17 November, 2014

Big Baby III

click here for part I or part II

Well I finally went in to the hospital in Phnom Penh today.  After waking up and thinking "maybe it will be better today" and taking one look at my leg and almost crying, I realized (and Wayne confirmed) it is not going to get better without further medical attention.

The thought of bouncing 2 hours to the city in a tuktuk did not exactly resonate well with my leg, so one of our staff drove me in his car.  He also took in his wife (a midwife) and a woman from the village and her 7 month old baby who was sick and needed medical care. 

An hour later I was dropped of at Naga Clinic, registered inside and waited to hear my name.  

First off, I had already called the clinic to make an appt. with the doctor that Wayne went to a few months ago (for leg problems also).  I called at 8:00am and she was able to see me at 10:00.  As I sat there in the waiting room it kind of hit me.  I believe this is the first time I have ever been to a doctor for a serious issue alone.  I though of all the times, well, not ALL the time, but many times when I had to go to the doctor...broken arm, ACL right knee, then the left a year later, etc..when I always had family or friends with me.

It seemed silly that at 46 years of age, I was getting teary eyes realizing I was alone.  Sometimes my life feels so adventurous and other times it feels so sheltered...anyway, I held back the tears as this spunky 60+ish Russian doctor came out.  I sat down in her office chair and she said, "What is the problem?"  

I held up my leg and she said "Oh my gosh" and immediately pointed to the bed in the room.  As I crawled up on the bed, she just kept looking at my leg and asked me all the necessary questions: what, where, when, how.  It's always kind of hard to explain how I did it, without knowing where I live or the kids or even my personality, so I did the best I could and she just shook her head.  What I really liked about her was she didn't poo poo around. Wayne had told me she's very straight forward and if there's one profession I want to be that way, it's the medical field.

Well she got out some alcohol to clean it and said "Do not scream." I thought " Why in the hell would I scream?"  then "What are you going to do to me to make me scream?"  As she gently  wiped my leg with the alcohol, she repeated it "Do not scream, okay".  Which I repeated in probably a bit too high pitched voice, "I will not scream". While inside I hoped that I did not just tell a lie!

She then walked out of the office AGAIN repeating those words!...leaving me to start to freak out about why I would scream and why would she think I would scream.  She entered again and walked to the little silver tray on wheels, depositing a mass of items upon it.  She then plopped herself down on a stool with her chest ot the level of my leg and pulled the tray to her.  I desperately searched the tray for anything shiny and calmed a bit when I only saw paper and boxes.

As she proceeded to put a generous helping of antibiotic creme all over the area and then the dressings, I suddenly realized she had been making a joke about the scream.  A very unfunny one at the time, but only because I didn't know her sarcasm.  (Later I told Wayne the story and he joked that maybe she said it to me, because he did scream when she fixed his leg, ha ha)  I then liked her more. You don't have to be politically correct in Cambodia, or fear getting sued, and it's kind of refreshing at times.

Well once she had explained to me everything that she was doing and my leg was wrapped up snug as a bug in a rug, she moved me to the other room where I received an IV cocktail full of antibiotics and other healing stuff and a shot in the bum.  That I didn't even feel!  She kind of pinched me and then stuck in the needle, so I was thinking of the pinch instead of the poke.  then she kind of scratched me a bit with one fingernail right next to the needle, so I didn't feel the medicine entering my body (which many times stings).  During the whole process I didn't know what she was doing and thought it was weird that this nurse pinched my butt and then scratched it a bit.  Not weird in a perverted way, but just maybe a cultural weirdness.  After it was over and she wiped the area where the needle entered I thought, wow that was the best shot I ever had.

I had to lay there with the IV for about 2 hours so I settled down to read the latest book on my Nook and finally dozed off.  I had the weirdest dream...

