The article has been automatically translated into English by Google Translate from Russian and has not been edited.

How we treated a child in the USA: what will surprise and shock you in an American hospital?

'07.08.2018'

Source: Julia Dyadyura

American medicine can be praised in any context and under any circumstances. This is especially abused by those who have ever been to some monumental hospital, which looks more like an expensive opera than a medical institution. They inspire confidence and salaries of doctors, and their long training, which is delayed for a third of their lives. Such people do even simple manipulations, like gods, explain each of their actions and prevent any of your questions, I always thought. When I happened to deal with this very medicine, I realized that doctors leave more questions than answers, like medicine itself.

When our son Oscar was born, we discovered ptosis - a drooping of the right eyelid. In fact, this is a weak muscle (or lack of it), which is an exclusively cosmetic defect and is corrected with surgery. None of the hospital staff noticed this drawback, although for the first 3 days the baby practically did not open his eyes with a sore eyelid. Strange, isn't it? We noticed it ourselves, started digging, and at the first consultation of the pediatrician at the Pediatric Assosiation, where we were servicing, we asked the specialist a question. Then we were assured that it happens, and everything will work out with age. Pediatric Assosiation, for a minute, is one of the best children's clinics in Miami.

Time passed, but nothing changed. At the next consultation in the 2 month, another pediatrician of this clinic responded affirmatively to my assumption of the disease and asked the receptionist to take a list of pediatric ophthalmologists who take on our Molina insurance so that we can find a doctor.

I took it and spent about a week researching the proposed options - what are the doctors, their rating, which of them take on insurance, and if not on insurance, how expensive will it cost us. I know English at that level to read texts in American newspapers, but not texts on medical subjects. Nevertheless, I managed and stayed at the hospital Bascom Palmer, which deals exclusively with the treatment of eye diseases.

They took our insurance, but they had to wait almost a month for 2 for the first appointment. Then I did not know that this is a normal practice of treatment for insurance. We waited for this time and with an anticipation of answers to our questions went. The first time we waited for a doctor about 2,5 hours, although we had a designated time. Looking ahead, I want to say that a long wait for admission is typical for most doctors and clinics, under insurance or not. Even in the Emergency department, where people need more rapid help, you have to wait.

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One of the waiting rooms in the clinic. Photo: from the personal archive of the author

In defense of hospitals, I want to say that the waiting room infrastructure usually has entertainment for children, TVs, magazines, and free coffee in unlimited quantities, and this somehow compensates for the waste of time. In other words - if you are planning a visit to the doctor, count on the time from 1 to 3 hours. Then how lucky.

American medicine is also interesting because you need to go through several medical assistants before you get to the doctor himself. In our case, at Bascom Palmer, during the first visit, the baby was first examined by a nurse's assistant, interviewed us, entered all the information into the computer, showed monochrome pictures to evaluate his vision, dropped drops to expand the pupil. After that, we left the office for about half an hour and an hour and again returned there for a short conversation with the doctor's assistant, and only then the doctor came in and analyzed all the information that the assistants provided to him.

We are under the supervision of Hilda Kapo, the best in the business, but she always has very few questions. In fact, I need to tell the medical assistants and the doctor the same thing several times in as much detail as possible so as not to miss anything important. What is important from my story, and what is not - only doctors know. Now I understand that this is a common practice. You should be aware of your illness or illness of the child and at the reception speak as much as possible.

According to the results of the examination, we were assigned to glue a plaster on a healthy eye in order to make the eye with the eyelid lowered work more. And, of course, they mentioned the operation, which will be needed when the child is older.

Another important point is that doctors in the USA are not particularly talkative and will not tell you everything that they think about the disease. And because here you need to ask questions, although they can not get answers.

For example, at our first meetings, we did not know what our level of omission was, when an operation would be necessary, and of what kind. The doctor answered ambiguously - It depends. Based on this, I advise you to make a list of questions before each consultation and not leave the office until you find out everything that interests you.

By the way, we have exactly the same story with a pediatrician. Usually, he does not talk about what is better to teach a child at his age, what to do, what not to do, what to feed or not to feed. Questions asked only the most on duty. For me, this is somewhat strange, because several friends in other states have pediatricians almost giving a lecture. Since during each scheduled visit you are given a piece of paper on which it is written that a child of this age should be able, it is assumed that you do not need any in-depth information.

So, we went home from the eye hospital, and our next appointment was after 3 of the month. All this time we had to glue the plaster and if for some time it was still possible, even though the baby was very unhappy, then from the 6 months he began to strip off the plaster immediately after sticking.

In one of our visits after 6 months, we were prescribed drops, which had to be dripped into a healthy eye so that it clouded the “look” for a while, forcing the child to use the eye with a sick eyelid. Fortunately, we were warned what could be the reaction if the drops do not fit.

