Too Much Excitement

Well, this is a medical post, so I'm sorry if there is TMI for anyone.  I was treated for prostate cancer in July of 2008 with a procedure called HIFU or High Intensity Focused Ultrasound.  Everything went as advertised, and after 5 1/2 hours on a table in Nassau, Bahamas I was cancer free.  The prostate was basically microwaved to death 2mm at a time, killing the nasty cancer cells along the way. A possible complication is some thermal damage to the urethra or the opening to the bladder, where the urethra connects.  Until Thursday night, I had no problems.  For no apparent reason, the tissue where my prostate used to be swelled and shut off urine flow.  This got progressively worse, until I woke up Jackie at 2AM and told her I needed to go to the ER while I could still walk.  We grabbed a tricycle and went to the Makati Hospital ER.  This is a government operated hospital, and Jackie thought I should go to a private hospital.  They were all so far away, I didn't think I could stand the ride to one of them.  In addition, there was no guarantee they would see me without a referral from a doctor, so I decided closest was best.  The triage nurse told me that I would have to pay because I wasn't a Philippine Citizen.  I said, "fine," so he put me in the system.  This starts with filling out forms by hand, in at least duplicate, using carbon paper for the copies.  Another nurse puts the information from the form into the one computer terminal in the ER.  After about an hour, a nurse took medical history and symptoms, and in another half hour, I got to explain the previous information to the surgery on-call.  She decided I needed a catheter inserted to relieve bladder pressure, and that I could get some tests and consult their urologist as an out-patient.  She did an exam and gave a commentary in Tagalog to her assistant, who furiously wrote down every word.  Then she turned me over to a nurse to inert the catheter.  Now I've had that procedure done before so I wasn't thrilled when he grabbed a plastic chair and pulled it in their break room and tried inserting with me sitting down.  I knew it didn't work, so I sat and waited for another hour for the surgeon to try it herself using a smaller size tube.  The nurse caused some trauma, and the blood in the tube was a little disconcerting, but I watched other nurses patch up a stabbing victim who was sitting in the same type plastic chair, in the ER waiting room, so I decided I wasn't as bad off as I could be.  Now Philippine health care is participatory, and you need at least one family member or Tagalog speaking friend with you.  The hospital doesn't have a central supply, so they sent Jackie to the pharmacy to get the catheter.  Then, the doctor was having some trouble threading the tube and injecting the water to blow up the balloon at the same time, so she called Jackie to help.  Jackie was not up to seeing me naked, with a rubber tube sticking out of the part of me she didn't want to see in the first place, and so the doctor had to figure out how to push the syringe plunger herself.  About 7AM, they were winding up the paperwork, and sent Jackie to pay my bill.  Now get this people, with NO medical insurance, my TOTAL ER bill was 200p...I'm not getting billed by the doctor or anyone else.  That's $4.35 at the current exchange rate.  The equipment was 20 years out of date, there were a LOT of people to take care of, but it seemed like the staffing was adequate, and everyone was doing their job, no one was gooding off.

The last Mayor of Makati has a reputation for efficient government, and was elected Vice President of the Philippine Republic in the recent Presidential election.  Jackie thinks his administration is responsible for the hospital being as efficient as it is.

I am probably going to a private urologist for my consult because of the cancer/HIFU issues, but I got competent, basic emergency medical care for $4.35  Jackie brought the receipt from the business office back to the ER, and they gave us a clearance form so the security guard would let us leave.

Again, I think there is something to be said for the Philippine way of lower tech, more staff.  However, the majority of Philippine workers, in all fields, seem much more customer service oriented than most US workers, and I have yet to see someone being lazy at their work.  The triage nurse said his goal was to work in the US, and I told him that any US hospital would be lucky to have him.

We walked from Makati to Pateros, me jauntily carrying my plastic bag of bloody pee, and Jackie leading the way through the maze of alleys.   We stopped at two drug stores, and neither had the medicine the doctor prescribed, so we caught a tricycle for home, and Jackie made me coffee and a thick chicken rice soup that is the Philippine cure all food.  Then she went out to the BIG drug store to get my prescriptions and to buy food for the day.  I'm going to have to see if I can find a collection bag that will go under my clothes so I'm not stuck in the house for 2 weeks.

I am drinking water, and the tube is running blood free now, so as long as I don't have some horrible complication from the procedure or cancer at work again, I should be fine.  Joan just brought me a fresh cup of coffee, so I'll post this and sip.  I miss my roaster, but I have learned to enjoy Nescafe' like the rest of the world.

Jackie got back from the drug store, and market.  Half of my prescribed pills cost 3618p  or about $80.  Remember, I don't have health insurance, so that's not a co-pay.  Prescriptions ARE taxed at 12%  I'm guessing that is because they are imported.

I just realized that Jackie opens cans with an 8 inch kitchen knife!  I need to find a can opener the next time we go to the mall!  I should explain that cans are not a common container for things we use every day.  Most things come in some kind of pouch designed to be either single use, or emptied into some sort of container.  For example, a Coffeeemate refill or a pouch of tomato sauce.