RTGFKAR's Tale

Here is a guest shot by RTGFKAR.

The saga of Hospital Chiriquí (OSS-PEE-TAL CHEEROKEE)

About four weeks into my ear problems; let’s borrow the understated term from our friends across the pond and refer to them “the troubles”; a resurgence of those old demons, “Wha?”, Huh?” and “Say again?”, I mean much more so than the expected aural infirmities of old age would allow for, told me that the treatment was not working.

Allow me to recap, or rather, having not broached the subject before, cap.

Having survived a childhood peppered with occasional bouts of earaches so severe I remember crying myself to sleep at night , and made it to adulthood, those memories faded, only occasionally surfacing when the inevitable cold or flu bug visited, their choice of guest quarters for the duration being my ears.

The cases were infrequent enough and those bad memories might have vanished into complete disremembrance, but for the next otic happening four decades into my mortal coildom.

Waking up one morning, I found I had lost the hearing in one ear. The upshot, to skip all the concern and conjecture you can imagine, was a flushing of excess earwax into a kidney-shaped pan held not-quite-tightly enough against my neck to prevent some of said agua-cum-cerumen mixture from dribbling down my neck, my shirt and my pants. A small price to pay to regain one’s hearing. Although there was also the matter of a stiff co-pay to our less-than-stellar insurance company, but that’s a rant of another choler.

When a similar situation arose a year later, experience led me to expect another flushing , preferably holding the kidney pan much tighter! Instead of the pan, though, I got a scan (cat, that is) and that feline prying into my cranium uncovered a cholesteanoma in my inner ear. Not a small hairless domesticated mammal cultivating potatoes in my ear canal, but “a growth”, the doctor said.

I wonder why doctors seem to have no idea where such a phrase leads your thoughts when they casually toss it out? But no, it was not a big Cee-little a-n-c-e-r growth or a tumor growth, I eventually discovered , but a growth of skin. My facial skin apparently forgot that it was supposed to stop growing when it reached my eardrum and so continued merrily on into my inner ear, where it proceeded to start dissolving part of that trinity of bones, the stirrup, the hammer and the sickle, that convey sound to your (or in this case, don’t convey sound to MY) hearing thingamabob.

OK, I know it’s not the hammer and sickle, I was just testing if you were paying attention.

Timpanomastoidectomy (Lets see Doc translate that into Spanish!), which sounds like the percussion section in the Johns Hopkin College marching band, or the final round question in the Lake Havasu Middle School spelling bee, was the procedure I needed to undergo.

Simply drill a hole in my head behind my ear, go in and snip-snip away the nasty growth and, oh yeah, salvage what you can of the remains of those anvil, iliad and oddessy bones with a little superglue, close up and WALLA!, good as new! (I eschew the French spelling of voila because I mean, really, how can you get ‘walla’ out of v-o-I-l-a?).

Quicker than Captain Kirk could say “Make it so!”, it was so. (I know, I know, testing again) What, however was supposed to be a short out-patient procedure (in at seven, out by three) turned into an overnighter when the anesthetic disagreed with me, leaving me groggy and nauseated beyond belief, I thought it went rather well.

Friends who came to give me a ride home said my dazed visage, unshaven and bandage-swathed head made me look like a Hell’s Angel after Altamont.

A couple of weeks of vertigo, lightheadedness and light-wallettedness (don’t get me started on that co-pay business again, this one was largantic!) and I was good as new! Well, OK, 70% good as new hearing in my left ear, but then, what’s a few more “Wha?s” among friends

Good otic hygiene and the use of Debrox for earwax removal and hydrogen peroxide for much cheaper ditto got me through the next two decades and into the third.

Now we’re getting to the more recent part of the cap. A couple of months ago that ole debil “Wha?” rose his ugly head again and drove me to a local ear, nose and throat guy who nodded in Spanish, gazed into my ears , flushed out more wax with a high-pressure fire hose and prescribed antibiotics and eardrops.

My eeriness diminished but did not go entirely away and subsequent visits resulted in more flushings, more antibiotic pills and butt shots. After another week with little improvement and an up-scaling of pain, the next visit to my OT-YGN (otolaryngolgist; Hey, women have OB-GYNs right?) brought the decision that the intra-muscular shots were not strong enough and that I had to go over to Hospital Chiriquí (HC) to get a couple of intravenous shots.

That about does it for the capping (and carping) and brings us up to the present day. Since we had missed lunch, we corrected that omission before heading over to HC where I went in with bro Doc for moral and linguistic support. When we were directed to the admissions office rather than the shots-are-us department, and the woman there began pulling out forms, I suspected there was more than a shot afoot.

