Guest Entry by Rees – Live from a Tajik Hospital

Guest Entry by Rees – Live from a Tajik Hospital

Well, I want to make a disclaimer and say from the outset that I’m so grateful that I was able to get this procedure accomplished in-country and avoided the alternative of making another trip to Turkey. No offense against Turkey.

So the saga started last Friday when I arrived in Dushanbe to meet with a urologist to see if he had the tools and experience to remove the stent from my ureter. I was encouraged that he wanted blood and urine samples as well as an ultrasound. When I went back to the guy who was going to take my urine sample, he handed me an empty (what I assumed was sterilized) tomato jar and said, “fill it halfway.” I proceeded to give him some blood, urine and got the ultrasound and was pleasantly surprised when the total for that first bill came out equivalent to 5 US dollars. As we continued to discuss how the procedure would go, he recommended that I stay in their VIP suite at the clinic/hospital at a much more expensive price of roughly $22 for both Sara and me. I told them that I didn’t think that would be a problem. He told me to come back on Monday to be admitted and then we’d do the procedure on Tuesday.  We understood his reason for my coming on Monday to be that we would have to get all the medications and supplies ready as well as make sure that I didn’t have a fever prior to the removal of the stent. You see, the hospital doesn’t just give you all the meds and supplies and then charge you for them later – you actually have to run out to the pharmacy and buy everything yourself – and I mean everything: gauze, syringes, rubbing alcohol, ampules of medications with the stuff to reconstitute them. That’s all assuming that the pharmacy is open. It closed early the day we arrived. Go figure.

My first night in the Tajik hospital: I think I saw our beds in a 1940s WWII movie but I must say they are very comfortable. Though there’s no hot water or heater (or working light bulb) in the bathroom and the temperature hovers around freezing – our actual bedroom has an electric oil-filled heater that took the edge off the bite. You see it was snowing the day we came. Our room was equipped with a glass coffee table and a Persian rug and I was fixing to sleep well the night before the procedure. That is until a rooster started crowing at about 10pm and proceeded to resume his crowing every few hours until it was really morning. There is a chicken coop just under our window. I think we saw some bunnies out there too. He must have been excited about having an American in the hospital because he was hooping and hollering all night long.

After an un-restful night of sleep, we saw the doctor (about 10:30am) who explained to us that the cystoscope (the tool we needed to get the stent out) was broken and that we’d have to go to another location for the actual procedure. Apparently he’d tried to borrow one from another hospital but they said no. He had the nurse give me some shots of pain meds and antibiotics and then we proceeded to the parking lot where Sara and I got in his car as he drove us to the other hospital.

When we arrived, he scrubbed in while Sara and I waited outside – literally outside, under some trees – and he brought out four new medical students. By the way, this doctor is an excellent doctor and by no means do I want to paint him in a bad light, I just want to highlight how different medical care here is than what we’re used to. We walked, the seven of us, to a different building where we’d be doing the procedure and it was nice to see that it was a real urology department. When I parted from Sara and walked in the room, the first thing he asked me, more or less, was if I wanted to pray. At least that’s what I think he said - mind you this is all going down in Tajik. I said, “sure” and prayed for God to help and bless the doctor and to have mercy on me and I thanked Him for His love.

-brief interruption while Rees is getting another shot which will hopefully help him sleep-

After we prayed I dropped my drawers and climbed up onto this archaic looking apparatus complete with stirrups. I was up high enough in the air that my crotch was level with the doctor’s neck. Though they did try to flush my urethra with novacaine (for which I’m very grateful) the next hour proceeded to be one of the most uncomfortable experiences of my life. Apparently , it was quite difficult for them to get their tool into my bladder.  After the first couple tries failed, each subsequent try was preceded by a chant in Arabic referred to as the “bismi Allah” which means, “in the name of God, the most merciful, the most compassionate.” Worth mentioning is a description of the tool they were using, which I don’t think a merciful, compassionate God would be a huge fan of. It was a foot and a half long metal tube. By the time they got the tool in, there were 4 doctors and 4 doctors in training in the room. When they were able to retrieve the stent and pull it out of my body, there were many sighs of relief – including my own – which I exclamated with a “Glory, Hallelujah!” It felt marvelous for about 3 minutes, as I sat there without wires, pipes or tubes shoved up my penis. Unfortunately it only lasted 3 minutes until my doctor put in a urinary catheter, explaining to his students that it was necessary to make sure that the urethra didn’t swell so much that I wouldn’t be able to pee. Then one of the more compassionate students asked the doctor, “how long does he have to keep that in for?” I was really hoping that I heard him wrong when he said, “two days.”  From there we walked back to our doctor’s car. He handed me his key and said to go ahead and open the car and sit down and that he’d be back in a bit. By the way, this whole time I’m walking around with a catheter plugged up by lidocaine ampules. We made it back to the clinic – having narrowly missed an accident involving a large truck. Needless to say, these are the moments that I’m very blessed to have a wife who’s a nurse. Upon my arrival at the clinic instead of getting hooked up to a catheter bag I was handed an old, crumpled up 1.5 Ltr plastic bottle to let my catheter empty into. As Sara took the Lidocaine ampules out of the rubber ends of the catheter we found out that some pressure had been building up as bloody urine squirted past both of our faces – I’m happy to report it didn’t hit the nice rug in our room. The doctor assured me that keeping the cathater in for 2 days was neccisary but I was convinced I could have it out and be peeing on my own in a much shorter time. I drank lots of water and tea for the next 24 hours and got lots of “I’m sorry sweetie” sighs from Sara so In the end it could have been a lot worse. I did spend 2 more nights in the clinic although the 2^nd night was without a cathater. In fact as soon as he took it out and I was able to pee, Troy came to visit. I was really hungry. As soon as I saw that the doctor had gone home for the day , troy and I snuck out on the town and went to a middle eastern resteraunt  in the city and enjoyed the evening tube free.  We came back just after 8 and Troy stayed the night with me since sara had already left to be with the kids and Troy had to stay in the capitol anyway and my room was more comfortable that the room he had booked. Anyway that is pretty much a wrap on this event other that to say when it came to paying the bill I found my most pleasant surprise.  3 days inpatient, Procedure, catheterization, and all meds and drugs for going home and while in patient was a total of $238.  At least the price was right.  In the End the only other thing that happened to me was a week and a half later my right testicle swelled up like a jumbo egg, from an Infection that drained down from my bladder.  This was not the best Christmas present I have ever received. (it happened on Christmas day) I am now on my 10^th day of bed rest from that issue, on the mend though and grateful to be fighting this one at home, and that my wife is a nurse. I think she is enjoying sticking me with needles a little too much since she is giving me 2 IM shots of antibiotics in the Butt everyday. Just kidding. (about her enjoying it, she IS giving them to me) For now that is my story, I hope to  be through the egg ball situation by the next week.

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