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Dear Friends and Family,

Typing with one hand is tiring but I wanted to give you a status report.  The last time I wrote was just after I got my cast.  It was proving pretty cumbersome but I could manage.  Then I had a conversation with our daughter Lisa.  Our grandson had broken his arm last year and the things they did were different than here.  That, and the hope of getting a waterproof cast prompted me to call an English speaking Dr. recommended by Kelli.  He said he would be willing to look at the x-ray done after the cast was put on but I told him there was only the first x-ray before the cast.  He offered to get an x-ray in his town and then give an opinion.  We went there yet on Monday afternoon and without doing an x-ray he suggested that we see an orthopedist doctor he knows.  He helped us make an appointment for the next morning.  This English speaking doctor was only 30 min. away but the next day we went back to the bigger city which is 90 min. away.

We had hired a private car and driver both days and we were glad we did as on Tuesday we had to go to several different places and  it would have been difficult on our own.

I was excited  because this guy could do a cast that I could swim in.  I thought that he would do an x-ray to see if this set was OK but he looked at the x-ray of the break and suggested that it be reset.  We had to call the other doctor by phone to translate.  We were able to have the work done that afternoon at a different hospital but we had to wait until my breakfast digested because they were using a general anesthesia.  While we waited, the driver took us to a shopping center with a big supermarket.  We got a few things harder to find here and Rob and the driver had lunch.

The hospitals in this town remind me of the small hospital where I was born and things seemed to be small scale and older though effective.  They look like something out of the 50’s.  I had not expected to need an ID so didn’t bring one though Rob had his.  I guess they figure that you will pay so they don’t need to track you down.  Things are pretty loose and very casual.  All the Drs. we saw were dressed in Jeans and T-shirts.  Even when we went in to an operating suite, no one had on scrubs or coats.

I had an IV but they put me under a mask to breathe something.  I went to sleep but I didn’t feel fully asleep.  I know I must have been though.  Before I fully awoke, I could feel my arm being jerked around but that was the final adjustment of the cast so when I opened my eyes there was no tiredness or disorientation.  I was told to go back to the  doctor’s  office for a follow up x-ray.  When we checked out, we had to pay.  Rob had brought some dollars which they would take but had to go to an ATM with our driver to get more.  No billing, no insurance processing, just payment.  We were going to charge it but Rob brought a Master Card and they only took Visa.  Rob gave them the rest of the money and the women who ran the place and a young man who may have been her son both had to look for change in their personal wallets.

We had already paid the doctor for the office visit before he did the procedure.  Now we went back and had an ex-ray in a small store front in the same building.  The hand was slightly in a different position than the other cast so I know it was set differently.  Without knowing about breaks, the second x-ray looks better.   Unlike the first guy who told me 4 weeks in the cast and then good to go, the instruction now is 5 to 6 weeks  in the cast, then another x-ray and if OK, two months with a brace which I took home with me.  Bummer but more in line with what I would expect.

You might be interested in our costs for all this.  The initial cost on Saturday for the emergency room, x-ray, medical staff and cast was $177.  The Marina gave us the car at no cost but we tipped the driver $12 (a day’s wage).

Monday we hired a driver to the closer town.  That cost was $30.  The doctor consult was $6.

Tuesday because it was from 8:30 to 7 p.m. The cost of the car and driver was $84.  The cost of the doctor was $18, the total hospital bill, including a room, IV, anesthesia, operating suite, anesthesiologist, nurses and cast was huge!  It totaled $400.  Then the x-ray and brace at the follow up visit was $18.

Compared to an average worker, the Dr. still makes quite a bit so it may have the same relationship as it is in the U.S.   But it really shows you how expensive medical care is in  the U.S.  We have friends from Europe and Canada who say they are afraid to live and travel in the U.S., even just changing planes, unless they have insurance but can’t afford U.S. insurance.  While most facilities in the U.S. are much better equipped, there are a lot of  unnecessary things done and charged for that doesn’t seem to happen here.  The payment situation also means that there is no lag time for payment, no cost of billing or dealing with insurance companies.  I don’t know how the locals do it though but the ones we saw while we waited, paid in cash.  The office had a waiting room with a woman who told you when to go in and who took the money.  The doctor had one room with some meds in a glass case, his desk, and an exam table.  When you call, he answers the phone.  It is probably a bit more sophisticated in Guatemala City but a friend who went there for something more serious still found it very inexpensive.  We saw a total of five doctors, and they all wore blue jeans as office/operating room attire.

The down side though is that while you can buy most any drug without prescription or regulation, drugs are still  relatively high priced.

At least I have a really neat cast that I can shower or swim in.  I will send a picture and a  link to the company.  It is not a solid cast so I can use a tooth pick to scratch anywhere and it allows good air flow.  It is much lighter in weight and after getting wet, you just dry the under liner with a hair dryer or fan.  I don’t know if this is used in the U.S. But it should be. is the web page.  It is worth looking at!

Because of the second trauma when they reset the wrist, there is some swelling and bruising which I can see and feel in my fingers but I am doing just fine.  I can also sleep well.  Rob is the one who should have your sympathy.  He is busy all the time with his boat projects as well as the work I usually do.  While he’s been cooking during this time, we are also going out to eat a lot!

We are back at Marios Marina for now and we won’t look at going to Honduras until the swelling is gone and the nerves have calmed so I would guess we are here for another week or two.  Our visas would need to  be renewed  at the end of the month if we stay past then and we would rather not have to do that!

Have a happy Valentines Day.  We love you!

Today on the morning radio net, the controller said  “Experience is when you get the test first, then the lesson.”  That is certainly true.

Learning lessons a plenty,

Sue and Rob

Here are some of the pictures at the hospital.  I am sitting in the waiting room and opposite me is a refrigerator from which they took a bag of blood for another patient.

You can see the patient room and bathroom.  It had two mismatched beds.  Rob is getting his thumb print on record as the person responsible for payment.  You can see the Admin office and hallway and patient rooms.

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