Tag Archives: IMSS

Final Thoughts on our IMSS experience in Guadalajara

How do you say denouement in Spanish? Shoot, I don’t even know how to say it in English! I think it means winding things up and bringing an end to the story. That’s what I want to do here. Our month in Guadalajara, most of it in the large IMSS hospital Centro Medico de Occidente is over, and we want to get on with life and living. But I know there are many who are interested in, not only the health of my husband and the outcome of his triple by-pass, but also the IMSS facility itself, and the type and quality of care.

So for the record, Larry is doing very well He’s feeling good enough that I’ve left him in the care of Marta and her sister Lulu, and taken some time off to get my friend Janet installed in the house she’s rented for the summer in San Miguel de Allende. She took it on my recommendation and through a contact I provided, trusting I’d be coming along to provide translation and introductions. She arrived in Guayabitos while Larry and I were still in Guadalajara, and waited patiently till we returned and he recovered enough that I could leave. She loves it here. Whew!  I’ll be bouncing back and forth between here and the coast for a while this summer. Larry will just be bouncing back. He’s on the road to full recovery.

Previous blog posts I’ve made these past six weeks (starting here) were done while we were in the middle of what turned out to be a long process. Read them if you’re interested. Friends and family already have.

So I’m writing this blog entry three weeks after the operation and two weeks after leaving Guadalajara. The drama has died down, and I’m ready to share some information and photos — and then move on!

I’ve uploaded some photos of our experience, mainly to give ex-pats in Mexico some idea of what to expect for their IMSS premium. IMSS, incidentally, stands for Instituto Mexicano de Seguro Social. It is the national health insurance that almost every Mexican carries, whether or not they can afford private health insurance in addition. Most surgeons in Mexico work for IMSS, even though many maintain a private practice, as well. For instance, the same surgeon that operated on Larry’s back a year ago (and who we paid directly out of our pocket) does the exact same surgery for IMSS patients. There is no deductible, no co-payment when IMSS pays. Larry and I had just enrolled in IMSS last year, and were not eligible to have his back done, as there is a waiting period of one year after your first enrollment. He didn’t feel he could wait that long. But now the yearly premium we each pay is about $320 U.S. dollars. That’s the very highest bracket because we are both over sixty years old.

Good health care is considered a right, not a privilege, in Mexico. The plaque at the main entrance to the hospital notes that it was built in 1977 under the presidency of Lopez Portillo, “para garantizar el derecho de salud a toda la gente Mexicana,” – to guarantee the right of health to all the Mexican people. Mexicans take pride in this facility, which covers I don’t know how many acres. It’s like a small university with at least seven large buildings and a number of smaller ones, including the blood bank. There are wide swaths of park like spaces, and promenades pathways. Take a look at the photo gallery below. One of my favorite shots is the large bronze statue that serves as the centerpiece for the campus and the motif for the IMSS insignia. It is a large eagle, its wings spread protectively over a mother nursing a child. No fragile feminine form is this, but a large boned indigenous woman, over-sized feet firmly planted on the ground. On so many levels this work of art symbolized for me the ethos of Mexico and her people. I had to pause and look at it each time I walked by.

From what I gather, the IMSS Centro Medico de Occidente is world-renowned for its heart surgeons. There was a wide variety of patients on the sixth and seventh floors of the Torre de Especialidades, from the former Orange County day laborer Juan Jose who I mentioned in a previous post, to distinctly upper middle class families from all over northern and western Mexico. Monterrey, as big as it is, does not have a similar facility. The only other comparable heart unit is in Mexico, D.F. While beds in the hospital rooms were reminiscent of scenes from The English Patient, equipment in the Intensive Care Unit was brand new, and whenever Larry had to go in for some test or exam, the machines used were the very latest. The hospital staff were well-groomed and their uniforms were immaculate. There was always a large contingent of nurses around, and they were quick to respond when anyone called for help. Most did not speak English.

There are no private rooms in IMSS hospitals. Larry shared his room with two other beds. He was happy to have been put in the bed by the window for the time that led up to the surgery. When he returned from the intensive care area, we had a slot by the corridor, which wasn’t half bad. In fact, it had a little more privacy. There are sliding curtains that can be pulled around the bed of each patient.

A family member or friend is supposed to be present or nearby for each patient in order to help with personal business like taking showers and feeding meals. Bed pans and patitos are provided, and there’s a room where you dump them, rinse them and leave them to be professionally washed. (I don’t know the technical English word for patito. It’s the blue duck shaped pitcher thingy that guys pee in.)  There are large bathrooms, one for men and one for women complete with shower facilities. They are not fancy, and it’s a good idea to bring your own toilet paper. It’s provided, but keeping the dispensers filled is not often a priority with the staff. Also bring your own towel, soap and other toiletries. What I saw was a good sense of community, where people cleaned up after themselves and respected the modesty of others.

There is no internet and no television in the rooms. I’m grateful for the lack of TV, as most Mexicans are very generous with their love of music or entertainment and tend to turn the volume way up so everyone can hear. I don’t have a smart phone in Mexico, as just a minimal little Motorola unit has served me well. I am rethinking that situation. I ended up taking a cab to the Telcel Client Service Center and signing up for a 3G USB plugin device, which will only cost me 399 pesos a month for the next year and a half. I filled out a long application which asked all sorts of questions, including the color of our house. I am not lying. After signing my name twenty-four times, I walked out with a tiny little plastic dohicky that gives me the world anywhere in Mexico. Sigh. I was desperate.

