Tag Archives: medical

Suzy’s Case by Andrew Siegel – a book review……

Over at A Reason To Read.….

photo from Amazon
www.Amazon.com

Amoeba please…………..

When  you visit a country like India, you are bound to bring back some kind of intestinal souvenir. Call mine an Amoeba. The last month and a half that I was in Delhi, I spent a great deal of time with the god of porcelain. He is not a kind god. He kept me very busy.

I finally acknowledged that going to the doctor might not be the worst option. Dr. Chawla was highly recommended and I can see why. She is great.

There were two problems going on – I have told you that I can multi-task my illnesses and I was not kidding. I had lots of intestinal woes and a pretty significant pain on my left side. They seemed unrelated. So bring on the tests.

I ended up with lots of specimen cultures (yeah, sorry it was as gross as it sounds) and an ultrasound and a CTscan. Dr. Chawla initially  started treating me for an amoeba – I am not going to get all the medical terms exactly right – I was in no condition to actually pay attention to everything she was saying. You have a pill for that? I will gladly take it. And then we discovered e coli. Yippeee. Yeah, I was pretty sick.

My kidneys were also swollen and I have/had calcification spots on my kidney and spleen. Whatever.

I know, I know – I should have just brought back the elephant blanket.

Antibiotics have now become my BFF.

I feel much, much better.

And I lost about 10 pounds. So there you go.

old delhi………

I have heard a lot about Old Delhi – and I finally got to go. It is not the place you want to venture out on your own for your very first visit. I never, ever felt in danger – in fact I got some of the most beautiful smiles I have seen since I have been here – but it is narrow and dusty and fast moving. It is not laid out neatly – you can easily get turned around. So, it’s just better not to go at it alone the first time. It was a super quick trip and I plan to go again – and soon. But for now, here is a little taste of what I saw.

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We rode the Delhi metro – it was loverly. Really clean and very easy to navigate. This is the way to go!

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There were lots of vendors selling food. It is beautiful but, no, I did not eat any of it.

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I loved this water pump – it seemed so out of place and so in place all at the same time. This man is washing off his broom.

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You could buy veggies. Very fresh veggies.

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And tassles. Yummy tassles.

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And you can see people working really hard.

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And animals working really hard.

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And more wires than you could ever count – in the land of technical assistance call centers – this irony is not lost.

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This guy was a great big smile just waiting to happen.

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A great big smile.

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The streets are narrow and crowded – but it is a fascinating place.

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I was offered medical books here. Too bad I don’t need medical books. There was quite a selection.

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And you know I loved the kick arse doors in this place. They rock!

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This visit was too short. I plan to go back and see the wedding district, the spice market, and the nut market. Plus whatever else the day has to offer.

International S.O.S……………

Does that sound like I am calling out for help? Really I am not – but here is something you should know if you are an ex-pat living in a third world country or if you plan to visit an impoverished area.

There is an organization called International SOS and if you are ever traveling in a foreign and/or remote area, you will want to remember they exist.

Here is their web address

www.internationalsos.com

Who are they, you ask. Well this is what they say about themselves….

With over 20 years of experience, we help organizations ensure the health and security of their travelers and employees around the world. We are the only assistance company with the global presence our clients demand.

Working in some of the most inhospitable places on earth, we offer international standards of medical care where it is not available or where cultural and language barriers exist.

Huh, you say.

What this means is that if you are traveling to a village (or even a large city)  in India (or China or Afghanistan or anywhere) and you get sick and that village/city does not have appropriate facilities and/or doctors to treat you, International SOS will step in to help you. That is very. good. to. know.

Many companies offer their employees memberships to International SOS as part of their compensation plan. But even if you are not a member – remember their name.  It it my understanding that they can still be very helpful.

In Delhi, they are located near the Apollo hospital.

Remember that the availability of effective medical resources is never a given – I had always taken this for granted in the U.S. – but no more.

I went to a presentation at my children’s school and  a representative from International SOS gave a talk on medical expectations in Delhi and India.

Here were some of his cautions….

Blood transfusions should only be accepted as a last resort – only when they are life-saving. Blood is not monitored that well here and some people are paid for their “donations”.

Apollo, Max, and Fortus are the only hospitals he really recommended.

He highly recommended getting rabies vaccines. When we were leaving the U.S. the rabies vaccine was not available as a preventive measure, only as a treatment once someone has been bitten by a rabid animal. But apparently it is available here in India. So we are going to get them here.

He also cautioned to get vaccines and prescriptions from the hospital pharmacies. It seems there is quite the pharmaceutical black market here and much of the medicine can be counterfeit. That makes it not only potentially ineffective, but quite possibly dangerous. And he cautioned us to ask the nurses to open any vaccine viles in front of you so that you know it has not been opened before. Whenever possible, get vaccines while you are on home leave.

Taking an ambulance to the hospital in an emergency might sound like a good idea – but they are not reliable and often do not have the medical equipment that would make it worth waiting for one. The presenter recommended practicing getting to the hospital before an emergency happens so you know what to do. He said it is particularly important to do a dry run at night.

