What is Egyptian medicine like? I have a first hand account through family emails regarding my Uncle Maher's elective total knee arthroplasty. This is my mother's diary of observations:
Again the airline Gods willing, we will get on a Delta flight that leaves JFK at 4:20 on Tuesday, June 24 and arrive in Cairo at 10:35 am on Wednesday, June 25. That is, if all goes according to plans. Maher's surgery is scheduled for July 5, so we are getting there earlier than necessary, but it was the best bet for the seats available and other considerations. No idea when we return--dad is saying sometime after July 10th but I am thinking later, as Maher will barely be out of the hospital by the 10th and it is important to make sure he is getting the best PT available.
We ran into our first glitch today. Dad called Costco to fill his medication and his insurance company said he wasn't eligible for a refill until Saturday, but we will be gone by then. So he had to call Humana and ask for a vacation over-ride, which they granted, but there is only one over-ride every 12 months, so that means no more vacations with Rx unless it falls within the insurance company parameters of refill or Dad pays out of pocket--$250.As it is, he pays $60 co-pay. Fortunately we could afford to pay if necessary, but for those who can't, it is like you have to plan your vacation around when your Rx is refillable and if you have several medications with different refill dates, how does one decide?? I have been urging Dad to go through the mail-order where he can get 90 days and it is supposed to be cheaper. Even then, one could get caught with not enough pills if it is towards the end of the 90 days and you want to take a spontaneous trip. Guess us old farts are supposed to stay home close to our pharmacies!!
June 27th--Maher's surgery will not be for a couple weeks, so we are here until mid-July. When they changed the surgery date to later in the month while we were in Atlanta, dad considered going back to Phoenix for a couple weeks, but with the difficulty we had getting from Phoenix to Atlanta. (24 hours) I just didn't have the energy to do it all again.
July 7th--Maher's surgery is uncertain--no one knows what is going on!! Mom
July 12th--No one is allowed in the hospital before 3 pm, so if surgery is scheduled before 3 pm, no family is present during the time of surgery. Not sure what would happen in the event of unforeseen complications; I wonder if any place on the chart is even a telephone number to be called in cases of emergency. I hope that Soheir doesn’t need heart surgery in a hospital such as this. Maher has languished in the hospital for a week after his pre-op testing. First surgery on the July 10th canceled—no reason given. Second surgery scheduled for tomorrow, July 13, i.e., bukra insha’allah. No one has discussed post-op PT. Word from Ahmed is that there is a good PT in Tanta. There are no waiting rooms in the hospital; visitors sit in the patient’s room despite there being four beds to a room and few chairs and no privacy screens. Although Dad said the hospital food appeared adequate, the family brings Maher food daily, including the day before the scheduled surgery on Wednesday. Sitting on a chair where I could see the underside of the bed, it had not been cleaned since it was installed in the 20th century! There were no doctors evident in the four hours I spent in the room/halls on Wednesday—none in the halls, in other rooms, etc. Just three nurses chatting at the “nurses station” and I use the term lightly. Dad's comment to all this, was, "You get what you pay for" which is a military hospital and therefore free. But free or not, I would think the military deserve the same as any other hospital would offer, so maybe this is SOP for all public hospitals.
July 13th--Hi guys, well, Maher finally had his surgery today. It all went well. Too bad it was so late in our visit, but there are things we can't control. Dad wanted to stay an extra day and drive to Tanta on Tuesday to see the PT clinic that Ahmed said was there, but I asked him what he would do if he didn't think it was that good and how could he change what is available. There is really nothing he can do except to encourage Maher to do his exercises as instructed. His sugar was over 300 so it appears he does have diabetes; he had told dad it only gets elevated when he is stressed and has never been diagnosed or taken meds for it. He will now. I told him it is his choice to stay an extra day if he wants to. A doctor is supposed to see Maher at 8 am tomorrow morning, so dad is leaving here at 6:30 to see if he can be there when the doctor is there. Dad ordered three months of his expensive Rx ($400 here vs. $1000 in the US and will pick it up tomorrow. I'll go to the hospital later in the day after the 3:00 visiting hours to say goodbye to the family. My plan is to close up the apartment on our own. We have always relied on the family--i.e., Maher--but that no longer makes sense. It is our place and we can do what needs to be done.
July 14th--Hi kids, Dad left the house today 6:45 am today to supposedly see Maher's doctor who said he would be there at 8:00. He did show up several hours after 8, comes in, asks how Maher is, answers nothing regarding starting him on therapy, waltzes out. Dad got the impression that Maher would do his therapy at home with the instructions they give him. Dad is helpless to do anything. I did go online and printed out several articles on PT and found some with nice diagrams and Dad explained them to Amr and Emad. His leg was bandaged from ankle to crotch with a drain draining blood. He was also getting a blood transfusion while we were there.
July 14th--As bad as health care problems are in the US and all the crap that happens, it is amazing what was done and not done in this first class military hospital here. Granted, Maher's treatment is free, but being a govt. owned hospital the standards should be better than they seem to be. Dad left early and I haven't heard from him, so I don't know if one, he got into the hospital and two, if the doctor turned up as promised.
A fascinating inside look at Egyptian medicine at a military hospital. Government run health care. You get what you pay for. It's no different than waiting 24 hours and dying at yer county hospital in the good 'ol US of A. I hope, but doubt that my Uncle will get appropriate venous thromboembolism prophylaxis for his surgery. If he is going home, I don't know how he will give himself subQ shots or take coumadin and get his INRs checked. I hope he doesn't end up with a DVT or pulmonary embolism. The risk of clots in these types of surgeries is high and standard of care (in the US) says prophylaxis is mandatory. Let's just hope...
I hope your uncle does well. Please, keep us updated.
ReplyDeleteWow, I'm published! In all fairness, I would like to add that there are some very good doctors and hospitals in Egypt. A long-time American friend had total hip replacement last year in a private hospital and she rates her experience A++. Her room was like a Hilton suite and the doctors couldn't have been better. The physical therapist came to her apt. for as long as it was necessary. She works for the US Embassy and has BCBS, so perhaps it is similar to the US in that the insurance is an important factor--private not government.
ReplyDeleteAs an addendum to this surgery being done in the military hospital--he has health insurance and if he had wanted the best private hospital experience, it would have cost him the equivalent of about $30,000, a huge sum of money here for a retired accountant. His sons being in the military offered him the option of this hospital.
Happy Mama
Like you said. You get what you pay for (or don't pay for). That's why Medicare is collapsing on its own weight. It fails to value the most important aspects of it's care model.
ReplyDeleteYou really can't expect care in an Egyptian hospital to be up to our standards, because all the docs are Cairo-practors.
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