Sunday, March 9, 2014

Spending Five days in a Foreign Hospital with my Baby

A few months ago I wrote about a negative experience we had at an Israeli hospital. Writing negatively is often easier for me. I’m more impassioned about negative experiences. I don’t know if this is true for all writers, or if it’s just my personality.  I feel an inordinate amount of outrage oftentimes. As I’ve gotten older, I’ve learned out to deal with these feelings, and not be so controlled by them. I also have a partner in life who balances me out, and doesn’t get ruffled by much.

(Actually this positive story has a negative back story, but I’m not going to go into that, although I really, really want to).

On the day of my daughter’s first birthday, Friday, she came down with a cold. The cold did not improve and on Monday, she was sent home from day care with a fever.  I stayed with her on Tuesday. My husband stayed with her on Wednesday, and when I came home from work, we noticed she was breathing rapidly. She wasn’t wheezing, she wasn’t having trouble breathing, she was breathing rapidly.

It was already after hours for my doctor – cue negative story, which I’m not going to write about – and so I called my friend in the US of 20+ years, Dr. Jennifer Miller

Jennifer is not just a friend. She is a good friend. The best, really. She is always there if you need her, really always.  And she has always been there for me, amazingly, since high school. So I called her, crying I believe, and I asked her how many rates should Maya be breathing per minute.

She told me the number and Maya was almost double that.  So we took her to the ER. Where to go? Our last ER visit nearest to our apartment wasn’t good. We had taken her to Tel Aviv with an eye infection, that ER was pretty good. But we decided to go to Schneider Children’s Hospital in Petah Tikva.  The hospital has an amazing reputation, and we decided to go.

Being in any ER isn’t usually glamorous, but this ER was very chaotic and very busy with a lot of yelling.  We were put in a mini room fairly quickly, but getting her seen just took a long time. When she was seen, we wouldn’t hear from nurses or doctors for very long periods of time, even after she spiked 105 degree fever.

My husband kept reminding me that we were in a public hospital. If I wanted to go to a private hospital, it would be different. But we were in a public hospital. After 12 hours in the ER, I called my own doctor here and asked him if we were in a good place. He said, the best. So we stayed.

After 16 hours we were admitted.  My daughter was preliminarily diagnosed with RSV, a common respiratory infection that in a small percentage of 0-2 year olds that can be deadly.  Maya wasn’t getting enough oxygen, and she would need to either wear a mask or be under something that looks like a dog house – official medical term. 

By the way, there is an RSV preventative medicine (not exactly a vaccine, but vaccine like), but it's extremely costly and not offered, unless you ask for it. And then, you have to pay a lot of money (unless your baby is very premature).  Although the $25,000 our insurance shelled out for her hospital bill, probably cost them more.

I talked to my older brother, also a doctor,  also while we were at the hospital, and he said my niece had had this. She wasn’t hospitalized, but it was a bit of a long haul and wouldn’t be something that would go away overnight.  My parents said my other brother had this.

We went up to the seventh floor and she was examined by the chief resident.  A nurse led us to our room, and I was shocked. We would be sharing a very small room with two other parents and two other babies.  Maya and I would be sleeping with two strangers.

This is where I have to admit to being spoiled. I’m a spoiled person. I’m not a brat and I’m not a snob, but I am spoiled. I thought to myself, how am I going to do this?

There would be more. We were in charge of Maya’s vitals. We had to take her temperature in the hospital. We had to notify the nurse if her oxygen levels went down. There was no central command center per say receiving this data or reacting to it.  If she needed a bottle, we’d have to get it for her. If she needed Tylenol, we’d have to go ask for it.  If she wet her sheet, we’d have to go get a new one and change it.  Oh, and there was no t.v.

(For people who are not spoiled, this is not totally normal from where I’m from in the US. You may have to advocate, but you don’t really have to do anything, typically. And there are t.v.s)

After her first 24 hours in the hospital room, Maya was doing great. We wanted to take her home. The next chief resident and the attending doctor said, “no.” She needed a full 24 hours oxygen free, no exceptions.

So I went to the chief resident and said, “Do you really think she needs to stay?”

He said, “She is borderline for sure, but you should know this disease can work very fast and she can get very sick, very quickly. But you are not a prisoner, you can leave if you want.”

We decided hesitantly that she should stay.  I didn’t want to take a chance and knew that some of my desire to return home was based on my own discomfort with the language and the nurses. (Also, my husband offered to be there with her all of the time, but I refused to leave, and needed him to run errands and sleep at home.)

Most people in Israel speak English, but at the hospital most of the nurses didn’t. I am also really uncoordinated and was very nervous. I wasn’t doing things the right way, or the way that they wanted me to.  I was also very tired, and my Hebrew just wasn’t working. The nurse would say, “Ima,” and then all I could hear was blah blah blah blah blah.

And then there were my roommates: One family was Orthodox, one family was Ultra Orthodox. Also, I didn’t know who would be staying overnight, the mother or the father, so I wasn’t comfortable sleeping in a room with strange men, no matter how religious they were. But clearly, I didn’t have a say on whose mom or dad stayed.  I also was dreading Shabbat. I wanted to be on my computer or talk on the phone. I didn’t know if they’d say something or ask me not to.

However, Friday, Maya took a turn for the worse. She was totally lethargic, feverish and needed constant oxygen. Had we gone home, we would have come right back. My in laws came with food.

We got along with our roommates very well. Their babies also had RSV, as did three other babies on the floor. One of the babies had stopped breathing and had come to the hospital by ambulance. They were both about 6 months old. Maya was a little on the old side to be hospitalized with RSV, and it’s unclear why she reacted that way. I spoke with the other mothers in my broken Hebrew. They were very nice and our religious differences never mattered. On Shabbat, I’d answer the phone, but leave the room. They never asked me to do this, but I did. I used my computer and they never said a word.  One time, I needed to change Maya’s sheets and couldn’t manage holding her and changing the sheet at the same time – although they had no problem doing it with it with their kids. They helped me and told me to ask them for help anytime. It was religious pluralism so lacking here and in the U.S., thriving in a small hospital room.

After being there a few days, the nurse realized I hadn’t bathed Maya. I was reluctant to bathe her in the sink there. It just seemed gross. The nurse told me it wasn’t her job to help me bathe my daughter, but she would help me. She cleaned the sink and then spent the next long five minutes yelling at me about this or that. “Ima blah blah blah blah blah” I apologized for not understanding what she wanted, and she said it was okay.

By the way, nurses in Israel are extremely overworked and underpaid, more so than the US.  Starting nurses make about $19,000 here. There is also a significant nursing shortage, embarassingly so for a first-world country. The nursing care we received, with the exception of one nurse, was excellent. Also, the nurses do every thing, you don’t see a doctor very often, really only once a day.

On Sunday, Maya was doing better, and we were released by about 5 p.m. As I walked around the floor with her, I kept thinking how lucky we were, and thought of all of the parents and kids where the hospital was basically their home away from home, because their children were born with severe defects or had cancer or liver failure. All I could feel was gratitude, especially for the resident who convinced us to stay after the first 24 hours and the attending physician who demanded it. 

The resident was beginning his shift right as we were being released. I found him and thanked him.

He said, “You know, the next day at home I looked you up in the computer to see what had happened.”

 “I sort of figured you would,” I said.

So, it wasn’t the US, but Maya received excellent medical care. It wasn’t fancy, but they got her better.  And in the end, that’s all that matters.

And maybe, just maybe, I’m a little less spoiled.


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