Tuesday, June 7, 2016

I'm Past Due

I am past due, way past due. Nope, I'm not pregnant. I am past due for a pelvic exam and mammogram. 

One of the challenges of moving around the world is having to find new doctors. Sometimes, in the midst of setting up a new life, again, I just don't get to it all. As this school year comes to a close I am realizing that I didn't have a checkup the entire time we lived in Beirut. That makes my last one three years ago. (I did think about doing it in Seattle, but my doctor moved and then we were changing jobs, therefore insurance companies - yadda, yadda, yadda.) I have even thought about it this year, going as far as inquiring with female colleagues. I knew which medical facility I wanted, but no one had a gynecologist recommendation for me. Yes, at that point I figuratively threw my hands in the air. 

Now, with the year wrapping up, I wanted to get as many things off my 'to-do list' as possible so I gave it one more go. I remembered that another teacher's husband is a doctor at the hospital where I want to be seen so I asked her if they had a recommendation. This should have been my move months ago!

Wasta kicked in and he not only had a recommendation, but had an appointment for me the next day when it usually takes a couple of weeks to get in. On top of that, he asked that I call him when I arrived at the hospital so he could walk me in, which he did. After the typical run around that a visit to a hospital in this country necessitates, I sat in the ladies only waiting area until it was my turn.

NOTE: Here doctors are almost all seen within hospitals. (The only exception we have ever had was G's pediatrician in Jeddah.) Even though you have insurance you still have to visit an insurance office and then a cashier and have all the proper stamps before you can continue with your appointment or testing. This is never a linear process, often going back and forth a few times between various desks, waiting your turn where this is no proper que, and as a female either being given an invisible bubble of space or ignored and shoved past.

Once the initial hoopla was accomplished I sat behind the partition for the 'female only' waiting area. One nurse called me back to take my vitals and then sent me back to the waiting area. Once it was my turn with the doctor another nurse came to get me, it was then that I found out they have no Pap smear kits available and won't have any for two more months. (I didn't ask how long they had been out.) For many of you this will be shocking to read, but for those of us here it is par for the course. 

It was not a waste of my time, however. I knew that I had to see a doctor to get clearance for a mammogram, which I obtained. I also was able to get some magical migraine pills. (You can get almost anything here without a prescription, but it also means you have to pay for it - though not much, while insurance will pay if you have a prescription.) 

One of my other goals was to look into where I am in the menopause progression. The doctor balked when I brought it up, but after telling him this is the age my mom went through menopause, and after he did an ultrasound, he seemed convinced that blood work might actually reveal something.

I left his office with an appointment for August 17th (the kits will be in by then, inshallah) and three sticker labels; one for the pharmacy, one for the lab work, and one for radiology. Now it was time for the scavenger hunt - could I be successful? It could go either way.

I first dropped my sticker off at the pharmacy so they could process the request while I searched the hospital for the various offices and tried to navigate the prerequisites for each department. Next I went looking for radiology. Upon finding the right reception I waited my turn only to be told I had to go to the cashier to open the file. "Lab work or radiology?" inquired the Cashier. "Both!" came my reply. After parting with 73 SAR ($19 and change) I headed back to join an even longer line at the radiology reception desk.

After a couple of people in front of me had been helped the man behind the glass recognized me and called me forward. (Yes, I was the only what woman gliding around in my abaya and one of the only women with neither my head nor my face covered - not hard to remember.) After some time poking around the computer he told me the female doctor (though I suspect lab technician) is out until July and asked if I minded having a male. "That is fine." We negotiated times and I chose next Wednesday as I am still here, but students are out of school so my class is not impacted.

Off on the next part of my scavenger hunt - time for blood. After a maze of hallways that started with entering the dental section, I found the ladies only room for lab work. The door was closed and there was no reception. A nurse happened by and after inquiring I was shown a number generating machine for that room that was further down the hall and on the other side. (So NOT intuitive!) As soon as the machine spit out my number it popped up above the lab door.

The lab door had a big "DO NOT ENTER" sign asking you to wait until someone comes out to get you. This makes sense as when the door opens anyone in the hallway might see the bare arm of someone giving blood. I sat down. I could hear people talking in the room and after about five minutes the door opened. No patient exited, but the two workers who had been chatting called me in. (Yes, efficiency is highly prized here...) More stickers were generated and viles set out and labeled. I told the girl (and she seemed like a teenager, but perhaps a youthful early twenties) that I would be fine as long as I never saw the needle. She sat me down and prepped my arm. I know I have good veins, but it still seemed to take her quite a while. I was prepared for the pain, but surprised when I didn't feel a thing. She was good! I praised her blood taking ability as she put the cotton and tape on my arm. I re-donned my abaya and headed back out.

This time a bathroom was my priority. That was another amusing scenario, but I will spare you. My final stop was to pick up my prescription. This should be my most straight forward stop - ha! I was send back to the cashier to have them activate this part of the file. (It is better to not ask why he didn't do it the either of my last two visits to see him.) Finally I was given six magic pills and pulled out my phone to get picked up.

Again, I will spare you the details of how Plan A and Plan B didn't work. Thankfully I only had to wait an hour for my husband to finish his meeting and come fetch me and thankfully I had wifi and a good book. What I will tell you is that while I was waiting I noticed the sleeve of my abaya was damp. I knew I hadn't gotten it wet while in the bathroom and was a bit baffled. It was the crook of the arm where my blood was drawn and I thought that perhaps something she had used to clean my arm hadn't dried and soaked through. 

A few minutes later it seemed to be growing, but it isn't like I could unzip my abaya and take a look. I pressed my fingers to the spot and they came away pink. I abandoned my post by the entrance and went to find a place where I could investigate. I returned to the check-in desk for the doctor I had seen and asked for a tissue. When I pressed it to my abaya and it came away red the ladies ushered me back and into a room. Removing my arm from the sleeve I discovered that the cotton was soaked through and my arm covered in blood. I was in no pain so I was not alarmed and applied pressure. The ladies were concerned, though, and insisted I return to the lab.

With my abaya over my shoulder they led me back. Once in the lab room I convinced them that I just needed paper towels and a sink. I got cleaned up and mostly rinsed out my sleeve. With a fresh band-aid applied and abaya on once again I returned to the entrance and my book to await my pickup.