In an emergency, he recommended calling the the hospital and asking how long it would take to get an ambulance to you. He said that they should be able to give you an idea of how long it would be. However, getting yourself there might be the best option and just might save valuable time.

He also said that calling International SOS might be a good idea – they have a staff there who can make multiple calls at once, which can reach out to multiple resources at once. If I remember correctly, they will stay on the phone with you until you have gotten help. Consider calling them from your mobile phone so you can remain on the phone if you change locations.

He highly recommended using bug spray that has a 35% concentration of Deet. It has been hard for me to find bug spray here – which is shocking- but I guess if it was more available, there would not be such a problem with Dengue fever and Malaria – bring a stock pile with you.

Road accidents present the greatest health risk in Delhi. Be very careful crossing the street and when riding on the roads.

He said it is important to get a general practice physician when you arrive. If you are with an embassy or international school, they can probably give you a list of doctors that have been recommended. International SOS also has a list of doctors they recommend.

Anyway, you know what is next – I am not a doctor and I do not play one on the internet. I will however pretend to have lawyer skills. This is information I received in a medical presentation and I am relaying it to the best of my memory – don’t quote me on any of it – do with it what you will. Obviously, you will have to determine for yourself what makes the most sense for you in a given situation.

john doe

You might recall that my not-so-little Bear was in elementary school in the United States and that our trip across the ocean landed him right into middle school. I was not sure how this new world would be for Bear. So far, so good.

Some things are certainly different – Bear has now been to a dance (and actually danced) and to a middle school party (and danced again). He is enjoying his journey. There are a lot of activities he misses and he misses his dear friends terribly – but he has made some good friends here and he is having a good time.

One of the things I did not expect was the stepped up homework. Not the volume necessarily, but the complexity. And I don’t mean harder – just more thoughtful.

The very first assignment Bear got was to write paper on John Doe. A paper that involved medical ethics. Excuse me – did you know that he’s 11. I took a biomedical ethics class in college. I loved it, but I was 21 at the time. That’s not exactly 11.

So, we read the scenario – it’s basically this. John Doe is a young man (20, I think) who has been in a terrible car accident. He is on a ventilator and is showing no improvement. His hair grows and his fingernails grow, but he is not responsive to voices or other stimulation. He is on a feeding tube. The insurance company will no longer pay for his medical treatment. He has been in a coma for 3 months. Your job is to advise his parents what to do in five paragraphs.

Okay, in five decades, I could not come up with the right words to advise his parents what to do – what do you mean 5 paragraphs? And do you understand that Bear is our oldest and we have not talked to him about any of this stuff yet, and we still have jet lag. And, remember, he is 11. Welcome to India.

I want to start by saying that I love the kids new school. We were thrilled with our school in the U.S. and I was wondering if our new school could possibly measure up. It has. It is really, really great – there is a lot of focus on creative thinking – not so much on memorizing facts. It’s taking in information and analyzing it. More of a swallowing it whole and letting it become a part of you than a “repeat what I just said” focus on learning. But did I mention, he is 11? Did I mention we still had jet lag? Can I find out where to buy goldfish crackers before I have to tackle medical ethics? Please?

So, before he can even start writing a paper, we have to talk about this. Just in case you have forgotten, let me remind you that Bear is a pretty logical thinker. That is, unless it comes to pulling the plug on a young man in a coma whose fingernails are still growing. Then apparently he becomes a big old softy. And, yes I love that about him. But it was hard to see his eyes melt away when I said he should at least consider taking John Doe off of life support. He looked at me and seemed to think, “but what would you do it if was me”? Dagger. I hear America calling – the land of the goldfish crackers that are easy to find.

How do you explain to your child that it makes you want to throw up to even consider that you could ever have to make this kind of decision about him – but that sometimes there are actually practical matters involved in these decisions. How do you define ethics – when your child thinks in black and white and there are nothing but grey answers available? Can we say role reversal? Me – the full fledged Pisces and sentimental sap explaining to the boy who wants to solve pi why it might make sense to not let John Doe “live”. And that same boy explaining to me that John Doe is still alive. Well, let’s talk about quality of life and cost of care and when are we going home again?

I told him ethics is when your brain meets your heart and they don’t always agree. If fact, they are bound to disagree because matters of the heart are rarely logical. And there are never any right answers. Math won’t usually help here – it is certainly not an exact science, if it is even a science at all. But how do you explain to those big brown eyes that what you can so clearly see that someone else should do might not be what you would do at all? Holy parenting, Batman. He decided John Doe’s parents should have a fundraiser to pay to keep him on the ventilator. I think this bodes well for number one hubby and me in our later years.

The final part of this assignment was a debate in the class. I would have loved to have seen that. The teacher was very careful to explain to the students that there were sure to be a lot of different view points and that everyone’s opinion had to be respected. That’s cool.