Wednesday, October 16, 2013

Is it Patience or Patient – or both?

Our last few weeks have been interesting to say the least. The last week of September our phone would no longer work saying we had used up our minutes. Never having used up our minutes in over a year being here, we were a little confused especially since we did not know we had a minute limit or what it was. Then we found that we could no longer text either. The younger missionaries dropped by and let us know they were having the same problem with their phone and we assumed Claro (our phone service) was having some problems.  Turns out the Area Presidency was cutting cost for the mission and we were caught in the middle not knowing when minutes started or stopped or how many we had. We still don’t to this day. This would have been noticeable since none of the members could get hold of us but was more so since we had no way to communicate with the doctor or hospital about Elder McKinney’s impending surgery.
We took this picture on the way into Guarapuava - I had noted the "Jan" on the outside of the 
building and was interested because no one here can pronounce the name

On October 3rd, promptly at 7:30 a.m., Armando Faccio arrived to drive us to Guarapuava. We were so grateful for his thoughtfulness in offering to take us, his promptness, and that fact that it had been prearranged since we had no phone service. We had to picked up an Rx for John’s blood pressure at the cardiologists before checking in at the Hospital. Everything medical is very segregated here. Doctors can prescribe medication only for their area of expertise.  

Elders Long and Perreira had helped us out by picking up a pair of crutches at the pharmacy for us to take with us. We carried them and our small overnight bags as we walked the block from our parking spot to the hospital. There was no drive up to the door at Hospital de Caridade São Vincente de Paulo in Guarapuava.

Note the stamp with hospital initials on the sheet.
We had been told that payment was expected at checkout – a combination charge for the hospital stay, surgery, doctor and anesthetist – in cash (we had previously asked for a quote on the price so we would know how much money to withdraw from the bank). This was reiterated again when the first part of "checking in" was with the financial manager.  DMBA had sent us a letter a few weeks before saying they were dropping our policy and had set us up with Aetna International just two days before the surgery.  We had to decide whether to try and push the surgery up to be within the old policy or trust that the new policy would accept our pre-existing problem. Aetna told us they would contact the hospital and let us know what arrangements were made but we never heard from them either by phone or e-mail and they seemed to be unavailable to take our calls – thus the cash payment. The other thing that we hadn’t been told was that we would need a co-signer (even though we had the cash with us!) since we were foreigners. Armando had voluntarily insisted on giving us a ride and then stepped up and signed 20 pages of legal documents assuring the hospital payment. He was not at all surprised as he had spent a lot of time in hospitals with his mother who has Alzheimer’s. We however felt like we had our personal angel with us.

This is Armando - who is our good friend - and in 
this case an angel who came to our rescue, 
There were a few differences in procedure here. At 9:45, we were told that they would check us into a room as soon as it was cleaned then take Elder McKinney from there to surgery.  The doctor had scheduled 1:00 p.m. as the time for the surgery. We were sent to a waiting room to wait for a room assignment. At 1:05 someone came looking for us to take Elder directly to surgery so they moved us to the Emergency area of the hospital and had him put on a hospital gown that was definitely not made for someone his size. He was grateful when they came back with a blanket for him.

Armando and I followed them up two floors and were left in the hallway as they wheeled him into the surgery section of the hospital on the third floor. After waiting for several hours, watching different family members be called into what we assumed was the recovery room, we started to wonder what was happening.  I finally took time to teach Armando about Suduko and let him play on my Ipad while we waited. After another ½ hour Armando asked someone at the door what was happening and they said Elder would be out soon. Then Dr. Eric Diegues came out, ready to leave, and I spoke with him as he gave me the thumbs up. We waited some more until, at last, they wheeled Elder out attached to an IV and headed down the hall with him to a double room that had a large family group inside visiting with a patient in the other bed.  They were asked to leave for a minute while the staff transferred Elder into his bed.
The half cast is on the bed: the doctor
cut it off to check his work before
checking us out

This is the spot - you can see cotton
stuck to the bottom of Elder's foot.

We later learned between some pretty serious vomiting that the spinal block did not take the first or second times they tried but finally on the third attempt they were able to begin the surgery. John does not remember any of it until he awoke and became nervous after some time of having no feeling from the waist down which lasted until early evening. It was quite a bit later that night, after 2 IV bags of medication for nausea, that he finally settled down enough to rest. He did not have an inch to spare as he fit from the bars on one end, to the bars on the other in the bed. They would not raise the head of the bed or allow him a pillow for over 6 hours because of the problems with nausea. We assumed he had the problem because of having sooooo much anesthetic injected. However, it turned out that our roommate had not yet had his surgery on his arm. They wheeled him out just after 6 pm and did not return until 9:30 pm when he & his wife commenced the same procedure of heaving, cleaning up, and starting over again.  The problem was not John’s alone. It was a long night as we all tried to sleep between waves of nausea and vomiting, nurse visits to change antibiotics (sometimes they brought clean linen and rags), and even the kitchen staff woke us all at 4 a.m. to bring in a container of coffee. When they again returned with coffee and warm milk I finally followed her down the hall to return the carafe and she offered me tea. I explained about our religion and we had to settle for the warm milk that they served with the coffee. Breakfast was slices of fruit, cheese & ham, and a roll along with warm milk. It had been well over 24 hours since John had anything to eat. He was pretty dehydrated and hungry.

Armando had stayed overnight with his cousins and returned to take us home. The doctor came to check the incision and tell us to return to his office in 10 days for a recheck. The nurses re-wrapped the ½ cast and told us we were next in line to check out. Several hours later we finally wheeled Elder to the nurse’s station to find out if we were going to be able to leave before lunch. Armando and I walked down to the financial office and paid the bill while the nurses brought Elder McKinney down. We arrived back in Prudentópolis hoping to be able to catch some sleep after thanking our good friend for his help.
This is above the sink in the bathroom. I had to put it in because I was fascinated by this example of
getting  clean in a hospital that does not have soap in any of the bathrooms.
That is also true in the clinics that we have been to.

