Annual Heart Check-up Adventures I

All medical appointments here are adventures, whether it is getting there or struggling with the language since everything is in español! Plus for my heart only right now, I am using the public healthcare system which here means all doctors and other staff work for the government, which always slows things down everywhere.   🙂   My October appointment had already been moved up to this November week because I was getting a new doctor.

This year they also decided to divide my appointment into two appointments, one for the EKG called electrocardiograma here with no initials used. Both appointments were last week (Tues & Thur), my first week back from a trip, already busy with the usual catch-up:

TUESDAY

I get a taxi to the 12 noon bus to Alajuela for my 2 pm appointment which in theory I should take the 1 pm bus (45 min ride), but there are too many possibilities like bus breaking down and long lines at hospital. — I arrive Alajuela before 1:00 and with a taxi to the big government hospital a little after 1 pm, show ID & cita (appointment) to guard and take elevator to the 4th floor for Cardiology and wait in this regular line (photo below):

Waiting line to check in for doctor.

It is to check in for my 2 pm appointment and then realize the adulto major (senior adult) line is a little shorter and I move to it and from a chair in it I took the above photo. Both lines move very slow and at nearly 2:00 I’m the second person in line for check-in when over the loudspeaker they call my name among several Hispanic names which is always funny (Gonzalez, Rodriquez, Doggett, Rojas). And of course my name is hard to pronounce. This means they see we haven’t checked in yet and so they call us to front of line and check us in. (So why wait an hour huh?)

She sends me to Puerta nueve (Door 9) where I wait with about eight other people for our EKGs. After about 20 minutes I am called in and of course an EKG only takes a few minutes and I’m off to the front door and a waiting taxi to get me to the Atenas Bus. Not bad for free medical service!

And oh yes, now they don’t worry about communicating with each other, the technician gives me a paper copy of my EKG folded into an envelope for me to take with me to my doctor appointment on Thursday. – Now the taxi ride to bus is easy with Oscar, a nice young taxista who handles the Alajuela traffic well and I include a good tip as always (it pays off in the long run as you will see).

It was not until I arrived in Atenas that I realized my cell phone was not in my front pocket. I walk back to our bus station and the nice folks there did not find my phone on the bus, but the Spanish-only young man grabbed a high school kid to translate and long story short he dialed my phone and Oscar in my Alajuela taxi answered and suggested two options of either him driving  here to deliver it or me going back to Alajuela to meet him at a place of my choice.

Zipper in front right pocket.

I chose letting him drive to me, all the way to my house mind you! I paid the fare and a healthy tip thinking all the time about how much a new phone would have cost.

Now – Why did it slide out of my pocket in Alajuela? I was wearing some new hiking shorts (almost all I wear here) and I have not yet had my seamstress sew a zipper in my front pocket to prevent the phone from sliding out while sitting. I lost a phone in a San Jose taxi in 2017 for this same reason and all my old shorts got zippers in the front right pocket then. See my 2017 zipper post. Monday or Tuesday I will take my new shorts to the seamstress for zippers!   🙂   Might be Tuesday since I have to go back to Alajuela Monday after my Spanish class to get my prescriptions!   🙂

 

And that is not nearly all of my heart exam adventure which continues on

Thursday

Since my doctor appointment is at 12 noon and we have a 10:20 bus to Alajuela, I took it. (All other buses are on the hour and I have no idea why this one is at 10:20!) But anyway, same procedure – get off the bus in Alajuela and grab a taxi (in long pants today since phone doesn’t slide out of them).   🙂

Get to hospital only 45 minutes early this time and go straight to the old folks line and wait to be called to one of these windows to be checked in again:

Check-in windows to see 4th floor doctors.  I’m sitting in row of chairs at right.

 

Same thing happens again today. I wait and wait and I’m second person in line and they call my funny name out among the normal names. I walk up to one of those windows and she checks me in, puts my EKG in my file folder and hands it to me, explaining that I must stop first at the vitals station for temp, blood pressure, etc. before wait at Puerta dieciséis (Door 16) for Dr. Garcia to call me in. I’m given a slip of paper with all my vitals (weight, height, temp, pulse, blood pressure and one more thing). I Carry that and my file folder to door 16 and wait about 20-25 minutes which is really not bad.

My new heart doctor is a kid, looks like right out of medical school (like one I had at my private doctor’s office in Atenas once) or maybe I am just old!   🙂   He was very nice and tried to explain simply to me in English (most of the younger ones speak English) why my current EKG did not show an arrhythmia this time but I still have the condition and he is going to keep me on the same medication, Atenolol  and a baby aspirin every day. Last year the doctor wrote one prescription, signed it, then made 11 more copies on his copier and printed out official-looking 12 stickers from another machine with changing numbers and stuck one on each of my 12 months prescriptions. (They are not allowed to give out more than one month of any drug at anytime.)  I take these prescriptions once a month to the Public Clinic Pharmacy here in Atenas to be filled for free! Last year he even included the baby aspirin.

