Urgent Doesn’t Necessarily Mean Urgent

On Tuesday of this week, I had a routine appointment at our assigned EBAIS so the doctor could assess my latest blood work results and write new scripts for the drugs that I take.

I take the meds to control a couple of medical conditions I have had for years and years. I won’t go into them because it’s boring for everyone, including me. I’m only writing about this to explain how we coped when sent to emergency or urgency at our hospital.

Here in Grecia where we live, we have our own hospital, Hospital San Francisco de Asis. It’s about a 12 minute drive from our house. This is one of the advantages of living in Grecia as opposed to Atenas (where we first lived). The assigned hospital for Atenas is in Alajuela, about a 30 minute plus drive away (and horrendous parking).

So, my last blood work results were not altogether good, with elevated potassium levels probably/maybe due to one of the latest drugs I had been taking. The doctor told me that  elevated potassium levels can cause damage to the heart.

My doctor said she was sending me to the hospital for observation (we were communicating through my phone translator). She printed out an “urgent” requisition for the hospital. The receptionist looked at it and said I was to go there “ahora” (now).

Phooey. So off we went. We did not know exactly where to go in the hospital so we showed the paperwork to the guard at the emergency entrance. He pointed to a small lineup outside a door just down the street from him. Showed my requisition to the guard at that door and he sent me in right away.

Whenever I wasn’t sure where I was to go, I just showed my paperwork to someone and I was redirected. Everybody was so helpful. Ended up at an admittance window where my info was again entered into a computer.

After that, we were sent further down the hall to another room where my BP, temperature and oxygen levels were taken. Further info entered into the computers. Then directed to sit in the waiting room. What seemed like chaos to our eyes at first then became controlled organization as we sat and watched everything around us.

There are doctor consulting rooms all around. We actually didn’t have long to wait before my name was called. The doctor was really nice - the translation app on my phone is invaluable. All my medical history is immediately available on the computers for any doctor/EMT, etc. to look at. 

She did an ECG and sent me off for bloodwork. I didn’t have to stay for observation. We were not sure where the blood lab was and a very kind and cheerful young lady took us right there and handled my requisition at the counter for me.

So now we know how to deal with this section of our hospital. Lesson - just show your paperwork to anyone who works there! It’s obvious we are foreigners and Costa Ricans are always willing to help out.

I was happy to be sent home, knowing that if there was a problem I would have heard about it by now. But if I had been admitted, I would have had no concerns about the level of care I would have received. It’s top notch.

P.S. The guards that are all around the hospital are not there because it’s a dangerous place to be. They are invaluable for keeping lineups orderly (especially now with Covid), directing people to the right place and so on. I always go to them when I am unsure about where I should be.

At the Dentist

As I have previously mentioned, we have an excellent dentist here in Grecia - Dr. Marco Vega Quesada. Again, here is his card:

His modern office is located near POPS on the second floor and across from the central park and cathedral. A plus is that he is bilingual, although his office staff is not. He also works at our Grecia Caja hospital, San Francisco de Asis. He and all his staff are so personable, kind and caring. Great view of the park from the treatment rooms.

I had my third visit with him this Wednesday for gum surgery. All my appointments so far have been late afternoon (4:30 pm). This means that quite often it is dark when I leave his office (this being the tropics after all). We don’t drive in the dark so Lance drops me off and I taxi home. Reasons for not wanting to drive in the dark: narrow, winding roads; few if any sidewalks and lack of shoulders; people, dogs, chickens walking on the roads, lack of street lights and so on. Obviously not all of Costa Rica is like this, but it is in our area and we prefer to leave the driving to the taxis. 

This particular appointment was over an hour long and I left with a mouthful of stitches and cotton batting on one frozen side, instructions to rest, avoid the sun, don’t drink hot beverages and take the prescribed medications. It was dark out by now.

So here’s the funny part. There’s a large farmacia (pharmacy) near his office and the taxi stand. In I went, handed over my script and was handed back a pack of pain killers, mouth spray and a large needle with vial! I thought ... am I supposed to inject myself? That’s for sure not going to happen. Then I remembered - in Costa Rica pharmacies provide a lot more services then just dispensing pills and selling shampoos. They will also give injections.

