So, basically, I'm still not getting better. I had continued going to various doctors at the same clinic after my last posting, and my confidence was diminishing. I had spoken with some doctors back home, and I was not getting the tests in Ukraine that would have been ordered for me in the US. They were testing for other things that American doctors thought would be a stretch. (In short, if these tests came up positive, it would probably be because I had epic bad luck and was sick with two things at once, but what they were testing me for to begin with could not have put me in the hospital at all, and definitely not with the symptoms I had.) Dr. Google was backing up all my suspicions. With each appointment either came more bad news, or more "Hmm, you're very sick, but we don't know what's wrong with you." The last straw came when I was told I'd reached a point where they couldn't do any more tests because the antibiotics I was on could interfere with the results. THIS WOULD NOT HAVE BEEN A PROBLEM IF YOU DID THE BACTERIA CULTURES TWO WEEKS AGO WHEN I WAS IN THE HOSPITAL AND WAS TELLING YOU I WANTED IT DONE JUST IN CASE I DIDN'T FULLY RESPOND TO TREATMENT. This isn't ever so much a "I told you so" sort of moment, but I'm not sure I can think of another situation that more deserved the phrase "You should have listened to me."
That day, I was ready to come home. I hated that my doctors wouldn't listen to me half the times, and the other half they didn't understand me. That wouldn't have been so bad if I thought they were ordering what was medically necessary. I was sick of being by myself. And, more than anything, I'm sick of being sick. Emotionally, I was completely spent, and I wanted out. I spent a long evening in an internet cafe pricing out tickets, trying to figure out if coming home was even feasible.
In between some frantic calls with my parents, another American doctor, and Wes, a very dear friend of mine who was traveling in Budapest at the time, I came up with one last plan. There is an American medical clinic in Kiev. I hadn't gone there yet because the first time I needed care was outside of normal business hours, and they don't have the specialist that I needed for immediate follow-up. However, all doctors at this clinic speak English and are certified in the US, so I figured this would be my very best chance. I developed a "wish list" of the tests I wanted, and if I couldn't get them (or couldn't get them in a timely manner- it often takes a week for a test you can get done overnight in the US), I was coming home that weekend.
The doctor at the American clinic was shocked by the corners that had been cut in my care. For the first time, I had confidence in the doctor I was seeing here. I had the first round of tests on Saturday, and those results come in Wednesday. I got more tests today (which come in Thursday), and I get more tests on Wednesday. I have one week left in Ukraine, and my hope at this point is that I leave with a diagnosis. I feel better about the situation, but I still wish I were home right now.
Bright side though: Today was the first day I took out my new camera. I can't wait to buy a new lens for it, but I'm so happy about it. :)
Monday, August 23, 2010
Friday, August 13, 2010
Drat
Today I went to the hospital to retake all my tests. They were supposed to pronounce me cured. They did not. I'm getting more and more distressed and would really like a glass of wine, which of course I'm not allowed to have because of the medicine I'm on. I go to another specialist on Monday, which happens to be the day my partners-in-crime leave.
And how is your day going?
And how is your day going?
Wednesday, August 11, 2010
The first sign Bakersfield has corrupted you
Last week, it reached 108 degrees in Kiev. While my teacher and everyone else was complaining about how hot it was, I was over the moon because it was DRY HEAT. The girl from Bakersfield and her friend from Arizona were in their element. :)
Monday, August 9, 2010
In which my worst nightmare comes true....
I spent Thursday afternoon preparing to spend the weekend in western Ukraine with my partners-in-crime: Brian and Ian, two CMCers interning for the Danish Refugee Council. I wasn’t really sure what the weekend would entail other than two 14-hour train rides in what Ian referred to as the “proletariat class,” loving on Afghan refugee children, and some sight-seeing here and there. I searched for an ATM that would accept my MasterCard, purchased water bottles and snacks, and began to pack. About an hour before we were going to leave for the train station, I start to feel funny. Really funny. At first I considered getting on the train anyways. The city we’d be in was close to the Slovakian border, and I figured if I needed medical care, I’d rather get it in the EU. The hotel we booked had AC and wifi, so if I just needed bed rest, I’d be more comfortable there. However, I knew that if I got on the train, I’d essentially be trapped there for fourteen hours, and that wasn’t a place I wanted to be sick.
