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Friday, December 16, 2016

### 300,000 ### .............and a HEART ATTACK!!!

WHAT????!!!!!   

I had a heart attack??  Noooooo....but I betcha it scared ya a bit, eh?

First off, I hit the 300,000 mark!  My blog has been viewed 300,000+ times!  Woohoo!!!

Now, about that heart attack.



The post before this one was about various people's medical experiences here in Ecuador...namely, Cuenca.

Two friends of mine, Franny & Robert, bought the house I purchased when I first moved to Cuenca.  I'm on Facebook but I rarely check it because I HATE FACEBOOK...its invasion of privacy, tracking, and the overwhelming task of keeping up with all the comments posted there.  I choose to have a life.

Well, Robert had a heart attack and Franny posted about it on FB to let all their friends know what transpired.  So, it wasn't until about a year later that I ran into Franny and heard about it.

I asked them if they would mind telling their story so I could add it to the medical stories published last week.   Ooopsie...I published it before getting their submission.

But, I think their story merits its own blog entry.    And, here it is (composed by Robert...the heart attackee):


One bright morning in June of 2015, I finished my exercise class and, as usual, walked the half mile or so back to my house.  I was a little winded and sweaty, but no more than usual.  

At this time, as far as I knew, I was in pretty good shape.  I was smoking about half a pack a day, though.  Indeed, I remember having a cigarette on my way home that day.  It would be the last I'd ever have.  

When I got to the house I discovered to my pleasure that our friend Rocío was visiting us.  She said she'd dropped by just because she'd had a feeling that she ought to.  

I chatted with Rocío and Franny for a while.  I began to notice that I was continuing to sweat way more than I would normally have expected to, and also that my pulse seemed to be awfully fast.  Then I began to feel a certain pressure, mounting to pain, in my chest.  I quickly realized that something was seriously wrong.  Pretty shortly after that I got a pretty good idea what it was, too.  I ran upstairs to use the bathroom, but collapsed before I could use it.  

I realized now that I was in real trouble and called Franny to help me.  She ran up to find me in a limp, wet mess on the bathroom floor.  She said, "I'm gonna call an ambulance."  

New Yorker that I am, I said, "No, fuck that.  Call me a cab."  So she ran to do that while I stripped off my sopping clothes and dressed myself in dry ones as quickly as I could.  Franny later expressed consternation that I would waste time so, but I didn't want to present myself as the sweating wreck I felt myself to be, even at an ER.  By the time I was dressed Rocío and Franny had found a taxi.  

By the grace of God Rocío knew not only where to go but how to get there.  We piled into the cab in a hurry and were at the Sala de Emergencias of the Clínica Santa Inés in ten minutes.  

If it hadn't been for Rocío, we wouldn't have had any idea what to do.  But she knew exactly what to do.  It is not an exaggeration to say that she saved my life.  They told me later that if I'd been even twenty minutes later I might not have made it.  

I ran up to the ER admission desk and stammered out my symptoms in the best Spanish I could: "Dolor severo del pecho . . . sudo mucho . . . pulso elevado."  Immediately they got me on a table.  They took my wallet, with Franny looking on, and I remember authorizing them to use my credit card.  I also told them at this time that I didn't have insurance.  

I felt terribly agitated.  I felt compelled through all this to be up, about, and active.  I felt this way even though I knew it was irrational.  Finally I heard someone say, "Give him something," and then they did, and it was easier.  

They catheterized me at once.  That is to say, they passed a special tool via an artery in my arm into the blocked artery in my heart, clearing it and simultaneously implanting a stent, a device intended to keep the artery permanently clear and open.  

It seemed to me only a short time later -- maybe ten minutes (but I heard later it was more like 45 minutes) -- that the procedure was over.  Sedated though I must have been, I distinctly remember turning to the med tech who had inserted the catheter, looking him in the eye, and telling him, "Gracias por salvarme."  

We'd asked not to have a private room, but I awoke in one anyway.  I spent the next three days there.  We knew the room would be expensive, and it was, but it was also very comfortable.  Indeed, in every respect, the care I got at Santa Inés was the equal of the best you could expect from any U.S. hospital.  

My cardiologist, Dr. Xavier Vásquez, visited me at least once every day to advise me about how I was doing and what I should do (which was, of course, mostly to relax).  The food was bland and awful in exactly the manner of the food in the better U.S. hospitals.  The maintenance of the facilities, cleanliness, etc., were absolutely the equal of the best U.S. hospitals.  

When I was released I wondered how they would bill me.  They had kept me with a saline drip running into my arm for some days.  When the time came, they simply insisted I go to the billing office and settle my bill before they would remove the needle.  This seemed a bit coercive, but one cannot deny its effectiveness.  (The only alternative would have been to rip out the needle and run.  I shouldn't wonder that people do this, but somehow, it didn't seem like the righteous thing to do.)  

