Sunday, March 4, 2018

The Bahamian Medical System: A View from the Ward - or - Shelagh’s Big Break: Lessons Learned

Shelagh and I wish to thank you for caring enough to continue reading to the end of the first part, let alone this far!  We want to share with you some of our Lessons Learned...

  • Buy the travel insurance.  One misstep away from home could be financially ruinous without it.
  • Activate WhatsApp on your phone before you leave.  Here’s how their website describes it: “More than 1 billion people in over 180 countries use WhatsApp to stay in touch with friends and family, anytime and anywhere. WhatsApp is free and offers simple, secure, reliable messaging and calling, available on phones all over the world.”  Basically, it allows you to use your phone for voice and text over WiFi.  But, you have to be able to receive texts to activate it, which is why I recommend activating before departure.  The app is so ubiquitous outside the US that Bahamians were astonished or dumbfounded when they said, “Just use WhatsApp!” and I said I didn’t have it (you know when your dog doesn’t comprehend something and cocks its head? It was like that).
  • Passports.  Always take your passports.  If day-tripping to a Caribbean Island you are generally told you don’t need them.  This incident proves you do, indeed, need them.  If we hadn’t had them, the first parts of this story would be very different.  According to Adrian (who crossed himself, looked to the heavens and gave thanks, when I said we had them) I would have spent hour after hour at the US Embassy getting replacements, at a cost of about $500 each.  And if you don’t have a passport and are going day-tripping to the Caribbean, get one.  It’s easy, not inconvenient, and a helluva lot cheaper than not having one when you need it.
  • If traveling overseas, make sure your two-factor authentication on your e-mail system doesn’t rely on your cell phone receiving a phone call or text message.  When I had to print insurance documents that were e-mailed to me, I wasn’t able to login to my Gmail account from the hotel business center because my cellphone couldn’t receive Google’s texted security code.  I was fortunate to have my laptop with me (a recognized device) to temporarily disable the authentication so I could use the business center computers.
  • When you travel overseas to areas that clearly are not “first world” countries, remember that the people who prepare and serve your food, keep the hotel clean and generally make your life easy do not live in that comparative splendor, they only work there.  If you venture just two blocks outside the touristy areas you will see how they live.  Tip generously, even excessively.  You are travelling overseas so you can afford it and they could really use it.


The Bahamian Medical System: A View from the Ward - or - Shelagh’s Big Break: Part 5


We woke up to a bright and sunny Saturday morning, day 7 post-injury.  Shelagh reported she had a moderate amount of pain in the middle of the night and took some pain meds around 3am.  Knowing her pain tolerance and stoicism (cats take lessons in stoic from her) this was not a good thing.  But the pain meds worked and she slept comfortably until sunrise.

As we rose, the extent of Shelagh’s solar exposure became more apparent.  The tops of her legs were red, as was her nose.  It wasn’t painful, or so she said (see note on stoicism above), but she was positively delighted at having had the opportunity.

We went down for another fruit cup breakfast from Starbucks.  As we did, I saw the Dream coming in (yet again).  We went out to watch it dock, but it was windy and cool…much too cool for Shelagh (I’m well-insulated).  So we went inside to watch.  Seeing these huge liners dock is a thing of wonder.  The Dream, 1,115 feet long, 137 feet wide, weighing 129,700 tons, came slowly into the harbor, stopped, then rotated 180 degrees and backed in.  Seriously, it was awesome to watch.
Parking The Dream
The Disney Dream has just completed it's 180 degree pivot and is now backing into its berth.


A bit later, Shelagh’s nurse, Chris Stabile, came to our room to introduce himself and assess Shelagh’s baseline status.  He also laid out the game plan for the day.  The three of us were to rendezvous in the lobby to head for the airport in a couple of hours.

As Chris was giving Shelagh the clinical once-over, I looked out the window to see a sight that will be all too familiar to my EMS peeps…
New Providence EMS Medic Unit Posting at McEmbassy

At the appointed time, I took Shelagh down to the lobby, then went back up to our room to get the suitcases.  As I left Room 528 of The James Bond Hilton I took a last look around with a small feeling of sorrow.  That room was my refuge, a place of shelter and safety during a very turbulent week, and whose haven I could extend to Shelagh to protect her when she was discharged.

We met Chris in the lobby and waited for the ride he had arranged to get us to the airport.  When it showed up (a Cadillac Escalade :-o) we got Shelagh in and I returned the wheelchair that served her so well for the past two days to the hotel.  Like the room, it was like parting with a friend.

We checked in, got through security, then through US Customs and thanks to Chris (and, I guess, to Shelagh’s ankle) we got to the head of each line.  It was a breeze. 