Turns out the ‘couple of shots’ was a regimen of drips, drops, drugs and drafts: an intravenous drip, lots of eardrops, pills and shots of drugs and , of course, drafts, courtesy of the backless hospital gown.

Not having expected an overnight visit to beautiful and lovely David (Daveed) and, having none of the necessary accouterments for an ensconsement in HC, I opted to go home, pack some stuff and return. The admission lady said she would be there until five, so I had plenty of time. I left Boquete about 2:30.. Since there is only one route from Boquete to David and since time was important, you can guess that all did not go smoothly.

Just past Dolega, traffic slowed to a crawl and then to a stop, to only intermittently moving in fits and starts. After about 50 minutes of creepy-crawling we reached the hill where the Atlas cervaseria (brewery) was. There were cars sprawled along the verge and a beer truck being towed away. Happy hour had apparently gotten out of hand.

The majority of Panamanians seem to work from 7:00 to 4:00, so the full press of Davidians trying to get home and the mass of suburbanites trying to get out of the city were being alternately routed along the one remaining lane where they had to drive as slowly as possible to rubberneck , or perhaps they were looking for some errant beer bottles.

I did make it to HC before 5:00, and, assured that some actual medications would be administered this day and I would not merely be checked in and put to bed, I checked in. No roach motel jokes, please.

Despite the fact that I had HC health coverage (note: $500 a year as opposed to the $650 a MONTH I was paying Kaiser Permanante in the US!) I had to pay a deposit. I guess to cover damage from the wild parties in the room. One’s reputation precedes one.

My coverage entitled me to a semi-private room, which was private for two days of my stay, since I had no cell-mate, er, room-mate.

Things proceeded quickly and efficiently. After I checked in to the room I was disrobed, begowned, heighted, weighted, blood pressured, deblooded and had a IV connection inserted into my hand and drugs injected, but no IV stuff.

I got ear drops, water and dinner; not bad,: ground beef, carrots, potatoes, yucca soup and pineapple yogurt, but still no IV juice. About 8:00 a nurse came in and unhooked the line I had been hooked up to. “Ahorra?” I asked, “Manana?” She replied, “Mas tarde.” Later.

This place is as quiet as a hospital. The halls are deserted and with my hearing loss there is an eerie silence over everything. Maybe the Earth has traveled through a deadly glowing comet tail and radiation has killed everyone and I am the last person alive on the planet!

Nah! The nurse just came in to hook up my IV and it’s dripping away. “Aunty Bee Ottico”, the nurse said. I wonder if I get Andy and Opie Bee Otticos, too? 9:00 PM it is.

The typical television cop/medical show IV setup looks like a big soft rubber bag with a long tube that goes into the patient’s arm. Mine had that, but between the bag and my arm was a clear plastic cylinder. The nurse would lower the cylinder below the bag, fill it, using about a quarter of the bag’s contents, inject a shot or two into a Y connection in the cylinder ( or the one in my hand) and let it drip merrily away.

Position and height was apparently important, for there was much adjusting of both and at one point the nurse asked me to lie down for the process and lowered the bed. Unlike the movies, where the patient is provided with a wheeled stand to hold the IV, that you can pull and roam around the room and halls, I couldn’t, because it was affixed to the bed frame (although the bed WAS on wheels, maybe I could… no, I’d never get it through the doorway!)

I noticed that lack of mobility one time when I neglected to pee before being hooked up and realized I was hostage to the six foot length of the IV tube. I evaluated my options:
1 remove the IV and go pee.
2 lift the whole apparatus, carry it to the John and go pee
3 Use my water cup and go pee
4 just go pee (Hey, it ain’t my bed!)
5 call the nurse
6 tough it out
I’ll let you decide which option I chose.
Under ‘thinking outside the box” I guess you could include the Catch 22 option too.

“Forty five minutes”, the nurse said it would take. It was more like an hour, given all the adjustments. Subsequent IVs did go faster after I learned to position my hand (and how to control the little plastic valve doohickey) I got a second at midnight and then 6:30AM.

I rarely sleep more than a few hours at a stretch, which might have fit nicely with the schedule here if only the sleepy-bye times and the wakey times coincided with the hospital schedule

About five different nurses visited me overnight , sticking thermometers in my ears, clamping my finger in a small device and clamping my biceps with a hydraulic strap and then listening to them scream with a stethoscope.