Meanwhile, we were very grateful for general conference and the connection we had that allowed Elder to stream conference in English in our apartment through his ipad while I attended the sessions and took roll Saturday and Sunday at the church where it streamed very well in Portuguese. We were fortunate to have Thyago M. be able to run the projector connected to John’s computer in the chapel for the four regular sessions and Priesthood session which we showed at 9 a.m. on Sunday. I was able to show the sisters the down load of the previous weeks Relief Society session on my computer in another room at the same time Priesthood session streamed for the men. We felt like this was a big improvement over last year. When we first arrived the arrangement had been to bus the branch to Guarapuava where they were able to see only one session before they returned home. In April we had started showing conference at the branch chapel via internet and only one person stayed for all the sessions  and most attended only one session but they were glad it was more convenient. This time most of the youth attended at least three sessions and the men saw priesthood and both Sunday sessions. There were six of us who saw all of them.  

Meron, Elder Long, Thyago M., Elder Pereira standing -
Amelia sitting - just before batpism. Thyago had his
first two baptisms between conference sessions.

We also had a baptism between sessions on Sunday for a couple in their 70s, Amelia and Meron Tupis. She had a personal miracle when her shaking from Parkinsons ceased after her baptism. We were also very grateful that the water heater had been fixed and the font was warm for this particular baptism.

Renato had to pick up John to come and enter information in the computer between sessions since both counselors’ names had been removed from MLS again (this time they were left in the system as clerks---who does this?). The payments for the bus the men took to Guarapuava for district priesthood meeting last month had been denied again. That always means the bus driver has to be paid with someone's cash.
There is so much to learn and do here that we take for granted at home.

Meanwhile navigating with crutches, non-functioning bowels, and a UTI that caused a fever became challenges for Elder McKinney as we waited out the ten days to return to visit the doctor. We had been told we would have to hire a nurse to change Elder’s bandages twice in the 10 day period but when we saw how simple the wrapping and cleaning were, I was able to purchase the supplies at the pharmacy and take care of that for John.  His leg was wrapped with cotton inside the cast – the actual incision covered by gauze after rinsing with sterile water first. Then the cast that covered his foot and back half of his leg was wrapped on with an ace type bandage for which they had no fasteners. (They taped it on at the hospital and I later used safety pins).  Since our phone continued not to function at all over periods of this time, we were pretty much on our own.  Elder Long, who was our district leader, was conscientious about coming by to check on us and gave John a nice blessing.
This picture is for James - whose last design is being made by Husqvarna.
We see them active even here in Brasil.

I mentioned earlier how specialized prescription writing is. Well, when we pretty much narrowed the fever down to UTI since his incision looked terrific, we found that the operating doctor could not prescribe an antibiotic since that was not his specialty. So we got to catch a cab to the clinic at Santa Casa Hospital where a urinalysis was run and we waited in line several hours for our turn to visit Dr. Garcia, a general practitioner.  The hospital had no elevator -- connecting the two floors of the hospital only by ramp--so the lab people, who we have become well acquainted with over the past couple of months, procured a wheel chair for Elder. It became quite clear to everyone waiting in line why we were there as the wheel chair rolled back and forth between “sanitario” and our place in line. The possibility was also added that there might be some stones causing a problem. Elder is having to develop some patience.

This is Elder McKinney waiting
patiently  for his time to consult
Dr. Garcia at the clinic.
Back to the phone system: we can now make calls within our zone to the Elders free. However, if we need to communicate with anyone in Curitiba – mission president, his wife, assistants or the secretaries – we have to initiate an emergency phone code, ring them, then wait for them to call us back.   This has been interesting for us since our police approved stay expired the week before Elder’s surgery.  Unbeknownst to us the mission secretary had scheduled us to go into Curitiba the same day as the surgery to renew our papers with about 30 others. We were told we could not go in prior to the procedure, so we were without legal status as we entered the hospital.

We also had an interesting phone call just yesterday, letting us know that the real estate agent wanted to show the property our rented church building is on to buyers. Since we no longer have out of area phone service we could only make our emergency call to the Mission President to have him talk with facilities management in Londrina and make sure they knew.

Meanwhile the president let us know that he really does not have a use for us in Curitiba (another couple is coming in January to serve in the office) but he had talked to the temple presidency and they can use us or we can stay here if we chose. We are feeling a little confused but we feel like there is still quite a bit we can do in Prudentópolis so we plan to be here unless things change again in the coming weeks. We will continue seminary class, piano lessons, trying to teach leadership skills, ordering supplies for the branch, teaching English, and befriending non-members in hopes of strengthening the branch here. Elder McKinney will be helping one of our young sisters fill out missionary papers soon. It is pretty exciting.
Scenery on the way to Guarapuava

Armando took this. Behind us is "The Hat" 
or ao chapéu

It is really green - Armando says after 
Guarapuava it is not this lush.

I always love the palms - here we are looking 
through the eucalyptus trees.
Monday, Oct 14th, while we were in Guarapuava for the checkup, transfers were made. Elder Long was moved to become our Zone Leader and Elder Matamala from Argentina became our new District Leader. As we became acquainted with him over lunch yesterday we found him to be a humble, spiritual leader and will be glad to get to know him better.

We are very blessed that the surgery went well, that Elder is now able to walk a little, and should resume normal activity after his next two week check. We are grateful that we know Heavenly Father loves us and has a plan for us. We find great hope and strength in the Gospel and the angels we have met here on earth. Still, please remember us in your prayers.

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