Health Care in Panama, a first hand view
Posted by Lee on October 2, 2007
If you do not live in Chiriqui and follow this blog you are probably wondering why the long pause. In fact Jennifer and I were heading out to Buenos Aires, Argentina and we were planning to be sharing steak and wine with some new friends there.
Instead Jennifer made the mistake of taking acetaminophen (aka Tylenol, Panadol or a dozen other names) and drinking alcohol at the same time. I cannot express how dangerous that combination can be if you drink any better than this article.
“Preview: Long-time alcohol users who take acetaminophen in therapeutic or modestly excessive doses are at risk for severe hepatic injury and possibly acute liver failure. Diagnosis may be difficult because presenting symptoms are vague. The authors review management of acetaminophen toxicity in both users and nonusers of alcohol and emphasize the need for greater awareness among healthcare providers and acetaminophen users of this preventable and treatable condition.
Draganov P, Durrence H, Cox C, et al. Alcohol-acetaminophen syndrome: even moderate social drinkers are at risk. Postgrad Med 2000;107(1):189-95
The symptoms of this syndrome do not present for 12- 18 hours after ingestion. Jennifer started having severe stomach issues on Tuesday 25 Sept and after a visit to a clinic in Boquete we drove to Hospital Chiriqui in David.
I have little prior experience with rural hospitals in any country but I need to credit the fast reaction and diagnoses from Dr Ivo Guerra who started treatment. As much of the english speaking Chiriqui community is aware at 11pm that night I received a telephone call from the hospital telling me she needed blood donors, fast.
Although the Regional Social Security hospital has a blood bank in David the private hospitals cannot access the resource. I put out a plea on the Boquete.org news server. The response was amazing, within minutes of the propagation of request people were calling offering to provide blood. Honestly an experience of community support I have never seen before in my urban American life.
The hospital was very particular about the blood donors and it made it very difficult; they would only accept donors between 20-50 years of age and meeting many other criteria. The support came for many people both in Boquete and David. Radio Chiriqui put out a call for donors, the Bomberos in David were contacted and the Boquete community came through. This blood issue is one that needs to be addressed by the Chiriqui community before this type of crisis is repeated.
After a few days and a lot on information I decided to transfer Jennifer to Panama City. Since her liver was shut down any possible bleeding could be fatal. She flew with a doctor and assistant on a charter plane from David to Panama City and was transfered to Hospital Punta Pacifica.
The care and facility in Punta Pacifica is as good or better than any I have experienced or observed in any hospital ICU in the US. The doctors are excellent as is the nursing and technical staff.
On Friday the entire situation diagnosed in Chiriqui was confirmed, additional tests were done and I was told that her chances of survival were very low. On Sunday her vitals started improving and as of Monday she is conscious and talking. Jennifer is still in very serious condition but is receiving excellent care and appears to be recovering. Time will tell.
Our experience demonstrated some need for community action.
I believe some Provincial blood banking system should be discussed and created so all people in need have access to blood in an emergency.
The medical evacuation option to Panama City is something I have seen in the US from disasters and from rural hospitals to more specialized facilities. I believe a plan should be in place with some funds to make this option instantly available to any one in the provence who might need the resource.
We live in a fantastic place but like all places we are human and we do occasionally need critical care.
I once again want to thank the entire Chiriqui Community for their support in our time of need. It is very important to emphasize that not only did the expats of Boquete respond but that the greater community also provided blood, prayers and support. I am not a believer in religion but I do think all who have prayed for my wife to survive. Whether it is the doctors, the prayers or just her stubborn personality it does appear she will make it.
Comments
11 Responses to “Health Care in Panama, a first hand view”Leave a comment, and if you'd like your own picture to show up next to your comments, go get a gravatar!
Thanks for the update and I am glad that everything appears to be moving the right direction. .
dear lee & jennifer,
all will be well for jennifer in time. you have been generous
and the community responded in like kind.
it is such a frightening time for you both & family.
you will remain in my prayers & meditation. ellen
My prayers are with you both! (Positive energy if you don’t believe in prayer.
Thank you for posting this and keeping us “fans” updated. What a horrific experience. God bless.
Melanie V.
P.S. We will be visiting the Boquete area in December and I hope to meet you then.
We are all thinking of you both and hoping for the best!!
All our Love,
Faith xoxo
Lee and Jennifer
My spouse has an auto immune liver disease…. which, like Jennifer’s problem is very difficult to diagnose.
While I have great sympathy for the distress… it is also very comforting to know that both a “willing community” and competent medical personnel exist in Boquete, David and Panama.
A very dear friend in Toronto has cancer of the bladder. He was diagnosed more than 2 months ago and will not be operated on for another 2 months!!!
We hope that Jennifer’s recovery is swift and complete.
My best wishes to you both. Hope to hear of a fast, complete recovery and see J’s wonderful photos back here again soon.
Hello Lee,
I’m so glad Jenifer seems to be on the mend. Gord and I were very worried about her. Hope she makes a full recovery very soon, and is out rating local restaurants again. I imagine you have already disposed of all the Tylenol in your house. I think I will do the same.
Best wishes,
Gordon and Anne
Before chucking tylenol, I have to mention that in the event that one contracts “Dreaded Dengue” {something which I have recently contracted again} the use of aspirin [a blood thinner] can be fatal.
Part of dengue can manifest itself with extreme “itchyness”… In my case it gets so bad that I am unable to function!
The treatment of choice is not HISTAL [4mg twice per day] but rather Tylenol/acetometafin.
It appears that the combination of alcohol and tylenol is the problem… not just the tylenol. Also, for anyone with a liver disorder… again aspirin is unacceptable… whereas tylenol is not.
This is the best news that we could have had and we are all so pleased. We are looking forward to seeing you and Jennifer back home in Boquete.
Love to you both,
Paul Jenny and Neimis
HI, my name is Viviane, i am new here in Boquette, only 3 months, retired with my husband, we are looking for an english or an english speaking GP Doctor in Boquete, could you please help us, Thank you