The food in the hospital ranged from pretty fair to really horrid. We could certainly tell that most of the kitchen crew was on vacation during Semana Santa and the week after Easter. One memorable meal was a cold hotcake with a half of a steamed chayote. But other times there was braised fish or chicken, and Larry said the one hamburger he got up there was really good. (Maybe that was just hamburger deprivation talking.) The security people at the entrance to the large Torre de Especialidades where Larry had his room, turn back people who are obviously bringing in alimentos from outside, but I found that in my big purse I could carry up yogurt and fruit, tortas, (sandwiches made on bolillos), and even the occasional tamale or taco. There was no problem bringing in Styrofoam cups of coffee from the nearby OXXO or Seven-11. There is also a twenty-four hour café, El Caffetino, in the basement that is pretty good. Familiares (family members caring for patients) are provided meals from the same cart that serves the patients, if they desire to partake. I usually didn’t.

Here is a checklist of the things we found most helpful to have:

Your own pillow – There’s nothing like this comfort. Wish I had mine right now.

A foam mattress pad – the hospital bed mattresses are covered in heavy plastic. Sanitary, but very sweat-producing.

A small folding aluminum chair — A side chair is provided for each bed, but if there’s more than one familiar present, the extra chair is welcome. It’s also a good footrest and place to put other stuff.

An electric power bar with multiple outlets — There is one outlet over each bed, and if you have multiple cell phones, a computer, or a small electric fan, you’re going to need access to more juice.

A small portable fan — Mexicans like rooms to be warmer and stiller than most North Americans are used to. Lulu and Marta spent almost 500 pesos for our little one — worth every penny.

A yoga mat or cardboard and extra bedding for whomever stays overnight with the patient. You’ll be sleeping on the floor, amigo.

Towels, washcloth, soap and personal toiletries. Toilet paper.

A large bag to store your stuff in, so you can lift it up and out of the way of the cleaning crew that comes in twice daily to sweep and swab down the floors. They also clean and disinfect those portable tables on wheels that fit over the bed. Nothing gets stacked up or messy.

Reading material or entertainment.

I was fortunate to have the company and support of Marta, our friend Lulu’s sister. Lulu has worked for IMSS in Tepic for twenty-seven years. Most of her family has worked there, so Marta wasn’t afraid to put on Lulu’s IMSS jacket and blend in with the personnel. She got a lot accomplished for us. She also took the night shift and let me go back to a small hotel room each evening, where I put my feet up, caught up on Facebook, and watched a tiny little flat screen television while eating chicken quesadillas from a place across the street.  This wasn’t the first hotel I stayed in. After two very sub par tries, I settled on the Hotel Durango, which sits right at the foot of the entry ramp for the hospital Urgencias entrance and the ICU waiting room. The hotel was noisy, but it was close and it was very clean. It was 100 pesos a night per person. I think I spent more on buying cell phone time than I spent on hotel rooms. I got one for Marta so she could have a place to runaway to during the day. There was also an elevator (which didn’t run on Sunday) and a restaurant that served a substantial mid day meal for 60 pesos.

Thinking about the weeks I spent there, I can’t think of any bad memories. All that remains is the good — the caring families who were generous with their help and support, the efficient staff. Gosh even the “queen of programming” who I referred to in rather unflattering terms in one of my posts, ended up knocking herself out to get Larry down for the final X-ray that we needed in order to leave the hospital. And it turns out she speaks excellent English! All we needed was a little patience with each other.

Like I say, the aim of this blog post is to provide information. People have said, “Well, you’ve got the subject matter for your next book.” I really don’t want to “go there” for a long, long time, if ever. It’s not that our experience was horrible, as some have thought. On the contrary, we learned a lot, were deeply moved and touched by much of what we witnessed and went through. We are also extremely grateful to Mexico and its people for providing this system and allowing us to join.

 

Still in Guadalajara…

I had to review what I wrote the last time. Did I actually say that maybe last Thursday we’d be headed home? And here we still are in the big G. But OUT OF THE HOSPITAL! That finally happened last Wednesday, almost a week after the operation itself.

The time Larry spent in Intensive Care was grueling for us all. I kept thinking of that movie Hands On a Hard Body, where a group of people are trying to win a car, and they have to keep one hand on its surface constantly or be disqualified. That’s the way those seats in the ICU waiting room were. Somebody responsible for the patient MUST be available at all times in one of two designated seats per patient. The seats depend on what bed the patient is in. It is a detailed system designed to minimize transfer of germs and keep track of people. it also insures that when a patient is moved OUT of ICU someone is on hand to know where they’ve taken him.   It makes a lot of sense, once you see the logic of it. But the execution can wear you out. Didn’t help that we had the lousiest seats in the place — the only two left that were that fiberglass egg-carton shape with no padding and no “give,” where the front lip of the seat cuts off the sitter’s circulation mid-calf. (I know: gripe, gripe, gripe. Sorry.) Marta and I took turns, she spending the majority of the night hours there. I was allowed in to see Larry three times daily: nine in the morning, one and six in the afternoon.

When they moved him, it came quickly. Late Monday afternoon they called out “Mish-ah-el, arriba!” Because of the way Mexicans write out their names, they settled on his middle name of Michael as the family name instead of Cobb. So I grabbed up everything around me and followed Mish-ah-el’s gurney down the hall, out the door, and up to a room on the fifth floor.  There he was until after amazing amounts of paperwork (which Martha handled for me and I therefore know nothing about), her parting the waters to get a final x-ray, and then “borrowing” a wheelchair to shove him through “Urgencias,” we bundled him into the Hummer and made our get away just in time to dive into five o’clock traffic.

