Medical Evacuation

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After having recovered from my first oral surgery in Lima the time had come once again to return for the follow-up and to have a bone graft done. My appointment was scheduled for the last week in May and I was told I would need about a week or so to recover from the bone graft surgery afterwards. So I packed up my backpack with just enough for the week and was on my way.

Upon arriving in Lima I had my follow-up appointment with the oral surgeon. When it came time to schedule the surgery, however, I received some interesting news. I was going to be sent to Panama to have the surgery. As it turned out, my dental issue was a lot more complicated than I had thought and Panama is known for having excellent medical care with services comparative to the States. When a medical issue is more serious, Peace Corps sometimes sends volunteers to Panama to have medical procedures done as opposed to sending them to the US. I was assured that I would be in good hands and would be getting the best possible medical treatment.

Arrival to Panama:

A week later I found myself in Panama City, it would be my first time back after seven years. My first trip to Panama was in 2009 when I volunteered for a month on the island of Achutupu, Guna Yala, an experience that later led me to make the decision to join the Peace Corps. I documented my volunteer experience on the island in an earlier blog titled: Living with the Kuna

Shortly after checking in to the hotel in Panama City I was picked up by Ricardo, the Peace Corps Panama’s Med Evac Assistant. Ricardo gave me a driving tour of the city and showed me where I could do laundry, go grocery shopping, and afterwards he took me to my consult with the oral surgeon. Ricardo was very helpful and supportive throughout the whole process.

During the consult, the doctor informed me that she could not do the bone graft as originally planned because the area had become infected again and it was pretty serious. Therefore, she would need to do a root canal to clear out the infection once and for all. After we had received approval from Peace Corps Washington, she schehdueld the procedure.

First Week in Panama:

Aside from visiting the doctor and running around to get various X-rays taken, the majority of my first week in Panama was spent trying to get over a cold. I suspect that the change of temperature and all the travel had something to do with it. In my community the weather is very warm all the time, then I took an 18-hour overnight bus to Lima where it happened to be winter, and then to Panama where it’s hot and humid. My immune system was not having it.

Unfortunately for me, at the time of my arrival there was a big H1N1 (aka Swine Flu) scare going around and it was all over the news. People in the hotel were literally running away from me when they saw I had cold symptoms. Fortunately it didn’t last more than a few days and I stopped scaring people away.

While in hotel I met another Peace Corps volunteer, Liza, who is serving in Guyana. She’s a community health volunteer who works at the only long-term care facility for children and adults with disabilities in Guyana. Liza had had also been sent to Panama for medical reasons. It was nice getting to know her and having a friend going through something similar to talk to. You can check out her blog here.

During the week we took advantage of exploring Panama City together and took a trip out to Isla Taboga for a day, a pinturesque fishing village on nearby island, just a 45-minute ferry ride away. The trip is $12 round trip. There’s also an express ferry which you can take which gets gets you there in 30 minutes for $20 round trip. We had lunch at London’s, a quaint restaurant on the beach owned by a friendly and hospitable couple.  I ordered grilled fish with patacones. It was one of the best meals I had while in Panama.

We also visited Albrook mall, which was also quite exciting, as it so happens to be the biggest mall in Latin America with over 700 stores and 100 restaurants. We spend most of our time in a store called Dorian’s, which I like to think of as the Panamanian Marshalls, only cheaper. It was glorious. Going grocery shopping and finding all sorts of US brand snacks I haven’t seen in almost a year was also a highlight.

On Liza’s last night we went to Casco Viejo, the historic district of Panama City, and UNESCO World Heritage Site. Filled with cobblestone roads and colorful colonial architecture, Casco Viejo has always reminded me of the walled city in Cartagena, Colombia. The best part of the night was finding loading our cups of frozen yogurt up with toppings at Forever Yogurt, which completely blew Pinkyberry and Sweetfrog out of the water. Poor Liza however is allergic to milk so she could only fill up her cup with toppings. Even still, I’ve never seen so many toppings options before. It made my night.

After Liza left (tear), I took advantage of exploring the city a bit more. I tried to be as active as possible before my surgery because I wasn’t sure what kind of state I’d be in afterwards. Some of these activities included bike riding along the Citnta Costera, eating a bagel at New York Bagel Cafe, going to the gym, going to the movies, going back to Forever Yogurt, and exploring Panama City.

Surgery:

 On Monday around 6 pm I had my first oral surgery. It was one of the most physically unpleasant and painful experiences that I’ve had in quite some time. The procedure was originally intended to be a basic root canal on one of my back molars, but once the doctor started working she discovered that there was decay in the roots of the tooth so she would need to extract both the molar and the roots in their entirety.

There were moments where it felt like she was drilling right through to my brain and my body began to tremble involuntarily and my eyes began to swell with tears. I tried to breathe deeply and relax; telling myself it would all be over soon, to try and remain calm and not freak out. Then I heard the assistant say something about calling the “patólogo”. Her voice sounded alarmed and my head began to spin. Patólogo… patólogo….what does that mean again? I thought to myself.. Ohhhhh right.…pathologist. But isn’t that the doctor that diagnoses…crap. My thoughts trailed off and I wave of fear and worry began to sweep over me. That does not sound good. I tried not to think about it, and not focus on the pain, struggling to fight to hold back the tears.

The procedure lasted about an hour. After the doctor finished, she showed me the tooth and roots she had extracted and told me that she had also taken out a small mass from under my molar, which appeared to be a cyst. She extended her hand revealing a small pink round fleshy object about the size of a marble. It reminded me of one of those rubber sticky balls with spikes you get in the gumball machines. “It’s probably noting” she told me, “but we’re going to need to send it to the pathologist to rule out anything serious.”

 As I walked back out into the waiting room I found Ricardo waiting patiently with a concerned look on his face. “How are you doing?” he asked. “More or less, I’ve been better” I replied weakly. He talked to the doctors and then went to go and pick up my various prescriptions before dropping me back off at the hotel. I was very thankful for the help.

The next morning I was feeling a lot better. For the next few days I was restricted from doing any strenuous exercise, swimming, sun exposure, and was limited to eating only soft foods and cold liquids. The doctor told me I was due back in one week, which just so happened to be July 4^th, for my follow-up and to get my stitches taken out.

The week in-between and pretty low-key and seemed to just fly by. One of the highlights was meeting up with Katiuska, a friend I had made while volunteering in Kuna Yala. She left Achutupu to study in Panama City. It was great to see her again after so many years.

Before I knew it was July 4^th. After waking up early and hitting the gym, I began my 4^th of July by having breakfast at IHOP with my friend Alexander that lives in the city. It had been almost a year since my last good American breakfast, and over two years since my last visit to IHOP so I was pretty excited. I ordered double blueberry pancakes topped with whipped cream. It was every bit as good as it sounds.

In the afternoon I had my follow-up appointment with the dental surgeon and got my stitches taken out. Before leaving, the doctor medically cleared me to return to Peru. She told me that she would contact me as soon as she had news from the pathologist and that she would need to have me back in another month and a half to do the bone graft procedure and tooth implant.

A few days later I was on my way back to Peru. I had really enjoyed my time in Panama (aside from the whole root canal thing) but I was looking to returning to my community and getting back to work. I am very grateful for the continued support of Peace Corps staff and doctors throughout the whole process. Having any kind of medical issue away from home in a foreign country can be extremely stressful and scary, but knowing that I had I had the Peace Corps staff there helping me every step of the way made all the difference.