Monday, June 14, 2010

Surgery, Croatian style

I've shared with some of you, via email, our recent experiences of having surgery at a Croatian hospital. It was interesting, educational and stressful. Though we've met many excellent, talented and highly qualified physicians here, their work environment, pay and equipment are significantly lacking. The level of care in the end may be more than satisfactory, but the overall experience is usually grueling. Despite that, some, like our wonderful pediatrician, do an awesome job working out of a tiny, run down pediatric office where I still feel like my kid gets the best care possible. But, due to lack of pediatricians, at school age kids have to shift away from a pediatrician to a general practitioner. Kids are very different from adults so I am not too fond of the idea of having to do that.

The fun usually starts when one tries to get to a healthcare facility. Whether it is a hospital or a clinic, you are almost guaranteed not to have a parking space available anywhere close by. Not even at a childrens' hospital. Many people come from other cities to Zagreb just to find that it is nearly impossible for them to park close to a hospital to get their sick child/parent/relative the surgery or health exam that they need. Once one fights traffic, poorly marked streets, uncooperative pedestrians, one person usually stays with the car and drives around in a vain attempt to park somewhere (often illegally), while the other person takes the child/parent/relative in to the hospital. The fact that one is surrounded with exceptionally beautiful historic buildings and scenery somehow loses significance when you're sick and trying to get health care. With enough luck a parking spot will be located within a reasonable distance and the driver will join others inside just to trek outside every hour to pay a hefty fee at the parking meter. Just to make things more interesting, most parking areas (depending on what area of town it is in) have a 1-3 hour parking limit. Last time at the Childrens' hospital I was there with Mia to get a pre-surgery ECG. Two frantic out of town parents were trying to get enough change for a parking meter. Apparently at a cash only kiosk in front of the hospital, they couldn't get any change for the meter. Either they already gave out all the change or were stingy and declined to assist. Fortunately I had just enough to help them and the kid's dad gratefully ran out to pay for another hour of parking. As if it is not stressful enough to have a sick kid in the first place.

We've encountered situations where we needed to go to two or three equally difficult to access locations to get the lab work that we need. We've had throat swabs done at our local office just to have to run the sample to the hospital lab downtown ourselves within the allotted three hours. We've come back to all of those locations to pick up results a day or two later to take those results to our pediatrician so we could get a referral and then take the results to the specialist. In all cases we got the care that we needed at a satisfactory level but really had to work for it, go to many places, spend a long time waiting in line (hours sometimes) to get things done. Who can afford that much time off work? That just really gets stressful.

Mia was scheduled to get her tonsils out and to have a cyst from her head removed. We made an initial visit to the specialist a few weeks prior which helped me learn the area around the hospital a little bit. The morning of the surgery we had to meander around for quite some time to look for parking. We managed to illegally squeeze into someone’s front yard and then walk a bit to the hospital and were some 10 minutes late for our pre-surgery anesthesia check up. Fortunately I knew a bit about what to expect and what should occur so I knew that Mia was fine and fit for surgery. She had a pediatric visit two days prior but much can change with kids even overnight. We only did paperwork prior to the surgery. They didn't weight her, check her temperature, checked lung function, heart rate... Either Birmingham's Childrens' spoiled me with being overzealous by doing all of that prior to their surgeries or this place was way under-zealous by doing none of it. I wasn't given a chance to read through the sheet that lists dangers of anesthesia but had to sign it. I knew what it should say from prior experience. What if this were our first surgery?

Finally we were placed into a room. We were in a 10x12ft room that held 4 cribs and two beds. And in the beds were post-surgical adults, not kids, as the hospital ran out of beds in rooms for grownups. On top of that there wasn’t a single chair in the room as parents aren’t really supposed to stay, I guess. I stuck around all day anyway, mostly standing, leaning, improvising... Mia's had nothing to eat or since the night before but she dealt with it well. Finally, at about 9:30, they got Mia into surgery. Even I didn't know we were about to go into surgery. That's how well we were informed. I though we had a test to do when the nurse stopped me and said I couldn't go any further. Mia was so mad about that once she got out of surgery because they lied to her and caught her off guard. That alone could have been the sole reason why she screamed for hours after the surgery.

Mia was supposed to stay overnight afterward but I insisted she be discharged. Even though she was fine and the actual surgery, I think, went well, everything else was a mess. We had two surgeries at a Childrens' Hospital a few years back. This was like going to a two star hotel after staying at a five star hotel. Mia was scared out of her mind. She didn’t expect it to hurt as much as it did and she was scared. Staff wasn’t overly informative so half the time I had no clue what was going on. In addition one of the adults in the room looked quite bad after surgery and Mia just couldn’t stomach seeing someone in distress and bleeding. As a result, she wailed and literally screamed about 80% of the time (possibly more) starting the moment she was wheeled out of surgery at 10am until we left at 5pm. I think that made her throat do even worse than it would have been otherwise. She was stronger than anesthesia or any other meds they gave her twice to try to calm her screaming down. I think they agreed to discharge us as I warned them that Mia was not about to stop screaming and that she would persist through the night. It wasn't an empty threat. Mia has the stamina of a stubborn mule and can outlast any adult that has had the luck to love and take care of her since she was a baby. We know from previous experience that she can literally go for hours without stopping. It's one of her amazing talents. When I saw that I couldn't calm her down at all I knew that everyone around her would be in for a treat. So they let us go. We lived within the city limits so they figured that we'd be able to quickly get to the ER should the need arise.

I was so relieved once we were outside the hospital. I held Mia most of the day so I was already tired. On top of that I am not in the best shape of my life. Still, I wasn't about to turn around and go back. I picked Mia up and put her little backpack on my back, and headed up the hill to our car which was about a mile away. Mia was quiet and kept patting my back. Somehow in her little head she understood that it was really hard for me to carry her and she was appreciative because I was taking care of her. She hasn't shed a tear since we were discharged. From a screaming banshee she has turned into a quiet, patient, understanding child. The kid really knows how to get what she wants. Finally I got to the car. I was secretly scared that it might have gotten towed. Fortunately, it was still there and we headed home.

Mia was relieved to get home at the end of the day and has asked to go sleep almost immediately. Quietly and without fuss she got comfy in my bed and fell asleep almost instantly. Many years ago grandma warned us about dangers of dehydration so I did my best to get her to drink at least a little bit during the night. A good night's sleep and familiar environment did wonders and she woke up feeling tons better. She still wouldn't let me touch stitches on her head for a while but perked up and everything was easy-breezy after that (in comparison anyway). Phew!

1 comment:

  1. M,
    I am so sorry you guys had to go through it. Of course, the most important thing is that Mia is ok. That said, I can completely relate to your post. :( My Sasha still tells stories of horror when she had to stay at the hospital in Minsk a few years ago.
    I agree that, despite all the problems, we should be really grateful for the healthcare in the U.S., escpecially when compared to other countries.
    Hang in there! Hugs and kisses to Mia, Ivor and Chris.
    Tatiana

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