"I was in the same clinic but they were over crowded and I had to share the left of my bed with another woman.  I kind of thought, oh well, and scooted over.  Then this ancient woman and her husband who were at least 110 years old were sitting in the chair on the other side of me and the woman kept trying to get in the bed too on the other side.  I thought "no way!" and pushed her off the bed and called for the nurse.  The woman got out and then laid her head right on my leg!  I said "NO! get off my leg it hurts" and then fell asleep.  I woke up and the lady on my left was gone and the old lady was trying to get into my bed on that side, but she was all tangled up in my IV tubes and it was coming out of my arm.  I called for the nurse and the nurses were trying to get her untangled without hurting me"  

Then my phone rang and I was thankfully awoken.  But I was all disoriented and kind of sat up panting and looking around.  I thought, what else did they put in my IV cocktail?

Finally it was over and the doctor knowing Wayne's capable skills allowed me to go home with all my medication and injections and not have to stay in the hospital for 5 days.  Although I saw the rooms and thought it would be like a short stint at a relaxation spa with full catered meals from whatever restaurant was in the area, but that was one expense that just wasn't necessary.

Final ITEMIZED bill for an uninsured person; which by the way, I   have I never had a full itemized bill voluntarily given to me in a US hospital. 

Dr. fee $60 (this includes her wonderful attitude, compassion, and off-the-wall humor)

Injection $6
IV therapy $6
Room fee for the day $30
Seven different drugs for the IV - $108

That's a total of $210 dollars for me to walk into a hospital get treated for major symptoms and walk back out.  Uninsured.

And the other bonus, for my medicines is:

Fourteen injections of Rocephin (Ceftriaxone) 1 gram each (2 grams a day for 7 days) - $164 - or $11.60 a gram
Seven injection of Solu-Medrol (Methylprednisolone) 40mg (1 time a day for 7 days) - $3.42 - upon closer inspection of the bill, they only charged me for one bottle of this, instead of 7!  That's not right!  I will have to take the receipt and the prescription back in with me and pay the difference.

I also am to take in tablet form:
Flagyl 250mg (3 x a day) - $5.00 - or $.25 a tablet
Diclo-Denk 100mg (2x a day) - $1.80 - or $.18 a tablet (I love saying "I'm on Diclo-Denk")
Daily for 10 days 

She also prescribed packets of Cicatryl ointment ($5.74 or $.41 a pack) to put all over the infected area and Urgotul (a mesh thin bandage strip to put over the ointment, but under the gauze) - $15. - or $1.50 a strip - enough ointment and bandage for 10 days.

That's a total of $193.36 for medicines that will heal me all up.  Not my co-pay, but the total bill from the pharmacy.

So what's a girl to do with all this extra cash she brought to PP expecting the worse?  Well, after a Istanbul Spinach Wrap from Vego I headed to Lucky's Supermarket where you can get any and all kinds of "Western foods".  I splurged on junk food!  When I am sick I may loose my appetite for a day or two, but then I crave comfort food!  Bad for you comfort food, things I NEVER eat here, but gorge on at Mom's house (I gained over 5 pounds the last time I was home!)

I treated myself to a gut breaking cartful of Nacho Chips Doritos, Lays Potato Chips(2 plain, 1 seaweed flavored), Cheetos, Pringles, Bean Dip, French Onion Dip, Jalapeno Cheese Dip, Mac and Cheese in a box(2), a large block of Cheddar Cheese, Blue Cheese, Mozzarella Cheese, Brie, I bought Brie for gosh sake! 

For those of you who graciously support my stay here, please rest assured that I also put in the cart: Olives (green and black), Tortillas, Jalapeno's, Nori Roasted Seaweed, Virgin Olive Oil, Tomato Paste, Pasta, Cashews, dried Black Beans, and 3 small baguettes.

I'm embarrassed to admit the total but it was much less than the medical bill! (can you imagine what it would have been if I had not eaten lunch first?) And pending another major accident, it won't happen again any time soon.   

I'll keep you updated on my leg's reaction to the antibiotics and thank you for your support, prayers and encouragement to me during this time. I never forget the privilege I have in this country.  Although wonderful health care exists in 'under-developed' or 'poor' countries, it is not available for most.  I could afford the $400 for a day of medical care with a foreign educated doctor, but many families live on that kind of money for an entire year.  Of course Cambodian's are becoming more educated and resourceful, but even so, a good monthly salary will rarely earn you more than $400. 