At the scheduled doctor’s appointment at Bascom Palmer. Photo: from the personal archive of the author
At the scheduled doctor’s appointment at Bascom Palmer. Photo: from the personal archive of the author

A couple of weeks after using the drops, at some point, Oscar turned red and then doused, then it became clear that he was allergic to drops, and we put them off. By the way, drops also paid for insurance. When a doctor makes an appointment, he sends a prescription to a pharmacy at your place of residence, where you can get this medicine by calling your name. In our case, it was CVS right outside the house, but they did not have the drugs, they contacted the doctor’s assistant to decide on the replacement, and when the doctor insisted on these drops, we were given a prescription and asked to look for a medicine in other pharmacies. If we did not find him, then we would have to buy it at the doctor’s office for $ 90.

Our next appointment was scheduled for the year in which we waited for a meeting with the doctor for almost 4 hours and found that the child supposedly sits down and still needs surgery in the near future, after which we are scheduled to meet with the oculoplastic surgeon.

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It looks like a machine-translator, which is used in the hospital. Photo: from the personal archive of the author

The meeting took place a month later, and at it we already used the services of a skype interpreter offered by the hospital. Unfortunately, you can find out about this service only if you ask. We asked. It looks like this: special equipment with a computer is delivered to the office. The doctor’s assistant selects the language and makes the call. After that, the translator gets in touch and translates your dialogue.

I want to note that the surgeon was laconic and said literally a few words about what type of operation would be needed - hanging from the eyebrow - and what consequences we should expect. No medical details (what Russian or Ukrainian doctors are guilty of), no details. As usual, we were supposed to ask a lot.

The operation should have been done under general mask anesthesia, and this caused me much more fear than the fact that the eyelid of the baby would be cut.

Regular office in the eye clinic. Photo: from the personal archive of the author
Regular office in the eye clinic. Photo: from the personal archive of the author

After the consultation, we had to call the department that deals with the operations and discuss with the coordinator the date of the operation and the expenses that we incur. Surprisingly, the procedure was prescribed through 1,5 of the month, and all expenses were covered by insurance. The child did not have to pass any tests before Day X or Day X, which was surprising to me, because in other countries they take this kind of test before the operation.

All that was needed from us was to send the form from the hospital to the pediatrician (although all medical institutions have a common system and it is not clear why they could not send this form through it) and come for a preoperative examination (pre-op) to the pediatrician and to the meeting with an anesthesiologist assistant the day before surgery.

We had a reception at the children's clinic 4 the day before the operation, at which the baby was listened to by the heart, measured the temperature and, assuring that everything was fine, issued papers for the hospital. I honestly tried to find out whether we need to do a blood test, to which I received a negative answer. As far as I know, all insurance tests can only be done with a referral from a doctor and nothing else.

The day before the operation, we arrived at the hospital for a meeting with an anesthesiologist assistant. It took about 3 hours. For all patients, a separate floor is allocated before the operation in the hospital. There we met with the nurse, who wrote down all the information about the child, allergies and so on, and then talked to the nurse-anesthesiologist, who answered our questions and asked us not to feed or feed the child for some time before the operation. To be precise, I myself asked her this question almost at the end of our meeting, because before that she had not mentioned anything like that. Maybe just did not have time.

We learned the time of the operation only the night before, when we called this nurse by phone. Such is their order.

Before the operation, the baby was dressed in a hospital shirt. Photo: from the personal archive of the author
Before the operation, the baby was dressed in a hospital shirt. Photo: from the personal archive of the author

The next day we arrived at the hospital in 08: 00 and 2 hours before the operation, waited in our own ward, which is provided only to small children. During this time, we were visited by nurses, an anesthesiologist and an assistant surgeon with various questions and recommendations.

Right up to mask anesthesia, I was with Oscar in the operating room. The operation lasted only 30 minutes and the baby moved away from the anesthesia in my arms. It went pretty smoothly. By the way, the surgeon looked to us in the ward immediately after the operation and assured that everything was fine, showing the photo “after” as proof from his smartphone.

Mom can stay with the child in the operating room until the anesthesia works. Photo: from the personal archive of the author
Mom can stay with the child in the operating room until the anesthesia works. Photo: from the personal archive of the author

We were discharged 2 hours after the surgery, they gave us a special ointment, and we went home. Fast discharge and home recovery are also common practices in American clinics. After a similar operation, for example, in Russia, the child is in the hospital for several days.

After my experience with doctors, I know that if you really want to understand what you’re doing to you or your child, you need to be in the subject line and be proficient in medical terms, don’t be afraid to ask questions and be able to insist on yourself if you think that it is necessary. And do not hesitate to ask about the services of an interpreter. With American doctors, as with any other, probably the best proverb says: trust, but verify.

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