sri lankan hospital report or “mary gets a single”

Day 1

trying to keep my chin up

Everyone has been so kind… Ramya for arranging my hasty return to Columbo for better medical care, Kumara from Fulbright Sri Lanka who drove 8 hours to get me to the doctor, Chitra for taking me to the hospital and checking me in. Karinsa and Callie even called me from Ramya’s cell phone; they are so worried about me and everyone keeps saying, “Mary would love this!” argh. Callie told me some funny monkey stories: Karinsa went out to grab a shirt which was drying on the hotel patio – and she felt tugging. It was a monkey wrestling over the shirt with her! Someone else came out of the bathroom to see a monkey sitting on her desk eating her banana! Gunda bundar! Bad monkey!

The doctor Selvie Perere, too, went out of her way to extend my appointment until 6:15 pm. Her office was next to her garage; a dark room with tall bookcases of old novels and reading material. After taking my history down in longhand, and asking about my symptoms, she gave me a quick physical for vital signs. She also believes this is a bacterial infection, and that it is in “a dangerous area” being to close to sinus passages and the brain. Great. She wrote up an admittance to Durdans Hospital in the center of Columbo, despite the fact that there were no beds available. On our way to the hospital, we stopped at the Sri Lanka Fulbright House so I could leave my luggage there. Chitra offered that I could call Don; even though I got teary, it was so wonderful to hear his calm and happy voice. I’m sure he and my mom are so worried about me… and I can hardly assuage them, as I’m very worried about myself.

my new home

Checking into the hospital was extremely efficient. At the admit desk, they reinforced again that they didn’t have any beds. I agreed that a “trolley” in the ER would be fine. While waiting, I observed that though the hospital was brimming with people, the mood was quiet. All the nurses wore white uniforms with nurses’ caps. After sitting for a while, I was interviewed by an intake nurse about my symptoms. Ten minutes later, I received admittance; suddenly, there was a bed available. After filling out a 10-question form, Chitra paid at the office. After she took me to my room – a single – I settled in to wait for the ‘house doctor’ to visit me. One nurse stopped by to see if I’d like anything to eat. Another nurse came by to take my temperature, and a third one popped in to weigh me.

my ‘guest bed’

A very young Dr. Preetap stopped by around 9 pm – took my history and vitals and asked for The Story. He told me that an ENT specialist would visit me in the morning, and that someone would take blood later tonight. Fifteen minutes later the blood work girls arrived, so hopefully, I am good to sleep. The pain is quite severe, and my nose, cheeks, and upper lip are swollen and flaming red.

Another nurse just stopped by with antibiotics – some sort of cloxocillin (?)… it’s so hard to understand the accents. I’ll have to ask the doctor to write it down in the morning.

Day 2

swelling has spread to the upper lip

My sleep was strange; the one thin sheet and sparse furnishings such a contrast to the 5 star hotels we’ve been staying in. I woke up several times, each time a little more nervous about the infection and the pain. At 6 the antibiotics arrived, followed by breakfast at 7 – 3 cold pieces of toast, a banana, and a fried egg. The head nurse stopped by with an entourage of beautiful Sri Lankan nurses in training – all in white – to ask how I was doing. It’s always “Good morning, madam” or “Miss Mary.” I told her I was very nervous, and she reassured me that Dr. Drahaman an ENT surgeon, would be very helpful

nurses station

My swelling is worse today, despite 2 courses of antibiotics. The left eye is a mere slit and the cheeks are fully blown up now. The upper lip is extremely aggravated, and my nose is so blown up and red, I fear it will never be the same. The pain is excruciating. I am scared.

make it go away!

Meanwhile, back at Kendalama, the crew has free time for biking, safaris, and hikes this morning with a tour to Darmala in the afternoon. Little do they know, that I have an ocean view – though it is over the rooftops of the nearby buildings, I can see the Indian Ocean sparkling in the sunshine.

My room has been a busy place with visits from the floor sweeper, the bathroom cleaner, the food lady, the floor washer, a ward doctor and finally the ENT. Plus a reassuring phone call from Chitra who promised to stop by sometime today. It’s quite odd – no one introduces themselves or makes small talk. I don’t know if it’s customary to ask questions here, but I have been doing my best to jot notes. Even though the doctors speak English, it is very difficult to understand, more so than in India. For instance, “You are from?” could mean your country of origin, the last country you were in, the last hotel you stayed in, or all the hotels you’ve stayed in.

