting or we traded places. I had to lay real still for 30 minutes before they rolled me out to the ambulance again and another ambulance had just arrived with another angiogram person coming in. Wow! They must like angiograms here!   🙂

BUT THE MOST FUN WAS THE DRIVE BACK to Hospital Alajuela which we did make in 20 minutes because the driver turned on the flashing lights and the siren and use the other loud horns and sounds to weave us through the bumper to bumper traffic on Ruta 1 which goes by the airport and thus heavy traffic all day. It was fun and I’m sure the driver enjoyed it and he did a great job! The Alajuela doctor kept reminding me “Don’t move! Don’t move!” referring specifically to my right leg because that is where they cut into an artery and that is not where you want a rupture or blood coming out. Then the rest of the day and second night was difficult because I had to lay still for 24 hours to help the incision heal and avoid a serious problem. I read on my Kindle and played games, talked a little, ate a little, and had to use a bed urinal, but I survived 24 hours of stillness of at least my right leg. Then another noisy night and a heart attack in front of me, meaning I am very tired now and will go to bed early.

THANK YOU to those of you who sent kind notes and prayed for me. It made a difference! It was a good medical test with a very happy result for a 77 year old with no junk in his arteries!   🙂

Keep Walking!   Keep Smiling!
Pura Vida!

Spending the Night in Hospital

Hospital San Rafael de Alajuela
More commonly known as “Hospital Alajuela”
Alajuela, Costa Rica

I spent a couple hours here today (Wednesday) with my translator Jason Quesada with the admissions director telling us at the exact time of our appointment that he was going to lunch.  🙂   Pura vida! We visited and waited an hour with many other persons I assume also wanted admission to the hospital. All along I expected to just get paperwork from this, my home hospital, to take with me to San Jose’s Hospital Mexico Friday morning for my angiogram. I was wrong! Lorenzo said that I would be admitted to an available bed in Alajuela and be considered a patient there for the angiogram. When time for the actual test they will transport me to Hospital Mexico (instead of down the hall) for the test because that is where the equipment is. (14.2 km or 8.79 miles or 21 minutes) Then I would be “transported” back to Alajuela Hospital where my doctor will say when I am dismissed, possibly Friday afternoon, though it could be Saturday.

That was all new and a surprise to me, as Jason said my face showed! Then Lorenzo (Admissions Office) said I will check you in today at 3:00 (it was 2:15) if we have any available rooms. Otherwise I will guarantee you a room at 3:00 tomorrow. (“Please God, don’t let there be an available room today!” I had no toiletries, extra clothing or phone charger with me.) Soon Lorenzo came out to tell me through Jason that they had no rooms left and he would see me tomorrow at 3:00. Yaay!
We got a taxi in the rain to the bus station and headed back to Atenas where I treated Jason to a late lunch or early dinner of patacones con carne machada. Delicioso! And now I’m back home wondering what it will be like for my first Costa Rica hospital experience. 
NOTE: I will not risk taking my laptop to a hospital and not sure I will have wifi anyway. So you can expect the full report by Saturday or Sunday. Another great Costa Rica adventure!  🙂

Hospital San Rafael de Alajuela

Hospital Mexico de San Jose

No Angiogram Today

Well, I did not get my angiogram today after two hours at Hospital Mexico (left) and another hour at Alajuela Hospital (my province hospital). It seems that the bigger hospital wants my regional hospital to perform some preliminary tests that they can do before the big hospital does my angiogram which is now rescheduled for 25 Agosto, oh, that’s August 25! And yes, they did tell me that earlier or the doctor scribbled it on the appointment sheet in Spanish that even my Tico friends could not read. Tough luck!

It is all part of the bureaucracy in the government healthcare that Ticos make fun of all the time but are also more naturally patient than Americans. And hey! I have more time than money! So, just another adventure! Plus Jason and I had a great lunch of Mexican food at Jalapeno Central in Alajuela today! They even have pecan pie! (Not something you find very often here!)

The other thing a learned today is how important it is to speak Spanish if you are going to live here as a local and use services like this! Sure wish I had learned Spanish when I was young! I’m a slow learner now! I really needed my translator today, Jason Quesada. My cardiologist will call me next week when he returns from a trip and get it all worked out.  🙂   Pura vida!

 -o-

And for my fellow readers and literary lovers, you must see this more sophisticated evaluation of Donald Trump that ironically uses a wonderful old Russian fairy tale to describe him: 

REBECCA SOLNIT: THE LONELINESS OF DONALD TRUMP


Are any of my American friends aware that your president is now the most mocked man in the world? How sad! And even sadder, my cable TV subscription does not include the American NBC network, thus I don’t get to watch Saturday Night Live! Sob, sob.  🙂  And even the YouTube clips are not licensed for showing in Costa Rica, thus can’t go there! I occasionally see little clips on Washington Post or a pirated one somewhere. So funny! 

Medical Test Tomorrow, Friday, Maybe

As mentioned earlier, I’m scheduled for an angiogram tomorrow, Friday, June 2. They were to call me by today and tell me the exact time. I never got the call. Long story, but I loaned my phone to a friend yesterday and he evidently turned the volume down to 0 or I could have accidently done it. I discovered it tonight and then found on the “recent calls” that the hospital tried to call me twice today. Darn!

Anyway, I am going to show up at Hospital Mexico at 7 AM tomorrow with my interpreter and hope I am still scheduled for sometime tomorrow. The devil is in the details and little things like the volume control button on my cellphone! Ugh!

