Friday, March 30, 2012

Medical Mis-Adventures--Part 3--Mexico City, 2012

Wednesday, January 11th

It’s my 6th day in Mexico City.  Early winter.  Soft, warm days; cold nights.  On the way to La Casa de los Amigos I realize I’ve eaten something that’s not settling well in my stomach.  I’m going to make it into the center, but the long metro ride isn’t doing much for my intestines.
When I get to La Casa, I just about race to the bathroom.  And then again 30 minutes later.

I reach into my pocket to get some money, but realize I’ve left home empty handed.  I ask the woman at the desk.  She lends me 200 pesos and I make my way to the pharmacy on the corner to buy some Imodium.  That gets me through the day.
I have little appetite, and what I do eat goes right through me.  Food poisoning, I think.  I’m no stranger to this!

Thursday, January 12th
For some reason, Steve is at home and not in school.  I text him and tell him I’m sick.  Really sick.  I can only get out of bed to go to the bathroom, which I’ve done all morning.  And even that’s an effort.

We agree to Skype.  I keep the computer in bed with me. 
“You’re scaring me,” Steve said.  I’m scaring myself, because I know I’m super sick but I’ve got absolutely no energy to get up, shower, organize myself.  I know I have to get to the doctor, so I text my friend Allison at La Casa and ask her if she’s be willing to go to the doctor with me.

I get out of bed.  Shower, I think to myself.  This is an effort.
Now you have to shave.  Put on socks.  Pants.  I’m having this running dialogue with myself.  I have no energy and am exhausted by the time I’m done.

I call a taxi and meet him downstairs and forty minutes later I’m in the center of the city.  I meet Allison, and her Honduran boyfriend, and they go to the doctor with me.
I’m grateful to them as I just don’t have the inertia to try to communicate with the doctor who speaks no English.

She diagnoses Gastroenteritis, prescribes meds. I take another taxi home and sleep all afternoon and evening.
Friday, January 13th

Things are a bit better.  The meds are doing their work and I have more energy.  I manage to go into the city and do a bit of work, but am exhausted by mid-afternoon.
That evening, my friend Gerardo calls and asks if he can come by to prepare a meal.  I’m certainly not eating, so I say yes.  This is no small thing that he does.  It takes him an hour and a half to get to Coyoacán, where I live.  This city is a monster and getting from A to B can be an ordeal.

But I do eat, and I appreciate the company, and am grateful that someone here cares. He leaves for work, I go to bed.  It looks as if my body is turning around.
Saturday, Sunday, Monday, January 14th to January 16th

I feel better, but not what you’d call “well.”
Saturday I stay close to home, but venture to Los Viveros, the nursery near my apartment, to buy some plants.  What should take 10 minutes, takes close to 30, with a long break in the middle each way.

That evening I decide to go to the movies.  I’m almost back to “normal,” so indulge in popcorn and a huge vat of Diet Coke. 
Three hours later, home, my fragile stomach starts in with cramps.  Horrible cramps for more than two hours.  It’s the only time in my life I have a small inkling of what a woman goes through in labor.  My stomach is twisted and turned and I’m in a lot of pain.  I’m actually afraid, until they stop almost as quickly as they started.

The rest of the weekend passes well, and I’m slowing slow signs of recovery, but not as fast as I’d like.
Tuesday, January 17th

I leave my apartment, head into the city and start the 11:00-1:00 weekly meeting of La Casa volunteers..  I’m not feeling all that great, but what transpires in those two hours is simply astounding.  I slip into remission.  It’s the only time in my life that I have ever used that word to describe something like this.  I can feel myself sliding down, sinking into an abyss of sickness that is frightening me.  I can’t think.  I have no strength and it’s taking everything in me to stay present.
By the end of the meeting I can’t go home.  I ask for a bed and sleep for two hours.  I’m no better, but at least I have enough strength to go downstairs, call a taxi and get home where I sleep the rest of the afternoon.