Here’s the scoop: Dr. Drahaman said I have a very bad and dangerous infection which started in my nose and has spread to my face. Unchecked, it could infect my eyes or brain. Very dangerous he emphasized. OK OK… I get it! When I asked him what type of infection, he said the only way to know is to do a biopsy in the operating theatre. He would cut my nose and take a culture; a very unusual and expensive procedure for this hospital. He prefers to put me on an intravenous course of augmentin and check tomorrow to see if the swelling has subsided. If not, then they will try something stronger. Do they even have vincomycin here, I wonder? I sense the doctor feels I’ve acquired an ordinary bacteria in India, but I have no resistance to any of the local bacteria. He asked me to take a picture of my face today, and another one tomorrow – that will help him see if the meds are helping or not.

I just received a call from the Fulbright Director Tissa who was in contact with the doctor, but wanted to hear from me how I was doing. He remarked that I sounded like I was in good spirits. He knows I’m worried, and that those feelings are definitely intensified in a foreign country. It was good to hear that he has the highest regards for Dr. Selvie Percra who is his personal physician. As I was on the phone with him, Dr. Pecra arrived to check on me. All this while two nurses tried, unsuccessfully at first, to start the IV for the augmentin. Dr. Perera has asked me not to worry – she will take good care of me. She inquired as to whether the food was alright and if I had enough to occupy me as I will be in the hospital from 3 to 5 days!

Lunch was interesting – white rice and everything else was yellow – curry, I think. I ate some of the rice and the chicken, and what might be potatoes. There also was a finely shredded green veggie that I attempted. At lunch, I was thrilled to get a call from Joan, Karinsa, Callie, and Samantha! They love where they are, but insist it’s “not the same without Mary.” I asked them to take lots of pictures so they can tell me all about it, and that I hope to meet up with them in Columbo. They were so sad to hear I would be hospital bound for several days, but promised they’d call me everyday. Phew- what a lifeline! They also took Don’s email address, so I hope he gets the scoop from them. I am, of course, concerned about my insurance policies- and whether I will have any coverage. Right now, Fulbright is covering the costs, but I’ll need to reimburse them afterwards.

Day 3

a little better?

Arghh – I’ve got to get out of here. There are little bugs that swarm over the tables scrounging for food – the baggie with my banana and bun had to tossed out. The bed is uncomfortable, the three small sheets going horizontally on the bottom keep coming undone, and I’m lonely. Very lonely. Being in a hospital in a third world country is quite disconcerting. Last night I slept so poorly due to the discomfit of the bed and the pain of my wound, that I made my escape plan. In the morning, I would figure out how to call the American Embassy and try to activate my emergency evacuation policy. The thought of flying 35 hours in this condition is, however, overwhelming.

This morning when I was awakened by the nurse for my injection of augmentin and capsules, I realized I might be feeling a tad better! The view in the mirror showed the same swollen face and a huge red bulbous nose, with additional pockets of swelling all around my eyes. Am I getting better, or am I getting used to the pain and deformity?

DON CALLED!!!! What a saint to persist and get through to me! He didn’t even know what hospital I was in out of the 10 or so here in Columbo. He just started calling random hospitals and asking for me! Finally, he got an email from Joan with the name and number of this hospital. Even though I was teary, it was so good to hear his calm voice update him with how I am doing. He’s contacted both insurance companies – my local and my international, and told me to not worry about the money. He’s been receiving updates from Joan (bless you) and Chitra so that has helped him understand my situation better. It’s a major relief for me to know that he can call at any time and find out how I’m doing. Unfortunately, there have been more deaths in Columbo, despite the cease fire for the All Asia Conference, so my Mom and Don sure have plenty to worry about.

The ward doctor just stopped by and I told her I want to leave, but she says that is up to the consultant. He’ll want to review the culture which might be ready tonight… and he may want to continue the IV injections of augmentin for several more days. Originally he said 3-5 days, and today will be only 2 days by late evening. Unfortunately, he won’t be able to see me until later in the afternoon, as he visits government hospitals (which are free for Sri Lankans) in the morning.

