For the past week or so, Mikkel has been recovering from a bad cold, starting with voice loss, then a deep cough, low fever, stuffy nose, and loss of energy. Because of the deep cough, we were concern that he might have bronchitis. So we ventured off to the Centro Salud, the Pedasí health clinic, which is about 2 blocks from our home. I had been there recently myself to get a doctor referral for a mammogram, thanks to my friend, PB, who helped me navigate through the system. The Salud is by no means anything like health clinics in California with all the bells and whistles, pristine, and modern. You will see old chairs, wooden desks, narrow hallways, and walls that could use a fresh coat of paint. But it is what we have here in Pedasí and in many towns throughout Panama. The friendly staff and doctors are well-trained and I have no complaints. There is a pharmacy, lab, observation room, examining rooms, a dental clinic, and emergency department. We had previously learned that if you need an ambulance to take you to the hospital in Las Tablas or Chitre, you have to come to the Salud; the ambulance does not come to you. And if it is not there, hopefully you have someone with you to drive you to the hospital. A new hospital in Pedasí has been built, but has not opened yet; not sure when that will happen.
Anyway, being familiar with how things work now, we went to the Salud and were told to come back at 3pm to see the doctor. There are different times, morning and afternoon, when the doctor will see patients; no appointments, just first-come, first-serve. We returned at about 2:45pm and joined the others sitting in the reception area until someone came precisely at 3pm to the window to write up an intake form on each patient. Everyone is basically on the honor system, knowing who arrived before them and after them, and lined up at the window accordingly. After receiving our basic information from Mikkel’s pensionado visa ID, we sat down in the hallway where a nurse would call each person in order to take vitals (weight & blood pressure). Then we sat in another hallway around the corner and waited for the doctor to call Mikkel’s name, again in order received. We then entered a room where the doctor asked questions in Spanish. That’s one reason why I was there, to translate for Mikkel and answer in Spanish; Mikkel has decided to rely on my Spanish understanding and knowledge and translate for him when necessary. After listening to Mikkel’s deep breaths, she determined he just had a bad cold, to our relief. She told him the usual: take Tylenol, drinks lots of water, and rest. For the cough, she prescribed a cough syrup. Out the door we walked, toward the reception window to ask about the bill – $0! Not sure why because it is usually $2; either way, wasn’t going to argue. We do not have medical insurance here in Panama. We chose to self-insure and the main reason is the low cost for health care, even without insurance.
The Salud pharmacy was closed, so we went over to the farmacia in town, about a block away, and bought the cough syrup. We have been there many times before to refill prescriptions I have from my doctor in the U.S. So we know Christian, the pharmacist, who showed us 3 different brands of the same medicine, one for $12, one for $8, and one for $6. Of course we took the cheaper one and with our pensionado discount, it came to $4.95.
Now in regards to getting a mammogram. For many of my readers, let me first tell you that I was diagnosed with Stage 1 breast cancer four years ago. This was discovered by my annual mammogram which I have done since I was 35 years old when my mother was diagnosed and eventually died of breast cancer. Long story short, after 2 lumpectomies to remove all of the small tumor and 2 sentinel lobes to make sure the cancer had not spread into the lymph nodes, and 6 weeks of radiation, I have since been cancer free. I am a survivor, but I do continue with my annual mammograms, having my last one in June, 2013 before moving to Panama.
So now being in Pedasí for over a year, I was due for another one and inquired around as to where to go. Hence, with my friend’s help, I went to the Central Salud a few weeks ago to get a doctor referral. Then a couple of days later my friend went with me to show me where to go at the Las Tablas hospital to get an appointment. Unfortunately, to our surprise, the soonest appointment I could make was not until November due to a recent campaign to encourage woman in Panama to have one for early detection and prevention. Not wanting to wait so long, the receptionist referred me to a clinic in Chitré. It would cost more, $35 at the hospital, $46.75 at the clinic. (Compared to what it costs in California without insurance, even the clinic cost was a deal.) I was able to make an appointment at the clinic in Chitre by phone and a few days later went, this time with 2 friends, and had the mammogram. Again this clinic, somewhat bigger than Central Salud in Pedasí, was not like the California health centers. There was only one machine in one very small room, unlike the health centers I have gone to in California with 4+ machines! each in a much bigger room. But again the professional staff was very friendly and patient with my attempt at speaking to them in Spanish. Afterwards I was told to return a couple of days later for the results and paid for the service.
Unexpectantly, I received a call from the clinic in Chitré a couple of days later asking me to return for more X-rays. They couldn’t tell me much more than that, only that I needed to come back a week later. Well, reminders of the emotions and feelings from the past began to rise up within me. I tried to tell myself it was probably because they did not have all the past medical history and records, and they probably saw a lot of scar tissue in the mammogram. Nevertheless, I spent the next week in prayer and asking others to pray as well. I remembered how prayer really helped me when I was first diagnosed with cancer, feeling great comfort and assurance that God would see me through this. He did then, and He did this time as well. I also called the medical records department of the doctors and hospital in California, asking for them to send me my records regarding everything about the breast cancer. They emailed me a form and after paying $15, they are mailing a CD with the records and X-rays. But I probably won’t receive it for about 3 weeks. The day finally came, and I decided this time to arrange for a translator who I have used previously so that I would really understand what the doctor and staff tell me. And, of course, Mikkel came with me as well. Immediately, the technician explained that they were just taking more mammograms of the one breast to make sure that what the pictures showed was scar tissue from surgery, nothing else since they did not have any base X-rays to begin with. I now took a big deep breath, relieved that the doctor was just being thorough. Afterwards, I saw the doctor who assured me that all was well, giving me written results in both English and Spanish, along with the X-rays. Doctors and clinics usually give you all the results of the medical procedures and service for you to keep for the future; in other words, you store your own files. I came away very satisfied and will return in 6 months to the clinic for a requested follow-up.
So I thought I would share some of our experiences with health care in Panama. Many of our friends asked about it when we had decided to move here. Yes, things are done differently than what we are used to, having lived in California all my life. But this is my home now and I accept these differences. I know it is not for everyone, even for some who live in other areas and cities in Panama. I do believe since we have moved here, we are healthier-more fresh fruits and vegetables replacing junk food and fast food; more exercise; more fresh air; and less stress. If there ever comes a time one of us needs more consistent medical care, we will cross that bridge when necessary. In the meantime, God has bless us with overall good health and we are happy with what is available for us now where we live.