Surgery in a Public Hospital in Panama: My Story.
Nurses in the surgery ward
I’ll be honest. I was in denial about my physical symptoms for many months. Indigestion and chomping on Tums like popcorn were the norm and even with the burning sensation, pain under my ribs and acid reflux - I didn’t go see a doctor.
Part of my reluctance to see a doctor was that I didn’t have any health insurance. When I moved to Panama, I knew that healthcare was affordable and I figured I’d pay for medical care as I needed.
Which was fine for routine care; bloodwork, mammogram and dental cleanings.
But I was a bit naive in having a plan for anything urgent. I learned the hard way, I should have had a plan in place.
On a Friday in the late afternoon, the internal pain on my right side was getting to intense to ignore. I put a call into the Panama Helpline, a $120 a year subscription for help in English during emergencies. But there was no answer.
I posted in one of the expat FaceBook groups to ask if the helpline was working. An hour and a half later, I was able to connect with someone who advised me to go to the public hospital in San Carlos, about a 45 minute drive from my home in El Valle.
It was a bit of a challenge to figure out how to get in the system to get seen, but once I did, I was fortunate to have an English speaking doctor who gave me IV paracetamol (Tylenol) and she told me she suspected I was having a gallbladder issue. She wrote a prescription for me to get an ultrasound and told me to come back to the hospital on Monday to schedule the ultrasound.
Blood pressure before surgery
By the time I got back home on Friday night I was in severe pain and early in the morning on Saturday, was vomiting and felt like my insides were trying to turn inside out. I called the helpline to see if there was a medical office open on a Saturday where I could get an ultrasound.
But in the time it took to hear back from them I started thinking about getting to a hospital - it was feeling urgent.
I got 2 different opinions on which hospital to go to from the helpline associates. I knew I didn’t have the strength to drive to La Chorerra over an hour and a half away. So I decided to go to the public hospital, Aquilino Tejeira in Penonome about an hour away.
I should not have been driving but I didn’t feel comfortable asking anyone for help; it’s too far, too much to ask and I didn’t want to be a pain in the ass. I do wish that the helpline associates had a protocol of assessing someone’s needs, perhaps they would have advised me to take an ambulance and arranged for one to pick me up.
It was confusing to navigate this larger hospital and how to get seen but I did get taken to a triage area and given some hydration. Even though I had the prescription for an ultrasound from the doctor at the hospital the night before, this hospital’s doctor told me they may not give me an ultrasound because it wasn’t an emergency.
I felt like it was an emergency. I broke down in tears and anguish. What the hell was I going to do? I didn’t feel like I had the strength to drive myself anywhere and my mind wasn’t processing information accurately due to the pain.
9 hours in the triage bay
Not feeling well at all
My bloodwork and urinalysis came back normal and the doctor said it was up to the surgeon on duty to determine IF they would administer the ultrasound. Finally, 9 hours later, they wheeled me into the small room for the ultrasound of my gallbladder.
I was brought back to the triage area where I asked repeatedly for more of the pain medication, the intravenous paracetamol, from anyone who walked by but no one reconnected the IV with the pain medication.
Finally, at 9pm someone showed up with a wheelchair and an identification bracelet to wrap around my wrist. I was told I was being admitted due to the inflammation of my gallbladder and the size of the gallstones.
Thank God.
I slept for most of the 2 nights I was in the hospital. It was an incredible relief to not be in such intense pain. A surgeon came to chat with me and told me due to the size and location of the gallstones, and the amount of sludge build up, surgery was the best option.
I was instructed to get an EKG, chest x-ray, blood panel and urinalysis no more than 8 days before meeting with the surgeon to finalize the surgery details. Oh, and I had to bring a blood donor to the hospital with me on the day I was meeting with the surgeon.
What the heck?!
What kind of bizarre healthcare obstacle course had I gotten myself into?
But in the public hospital system, it is typical that the hospitals do not have a blood bank and so they require you to bring a donor.
I didn’t even want to ask anyone for a ride to the hospital! Now I have to ask someone to get up at the crack of dawn, go to the hospital with me and get blood drawn?
But a miraculous thing happened, I had people offering to donate blood for me. My friends Katrina and Ken also lived in El Valle and were early risers, so off we went before the sunrise to the hospital for them to donate blood and for me to meet the surgeon and schedule surgery.
To my surprise, the next available date for surgery was 10 weeks away. At that time, it felt like an eternity. I was weak, had gallbladder spasms and sharp pains. I didn’t see how I’d make it 10 weeks.
But after 4 weeks, the sharp pain went away and I was eating solid foods, low or no fat, of course.
Blood donation area
Nurse’s station
Ward with 6 patients
That was just ONE stone
I was looking forward to the surgery so I could get back to feeling healthy and follow through on my intention of being more active.
The surgeon told me I could drive myself to the hospital and back home the day after surgery. Check in on that early Sunday morning was pretty smooth and I was brought to the same ward where I’d stayed for pain and inflammation management just 10 weeks prior.
My bed was next to the window, and even though the room was quite cold from the air conditioning, I had rays of sunlight that warmed the blanket covering my feet. Normally, my cat, Feather was my foot-warmer. But she was being looked after by my friend until I made it home after surgery.
The woman next to me was also having gallbladder removal surgery and some of her family spoke English and helped translate for me when the nurses came in to ask me questions using words I did not know in Spanish.
Two older women were being cared for around the clock by their adult daughters. They propped pillows, spoon fed with care, applied hand lotion and sat by their sides for hours. It was so tender to see that intimate bond between mother and daughter.
I thought back to when my mom was in the hospital and then in hospice care before she died. I sat next to her bedside with hopeful anticipation that she’d miraculously recover, or at least open her eyes.
Sitting at the bedside of a loved one who is sick or dying is an intimate and sacred time that we typically don’t get to witness others having. But in the ward with 6 patients, you witness many intimate exchanges between loved ones.
Three of us were woken up at 4 am and handed 2 razors and told to shave our torso and pubic regions. This would have been great information to have before my trip to the hospital. I could have done this with a hot water shower, shaving cream and without IV bags hooked up to each of my arms.
They took my roommate for surgery at 6 am and she was wheeled back just before noon. I was getting a little concerned that they weren’t going to get to my surgery that day. And I was hungry, craving tacos and really wanted just a few sips of water.
Just after 1 pm I was whisked away to the surgery suite where a kind English speaking anesthesiologist was there to greet me.
The only time I felt a bit anxious was when they strapped my arms out to the sides and I heard the metal clanging of tools being put on surgical trays.
The anesthesiologist injected the first part of the medication and I started to feel dizzy and relaxed but nervous I wasn’t going to go under all the way. This fear stemmed from a prior foot surgery where I woke up during the procedure, much to my and the doctor’s surprise.
The last thing I remember the anesthesiologist saying was, “Think about a beautiful place that you love.”
I whispered, “My garden.”
On the way to X-ray
My garden