Dr. Garcia said they have now consolidated that at the front desk and I had to take my folder back up front and wait in line again for the front desk to print out my prescriptions and make my appointments for next year. I waited about 15 minutes in the same line when one lady called out my name again and took my folder and typed a lot in her computer, then she said (all in Spanish with a nearby lady helping me where I did not understand)  “We no longer make appointments a year ahead. You must come back to the “platforma” in main lobby in March to make your appointments – so it was moved from Doc to front desk and now to main lobby in a later month – hmm. I had almost forgot about prescriptions then turned around and asked about that and she told me through the nice lady translator that I had to wait until Monday and then go to the Farmacia in the lobby for the prescriptions. She pointed to which slip I took there and which one for next March. Bureaucracy in paradise! So now I get to go back Monday and again next March 20 (which is sort of an appointment to get an appointment which I now remembered happened once before.) Maybe they think I’ll give up and not return or just die before then!   🙂

BUT HEY! IT IS ALL FREE! The private doctors here (like my GP and Dermatologist) are more punctual and provide a whole lot more services and speak English but you pay for those services! I figure my once a year heart exam was a good way to experience the local “CAJA” medical services like the majority of Ticos. Plus the private Cardiologist in San Jose Dr. Candy sent me to the first time charged much more than fifteen hundred dollars for her heart exam and her prescriptions were going to cost more than $100 a month! So I’m saving around $3,000 or so a year by using the public doctors and getting something for the monthly payment I am required to pay into CAJA as a legal resident.

Below is the Hospital Lobby where I will make my appointment in March and Monday I will go to the Pharmacy off this lobby for my prescriptions with many other people both times.

Alajuela Hospital Main Lobby

New Hospital Adventures

Hospital San Rafael de Alajuela, Costa Rica

Adventure 1: New Cardiologist Scheduled

It was time for my one-year checkup with my public hospital cardiologist yesterday, 27 Agosto, made by the doctor one year ago, Dr. Hernandez. In the meantime I heard around June from someone else with the same cardiologist that Dr. Hernandez (whom I really liked) had gone to Spain to study heart surgery and I would be getting his substitute whom the other person also liked very much, especially because he spoke English! So I was already expecting a new doctor, whom I learned today is Victor Andres Garcia Rojas (called Dr. Garcia) – and I will do another article below on Spanish Names using his.

Adventure 2: I Forgot Pre-appointment Blood Tests

Yeah! No good excuse! It was on my calendar that I wasn’t watching and I forgot that appointment a week earlier. The results were to be with the doc by yesterday so they would be part of his evaluation of my heart. I rationalized and said, “oh well, he will reschedule that and add to my file later. No big deal! Pura vida!”  Well, it is a big deal! Hospitals are very serious!

So I wait in the adultos major line (for old people & shorter than other line) for about 30 minutes. When I get to the desk there is suddenly a computer problem with a bunch of supervisor types coming in to explain something on the computers to all the clerks. Then finally my clerk takes my cita (appointment paper) and my cedula (ID card) and starts to check me in and I casually tell her about forgetting the appointment for blood workup. She stares at me, shakes her head and tells me she is sorry (this is all in Spanish of course) but “the doctor cannot see you without the blood tests.” Thus she makes a new appointment for me with Dr. Garcia on September 5 (Whew! I leave Sept. 6 for my Caribe trip!) Then, with multiple attempts, she explains to me that I must go down to main lobby (photo at top) and wait in line at the laboratorio for a new appointment and show them that it is needed for a Sept. 5 doctor visit. By then I remember waiting in that line a year ago for the missed appointment. My punishment for living a pura vida life!  🙂

So back downstairs to that crowd in top photo and actually the laboratory line was not as long as some of the others. I had my new lab appointment for this Friday in less than 45 minutes! This girl was not as slow a speaker or as patient with my bad Spanish and so she used her phone translator some with me, though I was understanding more of her Spanish than she thought. Language is all part of the adventure!

So now, (with all the complaints about slowness in public healthcare), I’m doing blood workup this Friday (just 4 days later!) and I see the doctor next Wednesday! Pretty fast I think! And this delay is the fault of my forgetfulness or not setting the phone calendar alarm on my lab appointment! Now I get to go back to the hospital two more times (More adventures!). And I will remember to fast 12 hours before my 6am appointment Friday!  Aren’t I lucky?    🙂

Adventure 3: Spanish Names – Why 4?

Be aware that this can be slightly different from country to country, but for the Costa Rica explanation I will use Dr. Garcia as my example:

Dr. Victor Andres Garcia Rojas

Victor = First Name;     Andres=Second or Middle Name;

Garcia=His Father’s Last Name;     Rojas=His Mother’s Last Name (maiden name)

Most people go by their father’s last name, thus he is “Dr. Garcia.” But on legal documents and other places they use all four names, like on the Cedula (ID Card) and in the hospital. Since I have only 3 names, the hospital or national healthcare program has given me a fourth name that is on all my hospital records = “Noindicaotro” as a replacement for my Mother’s last name. Interesting since it is not a word in my Spanish Dictionary!   🙂

Adventure 4: Talkative Old Man on Bus

On the bus ride back to Atenas (45+ minutes) I sat next to a very talkative man who did not stop talking and even singing the entire trip. It was mostly in Spanish with an occasional English word or phrase to show me that he knew some English. I had a crick in my neck when I got home for having my head turned to the left the whole trip. And no, what he said was not very interesting, but I appreciated his friendliness and I guess he appreciated me listening attentively.   🙂

 

¡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