First thank you all for your good wishes and prayers. Usually I answer each and every comment but I beg your indulgence, please consider this post as my letter to all of you.
Duke, my husband, is in ICU at Clinica de Merida. He’s been there since the evening of September 30th. He is sedated and intubated.
Hindsight is a killer, isn’t it? I am trying very hard to be present, and not regret any of my decisions along the way. Just like in my parenting, I know that I have done the best I can with the information that I had at the time.
Duke (and yes, that is his real name) is a private person, very introverted and quiet.Which is why I always refer to him as Husband on my blog. For the last couple of months he has been tired and irritable. Looking back, I now realize that he was probably not getting enough oxygen. My best friend says that now that we’ve been through it, we know what that looks like, so it won’t happen again.You can’t recognize something you have never seen before.
He came down with La Gripa (a cold) which progressed into a throat infection. He is a lifelong asthmatic, fortunately his asthma has been dormant since we moved here. Unfortunately, he was diagnosed as having COPD awhile back. A diagnosis of Chronic Obstructive Pulmonary Disease means you either have emphysema or chronic bronchitis or both. He has emphysema, which is not curable, it’s a progressive disease, and the best you can hope for, at this point in time,is to slow down the progression.
On the 16th of September, he felt so badly that we called our house call doctor to come see him. Dr R prescribed an antibiotic and a syrup to thin the phlegm. He was concerned and told me to call him in three days with a report of Duke’s condition. His lungs were clear at the time. On Friday, I called, Duke was getting better but slowly. Dr. R said let’s see how he does over the weekend, he should be much better soon. On Monday, he was worse. Dr.R came to the house, bringing a sulfa drug for Duke. Still no sign of pneumonia or bronchitis. Duke’s urine was dark, which concerned him, he suspected a secondary opportunist infection in the kidneys. He ordered some tests done, the lab came to the house and swabbed for flu and took a urine sample.
The tests came back negative for flu, and the urine which by this time was the color of strong black tea, didn’t have any blood nor bacteria. Dr R suspected hepatitis, and strongly urged me to take him to the hospital.
Even though we have Seguro Popular, I took him to Clinica de Merida. Well, actually, one of my girl friends came and we both helped him into her car and took him. I thought that he’d be there a few days max. His oxygen was dangerously low, and now he had fluid in both lungs. Luckily, no hepatitis or other liver problems.
I’m out of touch with how hospitals are in the USA, but here they brought a portable x-ray to his bed, and got back his blood work within a half an hour! The x-ray was digital and sent to the treating Dr’s phone! Dr. E admitted Duke into the hospital.
In the regular room, he was put on oxygen. Every 4 hours they nubulized him,every 6 the respiratory therapist came and thumped his back. He was on several IVs plus got a daily shot, in his belly button, to prevent an embolism. I pretty much stayed with him 24/7 while he was in the room. My wonderful friends came and sat with him for a few hours so I could either go home or to my own doctor’s appointments. They also took care of my animals for me.
Dr E mentioned the possibility of his being sent to terapias intensivas (ICU) but his blood work came back better than expected and so did his x-ray. He continued to improve but at an extremely slow rate. Wednesday morning he had a respiratory crisis.
Duke had been concerned about the money we had been spending. My cancer had cost us about $50,000 usd and our savings were very low. I just replied, “Good thing I didn’t have that breast reconstruction, we have the money to keep you here until you get better.” FYI, the quote for a breast reconstruction with implants and a prophylactic mastectomy on the other breast was around $22,ooo usd. Which would have completely depleted all our reserves, something I found more daunting than being lopsided. That is how I found out about Seguro Popular, and enrolled us both.
Dr E had explained to me that they would avoid intubating him because of his COPD. If he is intubated too long there is the possibility that his lungs will become reliant on the machinery to breath.
Before moving him to ICU,I asked Duke if he wanted to be transferred to another hospital, specifically either Clinica Yucatan, a very good but shabby looking private hospital within walking distance of our home, or the Hospital Augustin O’Horan which is the Seguro Popular Hospital or the Hospital de Alta Especialdades in north Merida, which accepts Seguro Popular patient at a reduced rate.