I called my dad at work. He searched around for one of the emergency doctors, and I spoke with him for a few minutes about my symptoms. His message was clear: It could be a UTI, but it could be worse. Either way, you need medical attention, since without treatment the infection can hit your bloodstream and go septic. Go to the doctor. Don’t wait.
I called the number of the US Embassy listed on the website for emergencies, and couldn’t get through. (Umm...?) Luckily, I’d met some American Marines who work at the embassy the weekend before, and I got the embassy’s actual number, and was patched through to the nurse on duty. She directed me to a hospital that was considered the best in Ukraine, and told me the doctors should speak English. I get in the cab and go. The boys, gentlemen that they are, offered to go with me, but I wouldn’t hear of it. In my head, it still couldn’t be that big of a deal, and I didn’t want them to cancel their trip (which, for them, was work-related) over this.
I got to the hospital, and the reception staff doesn’t speak English. I try pointing, but that doesn’t work. The only relevant word I know in Russian is “emergency,” but I can’t describe any of my symptoms in Russian. Finally, they bring out a doctor, and his English isn’t great, but it’s better than my Russian, and it’s enough. I tell him I think I might have a urinary tract infection. He orders a blood and urine sample. The former he was going to take from my finger, but he had me do the latter first. He took one look at the sample and said, “You need an IV, so let’s not bother ruining your pretty fingers, we’ll take the test from your arm.”
Before I got the IV, we got into a bit of a spat because I had heard horror stories of hospitals re-using needles in Eastern Europe, and I didn’t want them to poke me with anything I didn’t see come out of the package. At first the doctor thinks I’m joking. “Oh, don’t worry, you see that sink right there? We just washed it [the needle]; it’s very clean.” I must have looked terrified, as he quickly added, “No, no, single-use needles, we haven’t re-used needles in a very long time in this country.” I insisted I wanted to see it come out of the package. “What kind of country do you think this is? We had single-use needles even in the Soviet times!” I’d clearly hit a sore spot, but this is one of the few instances where I’m not going to feel an ounce of guilt for being the ugly American. Finally, the doctor has the nurse get a new needle. She looked quite confused, and the doctor told me, pointedly, “You see? She is young enough that she doesn’t even KNOW there was a time when we re-used needles.” Each time I needed a new shot, he made the same joke about washing the needles in the kitchen sink, and, each time, I was not amused.
I was lying in the hospital bed being pumped full of saline solution and antibiotics when my urine test results came in. “Ploha,” the doctor says. “Ochen ochen ploha.” Very very bad. He tells me he is surprised I am only now coming in because, given how advanced this looks, I’ve probably had this for at least a couple months. This comes as quite the shock because I’d felt fine until about 9pm that evening. The blood test came in about an hour later, and those were also ochen ochen ploha. The infection had hit my bloodstream, just as the American doctor warned could happen. As the doctor upped the dose of antibiotics, frantically rechecked my vitals, and shot me full of painkillers, he told me that I was about to go septic, and if I had waited until morning to come in, I could have died. In my head, I noted that if I had gotten on the train with Brian and Ian, the train that wouldn’t have arrived in Mukachevo until 2pm, I almost certainly would have.
I asked the doctor what kind of bacteria I had, where I could have gotten this infection, if he knew where exactly this infection was. He told me they didn’t test for the type of bacteria, as it would take a week for results to come in. He explained that, “in our country,” they give broad treatments, and then order more tests if the patient doesn’t respond. It saves money, he said. The entire ER visit was about $100, so money isn’t my first concern, and I told him that I wanted him to order the extra tests. I didn’t want to still be sick in a week, but then need to wait another week for the test results to come in because he didn’t order them this week. He deferred, saying I would see a urologist the next day, and he would decide whether I needed them or not.
The next day, I asked the urologist where I had this infection. “Who knows? Maybe your bladder? Maybe your kidneys? It’s very advanced though, so I think it’s your kidneys.” I’m alarmed by the lack of curiosity. Shouldn’t he be testing to find out for certain? As if he read my mind, he added, “I’d give you the same medicines regardless.” He also doesn’t think I need a specific test to determine what kind of bacteria is causing this, as the antibiotics he’s prescribing should kill it anyways. Like the ER doctor the day before, he says that this is how they do things in Ukraine, and 95% of the time, it works. My mom would later explain to me that this is what many American doctors would do for patients with MediCal or other insurance programs for the poor.