The AC in the Hummer didn’t work, and I took a wrong turn some place, but we got to Ray and Deb’s house out in the Palm Spring golf club atmosphere of Santa Anita about seven in the evening. Sweet refuge: big trees, birds, breeze and quiet. That’s where we’ve been recuperating — Larry getting stronger, the Hummer getting fixed, and my finally attending to the tooth that I fractured down the middle the first day we arrived at the hospital. I have one more trip to the dentist on Monday morning. I will go with the car loaded: bag, baggage, Larry and Martha, and as soon as dental surgeon extraordinaire Dr. Abraham Waxstein says I’m good to go, we will!

This is a bare bones update that doesn’t cover half of what’s been going on, but it’s enough for now. We’re headed to a bautizmo for the other Martha’s baby this afternoon. That’s Ray and Deborah’s housekeeper. We have a wealth of Martha’s around us, every one of them worth their weight in gold. I’m starting to think “our” Martha will be with us a long time more. She’s the wife I’ve always wanted. 🙂 Happy Mother’s Day!

Weird Place to Watch the Royal Wedding

The sala for familiares of patients in intensive care has seventy seats that look like the waiting area at the gate of an airport. Same way with the sala outside the quirófonos, or surgical operating rooms. I’ve spent a lot of time in both of them since six thirty Thursday morning. There is always a television going. It can get pretty surreal watching tornadoes in the States, the wedding in London, and this morning an awful children’s TV show called Sabadazo en PijamasSaturday Morning in Pajamas.  For a roomful of people who had just spent the night sleeping on the floor waiting for news of their loved ones, I suppose it was a bright note. Post-surgical familiares share this room with relatives of those brought in as victims of accidents. They bring them here from all over Mexico, airlifted from highways all over the country, set down in a grassy patch just behind our hotel. Intensive care is a huge building, separate from the thirteen story tower we’ve been in. “It’s the best in the country,” I’m continually told.

Marta and I switched shifts last Wednesday, so I could spend the night with Larry before they came to cart him away long before dawn. It was close to three o’clock Thursday afternoon before I got word that all had gone well and that he had been transferred to intensive care. Marta had carried all the stuff we had accumulated during our three week wait in the tower room here to my tiny hotel room — a small fan, the eggshell foam mattress thing, his pillow, a fleece blanket, rolls of toilet paper, toiletries and coffee cups from Seven-Eleven. (Hey, you save six pesos on refills, and they are handy for so many things.)  Now we are confined to two designated seats, assigned according to the bed number that Larry occupies. One of us is supposed to be in those seats at all times. At this present moment I’m playing hooky, because I’ve just seen Larry, and he’s doing great. He ate a whole cup of green gelatina, and made an awful face when he drank papaya juice. That’s my guy.

Not going into more detail, because I need to get back. Perhaps Monday they will move him back to the sixth floor. Maybe Thursday we can head home?

We’ve Got a “Go”

It’s finally set. The operation will be Thursday, tomorrow. The Queen of Programming and another doctor just came in, took a blood sample and had Larry sign reams of papers. His surgeon, Dr. Oscar Mercado will be by either this afternoon or early tomorrow morning, to introduce himself and get acquainted with Larry before the operation. It’s got to be official, and it can’t be as hard as this time leading up to it. we have been here three weeks now. If you’re going to have by-pass surgery in Mexico, don’t try to do it around Semana Santa, and try not to have O negative blood.

I reached a nether point yesterday morning. We had come to the point of having exactly two O negative donors. We needed at least six, plus a platelets donor of the same blood type. If you read my blog entry from Monday night you know that I was thinking we had three in hand and three more on the horizon. It turns out one of those “in hand,” Pedro, was not O negative. Raquel was rejected again, and our friend Ruth — who arrived at six in the morning from La Peñita, turned out to be AB-, an even rarer kind of blood than O negative. Seems less than 1% of the Mexican population is O negative. We’ve had a total of six definite potential O negative donors rejected for one reason or another, including Marielena (whose mom passed on Easter Sunday morning), Marta, Wendy DeBoer, Teresa, Raquel, and one other from the Red Cross list. We have placed radio station announcements, gone to the military hospital, called the Harley Davidson HOGs organization here, contacted the American consulate, placed notices on community boards in all the gringo conclaves, called all the names on Red Cross donor lists. I’ve been busy and on an emotional roller coaster with each possibility that surfaced, and each who was rejected. I came to a really low point Tuesday morning with all the bad news.

Marta was there to witness the meltdown. I am so grateful for her presence and support. She’s been sleeping on the floor next to Larry’s bed every night, doing our laundry during the day, and running interference for me, because frankly these last few days my Spanish has gone south. I see people’s mouths moving, and I either can’t believe what they’re saying or I can’t understand it. Marta had bought a little plastic wind up dog for Larry, because he misses Zack (and Cody, too, but let’s not go there). You pull a string and the dog’s head nods up and down and his tail wags. Marta pulls it and says, “Make you hoppy, hoppy. No sad. Hoppy!”

Straight from the blood bank, Marta dragged me to the hospital director’s office where she helped me pour out our tale of woe. She has learned this place inside and out. The director was very helpful and agreed that the blood bank accept the five comprobantes bequeathed us by the other patient’s family. We just needed to get them processed through the blood bank director. Who told us they were copies. We needed to have the originals. I had taken Manuel’s cell phone number (he being the son who handed them over to me last Friday). We got through to him, wonder of wonders, because my cell phone has not worked well in these buildings. He explained that the blood bank had the originals. Lots of phone calls and confirmations later it was determined that yes indeed there were five units of O negative blood residing in the bank, and with the two we had from the gentlemen from Lake Chapala, we could go ahead. Plus, the director went into a long explanation of how he could acquire plaquetas — which I didn’t understand other than we don’t have to come up with a donor. He wrote a long letter in his own hand to the Queen of Programming, and Marta and I came back up to give Larry the good news,

Love us through tomorrow, friends and family. Our hearts are full of gratitude for your presence through prayer.