Here’s another reason to get the travel insurance.  While Shelagh and I are adept at medical care and patient movement, getting through an airport and boarding/alighting an aircraft requires special attention and equipment.  Wheelchairs can get you through the terminal, even if it will cause extra time at security.  But getting on and off an aircraft when you cannot bear weight on one leg requires significant resources.  First, you have to make sure the gate attendant knows well in advance of boarding time about your needs.  Second, the flight crew needs to be told by the gate attendant about you.  Third, somebody has to show up to push you down the ramp, transfer you to what is called an ‘aisle chair’, a special wheelchair that will fit in the aisle of a passenger plane, and then help you transfer from the aisle chair to your seat.  Finally, let’s talk about trying to get through security on your own.  We had to cancel our return flights from Orlando and we would now be headed home from the Bahamas.  If you think you get run through the wringer at TSA normally, think about TSA’s Extra Deluxe Screening Process when you are an international traveler with a one-way ticket.  Being in the hands of a medical rescue service like On Call International makes all of that effortless because it’s arranged ahead of time.  And if you are too ill/injured to fly commercial, they will arrange an air ambulance.

Because we spent so little time getting into the airport we had time for a leisurely lunch – conch fritters for all three of us!  The three of us were first aboard – and last off – the Airbus A320 and had a comfortable and uneventful flight to Charlotte.

My Favorite Nurse and Her Escort Nurse
Departing Lynden Pindling International Airport 
Nassau, Bahamas

Charlotte to Richmond was a different story.  It was a long layover but the guys on the ramp weren’t prepared.  We were flying on a regional jet, a Bombardier CRJ-900.  It’s a small jet that seats about 45.  So small that you can’t use a jetway to access it, so you walk out onto the ramp and go up the airstair door.  Except in this situation, aisle chairs don’t go up airstairs safely and a portable ramp has to be used. 
Stock photo of an airstair door
It wasn’t in place when we reached the aircraft and had to be brought around by two people, one of whom had to be wrangled.  In the meantime, we sat out in temperatures that were somewhat above freezing, in the winds that are prevalent in the wide-open spaces of airfields, while wearing Caribbean cruise clothing.  It took a while to wheel the ramp around and get it set up.  The guy wheeling Shelagh in the aisle chair was kind enough to ask the flight crew for a blanket for her…after she asked him to…three times.
All this hardware for Shelagh?
Yes, and that's as it should be.
Anyway, we got aboard, got airborne and 47 minutes later were on the ground in RVA.  Chris took Shelagh in a hired Cadillac sedan (with a really careful driver) to Bon Secours St. Francis Hospital.  After I retrieved our luggage I drove my car and met them in the ED.  Wait.  That last sentence makes me sound like one of those crazies that drives their car INTO the hospital, so let me rephrase.  I drove to the hospital, parked my car and met them in the ED.  Once Shelagh was taken back to a bed from the triage area, Chris signed off.  We bade him farewell and thanked him for what he did for us.  Of course, we couldn’t thank him enough.

It was a very slow night at St. Francis so we were in and out in just under three hours.  In that time, Shelagh’s cast was removed, the wound and surgical incisions examined, labs were drawn, x-rays were taken, and a new, lighter cast applied.  We got home and got to bed 20 hours after we woke up.

To make a long story short (now that I’m well over 5,000 words into it), we are happy to be home and thankful for being in great continuing care. 


{Click here for Lessons Learned!}

The Bahamian Medical System: A View from the Ward - or - Shelagh’s Big Break: Part 4

We woke on Friday morning, now six days post-injury, rested, refreshed and happy as clams to be together again.

We had breakfast from Imperial’s and we ate nothin’ but Bahamian.  Shelagh had souse with Johnny cakes and I had a cheese on Johnny cake sandwich.  It was delicious!
If you want genuine Bahamian food, this is the place to go in Nassau.
But don't take my word for it, ask any of the locals who are the vast majority of the customers.

We spoke with On Call International who gave us our itinerary and told us Shelagh’s nurse, Chris, would be in touch with us later in the day to go over details.

After that, Shelagh took some pain meds (Tramadol. Write it down. Ask for it by name.) and then took a nap.  I blogged.

When Shelagh woke up it was near lunch time. So she got into the wheelchair and we trundled down to the hotel’s Starbucks.  We both got big fruit cups, while Shelagh got hot tea and I got iced coffee.  We took our tasty comestibles out onto the jetty at the end of the hotel’s beach.  As I trundled her wheelchair out towards the end of the jetty, I noted that if we were in one of the Lifetime Movie TV Network's movies, this would be the very beginning of the movie and I'd shove her off the end and into the water.  She noted she felt safe because I wasn't pretty enough to be one of LMT's villains.
The jetty (scene of the non-crime) is at center right

Once we finished, we took a moment from our busy sun tanning session to get a quick selfie.
This is from my selfie 'Blue Period'
After a while of watching the clouds blow by, boats coming and going from the Nassau harbor, and terns flying overhead, we went back inside to avoid sunburn.  We got in just in time.  We both got a good dose of Sol.  Shelagh looked dramatically better and healthier, wiping out the pallor caused by shock and then nearly a week in a windowless ward.

Our return to our room was followed by a packing session (Mirjana and I got everything packed on the Dream, but it wasn't necessarily packed in the right suitcase).  This was, in turn, followed by another run across the street to Imperial’s for take away dinner in our room.  Conch fritters and plantains.  After that, more Shark Tank reruns and off to slumberland.

{Click here for part 5!}