Over some several minutes, the billing office totted up my bill, printed it out, and handed it to me for my signature.  It was seven pages long.  I asked something to the effect of, "But what if I dispute a charge?"  The answer was, "You'll have to take it up with management later.  For now, just sign."  And so I did.  

The charge was about $9,300.  I signed the slip and went home.  



Later I reviewed the charges in detail.  They were voluminous, of course.  The charge for the stent alone was something like $2,500.  But I could not find a single instance of anything being charged to me that I didn't know I'd used, or at least have pretty good reason to know I'd used.  

There is no doubt that the cost of this hospital stay, especially for an uninsured patient, was an immense bargain by U.S. standards.  We have at least one expert friend who has estimated that it would have run into six figures in the U.S.  

Dr. Vásquez prescribed four medications at first.  One was an injectible that I had to shoot straight into my gut.  Yuck!  Fortunately, I only had to do that for four days.  Another medication, though, was a blood thinner called Plavix.  I had to use that for a year, and as I guess you've heard, it did cause a problem at one point.  But then the year ended, and I didn't have to take it any more.  

The other two medications were atorvastatin (aka Lipitor) and 81-mg aspirin.  I must take these every day for the rest of my life.  But apart from these pills (and continuing to not smoke tobacco), my life is quite unrestricted, not only as to diet (I can eat anything I please) but as to activity (I can do pretty much any exercise I like, too).  

In general, my experience of Ecuador's health-care system has been extremely positive.  My doctor has been great, the hospital staff was great, and if the bill was a bit of a blow, by God it beats the bankruptcy we'd have faced in the States.

What Robert THOUGHT he saw when he woke up.

....then reality set in.
...til next  time!

Dano


............AHHHHHHH......but WAIT!!!!    You thought the story ended there, right?   Hang on.

Franny, Robert's wife, tells us about the next exciting event in their lives.


A Bloody Emergency!!


My husband Robert suffered a heart attack in June of 2015. He received excellent care at Santa Inez hospital and was temporarily put on a blood thinning medication. One morning about six months later, he told me that while taking his morning shower his nose had started to bleed. It had taken a full ten minutes for it to stop. We agreed this must have been caused by the blood-thinning medication he had been prescribed. The next morning I heard Robert calling me and walked into the bathroom to find him with his head over the sink, a blood-stained towel in his hand and blood splattered all over the floor. He turned to me and said, “It won’t stop. I‘m going to faint.”

I immediately called our doctor, Pedro Martinez, and asked him what to do. He told me to take Rbert  to the Santa Inez emergency room. I was very glad our houseguest, Sara Coppler, was there. She ran into the street to hail a taxi while I helped Robert dress. She helped me get Robert into the taxi and came with us to the hospital. (A good thing, too, because during the bustle and stress of getting Robert into the cab, I lost my wallet with my keys, money and ID. I wouldn’t have been able to pay the cab driver or get back into my house!) I sat in the back seat with Robert, with towels held to his face and on his lap, for the quick ride to the hospital.

Once there Robert was hustled into an examination room while I provided his information to the receptionist. They were in contact with Dr. Martinez. Medical staff tried to stop the bleeding using pressure techniques, but when that didn’t work, we were told a specialist was on his way. We were taken to an office on a higher floor, where the nose specialist attempted to cauterize the wound five times. When that didn’t work, he explained he had done everything else possible, apologized to Robert, then jammed what appeared to be a blue plastic tongue depressor about five inches long up Robert’s nostril, followed by an injection of water. The item was actually a tamponade made of a special material made to swell up and provide pressure from within. 

Robert turned white. Apparently, this treatment is fabulously painful, thus the doctor’s apologies. Back in the emergency room, Robert was given intravenous pain medication and put under observation. Our total time in the emergency room was about three hours. We left with prescriptions for more pain killers and Robert was instructed to temporarily cut back on his blood thinning medication.

We are very grateful to the staff at Santa Inez. Without their intervention, Robert would have bled to death. He had to keep the tamponade in his nose for five days. It was incredibly uncomfortable and he had a hard time sleeping, but it did the job.



We did not have any medical insurance. The cost for the emergency room visit, the cauterization and treatment was $270. The prescriptions cost $60 to fill.

My advice: Be prepared to be confused and stressed when under pressure. I am a fluent Spanish speaker but it all flew out of my head during the emergency. 



So it is a good idea to keep the hospital address, your medical information and doctors’ names and numbers on a card. We keep ours taped to the inside of a kitchen cabinet. Also, scout out the emergency room nearest your home. Figure out where the entrance is. 

(Dano)
Well, that's the end of their stories.  No more drama.  You can all go back home now.  Nothing more to see.

...til next  time!

...really.

Dano

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About Me

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Cuenca, Azuay, Ecuador
This is all about my transition from an American lifestyle and culture to my newest adventure, life in Cuenca and greater Ecuador. I'll be recapping some of my day-to-day experiences (and mishaps) to highlight what it's like to live here.

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