In a labored whisper, he said, “I’m afraid that I am going to die.” Words fail me, my heart sank. I asked him if he felt that Dr E and Clinica de Merida were his best option and could pull him through this. Out of breath, he simply nodded yes. That is why I kept him in C de M. I felt that keeping him in a place where he had confidence in his treatment was more important than anything else.
Thursday morning when I went to see him in ICU, I glanced at his monitor. My heart lifted, his oxygen level was between 98 and 100, his pulse was 74! I was beyond happy, my mood soared. The move had been a good one, in his room he has struggled to get 84% oxygen. If your oxygen levels drop below 90% there is cause for concern. His struggles for breath had kept his pulse around 126, a big strain on his heart. Then I realized that he had been intubated, I felt like I was either going to faint or vomit, or both.
There he was in the bed, his hands tied down, a tube in his nose, a tube down his throat, and about 9 different bottles festooned on the holders. Dr E explained that they had tried to reach me, I have no idea how I could have been out of contact. Duke hadn’t responded as well as they had hoped to the mask and breathing machine, and had another breathing crisis. To be honest, I would have said, intubate him then. If he spends much more time with the tube they will have to perform a tracheotomy instead. Which in a way will be easier on him, since he won’t need to be sedated.
Wednesday afternoon, I had paid the bill to date, almost a week’s stay with a lot of therapy and care came to about $54,000 pesos.You’ll have to do your own math, but currently the exchange rate is a blessed 16 to 1. There was no reason to believe that the ICU would be more than 10 or 15% more a day. Since our money is in the USA and the amount that we can withdraw daily is limited, I chose to put the charges on the American Express card and make payments to it. Trying to keep up on things, I paid the first two days in ICU, that bill was $75,000 mxn.
I did the math and went begging. I talked to the social worker in admissions, Duke was getting a 10% discount on room and x-rays because of his age and INAPAM card, she got him an additional 5% plus extended it to lab work but not medications. The medications are more than 50% of his bill. I talked to Dr E, and explained that while I deeply love my husband, I could not afford to keep him in ICU much longer and needed to transfer him to the O’Horan or Alta Especialidades hospital. He understood, his suggestion was the O’Horan, he wrote me a report to take.
At the O’Horan, I went to Trabajo Social who sent me to Dirección, where they read the report, and called to the ICU. Sadly, there was no ventilator available. They advised me to return the following morning (yesterday, the 3rd) at 8 am and check again. I did, still no room, but they took a copy of my paperwork, my name and cell number and said they would call. I asked if they could contact Alta Especilidades for me, but regrettably, I had to go in person. I walked out of the hospital, straight to the street where I immediately caught a taxi.
Saturday is bad day to try to do anything at Alta Especilidades, it was virtually deserted. At the first checkpoint, I explained my plight to the guard, he sent me to Trabajo Social, where I passed another guard and was given a wristband. Alta Especilidades is huge and modern, I walked what seemed like miles. When I reached my destination, that guard sent me to a talk to a lady sitting at a desk in the middle of the room. She also listened to me, and explained that I had to go to Section 3, continuous admission. So back past the guards, out the back door and around the building I went. There, I talked to the girl manning the window. She read my papers, informed me that there would be charges to admit Duke, and went off to present my papers to the doctor in charge.
I sat and read, well, I held my kindle and looked at the words, but really didn’t comprehend anything. Finally, I worked on being present, on observing my breath. Eventually, she called me to the window, the same result as at the O’Horan, except she gave me a phone number to call. I did call at shift change but no one had been released yet. I am praying that someone in either of the ICUs will have a speedy recovery.
After visiting Duke in C de M, which is exhausting. On the advice of my sister-in-law, who is an RN, I have been massaging Duke and doing passive exercise with him. His limbs are heavy. I see him from 11 to noon, and again at 5 pm to 6 pm. I can return at 9:30 pm but I’m just too worn out by then.
So here we are on Sunday, it’s almost nine and I am going to walk the dog, take a shower and get ready to go. I’ve been leaving the house about an hour before time so I can walk to Avenida Itzaes and take a bus. I feel that I need to exercise, and the bus costs between $3 and $7 pesos (depending on whether they take my citur card) while a taxi costs between $30 to $50 depending on the taxi and whether it’s day, evening, or Sunday.
On the plus side my Spanish is getting really good and I’ve lost 3 pounds. This is all I can think to tell you all.