I thought back to last summer, when it seemed as though the quality of American healthcare was at the forefront of everybody’s mind. One fact that came up constantly was that Americans spend more than most other countries for healthcare, and it was open for debate why that was. One explanation that was frequently offered is that American doctors will test more aggressively than doctors in other countries, and Americans are more likely to seek medical attention for minor issues. I’ll say in my defense that, less than 24 hours after the doctors told me I had been close to dying, this isn’t exactly a “minor issue.” But I wanted more testing. I wanted to know what kind of bacteria. I wanted to know where. I might not have been able to do anything with the information myself, but I wanted the doctors to want to know. But if they were going to prescribe me the same meds regardless of the bacteria, regardless of which organ was infected, does it really matter? To me, once the words, “You could have died,” escape the doctor’s lips, I deserved all the extra precautions of having a backup plan in case I didn’t respond to treatment. But what if it hadn’t been as serious? Would I have still insisted? I can’t help but think I probably would have.
***
I’m home from the hospital. They sent me with half the pharmacy, it seems. No fewer than six types of pills to take every day, an herbal tea with anti-bacterial properties concocted for those with kidney ailments, and a chamomile soak for my bath. The last item confused me greatly. “Is it tea,” I asked the pharmacist in Russian. “No, it’s for bath.” Knowing some languages have different words for tea made from the tea plant, and tea-like beverages made from something else, I decided to press further. “Do I drink it?” “No, it’s for bath.” “Bath?” “Yes. Not shower, but bath.” She made some scrubbing motions. “Clear?” “Umm…. Yes… I take a bath with it?” “Yes.” “Ok….”
I spent two days in bed. I napped, I sweated through 100+ degree heat, and I finished one novel, read all of another, and then read the Perry v. Schwarzenegger decision. I got up only to take my medicine, go to the bathroom, grab the occasional slice of bread and cheese, or brew myself another pot of my kidney-tea. On Sunday, I finally had the energy to stand up long enough to take a shower and to actually prepare myself a meal. Today, Monday, my boys came back from their trip, and I left my apartment for the first time to get lunch, groceries, and wifi. I’m taking baby steps getting there, but I AM getting better, and I am NOT going to die in Ukraine, if for no other reason but the fact that I refuse to.
I called my dad at work. He searched around for one of the emergency doctors, and I spoke with him for a few minutes about my symptoms. His message was clear: It could be a UTI, but it could be worse. Either way, you need medical attention, since without treatment the infection can hit your bloodstream and go septic. Go to the doctor. Don’t wait.
I called the number of the US Embassy listed on the website for emergencies, and couldn’t get through. (Umm...?) Luckily, I’d met some American Marines who work at the embassy the weekend before, and I got the embassy’s actual number, and was patched through to the nurse on duty. She directed me to a hospital that was considered the best in Ukraine, and told me the doctors should speak English. I get in the cab and go. The boys, gentlemen that they are, offered to go with me, but I wouldn’t hear of it. In my head, it still couldn’t be that big of a deal, and I didn’t want them to cancel their trip (which, for them, was work-related) over this.
I got to the hospital, and the reception staff doesn’t speak English. I try pointing, but that doesn’t work. The only relevant word I know in Russian is “emergency,” but I can’t describe any of my symptoms in Russian. Finally, they bring out a doctor, and his English isn’t great, but it’s better than my Russian, and it’s enough. I tell him I think I might have a urinary tract infection. He orders a blood and urine sample. The former he was going to take from my finger, but he had me do the latter first. He took one look at the sample and said, “You need an IV, so let’s not bother ruining your pretty fingers, we’ll take the test from your arm.”
Before I got the IV, we got into a bit of a spat because I had heard horror stories of hospitals re-using needles in Eastern Europe, and I didn’t want them to poke me with anything I didn’t see come out of the package. At first the doctor thinks I’m joking. “Oh, don’t worry, you see that sink right there? We just washed it [the needle]; it’s very clean.” I must have looked terrified, as he quickly added, “No, no, single-use needles, we haven’t re-used needles in a very long time in this country.” I insisted I wanted to see it come out of the package. “What kind of country do you think this is? We had single-use needles even in the Soviet times!” I’d clearly hit a sore spot, but this is one of the few instances where I’m not going to feel an ounce of guilt for being the ugly American. Finally, the doctor has the nurse get a new needle. She looked quite confused, and the doctor told me, pointedly, “You see? She is young enough that she doesn’t even KNOW there was a time when we re-used needles.” Each time I needed a new shot, he made the same joke about washing the needles in the kitchen sink, and, each time, I was not amused.