DAMN. The ENT surgeon won’t release me. He wants me on the IV injections at least for 3 more days. He agreed I’m better, but is still very worried about the swelling and redness of my nose and cheeks; he’s concerned about the septum. He just won’t allow me to go gallivanting around the countryside! Dr. Selvie Perera agreed; she said I was lucky that I came in the hospital when I did. So 3 more days in the hospital – Friday, Saturday, and Sunday. I’m depressed. It’s such a contrast to go from traveling to sitting in one small room. I do appreciate their caring for my health, and I definitely got the impression that no amount of arguing would make any difference. I’m staying where they can monitor my progress and give me IV drugs, and that’s that. I’m so disappointed, yet grateful that they’re being cautious. I wouldn’t want to be on a mountain top four hours away from the hospital, now would I? Or would I?

Life is difficult in Columbo right now… the peace treaty has been violated and 12 people have been killed in the city. Many of the streets are roadblocked. Both of my doctors assured me that they would be in to see me regardless of the roadblocks. I can’t even read a paper, because of obstacles delivering them to the hospital. Is there anything else I can worry my mother about? Sorry, mom.

So here’s what I’ll be missing while I hibernate in my stark hospital room:
o Mihintale, ancient Buddhist site deep in the heartland of SL
o Biking tours of Kandalama area
o Anuradhapura, ancient city of Sri Lanka
o Dambulla Buddhist caves
o Discussion on Art, Graffiti, and Society in Ancient SL
o Sigiriya, giant rock with an ancient community on the summit
o Hiking time
o Dalada Maligawa, the temple of the tooth

I should be released on Sunday, which is a holiday for the Fulbright office. Either the driver will take me to a guest house, where a woman will take care of me until Tuesday when everyone returns to Columbo for lectures; or Kumara, the driver, will take me the 100k to Kandy where I can meet up with the group. I hope I can go to Kandy as this would allow me the chance to see the elephant orphanage!

GOD BLESS YOU, Joan! And Karinsa, Callie, Samantha, Jill! Your calls mean so much to me; they are a lifesaver. Hearing your familiar voices breaks the cycle of isolation that I feel here. Joan said, “Don knows you well. He emailed me that Mary would want to join the group before she is recovered.” LOL! I can’t wait to catch up on everything that’s been happening… I will live the Kandalama experience vicariously through your stories and pictures. Jill and Elizabeth drove a tuk-tuk! Sign me up for that adventure.

OUCH… those injections hurt more and more each time. My wrist is red and swollen; I hope they know what they’re doing! At least six more injections to go. Not sure that vein is going to hold up that long.

site of the IV injections

Mom, I know how worried you must be about me, but I am doing just fine (now). Hopefully just two more nights and two more days in this place. Then four days of touring and I will be on my long journey home to beautiful Maine.

Day 4

I’m definitely doing better!

Overcast and gray skies… my friends are off to the ancient city on the mountain. Sigh. Really big sigh. Hiking, fresh air, rocks, trees, archeological ruins, mountain views – this sounds like heaven to me right now. I can’t wait to hear all about it.

OK, let me gripe a little. Sleep was fitful as the one sheet on the bed routine just doesn’t comfort me like a light blanket or puff. With the AC on it’s too cold, with it off, yup, too stuffy and hot. While I’m complaining, I might as well mention that the allotted one tiny bar of soap is rapidly diminishing as I also use it to wash my hair and my clothes. And the one thin green towel is a little musty after 4 days of use. Let’s not forget the bugs crawling over the surfaces of my desk and nightstand. Worst of all, the injections. Man, do I dread those; they hurt tremendously, and my vein is swelling up. Food? I am forcing myself to eat a little. However, they do bring me tea three times a day!

my little green towel

On the plus side: Dundars Hospital is one of the best in Columbo- it’s one of two private hospitals in this city of 2+ million. Care is constant; I’m seen by ‘ward doctor’ – unusually bright and attractive young men and women – at least 2-3 times a day. Nurses pop in constantly, and in groups of 2-3. My admitting physician and specialist have come to see me every day. Apparently this hospital attracts the best physicians and doesn’t have the shortage of nursing staff that government hospitals have.

YEAH! Don called again! He sounded tired with work and home issues, and his worry about me obviously adding another layer of stress. After speaking with my brother Mark about my medical condition, he actually felt more confident about my treatment, though the way they are administering the augmentin seems different. My mom is worried, but apparently was more frantic over the three days bombings in India when I didn’t have internet to let her know I was OK.