-o-

It will be huge and just over the hill from Atenas, closer to me than the current SJO Airport. And I will only be 87 years old, so good time to come visit through the big new airport!  🙂  Click title to see pictures and read about this big infrastructure improvement here. 

Third Trip to Hospital Mexico Schedules June Angiogram

Locals most often describe CAJA (the government medical program) as a big bureacracy, and that is true, but it works! If you have patience!

My Atenas public doctor was limited in what he could do related to my heart arrhythmia, so he sent me to a cardiologist at Alajuela Hospital in Alajuela, our provice capital.

Three visits there gave me more tests including another EKG and a treadmill test, but Dr. Hernandez wanted an angiogram which Aljuela Hospital does not have the equipment to perform. He sends me to the biggest government hospital, Hospital Mexico in San Jose with his request for it. Over two months time I have had three very interesting visits, including with one lady who spoke very rapid Spanish and would not slow down, necessitating my rescue by a bilingual medical equipment salesman waiting in line.

Today was just an hour and a half wait in the crowded hospital cardiolgy waiting room where a doctor finally saw me briefly, giving me a piece of paper with a 2 June 2017 date for my angiogram and a promise that someone will call me to discuss the time and preparations. That will likely be an interesting phone conversation if I’m even able to complete it!  🙂  When you start living every day life here you realize how important learning the language is. I’m tired of not understanding or being bumfuzzled! Language-learning motivation!

And for after the procedure, which can include some anesthesia, I have scheduled my friend Walter Ramirez to pick me up at the hospital. Though getting there by bus is easy since the Atenas bus stops in front of the hospital!  🙂  Just don’t want to do that alone after anesthesia! Plan ahead!

First Visit to Hospital Mexico

Hospital Mexico Entrance
It is the largest public hospital in Costa Rica and where most serious
surgeries, tests, and treatments take place; “The Mother Ship” if you please.
There’s a tall building behind this with all the rooms, etc. 

My primary hospital is Hospital Alajuela where I have been seeing a cardiologist (cardiólogo) who now wants a picture of my arteries, an angiogram. Well the only public hospital with equipment for that is the main hospital, Hospital Mexico (named that because it is located in the Barrio México or neighborhood called “Mexico”). It is a huge hospital with lots of doctors, specialists and the ability to do just about anything any hospital can do! And it is paid for by the government healthcare program! I will never have a co-pay or any bill from either on of my two government hospitals. I’m very pleased with my healthcare here and my private options should I ever need them. Just be happier when I can speak better Spanish!  🙂

TODAY – 3 April
I had an appointment to get an appointment. I had to wait and go to three different people which only took an hour which is not bad in a bureaucratic government hospital. One of those was a lady who just created a file on me at that hospital, just like I had to do at Alajuela Hospital to get started there. I’m now one of their patients.
17 April
I have an appointment there with one of their cardiologists who will review the files I have from Alajuela and see if he agrees that I need an angiogram. If so, I assume he tells one of the girls to schedule it. That is two weeks from today which is really not bad. 
Later – Maybe this year or next
I go in for an angiogram (if approved) – Actually I think it will be earlier because I’m gathering that cardiology is considered more urgent, but it could still be 2 months away. We will see.  🙂
Technically, this is my second visit to Hospital Mexico, I did go there briefly in January 2016 on the Healthcare Tour of Costa Rica – which I recommend!

Doctor Visits

CARDIOLOGIST
Monday I had my first follow-up visit with my CAJA (government healthcare program) at Alajuela Hospital where my cardiologist did another EKG and a ultrasound of my heart. Then he personally monitored a treadmill test of my heart followed by another ultrasound he monitored. It was amazing to me that I was in and out of there in 45 minutes. He told me that the only other test he would like to have on me is an angiogram which he could not order until he consulted at least one other cardiologist there in the Alajuela Hospital because there is not much indication that I would have any blockage. He said he would call if it was approved and then I would have to go to Hospital Mexico in San Jose, which is the only one with the equipment to do an angiogram. It is the primary or main hospital for Costa Rica CAJA or government healthcare.

Well, his technician called me today y hablando sólo en Español. We both struggled through but basically I have to go back anytime tomorrow and get some “documentation” or paperwork from them in Alajuela to take to Hospital Mexico for an appointment for the angiogram. If I understood her correctly, my Mexico appointment is April 10 at 10 AM, but not clear yet if that is when I get the angiogram or, if like most things here, I may just be making an appointment for one much later. I should find out tomorrow.

This is how “single payer” or government or what Americans like to call “socialized medicine” works with priorities given to more serious things, emergencies, etc. It took two months for my first appointment with my cardiologist. No problem for me to wait for this as I don’t believe I have a serious problem. Best of all: No more cost for me now that I have a CAJA card, even if it led to the unlikely case of heart surgery.  I will keep you posted. Dr. Hernandez is basically building a file on me and my heart for any future needs and trying to be responsible for my heart. I appreciate that!

DENTIST
Today I visited my dentist who also speaks only Español and we managed fine for my annual teeth cleaning and checkup by the dentist herself and not a technician. She says once a year is fine and not the every 6 months U.S. dentists request to increase their income. She found the need for one tiny filling which I’m scheduled to get next Tuesday. And that is it for a year! And cheap! Many Americans come here for dental work to save thousands of dollars in what is sometimes called “medical tourism” or even “dental tourism.” A friend in Tennessee has come here twice for his dental work and saved a lot more than his plane ticket and hotel bill. That is for big work like bridges and caps.

Someday I will think about taking a photo at one of these places! It just hasn’t been on my mind with everything else to do like getting there and communicating!  🙂