Mixing with the natives

We have another saint tacked to the head of Larry’s bed, a gift from yet another well-wisher who comes by, counseling us to “Héchale ganas,” and “Anímate!” – Mexican versions of “keep your chin up.” Our sense of community here has grown. Larry and I are now good friends with quite a few patients and their familiares. Among them are Juan Jose and his wife Patty. They live in a little ranchito up near Santa María del Oro, with a view of the crater lake down in the center of the old volcano. Juan Jose worked for twenty years in Orange County, working two nine hour shifts a day, the first in the strawberry and tomato fields, and the second in a parts factory.  He lived in Santa Ana just a few blocks from the Civic Center, where I spent so much time volunteering in the jail. Juan Jose took advantage of the amnesty offered back in the eighties, is a U.S. citizen, and his three daughters live and work in Santa Ana today. He is fifty-one, and is in for heart surgery. His daughters send Patty money for her daily expenses here. She is sharing a room with Marta in our hotel. All those years driving the 405, looking at those strawberry fields and the men working them as I was stuck in traffic – interesting where we can end up.  

It has been a day of what seems like three steps forward and two steps back. Of the three of the donors Marta and I met early this morning at the blood bank, Pedro, Teresa and Raquel, two were rejected — rosy robust Teresa for anemia (hah!), and Raquel for not having slept through the night. Raquel had come straight from her night job to give us aid. Today I’m paying her wages to stay home and sleep, and then sleep through the night. She’ll give it another try tomorrow. Her brother-in-law just brought her federal ID by to us, so we can get the date early tomorrow morning. The donor we had lined up in San Miguel de Allende found no one who knew anything at the IMSS clinic there. She will also try tomorrow.

And tomorrow we have a hearty French Canadian coming in from Lake Chapala, a well-rested Raquel, and Ruth Suarez from La Peñita. Johan from the on-line community Jaltemba Jalapeño is driving her up. Ruth called early this morning, just having heard of our plight, and informed me she was O negative and willing to give. “If I need to go to Tepic,” she said, “why not just come all the way to Guadalajara and do it there?”

“Come on down!” I responded. Easier said than done. All the buses out of our area are filled with happy vacationers headed back to Guadalajara. So Johan and Ruth are leaving at 1:30 this morning and driving straight through here to the blood bank below. Sleep well, querida amiga! We want those globules fat and juicy. Yum! I’m feeling more and more like a character out of Twilight every day.

I am learning a lot more about blood than I ever wanted to know. I am also learning a lot more about health care systems and those who use them than any practicing Christian Scientist ever thought she’d need to know. It’s humbling, and enlightening. The courage, persistence, tender loving care, generosity, that we are being shown, that is being shared throughout the hospital – it’s a privilege to witness so much goodness in action. Why should I be surprised? Don’t I know that God is infinite good, and God is expressed in and through the lives of each and every individual son or daughter? Well, just because I know the potential beauty of music, I am still amazed and awed when I hear it played well by musicians who give it their all. Right now we are surrounded by a symphony of goodness, and we are amazed at each and every player. Bravo!

So, if we get all the proofs of donors copied and stamped and registered and into the queen of programming tomorrow by 9:30 in the morning, Larry will be scheduled for surgery on Wednesday. Or maybe Thursday. At least some time this week. Which is progress. You never know when or where you might end up, or with whom!

Watching and Waiting with “La Guardia”

La Guardia is what they call the skeleton staff that remains here at the hospital during this biggest of holiday weekends in Mexico. Footage of bikini-clad multitudes frolicking on the beaches of Puerto Vallarta, Mazatlan, Acapulco, Cabo San Lucas, and multitudes of other beach resorts along the Pacific Coast fill television screens in deserted Guadalajaran taquerias. My hotel is open, as well a small 7-11 across the street. There are two taco restaurants, which I think have doubled their prices because of the scarcity of any other choice for eating.

The food choices on the hospital trays aren’t much better. Before everyone went on vacation the food was actually very good, but what the minimal kitchen staff must do these days is dump vegetables and fruits into a big steamer with little or no prep, and send them up to be served. So Larry is faced with a shriveled looking apple, soft and squishy and whole, or a big chunk of summer squash, or half a chayote . The usual accompaniment is a big slab of panela cheese and four of those tasteless little Maria cookies. So I smuggle up  gourmet items from 7-11. Is your mouth watering yet? Think of us when you dig into that Easter ham tomorrow!

Our number of potential and actual O Negative blood donors is growing, thanks to internet connections, and faithful, hardworking friends. We have a donor from San Miguel de Allende, and another from Lake Chapala area, both ready to be tested and to give next week when the blood banks open back up.

Yesterday morning, the son of the woman who is O Negative and does NOT need the donors she had gathered, (see previous post) brought her comprobantes to me. We don’t know if we can use them or not as they are in her name, but they are at least proof that there is blood sitting there in the bank ready to be used and that her family is willing that we make use of it. Such sweet people. New friends.

Larry’s Spanish is improving, and he’s been going around with a bottle of lotion, offering it to guys up here waiting or recovering on this floor. The climate here is dry, dry, dry, and skin gets really crinkly.  A couple of potential donors have been found among friends and families of these patients, though he didn’t set out with that purpose in mind.  Among them is another potential plaquetas donor, something we need after our faithful Marta was rejected for lack of a crown on a molar.  My valiant friend Marielena didn’t pass either, after being tested last Friday. “Muy exigente,” people describe the blood bank here. English translation: picky.

