Thoughts on STX medical care?

Colleen:

My wife broke her ankle this spring and had to have it surgically mended with plates and screws. We considered medical evacution, but she had the surgery done on STX.

The hospital renders good care given their limitations.

STX only has a population of 50K+ so you need to compare the care that they can provide in comparison with hospitals in similar sized towns. It is not a major medical center hsopital

The hospital is under extreme financial pressure for a lot of reasons. Some common to all hospitals today and some unique to the VI.

Because of the underfunding, part of the hospital is shut down. What did that mean to my wife? The hospital didn't have a bed for her prior to surgery so she spent 17 hours on a gurney in a corridor in the emergency room.

Because the hospital is short on funds the kitchen shuts doen early in the evening. They were unable to feed my wife because the kitchen was closed. This made my wife unhappy, but it really was a serious problem for the diabetic in the emergency room who really needed food.

Another inonvenience my wife experienced was that the hospital was out of clean pillow cases.

The nursing staff was compassionate and the doctors were good.

If you would require very specialized care or complicated elective surgery you probably would want to go to San Juan.

Jim

Routine medical stuff (including *basic* emergency care) can be covered by local doctors and hospitals. Anything requiring a specialist, or treatment for a serious injury or medical condition requires travel to PR or the continental U.S.

In fact, my firm's insurance carrier was specifically chosen because of its comprehensive coverage of tx rec'd in the continental U.S., even though the downside of the policy is that any treatment rec'd in the VI is "out of plan" (and, therefore, out of pocket).

You DO NOT want to be treated for a serious illness or condition on STX if you can avoid it. That's not a slam against the medical staff that is here, who do good work for what they *can* do; STX simply does not have the funds and resources to attract large numbers of specialists or highly-experienced and trained medical professionals.

VB

Jim and Virginbound, thank you very much for the information.

Thanks!!!

Colleen

As a high end medical user, here's my two cents:

Go off island for specialty care. I see a neurologist in PR for pain management and to monitor to progression of my paralysis due to a tethered spinal cord. There are no pulmonologists on island, so I either need to find one it STT or also head to PR for that type of care. I am told that there is one neurosurgeon and one neurologist on island. The neurosurgeon was/is on an extended off island leave. The neurologist isn't listed in the yellow pages, so I only found out he existed through a casual conversation with a woman in a furniture store. It's my understanding that he also takes extended leaves from the island.

Should you manage to find a specialist, make sure he/she is on staff at the hospital. Docs in private practice do not have the rioght to admit to the hospital, so they need to turn you over to a doc on staff if you need that level of care. The last thing I need with my history is to be handed over to someone who doesn't know anything about me (Gads are there nightmare stories in that category!), so I decided I would be better off finding a specialist with hospital privelege on PR and build my relationship there. The first thing I cought after arriving on island was air ambulance evacuation insurance, which will pay for two trips to PR each year should I need to be admitted to a hospital.

BTW, it's not just specialty care that was hard to find for me -- I had a hell of a time finding a general practictioner to cover my more basic health needs like annual exams, watching thyroid levels, etc. One said he was just a simple country doc and my history of cancer of the spinal cord/ lung disease, chronic pain issues, etc. "scared the bejesus out of him." Another said he didn't want to take me because I might need to be hospitalized for pneumonia at some point and and is not on staff there and wants nothing to do with the hospital. He recommended that I get the island's one pain management specialist to treat me. The pain management gut didn't even want to see me in person -- he rejected me over the phone because he prefers to manage pain by procedures and "all I needed were narcotics." He suggested I try the island's one neurosurgeon. After a few more weeks, I finally found a doc who was willing to write refills for my pain meds (or so I thought) and treat my general needs. However, after a week of excruiciating pain and no sleep, I asked this doc about increasing one of my pain meds. He totally freaked and said he had done all he could for me and pointed me to the ER at the hospital. After I broke down sobbing at the thought that I was once again back at square one for even finding basic health care, he consented to still handling general care, but will not see me regarding my pain or more serious conditions. I am thankful that I found Dr. Ramos in PR, who has been a gift from God not only for his knowledge, but also for his compassion and willingness to work with me on how to get precriptions for my meds to me (none can be refilled or called in by a doctor) without relying on the US mail or having to make a flight to PR to pick them up in person.

Final thought -- if you take any narcotics or other specialized medications, you'll also want to build a relationship with a good pharmacist who will make sure your meds are on island in the quantity you require by the time your next refill comes due. This requires amazing timing skills on the part of the pharmacist, and some are way better than others at making it work for you,

Sorry to be long winded (again) -- but I guess that's what makes me who I am.

HC

HC
Thank you, thank you, thank you.

I can identify with many of your experiences. I am determined to make this work. Didn't even think about the pharmacists - one of those things you take for granted.

No apologies needed.

Which hospital do you go to in PR?

Colleen

Post Edited (08-23-04 16:21)

Haven't narrowed down a hospital yet over there becasue I haven't found a pulmonologist that I want to use yet.

My neurologist is associated with the Childrens' Hospital in the Santurce area of San Juan. Because I've already refused the only treatment option that exists for my tethered cervical spinal cord, paralysis, etc. (a very risky and invasive surgery involving a laser knife, grafts from a cows' heart membrane and lots and lots of titanium plates and screws that would likely leave me worse off than I am now), I shouldn't ever require more than an MRI to track that. (I did make sure there was an open MRI machine here on STX before we decided to move here.)

Will be happy to share whatever I find with you!

HC

Thank you. Good luck with your search for a pulmonologist.

Colleen