I was able to ride in free comfort to the city in an air-conditioned car.  The vast majority would have scraped together their yearly earnings and/or borrowed or stole money to sit in a mid-size car along with up to 10 or more other people (for $2 a ride) to get to the city where they may wait for hours to see an over-worked doctor working in an under-staffed, ill-equiped hospital.

If I was in a life-threatening medical emergency, I could be airlifted to a Hospital in Thailand, which by Forbes Magazine is among the best places in Asia for top-rate hospital care at reasonable prices.  I would get better, the mother of 4 with the same problem living in the village one kilometre from me would die.  

This is a fact I take to heart.  It is one I cannot change at this time.  This is the part of "White Privilege" I live with.  The idea that one life will be saved over another all because of money.

As Gail posted recently:
“The idea that some lives matter less is the root of all that's wrong with the world.”
Chief Strategist & Co-founder, Partners In Health

14 November, 2014

Big Baby part II

I feel really silly now posting about the painful stitches.  They were of course, but now below the stitches, I have a big black bruise and my lower shin is inflamed.  I believe I just bruised my shin bone, but it's up there in the top 5 most painful things I have ever felt.

Here's a photo of the culprit:

As I mentioned in the first post, the whole thing started out innocently enough - I mean, I just wanted to be queen for a moment.  Somnang's the one I finally pushed off into the water to achieve my short-lived fame as the reigning queen of the plastic blue land.  He's also the one who came running up after me right after Wayne stitched me up and jumped in the air and landed with his legs spread and fists wide in the air and said "I'm the queen!" laughing so hard.

Well today, a stayed in bed most of the day with my leg elevated.  I finally couldn't stand it any longer in my room, so I hobble to the Cafe on crutches, the kids were cracking me up saying "I'm the QUEEN!"  Even in my pain I have to laugh because as Heang said, "you did it to yourself".

Srey Pov performed Coin Therapy on me tonight.  It's an alternative medicine technique which the girls have done for me a couple of times.  It looks terrible especially on my white skin, but it doesn't hurt and it makes me feel better.

Well, here's my leg three days after:

and 5 days after:

6 days after and heading in to the Doctor!

Pretty gross huh?

11 November, 2014

Biggest Baby

I feel like such a big baby right now...

It all started with a gleam in my eye on a sweltering day.  I walked out of the cafe and saw a group of our boys playing in the water.  Most had their backs towards me; a perfect opportunity to jump in to the water and dunk a few heads before they even knew what hit them.

I slowly crept towards them while removing my shoes and glasses.  Right when a few were turning around I pounced!  I jumped onto a small cement barrier and high into the water right at the edge of their group.  

What should have been a refreshing experience immediately turned into confusion...I jumped and both of my shins slammed into something big! 

It seems the boys had overturned this very large blue container that they like to play with in the water.  It's best remembered as a key prop in our Ice Bucket Challenge.

Wayne has a blog post on the Wat Opot site about the boys playing in the water with it also:  click here

So this blue thing was turned over and floating about two feet under the water.  In my excitement to surprise the boys, I didn't notice that they were positioned higher than they should have been in the deep water...My shins hurt after the jump and upon realizing what I jumped on, I started to laugh.  I figured I bruised them bad but it didn't stop me from standing on it and becoming queen of the blue thing; well until they ganged up on me and my reign ended with a not-so-graceful fall off my throne.

At that point I figured I would crawl out since my legs were starting to hurt.  As I got out someone yelled "Melinda cheaum (blood)"  I looked down and there was a small but deep gash in my right shin.  I limped over to Wayne and casually said "Do you think this needs stitches" to which he replied "Yeah".  

I've mentioned it before that in Cambodia (and many countries) they do not have easy access to anesthesia, so you are stitched up cold turkey.  The kids here are super tough and do not cry from pain easily.  It's nothing for Wayne to stitch up a head or foot and everything in between with the patient patiently enduring it.

It's been kind of a running joke that I not-so-secretely wished to have stitches here.  It was usually a good hearted conversation between me and Kate, such as "I wish I would get hurt so you can stitch me up".  When I actually was faced with the fact that I did indeed have to get some stitches; that a needle would be forced into and out of my skin without so much as a painkiller, the humor quickly dissolved.