So we seem to gain and then lose and then gain some more. But actually each new contact is a friendship added to our growing circle. We’re settled in, practicing patience, and being so grateful for those who keep in contact and offer encouragement. Have a happy joyful Easter. Ours will be joy-filled, as well.

Living Out Loud, in Public, and in Gratitude

I’m not used to the whole world knowing what’s going on in our lives, but this O-Negative blood business has necessitated lifting my head, opening my eyes, un-pinching my nose, and engaging with the world out there. Writing this blog obligates me to stay positive, receptive and courageous. I refuse to become a black hole. Larry and I were raised with the saying “the hole that you give through is the hole that you get through.” So in the interest of widening channels, here are five things I’m grateful for right here, right now.

The IMSS staff with their impeccable grooming and crisp white uniforms. They are unfailingly polite and helpful. All I have to do is stick my head out the door and ask for help and they’re here. And this is a skeleton staff, as almost everyone has left for vacation.

The vendors outside who dispense not only tamales made with pineapple, strawberries, or green chilis and cheese, but also cups of liquid sweet avena (oatmeal) and atole in the mornings. And the vendors who sell jugos, fresh squeezed orange juice or jugo verde, a combination of orange juice, celery, apple, parsley, pineapple and a few nopalitos because anything with cactus leaves is interesting.

My hotel which for 100 pesos a night is so close by, spotlessly clean, painted a pretty color, and has a high definition flat screen television on the wall. I watch about a third of an English language movie a night before falling asleep. Oh, yeah, a good mattress, a ceiling fan, and motherly maid.

The fact that Larry has a bed by the window on the sixth floor. We have a panoramic view towards the soccer stadium, the plaza de toros, and the hills beyond. I brought opera glasses and gave them to Larry. “I see a Domino’s Pizza sign,” he said. He can also see my room from here.

The trees around the hospital and the medical campus that surrounds us. They’re huge, full of birds, and provide much needed shade for those waiting their turn to visit loved ones. They are full of birds, the names of which I would know if I were my mother-in-law. I’m not, but they sing sweetly for us anyway.

“…All the rugged way”

I’m writing this later than usual because I needed to get some joy back before putting pinkies to the keys. The day started with a series of rugged ups and downs. I got to the hospital room just after the cardiologist told Larry his operation would be Monday. Hooray! Then a woman who programs the surgery came in and yelled at us because we didn’t have the comprobantes in hand, that she had to have them by ten o’clock this morning in order for Larry to have surgery on Monday. She was so, ahem, emphatic, that Larry started getting upset. She kept telling Larry, no te preocupes, cálmate, cálmate, and then would continue speaking to me in a really loud voice, obviously very upset. English speakers aren’t the only ones who think yelling slowly at foreigners will get the point across. I sent her out of the room with Marta, who came back later and told me the surgery would be Tuesday. Disappointing, but Larry said you were never supposed to buy a car that was assembled on Monday, and maybe heart surgery was the same way.

Other good news of the morning was that we had an O Neg donor actually show up in Guadalajara. This after calling a list of eight O Neg donors registered with the Red Cross, Eric and his wife Shirley came into the city from Ajijic (out on Lake Chapala), making the effort to be at the IMSS central blood bank by 6:30 in the morning. That’s when people start lining up to get a ficha or date to give blood. If you get there early enough, you get a date that same day. It took them a total of about five hours waiting. I took a picture of their sweet faces. Wish I could download it. They headed back to Chapala, leaving me the first actual comprobantes I’d ever seen – the precious papers that say so much blood has been given for Laurence Michael Cobb. They also gave me the name of an O Neg friend of theirs, and I called him. He is willing to come in next week and donate. Blessings on these dear people.

I also received by email pdf files of the comprobantes of the three donors who gave in Tepic. I look at these, and they don’t look anything like the one I got from Eric. Sweet Lulu also gave in Tepic this morning, though I don’t see a comprobante from her in this group of files. I hope sometime during these next few days somebody, some where can help me make sense of this stuff.  But the whole world, it seems, is going on vacation. The hospital is left with a skeleton staff.

But the blood bank remains vigilant! Marta, our treasured donor for plaquetas, went in to be tested today. She flunked. She has a tooth descapada. The crown is off. Shoot, I had a crown come off the first day we got here. That’s why I’ve been eating quesadillas. They’re soft! But this was a real downer.

I also explored buying blood from a private blood bank. I was told by the IMSS blood bank that buying blood in Mexico is a federal offense, and IMSS will not accept blood donated or acquired through another hospital that may not have the same high standards as does IMSS. No ****! I keep saying I will translate the requirements for donors and post it here. It’s pretty amazing. One thing they don’t mention, but will also disqualify you is if you haven’t been living in Mexico for at least six months. So precious friends in the States who are willing to fly down and “be there” for us, sigh, it would be for naught! Thank you, anyway.

Then came another visit from the queen of programming who informed us that maybe some time next week would be the operation. And, maybe not. I said I didn’t understand all the waffling around, and was told that foreigners always want to know an exact date and time, and it just doesn’t work that way here. I need to remain calm, tranquilo and patient. I kept remembering Marielena’s assurance that the surgery will go through. We just may have to set up housekeeping here for a while.

In the midst of all this friends have been making grand efforts on our behalf, putting notices on web boards and e-zines, and giving counsel and comfort, by phone, by Facebook, by email. Other patients and their familiares come by to encourage and offer prayers. I treasure each and every one, and offer my own in the form of the hymn Larry and I grew up singing in Sunday School. I’ve been singing it to him very quietly. The words seem particularly poignant right now:

 Shepherd, show me how to go

O’er the hillside steep,

How to gather, how to sow, —

How to feed Thy sheep;

I will listen for Thy voice,

Lest my footsteps stray;

I will follow and rejoice

All the rugged way.