Breakfast. Served at 8:00; I would have expected earlier. A cup of warm milk with a tablespoon of what I took to be oatmeal floating on the bottom. I guess oatmeal is really expensive here. Fruit cup, juice (pear) two slices of lunch meat wrapped around a cheese filling and a wedge of eggy/potatoey omelet. And a cuppa, this IS Panama you know.

More clampings squeezings and stickings, I await more dripping. Oh, if you decide to have a stay here, bring shampoo. All they give you is a teeny bar of soap. There is a soap dispenser above the sink, but it hurts when you bang your head on the wall tile!

I wandered about while awaiting my meds. The drugas cart was a few doors down so I anticipated a short wait. My room was number six on the corridor from the nurses’ station with the room beyond mine the last one occupied. The hall extended down to room twelve and than a suite. Another corridor of rooms branched off near the end, which led down to another nurses’ station and more rooms. All were vacant. Doctors in Chirique must be doing a damn good job to be keeping the hospital so empty!

12:15 brought lunch, the biggest meal of the day. Chicken, rice and veggies, a piece of fried chicken, and tomatoes. Also a soup of chunks of potato, yucca and something similar to both. They all tasted the same. Oh, and a couple pieces of chicken in the soup. Pollo day at HC

After lunch another IV drip. My left hand gave out and the drip reduced to a dribble, so they had to open a new pipeline in my right. Inconvenient. I can’t write while being intravenoused, and I keep reaching for things, forgetting about the line.

My main concern now is whether I getta go home or will have to stay over another night. No one seems to know, only the scarce Dr Pazmino. I will have to buttonhole an English-speaking nurse and try to find out. Hmm, let’s see, how do you translate ‘buttonhole’?

Alrighty then. The elusive Dr Pazmino (Paz-mean-yo) ‘he no come to de osspital today”. I did, however, get a commitment from the nurses to call him. Obviously I hope not to have to stay over another night and definitely not a third, since I only brought two pair of clean underwear. What would happen if I had to drive home in dirty underwear and had an accident and had to go to the hospital? Every mother’s worst nightmare. She would turn over in her grave (an interesting concept, since she was cremated).

Alnotrighty then! Dr P showed up, examined my canalii and exclaimed “Mucho mayor!”, either “much better!” , or “I want your vote for mayor!” Even though it meant the former, he explained that the infection was so bad, that to stop the IVs too soon would result in my eventual return to HC. So I need to stay over not only this night, but the next as well! I guess I have to put my faith in modern medical science. Did I mention that I hate hospitals?

The rest of my vacation went about the same; lots of drips and drops. More chicken-heavy repasts and lots of wandering around the hospital for exercise and relief from boredom. Doc and Charly had come and recharged my underwear supply and coins for the coffee machine.

I had expanded my micro-fiefdom to include my roomie’s recliner for TV viewing (mine was a storage rack), his roll-about table for my beverage cart and in general usurping all I surveyed. I returned from a walkabout in the afternoon to find that my room had reverted to, well, a hospital room, my square footage severely restricted.

As I surmised, that afternoon brought another patient to the Ramon Arms wing of the HC resort. He was immobile and asleep the majority of he time, but had seven or eight generations of relatives attending him at all hours and his wife stayed all night, sleeping in my TV chair!

I was surprised to see the good doctor early Thursday morning; he examined me and said I could check out (easier said than done). No more medication, just go home. Were it only so easy!

I started asking nurses how to check out, the equivalent of banging my tin cup on the bars for the jailer to release me. The procedure was to start the ball rolling in the admissions office (shouldn’t there be a demissions office?), who would alert the accounting office, who would check with the nursing staff and consult various oracles. Basically, “We’ll get back to you.”

When I got back to my hood, a nurse informed me that I should go to my room where my meds were waiting. one last IV and eardrops . Apparently Dr P had meant to say no more medication not already scheduled. Well, it gave me something to do while the bureaucratic wheels ground.

When the IV finished, I asked the nurse if she would remove the IV from my arm (the third location, the second having dried up as well), but she would not. First I had to get a note from my mother and then a note from admissions which I couldn’t get until I paid up at the cashier., all of which awaited the proper portents and signs. Apparently they thought I wouldn’t be able to leave without paying if I had the IV needle still stuck in me; diabolical!

By eleven or so all the stars had aligned and I was able to bid adieu to the Chirique Resort and Spa. I still felt like I had balls of cotton stuffed in my head, and puncture scars and several prescriptions, but I had tasted my last of the chicken and yucca soup.

The overall experience wasn’t bad; the nursing care was very good, the rooms clean and modern, the food OK., not that I’d care to repeat it anytime soon. My 30% of the tab was under $500 for the three day stay;. Beats the alternative.