Step 1) Spend a few months in a foreign country by yourself
Step 2) Tell them you went to the hospital VIA your blog
With that intro, I have to start this off by saying there is/was nothing to worry about and I am fine. For added reassurance, if I really felt like I was in trouble or knew there was a problem I would let everybody know right away. I don’t deal well with uncertainty, but there were a couple days where I wasn’t sure just what was going on or what to expect.
After my first big diving day I felt fine, but woke up early the next morning to pee and when I returned to bed I was shaking quite a bit from a chill. I bundled up and warmed fairly quickly. I didn’t think much of it because I had been sleeping next to a window with a light blanket and persistent breeze. I had a hard time falling asleep and noticed a very slight chest pain…not enough to affect my breathing but it stood out as something unusual.
That morning I was feeling a bit weak and was hungry. I decided I’d give it some time to see if it would pass. Within a few hours it was noticeably worse. Although my dive profiles were looking good and I had no reason to believe there were any problems with diving, I have heard that decompression sickness (not very common) can happen unexpectedly. I didn’t necessarily think this was the issue, but being new to diving I was not sure how my body reacts to breathing underwater (I just got my certification here a few weeks ago…there will be an eventual blog about that). I could almost hear my mother’s voice saying “I really wish you would see someone to make sure everything is fine.” I found a local doctor and walked up to the counter. The young woman handed me a scrap of paper and a pen and said “Please write your name and age.” “That’s it?” I thought. I hung out in the waiting area which reminded me of my grandparent’s doctors office. Within about twenty minutes I was meeting with the doc who ran through a list of questions and was not very concerned about decompression illness. He did a general checkup and was surprised to find I was running a low fever (about 100-101 * Fahrenheit). He said rest for a day or two before diving again and gave me the following prescriptions: five day supply of antibiotic, three day supply of pain reliever and fever reducer. Total bill for the visit and prescriptions was RM 35.
Later that day the weakness really wiped me out. I booked the closest hotel I could find and at one point remember thinking “If there is an emergency, will I be able to move fast enough to get out?” On a side note, my brother and I semi-joke about “the ponch,” a mysterious and powerful reserve of energy that us Ritchie’s tend to possess. It is available to tap into during times of need. Without the paunch I probably would have been concerned, but even though I didn’t feel like it, I knew that if I had to get out of there I would have been able to. Before lying down I went to see the doctor again since my condition changed. I waited less than five minutes before being seen. He said I just need to rest for a day or two, and didn’t charge me anything for the return visit. I set my alarm for a few hours ahead and slept most of the day. I managed to eat half of a meal in the late afternoon, and thought about pets that tend to stop eating right before they die. Later at night I noticed the fever has responded to the medication and was feeling a bit better. I was thinking I might have been feeling so good that I would wake up the next day feeling fine.
I wasn’t back to normal the next morning, but my condition was definitely better. My chest was mostly cleared and I was still feeling weak but not completely worthless. Since I had absolutely nothing to do that day I decided I’d get a second opinion before diving again. If I wasn’t planning on getting in the water I think I’d just have waited it out…but I knew my mother would want a doctor to confirm I was fit to dive. After another “check in” and maybe a 20 minute wait the ‘dokter’ noticed I was still running a fever (I stopped taking the pills the night before because my temp responded quickly and had returned to normal before I went to bed). He was concerned about the fever because I didn’t have any other symptoms that would explain a high temperature. He was also concerned the chest pain could have been related to my heart, asked about family history, and hooked me up to an EKG machine that used suction cups instead of stickers to connect the sensors. I wondered if I was hooked up to “the Machine” and about to have the life sucked out of me like Westley in the pit of despair. The EKG was fine. He wrote a referral letter and sent me to the local hospital a few kilometers away. Total bill: RM 35.
