the way it goes...

no, i haven't disappeared off the face of the earth...i'm just way behind on updating my blog.

after 2 months of going to interconsulta (appointments in the hospital in teguc) at least twice a week, i just thought it would be interesting to give you all an idea of the typical happenings of our adventures while in the city...

i went in one day with one of our HIV kids, to have a biopsy done. we had to go in on public transport, which wasn't a huge deal (we generally have transport from the ranch, but since it was just one kid going in, we had to travel on our own). so, we show up to the hospital at 6:30am (left the Ranch at 5am), so we would be there in plenty of time for his 7am appointment. the doctor shows up at 7:30, and then decides that this child has to wait to be the last of all surgeries, because he has a skin condition (just fyi, it's NOT contagious by any means). the surgeon tells me that he has to wait to be the last patient because they have to FUMIGATE the OR after this child enters. what?!? totally not necessary, but ok, whatever. however, the most annoying thing was that they said this right in front of the kid. way to have tact.

so, we wait until 10am. they refused to let me into the OR with him, although they had been letting every other parent in with the kid, at least until they receive their anesthesia. five minutes later, they call me back inside, and tell me that we have to return another day, because the child was refusing the surgery. allow me to explain: we had already been for one attempt on this biopsy at a different hospital, where they did it by needle aspiration. after 1.5 months of waiting for the results (because the hospital was on strike), turns out that the specimen was bad, so it would have to be redone. we were all under the impression that the second time around it would be performed the same way. when the kid went into the OR, they put a mask on him, and from that moment on, he freaked out.

so, i go in to talk to him, and finally came to the conclusion he was just scared, because they hadn't explained to him what they were going to do. (please keep in mind this kid is 12 years old) rightfully so, he got scared when they told him they were putting him to sleep so they could cut out his lymph node. umm, i would've been scared too. so, he told me he would allow them to do it, just if i could go in with him while they put him to sleep. great, no problem. so i tell the nurses and the surgeon this, and they start giving me a hard time that this kid is being so uncooperative, and that they don't have time for these games. (what?!? he's 12!! and they're mad that he was scared??) they told me again that we would just have to come back some other day.

ok, the next week we go again, this time with a ranch vehicle, but only after having to fight with the director of transport. he told me there was no way i could get a driver. here's the deal, i had to first go to Hospital Escuela at 7am (public hospital where we go with the HIV kids for their monthly appointments in the infectious disease department), because i was waiting for urgent papers from the doctors that they promised they would have that morning, that i had to get to our social worker that day, because she was going to the court to speak with the judge about a few of our kids. i needed to then drop these papers off at our house in Teguc, and then get this boy to surgery by 8:30am at a different hospital. there was no way this was possible if I would have gone on public transport. so, the director finally gives in.

we arrive at Hospital Escuela for the papers. the doctors show up late, and oops!! they don't have the documents ready. they tell me i have to come back later that morning to pick them up (the doctors leave there at 11:30am) so, i tell my driver that, he FLIPS out, and starts yelling at me that i'm not the only one that needs transport, and that i'm asking too much of him, and on and on and on (this is not by any means the first time we've had problems with this guy - it's been ongoing for over a month. every time you ask him to go to a lab, or hospital, or whatever, while we're in the city for appointments, it's like you're asking the world of him. it's like he thinks we're just asking these things of him to make him angry, but everything we ask of him is necessary for the work we do.) ok.

we get this kid to the other hospital at 8am, and the surgeon sends me to a pharmacy outside of the hospital to buy a pill to knock the kid out before his surgery. the pharmacy doesn't open until 9am, so we sit there and wait. the woman shows up to open, and oops!! she doesn't have her keys. she goes back to her house, and gets back at 9:45. i finally am able to give them our prescription, which clearly states we only need one pill of 5mg. well, they only have 7.5mg or 15mg pills. i ask for a 7.5mg. she comes back with a box of 30 pills. i remind her we just need one. she comes back, gives me the pill, i go to pay, then look more closely at the pill, and it was a 15mg pill, not the 7.5mg. i eventually get the right dose.

we get back, and i tell the surgeon i had a 7.5mg pill, and we decide to just give him half of it. the doctor then tells me he wants the other half of the pill for himself!! haha, ok. i'm not sure if that's really ok, but i just gave it to him. odd.

the kid gets knocked out cold. i get him on the operating table, they put him under even further. i watch his oxygen saturation drop from 100% where it should be, number by number, all the way down to 74%, which is not good. as the numbers go down, machines start beeping, red lights flashing, and nobody notices. finally at 74%, i ask one of the nurses, what those numbers are. one is 74, the other is 108. she tells me both numbers are his heart rate. huh, i never knew your heart rate could be 74 and 108 at the same time. finally, the other nurse looks at it, and says "hmm, yes, his sats are dropping". YA THINK? so, they start to bag him. i was sure i was going to lose that kid right then and there.

ok, they finally get him all taken care of, he starts waking up, i go outside to change, and my phone rings. it's the driver, all upset that we're not done yet. (he had called 10 times while we were in surgery) he tells me to tell the doctors to hurry up, because he is waiting. ok, sure, right, i'm sure the doctors would really hurry up, just because our ride is waiting. the driver tells me i need to meet him at the airport, because he was going there to pick up a visitor. i told him there was no way i was getting this kid on a bus in his state. i mean, the kid couldn't even stand up with help at that point. driver gets mad, and hangs up on me, for the 3rd time already that day. so, he finally shows up, i met him out in the front of the hospital, and tell him we need to drive around to the other side, to pick the kid up outside of surgery, because he couldn't walk out to the front. gets mad again, floors it, he nearly hits a man crossing the street (the visitor he had just picked up is a 60 or 70 year old man in a wheelchair, who is sitting in the front seat, probably scared out of his mind). i go to help the kid walk out to the car, the driver telling me to hurry up because we're late getting back to the ranch.

we finally make it out of there alive, and go to the lab to leave the lymph node for biopsy, etc. the microbiologist there tells me that they can't do all of the tests ordered, because the surgeon put the lymph node in the wrong preserving solution. haha, sweet!! way to top off the day.

i ask the driver to stop at a grocery store that was right on our way out of the city, because the kid had to use the bathroom, and i needed to grab him something to eat, because he wasn't allowed to eat anything all day before his biopsy (and at this point it is 1pm). he gets mad again, saying i'm asking too much of him. but we stop briefly, and head back to the ranch.

the next day, the general director of the ranch, comes to me with a complaint from the driver. the driver had told him that i made him stop at the grocery store for the visitor, because he was hungry. (remember, that we stopped at the store for the kid in the first place. i offered to buy something for the visitor as well, because we were going to miss lunch on the ranch, and he had been traveling all day, so i was sure he was hungry) but, funny, because during the rest of the day the driver seemed so worried about this visitor, about getting him to the ranch quickly so he wouldn't be uncomfortable. and then he complains that i wanted to stop to get him something to eat. ugh.

so, that's where the adventures for the day end. it just seems like each time we go to interconsulta, it's one joke after another, whether it be with doctors telling me the wrong dosages of medications the kids are supposed to be taking, just because of their lack of checking their notes well, or prescribing medications that shouldn't be used together, or eye doctor offices not having a contact lens that we had paid for 4 months ago that still hasn't arrived, or labs being out of reactant to do the simplest of blood tests, etc. it can be very frustrating work...

sorry for ranting.