Medical Writing

Deborah Liao, PharmD

International Adventures in Healthcare, Bolivia Edition

Guess who found motivation to create a new blog post (I know, I suck at blogging and most people don't really care to read anyone else's blog all that much. I'm okay with that)?

But first, this picture of a Halloween dog seen last night in La Paz, Bolivia. I think his face accurately conveys my grumpiness. 

This morning I was enjoying my breakfast of eggs and coffee while the very friendly house cat curled up on my lap for some loving. I've been here a week and she's generally been fine with me, although my host did mention that while she gets along fine with men, she tends to bite women. What I didn't expect was for her to really truly bite me like she was trying to kill something.

With that said, I guess today was my lucky day. Because the instant I took my hand away from her, she struck with such speed and sank her tooth into the meaty part of my hand between my thumb and pointer finger. Which is probably a better thing than on the bone or joint, based on my online research following the incident. At the very least, I knew, from pharmacy school, that cat bites are bad news. So I said F*#K a few times, rushed to the sink to wash the wound immediately, and then applied the closest thing I could find to a disinfectant, hand sanitizer. And then decided I needed to go the the doctor or hospital. 

Because I have no problems with going to healthcare facilities in other countries, and because my Spanish is improving very slowly, I felt more than comfortable running to the ER at Hospital de Los Pinos in La Paz. For 10 bolivianos, I hopped in a taxi and got dropped off. I think because it was a Wednesday morning, the ER was pretty empty and I sat with a woman who was there for stomach pains and we watched the local news coverage about rabies in Cochabamba and the alms for Todos Santos today and tomorrow. 

It wasn't clear to me what the triage system was. You don't go to the window. You wait for a nurse to come out and ask you what's wrong and in my case, it was, un gato me mordio mi mano a la siete y media en la manana (forgive the lack of accents - I'm on a PC) y necesito limpair la herida y necesito recibir un curso de antibioticos. This was 8:30 and I was told that I would be seen at 9:00 am. So I ran out to get cash from an ATM near the Hipermaxi supermarket and came back. At 9:00 am I was promptly brought to the large and clean triage area where the doctor asked me what happened and then cleaned the bite while we conversed in English and Spanish. After being wrapped up and receiving a prescription and directions for care, as well as advice to come back on Friday for follow-up. 

And just a note, in the hospitals here, after you're seen by a doctor, you go to the cashier's window to pay for the medical consult but first you need the ticket from a guy standing near the machine near the window (the C1-005 caja ticket). If you also received a prescription, you bring it to a separate pharmacy window where they print out a bill and you go back to the caja and pay for the prescription then back to the pharmacy window to pick up the medications.

All told, it took me about an hour to be seen and cost me 45 bolivianos for the consult and 46.20 bolivianos for the 7-day course of dicloxacillin every 6 hours (I have an alarm set for every 6 hours to ensure I take it!). From the time I was bitten to my first dose of dicloxacillin, it was maybe 2.5 hours. I'm hoping that there won't be an infection. My hand does hurt and I imagine my body is working hard to stave off an infection. I also skipped my evening workout in favor of keeping my hands clean, not stressing my body with a hard workout, and resting more. 

So, send me healing vibes! I'm a dog person and today just sealed the deal. 

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