Visits

Friday, October 27, 2023

Don't Panic!

This last week in south Bali has been so hellishly hot and so fiendishly humid that I suddenly found myself short of breath a few days ago. I mean gasping for breath whenever I was outside. Of course, I was not sure that this was the actual problem (given the widening array of actual problems that I have), but it was becoming clear that something seemed way wrong and that I should probably address it. Therefore, I did one of my most personally hated things and headed for the hospital. I was thinking that perhaps they would give me an inhaler or something like that. I chose Sanglah Hospital as an alternative to the usually highly annoying and incompetent Kasih Ibu, where I had once been diagnosed with an infection that I did not have and on another occasion erroneously told that part of my right ear would have to be removed because of skin cancer (and I got that close to actually doing it!).

So anyway, I headed for Sanglah, only to find that the parking lot was full. More than full. Full two times over. As I drove around in circles, baked to a blistering crisp, and gasping for breath, I finally gave up, said F-it, and wedged my bike eventually back out of the superfluous parking area.

What now?

Well, I decided to go to the Prodia blood lab instead. Maybe my borderline diabetes had finally crossed the border. Air hunger, after all, is one symptom of high blood sugar. Or maybe my blood pressure was high. It had been so one time in the past. In any case, I figured I could get a few basic lab tests and present these later to some doctor somewhere who worked in a facility that had a parking lot with at least one open space in it.

Using the trusty navigator app on my hand phone, along with earphones, I was straightaway led into a maze of backstreets and alleys that did not in fact end up at the Prodia lab. It turned out that one had to do this by turning off ones navigator and finding the place for oneself.

Having gotten the blood draw, I gasped my way home to wait for the results.

The results showed, as has been the case for the last 3 years, borderline high blood glucose and high cholesterol. I had succeeded so far in spending 650.000 rupiah to find what I already knew. Knowing this result, did not decrease my shortness of breath. It had gotten worse.

Okay then, Kasih Ibu. It is fate. It is a curse. 

Off I go.

At Kasih Ibu they tell me that no doctors are available and send me to the emergency department, which constitutes an insult to language, actually. It is one small room with two beds and one curtain. The emergency department. The department itself is clearly in need of emergent care.

A resident comes in, I tell her my story, and she decides I need an EKG and a chest x-ray.

Oh my God! See, I knew I was dying!

And so we wait. Tick, tick, tick.

And then a lot more ticks.

At last, the tests are done. And they reveal the worst. They are normal.

Could it be, I suggest, as I suggested in the first place, that my problem with breathing has something to do with the unusually extreme heat and humidity?

Hmmm.

They place an oxygen tube in my nostrils and go away. About an hour later, an Indian doctor shows up. She wants to talk about blood sugar and cholesterol. In general. I steer her back to heat and humidity.

In this kind of heat, people need to be less active, I think, she tells me. What are your daily activities?

Activities?

Yes, what kind of physical activities do you do in a typical day.

Umm ... Drink coffee and watch TV.

Thr end result of this emergent visit is that they do not prescribe any medication and they do not cure me of my shortness of breath. They suggest that I see a doctor at some future time. If I'm still breathing.

Dejected, I return to my house. I have not been there 5 minutes when I realize that I have left all of my documentation on a table at the hospital. My ekg, my x-ray, my patient billing information, and so on.

Shit!

My breathing grows worse yet.

Back to Kasih Ibu.

Not absolutely necessary. But they had told me in the emergency department that my usual doctor, the astoundingly incommunicative Dr. Yoanes, would be working this evening from 6:00 until 9:00. Heck why not pop in and see him after picking up my paperwork? Not that I miss him, but damn, if I'm going back anyway, why not?

It is my good fortune to find that apparently no one else cares to see Dr. Yoanes. At 6 o'clock, I am the lone patient outside his door, something unheard of in Indonesia, where the hallway outside a doctor's door looks something like the parking lots. 

I tell the doctor about my shortness of breath. But he wants to talk about blood sugar and cholesterol. He is irritated that I did not get a full laboratory panel. If you do not get a fasting blood sugar and the complete cholesterol panel, we cannot see where your levels have been.

Okay, sure. Now how about this shortness of breath?

He motions for me to get onto the examination table. As a rule, Dr. Yoanes does not speak. He motions with one hand. He proceeds to perform a cursory neurologic exam.

I pass with flying colors, I think, at least for a neurologically compromised person. Yay.

I begin again to describe my earlier experience in the ER and what brought me there.

What is your typical activity level, he asks?

Oh God. 

This started like 3 days ago, I tell him. I started to feel like I couldn't get enough air. Each day it got worse. As soon as I go outdoors, I can't breathe. I struggle to get a breath. I start to feel panicked.

Ah, the doctor says. 

That could be it!

Mm, he says. 

He gives me two prescriptions. One for atorvastatin, a cholesterol lowering agent. A second for something called clobazam. And says goodbye.

On arriving home, I look up the med.

Clobazam: A benzodiazepine, typically given for panic disorder. 

Patient, heal thyself.

6 comments:

Christoph said...

I hate to say it and I am sure u already know but my first idea is „quit smoking“

Anonymous said...

I thought only the American medical system treated people like dumbshit pieces of meat, and arrogantly ignored their complaints in favor of their own biases. I was wrong.

R.W. Boughton said...

Chris--Stopping or decreasing smoking in a good idea in any case, you are right. Apparently, however, it is not related to this current problem, given the clear xray and the normal ekg.

R.W. Boughton said...

Anonymous--LOL. Yes, you were😉

MB said...

A bit of steroids might help with a lot of your symptoms.

R.W. Boughton said...

MB--Yes you are right, although I have to be careful with steroids because of my stomach ulcer.