I was lying in the hospital bed being pumped full of saline solution and antibiotics when my urine test results came in. “Ploha,” the doctor says. “Ochen ochen ploha.” Very very bad. He tells me he is surprised I am only now coming in because, given how advanced this looks, I’ve probably had this for at least a couple months. This comes as quite the shock because I’d felt fine until about 9pm that evening. The blood test came in about an hour later, and those were also ochen ochen ploha. The infection had hit my bloodstream, just as the American doctor warned could happen. As the doctor upped the dose of antibiotics, frantically rechecked my vitals, and shot me full of painkillers, he told me that I was about to go septic, and if I had waited until morning to come in, I could have died. In my head, I noted that if I had gotten on the train with Brian and Ian, the train that wouldn’t have arrived in Mukachevo until 2pm, I almost certainly would have.
I asked the doctor what kind of bacteria I had, where I could have gotten this infection, if he knew where exactly this infection was. He told me they didn’t test for the type of bacteria, as it would take a week for results to come in. He explained that, “in our country,” they give broad treatments, and then order more tests if the patient doesn’t respond. It saves money, he said. The entire ER visit was about $100, so money isn’t my first concern, and I told him that I wanted him to order the extra tests. I didn’t want to still be sick in a week, but then need to wait another week for the test results to come in because he didn’t order them this week. He deferred, saying I would see a urologist the next day, and he would decide whether I needed them or not.
The next day, I asked the urologist where I had this infection. “Who knows? Maybe your bladder? Maybe your kidneys? It’s very advanced though, so I think it’s your kidneys.” I’m alarmed by the lack of curiosity. Shouldn’t he be testing to find out for certain? As if he read my mind, he added, “I’d give you the same medicines regardless.” He also doesn’t think I need a specific test to determine what kind of bacteria is causing this, as the antibiotics he’s prescribing should kill it anyways. Like the ER doctor the day before, he says that this is how they do things in Ukraine, and 95% of the time, it works. My mom would later explain to me that this is what many American doctors would do for patients with MediCal or other insurance programs for the poor.
I thought back to last summer, when it seemed as though the quality of American healthcare was at the forefront of everybody’s mind. One fact that came up constantly was that Americans spend more than most other countries for healthcare, and it was open for debate why that was. One explanation that was frequently offered is that American doctors will test more aggressively than doctors in other countries, and Americans are more likely to seek medical attention for minor issues. I’ll say in my defense that, less than 24 hours after the doctors told me I had been close to dying, this isn’t exactly a “minor issue.” But I wanted more testing. I wanted to know what kind of bacteria. I wanted to know where. I might not have been able to do anything with the information myself, but I wanted the doctors to want to know. But if they were going to prescribe me the same meds regardless of the bacteria, regardless of which organ was infected, does it really matter? To me, once the words, “You could have died,” escape the doctor’s lips, I deserved all the extra precautions of having a backup plan in case I didn’t respond to treatment. But what if it hadn’t been as serious? Would I have still insisted? I can’t help but think I probably would have.
***
I’m home from the hospital. They sent me with half the pharmacy, it seems. No fewer than six types of pills to take every day, an herbal tea with anti-bacterial properties concocted for those with kidney ailments, and a chamomile soak for my bath. The last item confused me greatly. “Is it tea,” I asked the pharmacist in Russian. “No, it’s for bath.” Knowing some languages have different words for tea made from the tea plant, and tea-like beverages made from something else, I decided to press further. “Do I drink it?” “No, it’s for bath.” “Bath?” “Yes. Not shower, but bath.” She made some scrubbing motions. “Clear?” “Umm…. Yes… I take a bath with it?” “Yes.” “Ok….”
I spent two days in bed. I napped, I sweated through 100+ degree heat, and I finished one novel, read all of another, and then read the Perry v. Schwarzenegger decision. I got up only to take my medicine, go to the bathroom, grab the occasional slice of bread and cheese, or brew myself another pot of my kidney-tea. On Sunday, I finally had the energy to stand up long enough to take a shower and to actually prepare myself a meal. Today, Monday, my boys came back from their trip, and I left my apartment for the first time to get lunch, groceries, and wifi. I’m taking baby steps getting there, but I AM getting better, and I am NOT going to die in Ukraine, if for no other reason but the fact that I refuse to.
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