That evening, my angel-friend texts me.  “Can I prepare you dinner?”  He comes with chicken, soup and rice, none of which I can eat.  I sit at the table, but my head is on the placemat.  I eat a bite of chicken and another of rice.  Just the smell alone nauseates me.  I can’t eat and I can’t even sit up straight at the table.
Reluctantly, he leaves at 9:00 pm.  He works nights, so I tell him I’ll text him every time I wake up. Which I do, a lot, because my intestines are in a full-fight battle and I’m in the bathroom every hour.  Surprisingly, though, I do sleep, and my reports through the night are encouraging.

Wednesday, January 18th
I’m up by 8:00, sicker than I’ve ever been in my life.  At least lying in bed I had the illusion that I felt alright, but the trips to the bathroom have increased.  There is radical diarrhea. For every liter of water I take in, two liters is coming out. I’m honestly frightened.

No one is in the house.  The landlady had left for LA early in the morning, and I’m alone in Coyoacán without a health plan.  I don’t even know where to find a hospital in then neighborhood.  I begin to experience a deep loss of hope.  There is absolutely no way I can get into the center of the city, and I have to acknowledge that I’m gravely ill.  What’s happening is beyond normal.
So I reach out.  I email an acquaintance from Plattsburgh who lives in Mexico City.  I know she’s constantly connected to the Internet via her Smart Phone. 

“Amy,” I tell her.  “I’m very sick.  Can you direct me to an English speaking doctor?”
What I didn’t know is that she picks up the email in Boston, immediately contacts her husband who’s a CEO for a multi-national in Mexico City, who then contacts his secretary who contacts the driver.  Within minutes Amy emails me back and says, “Marco’s on his way.  Be ready in an hour.  He’ll bring you to the hospital.”

I pick up the apartment, pull together things and put them in a day pack.  Somehow I have the foresight to pack my credit card and passport.  I email a few people at home to pray for me—my Aunt Gloria, my pastor at church, Ed and Rita Graf.  I’m afraid, but less afraid knowing that I’m on my way to medical help.
Then I wait.  I’m overwhelmed—not only with the kindness that’s directed at me, but that I’m going to be ok.  I start to cry—tears of relief and tears of gratitude. 

Maria, Scott’s secretary, is in constant communication.  “Marco’s 30 minutes away.”  “Marco’s ten minutes away.”
Then Marco calls, I go downstairs and he picks me up and we head up and out of the city to Interlomas and Hospital Angeles.  He gets me into the ER.  My Spanish is perfectly fine for checking in, but not good enough to describe the nuance of my illness.

Not to worry.  Two interns appear, both of whom speak very good English.  Scot had also called his internist, Dr. Taché, who shows up thirty minutes later.  These guys are good.  They can see that I’m dehydrated and they immediately order the first IV.  “We suspect something more,” said the good Dr. Taché.  Can you give us a stool sample? “
Dah, I think.  That’s all I’ve been able to do for the past 36 hours. 

I easily do what they ask.  I’m suspecting ghiardia.  It won’t be the first time.
Then I wait.  At least I’m waiting in a good place.

An hour later the interns and the doctor return with an initial diagnosis—ghiardia.  They prescribe a two more IV’s—hard core Flagyl, a super concentrated antibiotic that kills the bacteria causing this specific infection, and Pepto-Bismol to soften the effects of such a strong antibiotic on an already challenged intestinal system.
“We want you to spend the night,” said the doctor. 

I suspected that, and I’m glad for it.  I don’t want to be home alone in this condition.
Within minutes the “men in black” come by.  The accountants.  Whatever prompted me to bring passport and credit card? I have to prove my identity and whether I can pay for this service.

I’m wheeled upstairs.  This is no ordinary hospital, and certainly not the hospital that the average Mexican has access to.  My room is a suite with a fine view of Santa Fe.  These are highly desirable neighborhoods and real estate prices reflect it.  The day is lovely and it’s nice to check out the high end apartment towers nearby.
I’m a bit worried that this is going to cost more than the cap on my credit card, so I call home, call the Credit Union, call Visa. 

That evening I receive a text from Gerardo: “Estoy en la Catedral en el Zocalo. Estoy pidiendo a Dios por tu salud. Animo hora por media hora para tu salud.” I’m in the Cathedral in the center of the city praying to God for your health. “  How am I blessed with such a good local friend?
Doctor Taché checks in several times, as do the interns.  “We’re not totally satisfied,” he tells me.  “We suspect even more.  But cultures take time and we won’t know until tomorrow.”

