Tuesday, December 7, 2010

Surgery in Qatar

Yesterday I took a leap of faith and had surgery here in Qatar.  Why?????!!!!! you ask.  The pain from flexor tendinitis (trigger finger) in my right hand was getting unbearable and making it difficult to do the simplest task.  I didn't want to wait until the summer, which is the next time we will all be in Bountiful, so I knew I had to bite the bullet (continuing with the trigger finger theme) and find a good orthopedic surgeon here in Doha.  Dr. Bhat came highly recommended, but he practices at Doha Clinic Hospital.  That was disappointing because this clinic/hospital is run like a circus.

I actually met Dr. Bhat last year when I was having pain then and he gave me a cortisone shot to see if that would take care of the problem.  Well, it did work for awhile, but this last October I was in bad shape again.  I went ahead and scheduled the surgery, but I came down with a serious ear infection and was too sick to go through with it. 

So when I went in last week to start the whole process over I also had to have a cortisone injection in my left elbow for the tennis elbow malady I have.  With my kind of ailments you would think that I am a maniac athlete or something but no.  I just have diabetes which can cause extra swelling in my joints and this is what aggravates all these poor tendons.  After x-rays and waiting hours and hours and then going back the next day, I finally got the injection.  I have had quite a few of these injections in my time and this one was by far the worst.  I don't know if it was how he placed the needle or because I had let the pain get too high, but this one was bad.  If you have never had one before it just feels like someone is pushing a needle into your bone.  Usually the pain goes away when the injection is over, but this one didn't.  For two days I was crying and not able to move my whole arm.  Even my fingers were swollen so much I couldn't put my wedding rings on.  When Brett called Dr. Bhat for back-up he just said I should double up on the pain killers he had given me.  Well, this country's idea of pain management is archaic so that didn't help at all.  Luckily my friend Victoria (name changed to protect the innocent) had some vicodin from a previous surgery and brought it right over.  Oh, man was I so much better.  That little injection cost me three days of my life, so you can say I was having second thoughts about the upcoming surgery.

I pressed on though and found myself at the Doha Hospital at 11 AM ready to take the plunge.  From Dr. Bhat's office the nurse took us to the surgery check-in desk and then my room and then left.  It was a double room and there was a Sudanese man in the next bed.  I asked Brett to make sure we were in the right room.  The nurse came in and closed the curtains around the other bed and told us that he was just the husband of a patient who was in surgery at the time.  Then she handed me a gown and told me to change.  So I went into the bathroom and did just that.

Other nurses then came to prep me for surgery.  One nurse checked my vitals, inserted an I.V. in my left hand, and gave me some medication to make me sleepy.  Another nurse proceeded to shave my hand and arm.  I barely have hair on my arms, let alone my hand, but I guess in this part of the world most women have a lot more hair than I do.  The unfortunate thing is that she nicked my wrist and now I have a cut there that hurts more than the actual surgical incision.  The nurse then wrapped my hand and arm in some plastic sheeting and taped it up.  Then I proceeded to sweat from the plastic.  It was a very strange process to me but I was still pretty patient at this point, especially with the drugs kicking in.

When they finally came to get me for surgery I was quite sleepy, and I just remember having to transfer my body from one bed to another way too many times and watching the ceiling tiles roll by on my way to the surgical center.  I was looking pretty good at this point I'm sure with my hair in one of those surgical caps and a stylish blue hospital gown.  There were quite a few people in the hallway as I rolled through and I could imagine what they were thinking:  "Hey, look, a white woman in our hospital.  I guess fear looks the same on western people as it does on eastern people."