Thou wilt bind the stubborn will,

Wound the callous breast,

Make self-righteousness be still,

Break earth’s stupid rest.

Strangers on a barren shore,

Lab’ring long and lone,

We would enter by the door,

And Thou know’st Thine own;

So, when day grows dark and cold,

Tear or triumph harms,

Lead Thy lambkins to the fold,

Take them in Thine arms;

Feed the hungry, heal the heart,

Till the morning’s beam;

White as wool, ere they depart,

Shepherd, wash them clean.

The adventure April 16 – April 19

The following are Notes I posted on Facebook, but I find that many of our friends and neighbors can’t access that information. I’ve decided to post this on my public website as our personal experience may be of help to others going through similar situations. The writing is raw, unedited, and often comes straight from being cut and pasted out of correspondence to a particular individual or group.

April 16, 2011 — Update on Larry

This isn’t exactly blog material, so I thought I would post this update I wrote to my family here on FB in a note where those who are interested could read it. Too tired to edit….

Dear Siblings, et.al.

I now have a little thumb drive thingy that gives me internet where ever there is a cell phone signal — like the Virgin Mobile one you introduced me to, Amy, only this one only required sheaves of paperwork, a four hour long session in a TelCel Customer “Service” Center, and I’m on the hook for $399 pesos a month for the next year and a half. I signed my name twenty-four times and answered every question imaginable – including what color my house was. But at least I’m now connected. I’ve missed being able to keep you up to date.

Larry and I got here a week ago Tuesday, April 5. Since last January we’ve been going up to Tepic at least once and sometimes twice a week for a series of appointments at the Instituto Mexicano de Seguro Social. That’s the Mexican national health insurance that practically everyone in Mexico has. As employers, we paid for it for our workers when we were building the trailer park, and two years ago we became members ourselves, paying at the top bracket, because we are both over 60. It cost us MN$3,200 each a year. That’s pesos, which are worth about 8 cents a piece. About last December, after Larry had recovered from his back surgery of just a year ago, he found he wasn’t able to exercise with the vigor he was used to. It got to the point that he could take an early morning walk, very slowly around the neighborhood park with his friend Danny and the dogs. But by the time he got back around 7:30, he would have to take a nap until about 10. That’s when Danny would pick him up and drive him around for several hours. Then they’d eat lunch out, and Larry would come back and nap for several hours. He’d get up and have dinner, and then go to bed around 8, sleeping hard until 6 the next morning.

So he’s been going through a battery of tests, and we ended up here. We’ve had a friend, Lulu, at the IMSS clinic in Tepic. She is head of making appointments, and has accordioned the whole process up for us, rather than dragging it out over half a year. So, at last, he had an angiogram here in Guadalajara last Monday afternoon. That’s where they shoot you full of dye to be able to see where there might be blockages. And if the blockages are fixable at that time, they do it with little stents, or “cateters.” The blockage was too extensive to do that. So they approved him for what I guess is a triple by-pass. All of this is fully covered by the IMSS insurance, but there are a few little requirements in this community of insureds. Everyone who is to have an operation must line up 8 to 10 blood donors, and one local (Guadalajara) “plaqueta” donor. I believe that term is platelet. That person has to be ready to give the day right before the surgery. When we first got this news it was “no problem,” and we had plenty of potential donors. Danny rented a van and took four happy campers to Puerto Vallarta Thursday. And our friend Alejandro, a student in Tepic, got two of his friends and went down and gave. We were well on our way to having enough donors.

Then things started going haywire. Cheesh, I don’t want to go into all the details. Things just got complicated. It has to do with making appointments in order to give blood, and limiting the number of donors per patient to just so many a day, and it being the beginning of Semana Santa here — which is the BIGGEST holiday time of the year, and faxing proof of donations to me and my not having a fax machine in my suitcase, and every thing in Mexico closing up for this next week. And to top it off, the blood bank here asked me what type blood Larry had. O Negative. Oh. The blood bank people are insisting now that all donors must be O Negative. But there are others (nurses, some of the doctors) who are saying otherwise. We are working our way through all this. We have friends in some good places, but just about everyone is on vacation.

In the meantime, Jim and Forrest are getting their blood typed on Monday. Theo is O Negative, so there’s a good probability those guys are, too, though they’ve never had a blood test before. But Forrest is in the last few weeks of his first semester back in school. We don’t want to screw that up. In the meantime it turns out that Marta, our angel friend Lulu’s sister who came along with us to help out (and who gave a first impression of being a strumpet and a total flake) is O Negative. Larry burst out laughing when he heard that. Marta is willing to be the platelet donor, and has quit smoking and eating Cheetos in preparation for her task. She’s taking it very seriously, and says she has found a purpose in life — helping others. I must admit, she’s been a VERY big help to us. She sleeps on the floor in the hospital room through the night, so I can sleep in the hotel and be with Larry in the day. But during the day she also does laundry and shops — like finding a portable fan for Larry and one of those egg carton mattress pads. Lulu had to go back to work, but left Marta an IMSS jacket and ID badge, so she is able to go in and out and poke around and ask questions and look official. She’s really got the attitude down. It helps that she is also wearing much higher necklines.

