Tuesday, June 22, 2010

Visiting the Emergency Room in a 3rd World Country

Well, now that four of the ten of us have experienced what it is like to go to the ER in India, I now feel comfortable posting to you all exactly what it was like for me. I was worried to post it at first, since I think many of the groups parents are reading this blog and I didn't want them to worry, but this blog is supposed to be about health care practices in India, and we have truly experienced it first hand. (Plus Kathryn said she was going to blog about her experience so I'm doing it too hehe). Oh, and just so you all know, Kathryn and Nathalie went to the ER a few days ago for food poisoning and Allie went for a clogged duct in her armpit. Everyone else is fine :)

So last week on Tuesday we were all sitting at dinner eating this rice dish that we had eaten previously when I ate what I thought was a green bean and turned out to be the HOTTEST pepper I have ever tasted in my life. My entire mouth and lips were burning for a good 15 minutes, even after I put a spoonful of peanut butter in my mouth. Finally it subsided and I went outside for about 30 minutes to talk to on the phone and my stomach started to hurt so I decided to just go to bed. Lying in bed my stomach pain increased tremendously and I felt like i was burning from the inside out. I filled up my Nalgene and drank all of it hoping it would help the pain. Then I remembered I hadn't taken my contacts out, so I went to the mirror and pulled them out. I think there must have been some of the pepper still on my fingers though because it made my eyes start to burn too! Before I knew it my eyes were nearly swollen shut. I took 2 Benadryl and tried to just go back to sleep. Then I started wheezing. It was only on exhalation at first, but then my roommate came in to go to sleep too and she said she could hear my wheezing too. We decided if it didn't get better in about 20 minutes that I'd go wake up Dr. Blenner. However, it wasn't getting any better at all! In fact, it was getting worse. I was wheezing terribly on inhalation and exhalation and was beginning to feel my throat get tighter and and tighter. We ran downstairs and called an ambulance.

Now the "ambulance" was a hard cot in the back of a yellow van. There was no EMT, just a driver who took us to PSG hospital (luckily located right next door to our guest house). When we arrived they tried to put me in a wheel chair but being obstinate and stubborn I insisted that I walk to the ER. The "ER" is a room full of 8 "beds", separated by curtains. The "beds" are not beds at all but in fact hard plastic tables which bend in half if you want to sit up. The doctor and nurses (who were actually nursing students but we didn't know that at the time) told me to lay down and then started asking my roommate Kelsey everything about my medical history and who we were and what happened. The nursing students took my blood pressure and put me on a pulse oximiter to measure my oxygen saturation. I kept trying to sit up and tell them myself but they wouldn't allow it. Even after Kelsey told them that we weren't related and she'd really only known me for less than a week, they insisted that she answer all the questions. Even after determining my diagnosis they refused to tell me what was going on, they directed everything at her. So here I am, lying on a hard plastic bed in a 3rd world country gasping for air...trying desperately not to cry for my mommy. I politely suggested to the nurse that MAYBE I should sit up since I can't BREATHE...she agreed that would be a good idea. Then doctor ordered some medications at the nursing students (they spoke in Tamil so I had no idea what was going on) and suddenly someone is coming at my hand with a long needle. I demanded to know what the medication was but Kelsey nor I had ever heard of it. We actually thought they were just starting an IV. I turned my head and told Kelsey, "watch EVERYTHING they do! Make sure they use alcohol to clean my hand first!" It turned out that they injected the medication straight into my vein, there was no IV. After the injection they told me to take off my glasses and they placed a nebulizer over my nose and mouth. So now, I couldn't breathe, couldn't see, and just been injected with a foreign medication, oh...and I REALLY had to go to the bathroom after drinking my whole nalgene of water.