I had a lot of nurses and technicians hovering around me at this point.  They wanted to know about my insulin pump and they looked worried that my blood sugar would drop suddenly if I left the thing on, but I succeeded in convincing them that it would be okay staying attached to me.  When I finally got into the operating room more nurses were positioning my arms and one of them started prepping my left arm and hand, so I reminded her that the surgery would be on my right hand and she laughed.  Then she said, "We can do two for one!" as she smiled.  I couldn't tell if she had purposely tried to worry me or if she was just covering up her mistake.  I must say that it is a little unnerving to listen to all these people speak in Arabic and not know what they are saying.  They would talk and go about their work and then laugh and continue on.  Things quieted down after Dr. Bhat came into the room.  He came into my line of sight and called me by name.  Because he had a surgical mask on I asked if it was truly him.  He said, "Yes, it is Dr. Bhat himself in person!" and then gave a very dignified doctor laugh.  Maybe they also gave me the sleepy medication so I would be more likely to laugh at their little jokes.

So for this surgery they only applied a local anesthesia with a tourniquet on my upper arm.  When I had this same surgery done on my left hand in the U.S.  Dr. Huish put me completely out, but I've quit trying to compare things here to things there, so I put it out of my mind.  The tourniquet was very uncomfortable - probably on purpose so I wouldn't think about the other things going on.  Dr. Bhat then injected the anesthesia into the I.V. they had started on my right hand and my hand felt like it was on fire.  There had been no warning at all.  It then occurred to me that these people weren't the greatest communicators.  When the nurse took us up to the room she just started walking away from the surgery intake desk.  I had to ask her if we should follow her.  I try to give them the benefit of the doubt about English being their second language and all, but sometimes I just think it is a cultural thing to leave people in the dark so they then don't have to be pinned down on anything - more on this later.

So then the cutting, tugging, snipping, pulling, and sewing commenced and it wasn't fun.  It didn't hurt a lot, but it is rather unnerving to feel the movements with some discomfort, but not be able to really tell what is going on.  And you can believe I wasn't going to watch even though I could.  I was content to just sit there with my oxygen mask on and try to stay in my happy place in the tile ceilings.  I think at one point I might have gotten a little too uncomfortable and started moving too much.  They might have had to give me additional anesthesia because after Dr. Bhat said he was done with the cutting and just sewing me up I kind of lost time after that.  The next thing I remember was them asking me to once again move onto the rolling bed.

I stayed in recovery for awhile and shivered away the anesthesia, which is normal, but a warm blanket from the nurse helped.  Then they took me up to my room and Brett was there with a big hug, a smile, and even a kiss, and in a public place no less!  He had made friends with the Sudanese gentleman in the room who had his wife back from surgery by then and they were making a business connection by exchanging email addresses.  This man later checked on me when Brett was gone and called me Mrs. Brett when asking me how I was.  And to think I was scared of him when we first arrived!

Well, after that I slept - sort of - and rested while Brett went and did car pool at the school.  He then brought Abbey back to the hospital.  I must have looked pretty rough, because Abbey's face was a little scared when she came in.  I felt bad that she caught me with my guard down, so I forced myself to perk up a little after that.  I changed into my street clothes and conveniently bumped my I.V. pic line so they had to remove it.  Abbey said I looked better.  She was a sweetie and read her Harry Potter book to me and did her homework.  Brett went and got food from Turkey Central and we had a picnic on my bed.  We kept asking when the doctor would be coming in and they always said in five minutes or so.  Well, at 4 PM they finally told us that it would be after 8 PM when he would be able to come - after his clinic hours.  So the same day surgery was looking more like an overnight stay all the time.  Brett left to go to a doctor appointment and do his home teaching.  When he came back it was after eight and still no doctor.  Abbey was super tired. 

Brett said, "Grab your purse.  We're leaving." As we walked (I kind of wobbled) past the nurses' station I saw this look of disbelief on all their faces.  They quickly jumped up and tried to persuade us to stay, that the doctor would be there soon.  I explained that we had been waiting too long and I needed to get my family home.  They had me quickly sign some papers and gave me some pain meds, but they were still trying to keep me there.  Brett just thanked them and ushered us out the door.  I had never broken out of a hospital before and it felt kind of exciting in a Tom Cruise kind of way.  As we pulled into the driveway at home the nurses called me and said that I needed to come back to get the antibiotics the doctor had just prescribed.  They were in disbelief when I told them no, that I would try and pick them up the next day.

