HAPPY TO BE HEADING HOME

          ONE LONG DAY AHEAD

     I was delighted to learn I would be leaving the hospital and after the fact glad I didn’t know ahead of time what a chore it would be. The girls had stayed on the boat for all activities for the two days I was hospitalized. Their mother, my daughter, stayed in a nearby hotel, stayed days with me, brought me food and did all the things for me that I could not do myself. Someone, probably an aide took my BP early in the morning and without exaggeration that was about the extent of my nursing care.

    I left the hospital at 7:00 AM by ambulance with a doctor for the 45-minute ride across the island as the ferry was on the opposite side. My older granddaughter rode with me in the ambulance while my daughter and other granddaughter followed in a cab with the luggage. On arrival at the pier I transferred from the gurney to a wheelchair. The ferry landing was a mob scene of people waiting to board the ferry. All luggage was thrown up on the roof of the ferry. When all was said and done I was stunned to learn I in my wheelchair was to be lifted up onto the roof along with all the luggage for the channel crossing! The doc stuck with me and my chair. My three girls were below inside the ferry listening all the while to the cab driver muttering, “I hope my friend is there with his truck.”  Shades of what was to come!

    Arriving at the Baltra landing I realized the tide was out as I looked up a  good two feet  across a space of at least a foot----boats never hug a pier as there is at least a bumper between the boat and pier. Helpless with a bulky cast on my leg I’m wondering just how I’m going to get up onto that landing. My daughter watched from land, praying, please don’t drop her, as 4-5 men picked me up and over to terra firma.

     In Baltra I had noted the lovely small open-air airport terminal of old was gone, replaced with a new modern facility. The old  school bus that transported one from the airport to the harbor was also gone replaced with a big modern  tour bus which seemed like overkill as it was at best a mile or so to the harbor. My problem was that there were two nice steps up into the bus  and one legged me was never going to conquer them.  However my farm truck was waiting right behind that nice new bus. Up onto the bed of the truck I and all our luggage plus my younger granddaughter –and the doc—went. The duffle bags served as an extra wheelchair break as we rode over the switchback paved road through desert landscape to the terminal.

    In the terminal is where the doc was useful, He knew the layout, maneuvered the various twists and turns straight to the airport MD office and was able to communicate with him. After a BP and temp check I had the papers needed to travel. We traveled Avianca Air (Columbian) to and from the islands. With foreign airlines one never knows quite what to expect and we already knew how rude and blaise the crew was.

    Baltra’s airport has no ramps so one deplanes via steps directly onto the tarmac. I had visions of sitting on the steps and inching myself up backwards to the plane’s doorway. But I was denied that exercise when a fellow grabbed the handles of my chair while two others grasped the front wheel bar and carried me up the steps. They obviously had a lot experience with that little maneuver. 

      Because I wanted an early morning flight we had a long layover in Quito—but we were one step closer to home.  On the way to the Quito airport a few days earlier both my daughter and I  spied a Wyndham hotel very close to the airport. She had the foresight when changing plane reservations to call them and reserve a day room for the layover. It was only minutes after a call

to the hotel before a new high-end van arrived. The two steps up into the van left  everyone scratching their head. Before long the youngest of us asked the driver to open the hatchback. After consulting with me we decided I could slide from the chair into the luggage hold. With some pidgin Spanish and charades she conveyed this to the driver. The other granddaughter grabbed her new blanket she’d bought at the market and soon I was as comfortable as can be.

    Arriving at the hotel the bellboys rushed to open the hatch to unload luggage. U can imagine their dismay when they opened up and saw this elderly lady sitting there with a cast on her leg, a smile on her face waving while saying, “Hola!”

    This van scenario was repeated a few hours later to get back to the airport. We arrived at ABIA 27 hours after we started and headed directly to our local ER.

A THIRD WORLD HOSPITAL VISIT

TWO DAYS IN A THIRD WORLD HOSPITAL

They do the best they can with what they have

        It looked like a hospital, smelled like a hospital so it must be one. Entering the hospital a whiff of antiseptic cleaner was reassuring.  In hind sight I have no complaint about the cleanliness of the facility. The use of gloves seemed appropriate, but mask use was way over the top. One hung around everyone’s neck or from an ear. A need to mask up to take my blood pressure---really? In the ER I observed packaged needles, syringes, IV fluids, medicine vials provoking no worries there.

     Narcotics were not in short supply; they were nonexistent. I was told no codeine, oxycodone or other narcotic was on the islands. Ibuprofen was readily available and was always given with a pill ‘for your stomach’. The pills came in uni-dose packs. That’s good! In the ER as soon as I slid from the gurney onto a more sturdy stretcher/bed a nurse appeared at the bedside table and started to prepare an IV. She had a 250cc bag of solution and two vials of medicine. Before she opened anything I asked what it was----didn’t want her to waste the material by opening them.

   Unable to get any kind of answer I made it clear I was refusing any IV. It was my desire to stay clear headed and alert. A Cuban doctor, who had been on the island four months, arrived having read the X-rays I’d had taken in a facility around the hospital’s corner. The X-ray machine appeared modern and the technician knowledgeable as well as friendly and concerned, The doc started talking surgery, which I knew he would. I was pretty adamant in my refusal, which he did not argue with. I instructed him, “Just immobilize my leg so I can travel.”

     He applied a plaster soft cast and admitted me to the hospital for observation. By the time I was in a hospital bed it was nearly 10:00 PM—eleven hours after the injury.  Now it’s time for many surprises. Apparently the hospital had no elevators as I was wheeled up a long moderately steep ramp broken in the middle by a 90-degree turn.  Not having seen a hospital ward for decades I was a bit surprised to be wheeled into a 6-7-bed ward, but the real shocker was to see four males occupying the other beds.

    What the heck, a curtain could take care of that---except there weren’t any! Between the beds or at the windows. There was a 6-foot screen on a metal frame between my bed and the next. The outside walls were all tinted glass which in the right light acted like a mirror of the entire room! We  know all privacy is now lost with technology, but this was a bit much!  Once in bed I looked for the call light and bed rails. Where could they be---nowhere. There was one plastic patio chair in the entire room and we happened to have it—and kept it.

    The tissue paper thin sheets did nothing to prevent the plastic mattress cover from creating a lovely

contact/heat-related dermatitis.  I guess Americans are funny as I had to ask for a pillow. I did get it in a timely manner and then I asked for another  so I could elevate my leg. The nurse returned a few minutes later with a comforter that had been cut in half. She folded one half and put it under my leg and then carried the other half out of the room---but not before I asked her to hand crank up the bed. How many years since they have disappeared? There was no bathroom in the room—not that I could have gotten to it, and somehow in this process a bulky old steel bedpan arrived on my bedside table.

    It’s a good thing I knew what to do with it, but I was on my own to maneuver it. This is definitely a place where a patient needs an advocate as my daughter did all the empting of the bedpan and bringing me T>P>from the bathroom across the hall. The next morning I asked and made motions for something to wash with-just a wet washcloth would have been nice. “Uno momento”, meant never. Handi-wipes would have to do!

     My ‘observation’ consisted of seeing no one after I got the folded comforter until 5:00AM when the lights in the whole room---no bedside lights--- were turned on and a masked someone came in to take my BP.

    The food was terrible and always arrived cold. Fortunately my daughter had access to a restaurant across the street from the hospital and she brought me food and all the  bottled water I needed. There was no water pitcher nor glass left for me!

    You can imagine how thrilled I was, because of the involved arrangements needed to be made to get me home, that I had to spend an extra day in the hospital. All I can say is they did the best they could with what they had, but thank goodness my stay was no longer!