Kelsey left to go fill out paperwork and I looked up at the ceiling through the tiny slits in my eyes that I could barely open and everything around me was a nauseating off-white color, the walls were cracking in the corners, the sheet on top of me looked like it hadn't been washed after the patient before me used it, and I had three Indian nurses staring at me with very stern faces. I remember thinking, this is exactly what a nightmare would look like if I were having one...only this is real life. Adam had just sent me a picture message to my blackberry of him and Dally telling me they missed me...then I could no longer hold back the tears....which made my face turn very red and even more swollen which made the nurses even more concerned. Then, out of nowhere, (I'm assuming because I was so overcome with emotion) I just started my period. I stood up and informed them I was going to the bathroom right NOW. One of the nursing students started to follow me. It irritated me but I decided I had to pick my battles at this point. So through blurry, barely opened eyes I walked to the bathroom down the hall, praying very hard that it was a real toilet and not the hole in the ground "toilets" that exist in most bathrooms here...and yayyy it was, but there's no toilet paper. Now I'm just hysterical trying to ask this woman for toilet paper and she's looking at me like I'm an alien. Finally I spotted some sitting on the EKG machine and snagged it. One of the people working there said I couldn't use it, that it was for cleaning the machine...I ignored her and took it anyway, what else was I going to do? Finally I came back to my "bed" in the "ER" and laid down. I could breathe again, but I was developing a dark red rash around my neck and it was spreading down my chest, then my lips started to swell too...I was really looking hot let me tell you. They decided to give me an intramuscular injection, which I was fine with, until she told me it would be given in my butt. I argued with her for a good 5 minutes about the risk of hitting the sciatic nerve, and that she needed to give it in my arm, but she wouldn't budge. Finally I just let her do her thing as the Benadryl and whatever medication they put in my hand was starting to make me very drowsy. An IM injection is supposed to be darted into the muscle very quickly, but she put it in very slowly and then injected the medication even slower...super fun.

Suddenly two girls slid around the corner and ran into our "room." They were two of the PSG nursing students we met at orientation who were dressed in the beautiful Sarees! They demanded from the other nursing students (who were a year below them) to know what medications they had given me and what had happened. Then they stayed with us the rest of the time reassuring us that everything would be okay and calming me down and making us laugh to take our minds off things. After they came, 3 of the professors arrived and Dr. Blenner came, and eventually I had calmed down and realized everything would be okay. I had simply had an allergic reaction, most likely to the pepper I ate at dinner. They made me stay for another hour for observation, where I could barely keep my eyes open, let alone listen to everyone who kept lecturing me never to eat a pepper again...I wanted to say, "Yeah, I didn't try to eat a pepper people, I thought it was a green bean, I'm not an idiot". Finally, about 2 hours after entering the "ER" the "ambulance" took us back to the guest house and we fell asleep.

I suppose it was good to know that we have access to generally "good" health care very quickly should we need it in an emergency, but it was also good to learn what it is actually like to be a patient in one of these places.

Disclaimer: Parents, please don't worry, we're fine.

5 comments:

  1. oh my god micaleen! i'm glad you're okay! sounds like you're having fun over there :)

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  2. OH MY GOD BIG! That must have been a very scary experience! I am glad you are a strong young lady. Don't eat any peppers or anything that looks like a green bean. xoxo

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  3. Hi - I stumbled on your blog from a post on the SDSU blog about your trip... I'm glad you are okay after your allergic reaction! I had to comment on this post because I too just had a similar emergency experience in El Salvador. I got salmonella and had to find a clinic, which sounds very similar to the hospital you visited. It was a semi-open air facility, dirty bathroom w/no sink to wash after, unclean sheets on the beds, a small little consultation "room" w/a 3.5ft table to lay on, and a shot in the butt! I found out after returning and visiting my own doctor that the meds they gave me were perfect for my condition, which is a relief! So like you - it was "good" healtcare and a good learning experience! =)

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  4. At least they dont demand your insurance status before treating you!Your problem was resolved and thats what matters in the end. What is this third world mean? American think they live in a different world. Sorry to break your bubble of comfort.

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  5. I feel confident that in the US they would treat my anaphylactic reaction prior to questioning my insurance, otherwise I'm quite sure my airway would have closed! Not to say our healthcare system is any more than sub-par...But you're right, what matters is that I was treated well and my illness resolved. I did not mean to suggest that India is literally as different word, just figuratively, quite different that what i was used to! My bubble of comfort was absolutely broken, but I assumed it would be at some point during the trip.

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