There’s so much to be grateful for. So many good friends knocking themselves out for us. So many NEW friends we’ve met going through similar circumstances. “Héchale ganas,” the son of the man who was in the bed next to us said as he left. He’s 22 years old and looks sixteen — Umberto Junior. Umberto Senior had a picture of his grand daughter in a pumpkin costume taped to the head of his bed, along with a picture of the Pope and a likeness of the Virgin of Zapopan. Umberto Junior lost half his hand in an industrial accident several months ago, and told us he knew some of his donors were O Negative. He’s going to look them up for us. I spent several hours over the last week reading the Bible Lesson in Spanish aloud to Umberto Senior, who was very frightened. He said what I read “filled him.” So his family is returning the kindness. And they also left us the pictures of the Pope and the V of Z.

We’re going to get through this, and it will all be good. Keep us in your prayer and caring. We love you all.

April 17, 2011 More Update on Larry

I am absolutely overwhelmed with the loving response from friends far and near. I would write each one individually if I had the time, but know how my heart is uplifted with each kind word. I’m going to carry my TelCel stick up to Larry’s room tomorrow and let him log onto my FB page and read through everything. I know it will do him good.

He’s doing fine. Getting a LOT of rest. I’m not particularly, even though technically today was the official day of rest. Sundays everything closes down, even the front gates of the hospital. You have to come around here to the back at the emergency entrance. That’s where my little hotel is. At last I have a decent room, sort of like a little European pension. There are twin beds, so I have a nice big work space where I can spread out papers and clothing — since there’s not a closet, cabinet, chair or desk. But the iron bed steads are painted white and the bedspreads are in good conditions and actually match the color on the walls — which isn’t awful. Marilyn included some clothes pins in the suitcase of clothing that Eddie and Roberto brought today, so I can pin the curtains together. That way the breeze doesn’t expose me to the taqueria across the street.

There’s even a tiny little elevator, but since it’s Sunday it wasn’t running. Oh, well, neither were the elevators in the hospital tower where Larry is. He’s on the sixth floor, and remember, they start counting “one” after the ground floor. One hundred and fifty steps. I finally counted them after the second trip.

I really hesitated to write that last paragraph, because it makes the hospital sound backward and third world. It’s not. There was just a transformer that blew up, and they have prioritized use of the power available. There was ONE visitors elevator available, but on a Sunday afternoon it was unbelievably crowded with a really long line waiting for it. This hospital complex is really more like a large university campus, and is pretty impressive. It goes for blocks with massive concrete buildings (hence the lousy cell phone coverage inside), park like areas, huge trees, lots of walkways, etc. And a big bronze statue of the IMSS logo — an eagle, its beak extended, with broad wings overa nursing mother and child. I find the image comforting on many levels. Both the U.S. and Mexico have an eagle as their emblem. The one on the Mexican flag has the snake in its mouth, and the one on our currency has arrows and an olive branch, but I particularly like this IMSS bird. It represents a national priority of a different nature then we usually associate with eagles.

We continue getting donors, even though they aren’t O negative. So grateful for every one of them. It is the blood bank that told me we must have all donors with O negative. Nurses here, the doctors, and the surgeon in charge all are willing to go forward. They are pumping anti-biotics into Larry (at least that’s what it says on the drippy thing they keep sticking in him), and giving him a special drink before each meal to “fatten him up” before surgery. I’m trusting this thing is going forward on Tuesday, blood bank or no.

This morning Larry and I had a little reading time together, and came to the Bible passage where Jesus prays, “Father, that they may be one.” I laughed out loud. Looked like O-ne(gativo) to me! OK, so that’s the way my mind’s going these days. It’s surely a corruption of what the passage REALLY means, but other verses talked about there being neither Jew nor Greek, slave or free, male nor female, because we’re all “one blood in Christ.” Well, I’m figuring that “Christ” stands for love, and there’s ample evidence of Love with a capital L all around us. I’m not going to go sorting it out into A’s and B’s and O’s, negative or positive. It’s just One big Oneness, and the question is not how much or how many or what type, but how big is our sense of that Oneness. It’s got to be Infinite. And that’s enough. Amen.

That sounds like a good place to stop. I will for now. I feel downright cozy being with you. thanks for being there.

April 18, 2011 Standing by the bed waiting

I’m taking the easy way out and copying the body of an email I just sent to my sister….

Hi Amy,

Just got your voice mail, but it cut off before you said the second thing. But the first thing was dear enough. Wow, I think we have more O- blood bearers in our immediate family then there are in all of Mexico! All three of you, huh! Well, JP is too young, John too old, and you, sweet sister, are a little far-removed from Mexico. Hah! But thanks so much for the offer. We love you all so much. We have one valiant O- donor who spent the whole day up in Tepic being interviewed, rejected, accepted, and finally drained. Lulu referred to him as the “guerote grandote.” That means great big white man. If she could only see our family! “GG” is Colin Kearns, Larry’s surfing buddy from Vancouver Island, whose house we stayed in when we first visited here.

But good things are going on. It’s been a roller coaster day of highs and lows, but I won’t go into them. I INSIST that good things are going on. I just got off the phone with Mom, telling her the latest development:  There is a woman on the other side of this floor who was scheduled for surgery tomorrow. For over a week she has been gathering donors because she, too, is O-. Today the doctors said they were NOT going to operate on her. A young woman doctor here on the floor put me on to her. I went and talked to her and her husband. They were slightly suspicious and reticent, but after a while they said that their son would be here this evening and they would decide whether to release their “comprobantes” to us — and on what terms.

