Hospitals:
My first stop was the emergency room at Punta Pacifica Hospital. It's a small (75 beds) relatively new facility that opened three years ago. It's affiliated with John Hopkins and Johns Hopkins Medicine International manages the hospital. The facility was spotless, no wear and tear (it's new) and although it wouldn't receive any interior decorating awards seemed very functional. Every piece of equipment I saw looked to be "state of the art". Doctors all spoke English, as did the technical people (x-ray and CT scan). Language issues with other personal occurred - but an English speaker seemed to always magically appear at the right moment. Nice private room and the food was pretty good. Story: My parting memory of Punta Pacifica - the wheelchair ride when we checked out. The muchacho with the wheelchair arrived, loaded me up and off we went - never associated the phrase "wind whistling thru your hair" with a wheelchair ride - Jane was out of breath when we reached the front door!

Clinica Hospital San Fernando (2nd stop on my tour) is an older, larger and much busier facility. It show a little "wear" but was very clean and again the equipment was up to date. Didn't see the inside of a room (outpatient procedure here) nor eat any food. Again every doctor and tech person I came in contact with spoke English, nurses and orderlies it was hit or miss with English. Story: During the prep for the ESWL the Spanish speaking nurses and I were doing our best to communicate when a new face appeared - first words she spoke "I have a present for you" (I answered, "what") and she said "ME" - "I will try not to hurt you putting the IV in". She didn't.

Doctors:
Only one thing mattered to me - they all knew what they were doing. The specialist talked with me at least six times (explaining options, answering questions and checking in after the procedures) and Jane a couple of times. Even gave Jane his cell phone number (yes, cell phone - not an office number to call) and stressed that she should call him ANY time of the day if we had a question or problem. I would also receive a visit from a cardiologist and the anesthetist. None of these doctors seemed to be in a rush and spent considerable time with us. Story: The procedure at Punta Pacifica started EXACTLY on time, the last thing I remember was the anesthetist saying everything was ready as he turned on the music - "Night Moves" by Bob Seger.

Insurance:
When it comes to dealing with health insurance companies, Jane is chief in charge, primarily because she won't stop until an issue is resolved and she gained a LOT of experience dealing with the claims people when we lived in the Virgin Islands. Here in Panama we have opted to carry only hospitalization coverage because doctors visits and prescription medicines are so inexpensive. For my procedures the Hospitals obtained all the necessary pre-approvals and we did nothing except sign some forms. We are still trying to resolve coverage for the ER charges, but overall, we are happy with the level of coverage and hassle free process provided by World Wide Medical.

The not so good:
The ER at Punta Pacifica was WAY too cold - think it was a plot by those of you living up north to make me feel your pain. It also, took us a loooong time to checkout - a Panamanian explained that it is always easy to get in, but hard to get out of a Panama hospital.

If your wondering why it took so long (seven days) between the first procedure and the second - the only ESWL machine in the country broke. One of the factors that keep health care affordable here is that every hospital doesn't have the newest/greatest gizmo. It's also the reason why two different hospitals were used - they seem to understand that it's not cost effective to duplicate what someone else offers a couple of miles away. Probably works most of the time, I just got unlucky.

This turned out to be longer than I had planned - it's tough cramming ten days of "big time hurt" into a couple of paragraphs. I've got a followup visit with the specialist tomorrow, hoping for good news. I really want this to be the last medical related post for a long time. Take care.

Tags: Medical