ICU in India

No pictures today. I didn't think to grab my camera on my way to the hospital yesterday. It was not exactly a fun day in India for me. But it was a successful one. I did live to tell about it.

I have been trying to drink a lot of water due to the heat. But, apparently, I am not drinking enough since I began to have heat stroke symptoms again on Wednesday morning. This is the third time I've experienced them. The first time, I fought back to health without outside assistance, the second time I went to see a doctor at a Catholic hospital for a shot and some pills. This time I was admitted to the Public hospital where poor people go for free care and taken to ICU.

I decided that I needed an IV drip when my temperature shot up to 102 in a few hours. A young priest was assigned to take me to the Public teaching hospital since he was related to the head of Pulmonology. Fr. Suneel was able to call ahead and ask for someone to attend to us. I'm not sure if they have an ER and in any case, they were all afraid we would just sit and wait for hours if we didn't know someone on the inside. I asked Fr. Joseph to come with us as he served in Chicago for five years and his English is better than most of the people who live there. I made him promise not to leave him at any point and this turned out to be a very good decision.

About half way to the hospital, my extremities started tingling begining with my hands and feet and traveling towards my body, probably due to low blood sugar. By the time I got to the hospital I couldn't stand without help. Since the hospital doesn't have orderlies to transport you in, this turned out to be a problem. I got into a wheel chair and eventually put myself onto a bed wit help but it was difficult. when they finally decided to move me to ICU, I had to get up and transfer myself to a gurney- the beds don't wheel and there are no boards to transfer a patient. So I had to move myself.
Patients also bring their own clothes apparently since I was never put into a hospital gown. Since I had been violently sick, I was a sticky, wet mess and I stayed that way for several hours until Fr. Suneel went back with the driver to get some of my clothes. I was still burning up so I was ready to cut my own clothes off and I tried to indicate to get me out of my clothes. They were more worried about my modesty the whole time. Eventually someone got me into one of my own nightgowns. Had it been the US, they would have had those clothes off, along with my watch, bracelet and ankle bracelets in a jiffy. But nobody goes out without their bangles, so an IV was eventually started with bangles still attached.

I never saw most of what happened after we got there as I had my eyes closed. But I did stay concious and I tried to keep listening to all questions and answers. there seemed to be a lot of debate going on and two doctors concurred it was food poisioning. Eventually, they gave me some shots and started an IV but my temperature wasn't coming down fast enough, plus the power went off and the room quickly got stiffing hot. It had only a fan, no a/c. So it was decided to move me to ICU which had A/C. This is when I discovered that they couldn't wheel from the bed I was on and that I had to get up and walk the few steps to the gurney and get up onto it myself. This was not easy in my condition.

I finally opened my eyes, I was behind a curtain. There were flies trapped in the windows and flying around. Fr. Joe was swatting mosquitos. I could hear the death rattle of the man in the bed on the other side of the curtain. there was a port for oxygen but that was all the equipment that was there. The only other difference from the standard room was that I was behind a curtain, there was A/C, only one "family member" could be there with me (instead of the entourage that came with me), the oxygen port and the bed could be raised and lowered. That was ICU. There were at least 30 people behind curtains. No rooms, no monitors, no equipment. Toilets were down a very long corridor, no commodes provided- just a room with a drain and a water spigot. After three 400 ml of fluid, I didn't care if I peed on the front lawn.

I had an aide assigned to me and Fr. Joe gave her cash to stay and take care of me after her shift ended. She knew her way around inside the hospital and since it was not a Catholic hospital, we needed some help. Nobody spoke English in ICU. Father had to rely on Telegu, Tamil, and some of the language of Kerala to speak to the people who came in and out. Most of the staff came around to see what I looked like and to ask what I was doing there. I could hear the word, "American" among the tumble of Telegu converstations and Fr. said everyone wanted to know where my husband was. He said I came alone which was a big shock to them and that he was my only relative in India. I eventually told him that he should say he was family on my mother's side. At least my mom and my brothers get a tan and he's pretty dark.

When I was China, an American nurse who was living there as an expat with her husband and children, gave us a lecture on what to do if immediate medical attention was required. It was perhaps the most scary lecture I have ever heard. She was forthright, honest, specific and detailed. I'll never forget Roxanne or her instructions. So I'm going to pass them on here in case you ever find yourself in a foreign country needing emergency medical attention.

1. Always have cash from the local currency on you for an emergency. Cash speaks the loudest and it translates into any language even if you don't speak a word of it. Trust me on this one.
2. Know how to call for an ambulance AHEAD OF TIME and if they will actually come and where they will take you. This last issue can be a life or death decision. Have a back up plan if you don't get the answers to these questions that make you feel 100% confident. Write down the name of the hospital in the LOCAL language as not all cab drivers will ble able to figure out what you are saying, especially if you are aggitated.
   
3. Know which hospital you should go to and how to get there. Not all hospitals will take a foreginer. they don't want to deal with the hassles if you die. (Feeling "weak" in India is an everyday occurance and not taken as a symptom of anything since malnutrition is rampant, the heat is brutual and life is hard. So they won't take you serious if you say your are really weak. They'll probably tell you to home and lie down instead of running an IV drip or taking your temp.)
4. Be an advocate for the person you are with and have an advocate if you need medical attention. Carry a list of the meds you are taking and the dosages. No one ever asked me if I was taking any prescriptions while I was in the "ER".
   

I did three things correctly yesterday:

1. I insisted I needed medical attention.
2. I said I needed it NOW when they said I would be taken that evening which was six hours later.
3. I got the best translator in the house and made sure he stayed with me 100% of the time. He was also my advocate.

They did two things right: they called ahead to someone they knew personally and got me to the head of the line and Fr. Joe paid cash to get support and info inside the hospital.

Emergencies can happen anytime, anywhere. Have a plan before you need one.