“Hay que dejarlo en las manos de Dios,” everyone keeps telling me. Especially a little round angel-faced lady who has kept popping up at my elbow, giving me hugs and encouragement all day long. For the life of me I can’t remember meeting her among all the people I HAVE met up here. But she just came into the room and said she’s going home now. I finally just asked her flat out what her name was. She smiled up at me. “Guadalupe,” she said, and then waved good bye. Too sweet. (I leave you to the strains of either The Twilight Zone or the Hallelujah Chorus. You choose.)

besos to all three of you,

April 19, 2011

Roller Coaster or Learning Curve? You get bugs in your teeth either way

And tears in your eyes. I admit it. I totally lost it today. I boo-hoo-ed into the ears of anyone who happened to answer their cell phone. My apologies. I am now post melt down and my grip is much firmer. I also finally had lunch around 3:30, which improved my outlook no end. Life looks much more rosy with a couple of quesadillas — they’re LITTLE — in your tummy.

Some time this morning, in the midst of all the back and forth of telling us what we could do, what we couldn’t do, what someone else was going to do — and not do, my lights went out. I saw mouths moving and Spanish words flying around, but I couldn’t grasp anything any more. I just went blank, and Larry rolled over and went to sleep. There was no rousing him. It was his way of shutting out the chaos, and I wanted to kick his butt out of the bed. Or at least move him over and crawl in with him, pull the cover over our heads and make it all go away.

It seemed so perfect, those five  O Negative donor comprobantes that the woman wasn’t going to use. The family was so sweet this morning, eager to let us have them. But alas, they were not theirs to give. The blood in the bank belongs to the blood bank, and just because it was given in your name, doesn’t mean you get to say where it goes. In retrospect, a very honest set up. I was ready to pull out piles of pesos (thank you, Mommy) to express my appreciation. But I’m/we’re learning a whole different way of operating that doesn’t involve waving a checkbook and moving to the front of the line. Is this a constant lesson for me, this process of engaging with total strangers, meekly asking for help from friends and family, opening my life so others can become involved? Thought I’d learned that once. But maybe once is not enough. Maybe you just can’t get enough of being involved.

I joked when we started this process that now I see why Mexicans have large families. I also see why the vast majority of their young people are conscientious about staying healthy, don’t take drugs, and don’t get tattooed. All of those things exempt you from the blood donor pool, and being able to “be there” for your family and friends is a high priority for this population. The lines at the blood banks are long, and the waiting rooms always filled. Those who go to donate get there at 6:30 in the morning to get a place in those lines. The patient in question may not use all that blood — usually doesn’t — but having all those donors in your corner, I suppose is a way of indicating that there is a group of people who think you deserve to stick around — tangible evidence that you would be missed. That has to have an effect on the morale of an “infermito,” as those in the beds around here are usually called.

A good friend posted our plight on the web board at www.chapala.com, and in response someone gave a list of o- blood donors registered at the Red Cross. I called all eight on the list and got one who was able to give. Hooray for Eric from Canada! I’ll look for him and his wife tomorrow morning.

And then I got a call from Nena, my good friend Marielena Lozano, who has been in Turkey for the last two weeks. She came sailing  up the staircase to meet me in the main plaza in front of the hospital, gorgeous, poised, absolutely in command — and I collapsed in her arms. She called her cousin who works in another IMSS clinic to get the straight scoop on how things are done and should be done. I got assurance — no one is going to kick us out or make us stay forever. It IS going forward. There is no way to stop it. And we can get donors of other blood types. Those DO count for something. (thank you Vicente. thank you Alejandro, Oscar, Lulu and so many others) And as a cherry on the top, Nena is O negative. “See,” she says, “you have one more donor!”

So Larry is scheduled for Monday, and little by little we’re going forward. Close friends are a cell phone call away, and others are even closer geographically, ready to come by and hold hands and offer comfort. We will have a week of Semana Santa here in Guadalajara, resting, reading and enjoying the peace and quiet. It is a madhouse in Guayabitos during this vacation time. But Eric Nice is watching the house and the puppy. Well, a puppy no longer. From what Eric tell us, Zack has come into his own with Cody gone, assuming fierce barking responsibilities, standing sentry duty up on the verandah railings. Brave dog. Good example. If you can balance like that, we can hold on for this ride.

Adventures in Mexican Health Care

My husband Larry has been interned in the Centro Medico del Occidente in Guadalajara since April 8. I was without internet for the first week of that time, but once I got connected I started posting updates on my Facebook Notes page. I thought they were accessible to everyone, whether or not they had a FB account. I guess not. So I’m transferring them here to a more public place, minus the supportive and encouraging comments — which have meant the WORLD to us. Right now I’m writing from the middle of what some might imagine to be the worst nightmare ever. But my hope is that as we work our way through this experience, what we learn will be of help to others.

Our current need is outlined below — a notice we’ve put on internet bulletin boards and sent out in emails. Might as well post it here!

Laurence Michael Cobb
IMSS Number 5509470021
Bed 6123 in the Torre de Especialidades at the Centro Medico del Occidente on Belisario Dominguez in Guadalajara

 O Negative blood needed. Can only be donated at an IMSS Clinic which accepts donations and will transport the blood by ambulance to Centro Medico in Guadalajara. If donor is near Guadalajara, it is better to donate at the blood bank here at Centro Medico. All blood must be transported here. Those who donate will received two slips of paper. These should be scanned and sent as a pdf attachment to coreofthecorn@gmail.com. That is the address of Larry’s wife Susan. She must have the printed hard copy of these comprobantes in hand in order for surgery to be scheduled. If the donor is giving at Centro Medico, Susan will come down and take the comprobantes directly from you.

Larry Cobb is 64 years old, is a veteran of the U.S. Air Force, where during four years of service, he gave blood every forty-five days. He and his wife Susan have been married for over forty years, and have lived in Mexico full time for almost five years. They live in Rincon de Guayabitos, north of Puerto Vallarta.

Donors should take with them picture identification which gives age. They must be over 18 and no more than 65.