As Wayne readied the 'clinic' I had Rortana run to get me a towel since I was still soaking wet.  As I busied myself putting the towel on the desk and positioning myself with easy access to my shin, I started to feel nauseous.  Why in the hell did I ever think I wanted this!  This is going to hurt BAD!  

I like to think I have a high tolerance for pain but as soon as that needle pierced my tender hurt skin, I thought I was going to throw up.  There was a small crowd of children outside the window and I tried to play it calm, but IT HURT!  SHIT it HURT!  When Wayne tied it off I again thought I would throw up!  I could feel everything!  I could feel the cut being brought together as the string was tied into a knot.  I looked down and thought "thank goodness it's over" but then I looked again and said "I don't think it needs another stitch, right?" and Wayne replied, It probably needs another one.  

I slowed down my breathing and unclenched my hands from the sides of the desk and endured another stitch.  Even as I type this I am getting nauseous, half of the pain is knowing that the needle punctured my skin twice.  I can still feel it going in, slicing through my tender tissue and back out the other end.  

You try to think about it without squirming?   Can't do it can you?

I have a whole new understanding for the following posts and a whole new respect for the people.


I am now laying in my bed on the computer and the girls just came in to check on me and brought me a cup of hot tea...maybe being injured isn't that bad after all.

10 November, 2014

Cambodia travel.

I had the opportunity to travel with Mujin from the Douglas A. Campbell Foundation to some remote regions in the northwest of Cambodia.  Mujin was going there to check up on 5 water wells they financed the previous year through an organization called Lotus Outreach Cambodia (LOCAM).  

I had never been in this part of the country and the scenery was beautiful and so different than the rice paddy fields I am used to.

It took us about 3 hours to get to the town of Pursat and then another 2 hours to drive to the first well.  It took a little longer because of the cattle roadblocks and difficult roads…

At one point we drove through water that would have been up to my waist!

After ditching the car because the road was becoming impossible,

  we started out on foot.

In the first village we went to, all the people who have access to the well were present.  For each well, every family who uses the well must pay a one time fee of 10,000 Khmer riel, ($2.50 USD) and then 500 Khmer riel (about .12 USD) a month for upkeep of the well.  Each well supports up to 30 families.

We visited 4 more wells each in very remote areas except for one. 

The villages are made up of IDP’s or Internally displaced people.  These are people the government displaced because they wanted the land the families were living on.  They uprooted families (some of them had been living in areas for generations) and placed them in mismatched units in land formerly un-occupied.  Land that is beautiful and lush during the rainy season, but 6 months out of the year, they will not have water nearby, thus the need for a well.  

It's unfortunate that the people who need the most assistance are the ones that live so far away from the main stream.  I live in a rural area, but I'm only 1 and a half hours from the capital city and only 10 minutes from the main highway to get there.  

It's ironic that I absolutely LOVE mountains and oceans, but was born and raised in Kansas, the 7th flattest state in the US and now reside in a relatively flat land surrounded by rice fields.  My short stints in  coastal Spain

mountainous Austria, (and that's a real photo, not some cheesy backdrop!)

and on the river in Belize sustained my environmental ascetic pleasure... 

But to really get to the people in need, you must be prepared to trek down the roads less traveled and plan to stay for a long while.  None of this fly by night NGO do gooders who want to write home about "all the help they are giving the poor helpless people".  I do not live in an area where people commonly die from lack of water or from common dirty water related diseases.  

Traveling to these areas gave me a microscopic glimpse into poverty, depression, displacement and feelings of utter helplessness from people who do not have many choices in life.  But it also gave me a small glimpse of the appreciation for things (albeit few) that the people do have and the happiness and joy they do experience living with what they have.

Mujin and I talked about the difference between poverty and miserable poverty.   You can be very poor and lead a happy life.  But to be very poor and miserable is another factor all together.  The people we saw were poor, but not miserable.  They definitely benefited from the wells their villages were given - and they will really be appreciative during the 6 months when they will have no other water source, but in general (frustration over their inability to secure land rights aside) they were not in miserable poverty.

How would I handle personally being involved in the lives of those who are experiencing miserable poverty?  

That's a good question.