I spend as pleasant an afternoon as possible.  And I’m feeling better.  What with the hydration fluids and antibiotics, by nighttime I already feel on the mend.
Thursday, January 19th

I’m quite content to spend the day in the hospital, and my instinct’s telling me I’m not going going home. I have my iPod and both phones—my Mexican phone and my New York phone.  There’s lots of communication and I feel connected to people at home and in Mexico City.
I watch movies, ask the nurses if I can take a walk.  They unhook the IV’s and I stroll around the hospital.  I sneak downstairs and buy a Diet Coke which I’m not allowed to have.  I take a look at the cars in the parking lot—BMW’s, Mercedes, a Porsche.  This hospital’s designed for those who have.

Those who don’t have do have access to medical via government insurance, but it’s nothing like this.  I thought back a year when I escorted a friend to his local hospital for out-patient surgery.  He came out twenty minutes later telling me that surgery had been canceled because the wall to the surgical unit had collapsed. 
Mid afternoon Dr. Taché and his interns visit.

He confirms the results of the cultures--E-coli and salmonella.
E-coli and salmonella?  These on top of ghiardia?  No wonder my stomach was so mightily assaulted.  They tell me that I’m going to spend another night, which is just fine with me. 

I do get a bit worried about how much all of this is going to cost.  I have good insurance, but this is a cash deal and I’m worried I won’t have enough to pay.
But it’s ok.  Whatever it costs to get better is a much smaller price than death, which was the only other option.

Friday, January 20th
I am feeling so much better.  I’m served lunch, then Dr. Taché and his interns come by.  They ask how I’m feeling, tell me I’ve progressed well and tell me I can go home.

It’s timeWhat I’ve come to realize is that the doctor has been keeping in daily contact with Scott and Amy, so I’m not surprised when Maria contacts me to tell me Marco can pick me up when I’m ready.
I ask for an English speaking accountant, as I want to go over each item in the 14 page document of expenses.  All seems to be fine.

And, to my utter surprise, the total bill is in the $5,000.00 range. 
$5,000.00.  In 1995 I wasn’t feeling well at school, ended up in the ER and the hospital for the night, and the bill 17 years earlier was $7,000.00.  My aunt later told me that she had a four hour stay in the ER last summer and her insurance paid out $4,000.00.  $1,000.00 an hour!

I get home mid afternoon, stay very close to home, as I do all weekend.  I’m better, and that’s the important thing, but it’s going to take a long time for appetite and energy to return.
Postscript:

For days after I was released from the hospital the only things I could eat were apples, ham slices and potato chips.  Obviously my body was crying out for something that it lacked.
I was only in the city six full days when i came down with the first symptoms.  Where did i get this tirad of infection?  I asked one of the interns, a young Mexican woman who'd grown up in Syracuse.  "It was just your bad luck," she said.  That seemed the best answer I'd ever get.
It would take a full three weeks beyond the hospital before my appetite and energy levels were returned to normal levels. 

In the end, I could see how people die.  I came close to it.  If someone is frail to begin with, an illness of this gravity would wear them out.  If someone lives far from emergency services, what would they do?
My body was assaulted.  On the morning that I went into the hospital, fluid was coming out of my organs.  It was only a matter of time before I would have gone into shock.

This happens every day among the poor.  My multiple privileges were never lost on me: escorted to the hospital in a bullet proof vehicle; top notch medical care that I was able to pay cash for; follow-up meds and appointments to make sure I stayed well.
I am grateful still for the angels in this drama: my local friend Gerardo who never abandoned me; Scot and Amy who made sure I got to their hospital and to their doctor; friends and family at home who stayed close and who prayed for me.

I write this more than three months after all this occurred.  I can honestly tell that not a day has gone by when I haven’t thought of this.  I wish I could say that my body fully recovered, but t here is something wrong with my stomach/intestinal system.  It’s just not been normal since January.
But I am grateful!   Grateful beyond mere words for all that was done for me and for the fact that I recovered and moved forward.

It is always best to think of the glass has half full.

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