I arrived to find the sign in disrepair. So many letters were missing that I don’t think I could have identified the building had it not been located at the end of the road. This did not inspire confidence. Inside I found a scene reminiscent of hospital images from decades ago. I walked a long hallway that had open areas off to either side, each holding six beds…like a big room with one wall open to the hallway and three beds on each side of the room. I couldn’t help but think “These people are really sick.” You could see it in their eyes, their skin, and if that wasn’t enough some were moaning in pain. It felt like I had entered the first level of hell. In reality, this is nothing more than a hospital without individualized rooms, and people are likely being taken care of to a good standard, but coming from my sterilized and rich American medical background this was somewhat discomforting. I came to the desk where my contact was working. I handed the letter to a Chinese man, I’d guess five years younger than me. He was very nice, but had long, thin, evil looking fingers. After reading the letter he looked at me and said they wanted to make sure there wasn’t anything wrong with my chest, and that they wanted to make sure there weren’t any problems with my blood (such as Malaria, which was what I was starting to think could have been the problem). With a big smile he went on to say that I would need to stay in the hospital for a couple of days because the blood work wouldn’t be ready until the morning. I laughed, though he made ‘a funny’ and said “You’re joking right?” He replied “No, we need to find out why you have a fever and you should need to stay here.” Was he messing with me because I was a white guy? There was no freaking way I was going to stay in this hospital any longer than I had to, and I definitely was not sick enough that I needed to stay. I had walked here after all, and quickly negotiated the phone number to call in case I was not able to get out of bed in the morning.
The first order of business was having an x-ray taken of my chest. From the time I walked in the front door until the time the x-ray was taken could not have been longer than fifteen minutes. It was similar to any x-ray that I have had maybe ten years ago. I was then told the nurse will take some of my blood, and just a minute later she arrived. I had imagined the nurse to be a large, scary looking woman with really bad teeth, crazy eyes, and an ugly smile, manhandling my arm and retrieving blood using an outdated syringe. Instead, it was a cute Malaysian with a nice sterile cart and packaged syringes and needles (I don’t know if I’d have allowed it any other way). I’m surprised to say it, but it was the best blood draw I think I’ve ever had. She was gentle, careful, and there were practically no signs of bruising post-poke. I asked if I needed to pay, and the doc said we would square up when I returned in the AM for the results. I got the hell out of there. Later that night while lying in bed I asked myself what could be wrong with me.
The next morning I woke up and peed…then just a few minutes later peed clear…I thought “Could all this be from dehydration?” I made the trek back to the hospital. I walked up to the desk feeling very good, and thinking that everything was going to come back fine. My confidence wained when he said, “Let’s sit down over there to go over your results.” I wondered “Does this mean there is something wrong. Malaria!? It comes in waves…” He sat down next to me and said “Your chest x-ray looks good, and your blood is fine.” Holding a stack of papers he explains that my ‘X,Y, and Z’ blood tests all look good (there had to be a dozen tests that were performed…electrolytes, malaria, dengue fever, and more). He then said “I think you were just dehydrated, and that you will be fine.” Ok, a confirmed self-diagnosis is definitely a plus, but I couldn’t believe that I did not have headaches through any of it! I often have a headache with only mild dehydration, but here I’m badly dehydrated with no headache. I asked how much the bill was, and he says “There is no charge, maybe next time.” I seriously choked up for a second. Here I am, ‘the rich white man’ coming to the hospital, being treated, and not getting wrenched financially. Not only would I have had masses of paperwork, long waiting times, and a bunch of hoops to jump through, this same visit in America would have probably cost more than the total expenses for my entire trip to Malaysia.
So what’s the tally for all this? Let’s see what was included first:
– Three visits to the doctor that included two evaluations
– Visit to hospital
– Three prescriptions
– EKG test and evaluation of results
– Chest x-ray
– About a dozen blood tests
– Review of results with physician
GRAND TOTAL FOR EVERYTHING: RM 70 (about $22 USD)
Adding up total time spent for all visits (that’s from the time I walked in the front door until the time I walked out) could not have been longer than two and a half hours…that’s for everything. So much for the fears I’ve had surrounding foreign hospitals. This was as good as the treatment my Grandmother used to give me when her office was the first floor of my house. I don’t know that I’d want to be here for any serious complication or condition, but for all that I had done it was great.
Feeling great physically, and with solid reassurance that I am healthy, it’s off to the dive shop. Later that day I am diving in paradise. So what of the chest pain? After my next dive I noticed the regulator (thing you put in your mouth to breathe) was dry…there must have been a slight leak in the last regulator I used! I probably breathed in a few drops of saltwater.