I’ve had a busy morning; Fulbright Director Tissa called and Fulbright staff member Ranmali stopped by to visit at the same time. Tissa has been in communication with Dr. Selvie Perera and is pretty sure I’ll have to stay 2 more days. In his last communication with her, he mentioned that I was keen to join the group, but apparently she is very concerned about the dangerous proximity of the bacteria to the brain, and wants me on IV meds for 5 days. Argh. When she stops by today, I’m going to do my best to convince her that I am doing so much better. If I can be released tomorrow, Tissa will talk with Kumara about using his day off to release me, pay the bill, and drive me to Kandy.

Truly, the swelling is now limited to my nose, and even that has diminished to the point where I can see the nostrils again. The throbbing pain has ceased, and it only hurts if I touch it. Unfortunately it is still bright red; maybe that will be my souvenir from Sri Lanka. Ranmali is preparing for a lot of company tonight, and felt badly that she would not be able to visit again this evening, but left her mobile and landline numbers if I needed her for any reason. I assured her I was just fine, and asked her to tell Soraya not to stop by tonight either.

Dr. Drahaman feels I am doing better and would be willing to release me tomorrow, “but that depends on Dr. Selvie Perera.” He will prescribe oral augmentin and Dalacin C to be taken 3x per day for the next 3 days. Should I have any loose movements, I am to stop the Dalacin C immediately and call him. I am not to touch my nose except to apply the cream 2x per day. He also warned me to expect inflammation for up to 2 more weeks, though I should see gradual improvement every day. Overall, this is excellent news… please please please release me, Dr. Selvie Perera!!!!

Injection number 8. EXCRUCIATING. Liquid fire burning through my tender and swollen veins. I am using Lamaze breathing, prayer, and visualization simultaneously – and not with great results.

Soraya and Chitra both called to check on me – so kind. It felt so wonderful to tell them that I am almost fully well! Both are curious about when I might be released, and I am frustrated by not knowing that myself, as they all need to make arrangements. Soraya wanted to stop by to see me, but I told her no as she has had a long trip from Kandalama. She told me that everyone mentions me all the time: “This picture is for Mary… Mary would like this so much… we miss Mary.” At dinner, the director, Tissa, made a toast to me. Soraya said his words were so moving as he summed up for everyone how much they missed my presence. Wow. My first toast and I missed it!

I used a little American assertiveness and politely inquired of the ward doctor at the desk how I should go about checking out tomorrow. I assured him that there is really no sense taking – or paying for – a room that I don’t really need. He did the head bobble thing and spoke in Sinhalese to the nurses who also head-bobbled. Then he said I need to be discharged by Dr. Perera.

Lo and behold, who comes to my room at 6 PM? I was so surprised – but glad. I asked Dr. Perera if she came just because I was bugging the ward doctor and nurses, but she said no. She was barricaded in her house on Parliament Drive because of the Asia Conference, so she had to make late rounds. She chuckled when I told her she should be at the theater or the movies. After asking how I felt, she quietly said, “OK.” In my exuberance, I jumped up and hugged her right on the spot! I profusely offered my gratitude for her expertise and care which she accepted with grace.

I’m going home at 9 am! No more injections! My room in Kandy is booked, and I will see everyone at lunch tomorrow! Yippee!

I was awakened at 5:30 am for vitals after a poor evening of sleep. “You go home today?” was the query. Breakfast wouldn’t stay down – maybe the ice cold toast and eggs? Maybe the fatigue? Maybe the meds? Soraya arrived at 8:45 to check me out and within 30 minutes I had my discharge, my meds, and my bill paid. (67,000 rupees = $700).

Day 5

I’M OUT!!! Kumara had great difficulty getting us out of Columbo; it took over two hours due to roadblocks. The heads of states of SL, India, Pakistan, Afghanistan, Nepal, Bhutan, Bangladesh, and the Maldives were all in town for the SAARC conference, so this brought the highest security along with 45,000 soldiers. So the length of our trip was doubled as we pulled into Kandy at 2 pm – right behind our Tour Bus that had just finished its morning trip to the Tooth Temple. I can’t wait to run in after everyone!

view of coastal Columbo

Brian, look at that billboard for mtn bikes!