So I was motioned into the back of the farmacia, had my blood pressure and heart rate recorded, then into another room - up on the table and the deed was done. I’m assuming the shot was antibiotics - the doctor explained everything to me but I think I missed that part so I was kind of shocked when I saw the “giant” needle. Poor Lance - I had phoned him to say I was not yet in a taxi but in a farmacia waiting to have a shot of some kind, but I couldn’t talk very well with the freezing and batting or even explain why this was going to happen to me. I was a bit addled!

Anyway, taxi home and I got to see all the wonderful Christmas light displays on the houses in our neighbourhood.

Interesting Stuff That Happens To Us

We are quite fortunate because Costa Ricas always seem to be helping us out when we get stuck. I think it is in their very nature to be kind and helpful.

Recently I received a parking ticket. Parking in our town of Grecia is a system called elPark. You pull into a numbered parking spot, pull up the elPark app on your phone, enter the stall number, the minutes/hours you want to park for, and pay for the time on the phone (using a preauthorized credit card number). Then I get an email from elPark with my parking details.

The ticket was incorrect and I had the emails to prove it so off we went to City Hall. The guard at the front gave me a ticket to see an agent and I guess it was a ticket for old people because I went right to the front of the line in a crowded room of folks waiting to see an agent. The agent looked through my paperwork then directed us out of the room and down somewhere else. We couldn’t find “somewhere else” in the building. In consultation with the building guards, a Costa Rican came to our rescue! 

This shaven haired, very muscular and tall man indicated we should follow him. We walked and walked - I whispered to Lance that we were following a complete stranger to who knows where. Into the Mercado Municipal de Grecia we went (a huge indoor market in the middle of town). Past all the fruit, vegetable and meat venders to a set of stairs. Up we went - turns out it was the office of elPark so our stranger knew exactly where to take us. We thanked him and my ticket got sorted out.

Another example: we recently renewed our cedulas (residency ID cards, everybody has one) and had to wait for them to arrive - they expired on March 29. Since our association with the CCSS (socialized medical system here - if you have residency you must join) expired on the same date, we had to reassociate with the CCSS. This meant taking our new cedulas and all associated paperwork to the affiliation wicket in the CCSS medical clinic building in Grecia. You sit (or stand if there are no chairs) at the end of the line and wait. On this day, we waited three hours but I’ve heard of longer and shorter wait times. Finally our turn came but it quickly became apparent that we were totally at sea what with the ambient noise around us and the rapid fire Spanish from the clerk.

To our rescue! Costa Ricans! One lady in the lineup saw our predicament and sent her husband over to help us. He was bilingual so thanks to him we got through it all. It’s nerve wracking because you never know if you have all the correct paperwork and if you don’t, away you go to get it and come back and line up again. We were asked if we were married and thankfully I had our Costa Rican marriage license with us. There’s a reason why we remarried in Costa Rica. I won’t go into it here but I did a blog post on it a few years ago.

Turns out our rescuers are also our neighbours - they live not far from us in the same complex. They rescued us a second time, the very next day. Now that we were reassociated with the CCSS, we went to our newly assigned Puente de Piedra Ebais so I could make a doctor appointment. We had been told to be there at 0800 but the receptionist was telling everyone to come back at 0900 the same day. Our angels somehow talked the receptionist into giving me an appointment for the next day right then and there.

The next day, back at our Ebais clinic and waiting to be called by the nurse and then the doctor. The Costa Rican lady next to me started to chat, in English! She showed me photos of her husband and children. We traded names and phone numbers and it turns out she lives not far from us. She even went into the nurse’s office when my name was called, saying “venga, venga” to me (“come on, come on”) like they do when calling little kids. She stayed and translated for me which was a blessing because there were lots of questions about my medical history. We had some good laughs when none of us could make ourselves understood - pointing at private parts and so on. You will always see a nurse first before the doctor - they take your height, weight and blood pressure. Everything is entered into the computer system and the doctor pulls the same info up on his computer.

Fortunately, the doctor was bilingual.

The Puente de Piedra Ebais clinic is much larger and more modern then the Barrio Jesus clinic we were assigned to when we lived in Atenas. The nurse and doctor offices are large and the nurse has an electronic blood pressure machine and electronic scales, not what they have in B. Jesus. It’s also very close to our house - a five minute drive. Grecia has its own hospital - Hospital San Francisco de Asis.