So I felt really good today and went over and picked up the antibiotics.  The nurses told me that I needed to see Dr. Bhat today or tomorrow so he could change the dressing, but I told them that I could change my own dressing, especially if it meant I wouldn't have to wait for hours to see him.  Again there were those looks of disbelief.  Here was this western woman who had had enough of their system and wasn't going to just take orders.  I went straight home after picking up Abbey from Girl Scouts and changed my dressing by taking off the pound of gauze and wraps and exchanging them for a couple of bandaids (wow, that razor cut burns!) and an old wrist brace I had.  And then I started playing the piano, just to see if I could!

So I have decided that the way Doha Clinic/Hospital runs mirrors the culture, which makes sense to them, of course, but is total craziness to me.  It is this:  They want to tell people what they want to hear, so they do.  They don't think twice about saying misleading things or saying nothing at all and putting their hand up in dismissal.  Integrity has a different definition here.  No appointments are made before you arrive for a clinic visit.  You must show up, talk to a receptionist who then gives you a number for the doctor you need to see.  Then there is a flat screen T.V. mounted on the wall in the hallway that gives the details of numbers being called for which doctor and how many patients are waiting.  Of course, there are separate waiting rooms for men and women and the appointment T.V. screen doesn't work in the women's room.  No one can even hear the P.A. announcements for the next patient so I basically had to jump back and forth from the waiting room to the jumbo tron in the hall to see if they had called my number. 

Last week when I went to have my x-ray read and get my cortisone shot I waited for one hour in the waiting room and then noticed that patients without numbers and holding x-rays were going right into Dr. Bhat's office.  So I went down and stood in the hallway next to his door to try and figure this out.  The patients that the nurse was leading into the office were dressed in abayas and insisted they be seen.  My number was up on the board yet I waited for another hour before speaking up and telling the nurse the situation.  She just gave me a dismissive hand as she closed the door after leading more abaya clad women into the doctor.  When I finally got into the office I was so upset I said, "I guess next time I will just wear an abaya and push my way into your office instead of making an appointment." I could tell the doctor was a little offended, but he asked me what I meant.  After I explained he then told me that all those women had earlier appointments and were just having their x-rays read.  When I told him that he had told me the previous day that I would have to come back that day for him to do that, he said, "Oh I thought you had another appointment here for something else and were coming anyway.  You could have knocked on the door and I would have seen you." (By the way, the door has a sign that says "Do not knock the door." And that is a direct quote because I memorized it during my hour-long hallway vigil.)  I just sighed in disbelief and determined then and there that I was going to play by my own rules from then on, and I guess that is just what I did when I followed Brett through those hospital doors.  They are all just lucky that my trigger finger issue wasn't caused by real trigger finger action or who knows what I would have done instead of vent via my blog!  Well, happier typing from here on in thankfully!


Marinda said...

Oh so sorry. Sounds like a nightmare. I hate hospitals. period. But in a foreign country and culture it must be so much worse! (although Hyrum's birth here in Germany was fantastic compared to the other boys in the U.S. - but anyway...)

Glad you survived!

Breeann said...

Wow are you brave! I cant believe that it was such a crazy experience. Glad you came out well. At least you have a great story!

terahreu said...

Wow! What an ordeal! I think you are very right about how the culture is reflected in the way they organize anything in this country. 'Sit and wait, sit and wait' eventually you should just start elbowing the old lady next to you to get in first. It seems to be the only method that works! It seems like your hand is doing well enough to type! That is great! From that description, I can't believe you can even move you hand at all. Yikes!

shazaniq said...

Doha medical center is most famous treatment platform for Surgery. really impressive job done by doctors i hope it would best platform in middle east medical progress.

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