After the appointment I had to get to the “surgical center”. They don’t do procedures in the medical office, we go to the place where the equipment is located. We think this “office” is where multiple doctors go to use the equipment. They call us a taxi. We arrive 20 minutes early for my rushed appointment at 2pm. Bueno.
The place is supposed to be across from Banorte (a bank). We recognize the bank, but the street number on the building facing it indicates a small, crumbling house-like structure attached to other dilapidated buildings on either side, with no front entrance. There’s a skinny carport with a car in it. No signs. Highly confused, we go up to the carport door and knock. The lady comes out and blabbers in Spanish and we don’t know what she is saying. She is not helpful. She acts like she doesn’t know why we are there, even though I am pretty sure she was the one doc called while we were sitting in the medical office to check on being able to do my procedure that day. We figure out this is indeed the place, as strange as it may be, and she reluctantly lets us in.
This woman was the first person I have met here in La Paz who was not nice. Period. She asked why we were here and I had no words to tell her I needed surgery, all I could say was “laser”. I could not even remember the word for eye which is “ojo”. I know it, but her severe impatience exacerbated my brain freeze. Only one week into our Spanish classes, I couldn’t think of even the basics. I became tongue-tied which frustrated the hell out of her apparently. She huffily told us to sit and wait. Brian went across the street to get cash, they don’t take credit card.
While he was gone, I was alone with the dragon-lady and she proceeded to rapidly grill me in Spanish. I couldn’t understand her. But I understood one sentence very clearly. “How can you possibly live in Mexico and not understand the language?” How is it that you communicate?” I was floored at her rudeness. It wasn’t a question of curious intent; it was more of a statement with a haughty implication of ‘how stupid are you’, plus a little bit of ‘how dare you’ thrown in there. Stuttering, I tried to explain that we were taking classes at a school but she pretty much stopped talking after that, not being worth her time.
I asked where the bano was and couldn’t stop the tears from coming I was so mad. Mad at her, mad at not being able to understand, mad at not being smart enough to remember faster what I DO know, mad at not having a good comeback (it’s hard enough in English), scared of whatever this procedure is going to involve. I’m in a f’ing broken down house, in the barrio, with no sign of any sort, I am paying in cash like it's a drug deal, and the receptionist is a complete b”””###. I return to the stark living room/waiting room sporting just 3 couches, a worn desk with nothing on it but a phone, one lonely filing cabinet and completely blank walls and stare at the cold, dingy, tile floor.
Brian is back by now but I can’t help my tears from continuing. He asks me what is wrong and I have to wait to tell him after she is distracted by another customer. There are 6 of us in the waiting room and this receptionist does nothing but jabber for an hour about food to the other 4 people. I have no idea why she gets paid other than to watch the equipment and make sure no one comes in to steal it. I’m sure she would scold them out of it.
I seriously begin to question my decision. Brian is worried, asking me if I want to leave, am I uncomfortable? Yes, I am uncomfortable. But we think through this logically and the thing that is making me uncomfortable is this person. My dentist’s office was in a former home, as was even my cataract surgery, performed in an old turn-of-the century mansion in Hillcrest complete with waiting room in the former living room w/fireplace and optician in the parlor. I can get over the starkness, deterioration (probably from Hurricane Odile) and non-hospital like qualities of the space. I like the doc and I think I trust him. I have heard only great things about him from several Americans and locals alike. Ok. Breathe. Ignore little miss ‘didn’t eat her frosted flakes this morning’ and focus on why I am here. (Bonus points to anyone knowing who coined the ‘frost flakes’ phrase.)
Doc finally gets here and we go into the equipment room (former bedroom) that Miss Frosted Flakes is guarding. I make Brian come with me. I sit on a stool and face the laser. He puts a small hockey puck over my eyeball so it doesn’t move and starts looking for the tear. Then it’s several minutes of consecutive bright flashes. During every one my left eye closes or squints due to the brightness, forcing the right eye to try closing but it can’t. It doesn’t hurt, I just feel some pressure, but the bright lights force an automatic blinking reaction that you just can’t control. I feel like my eye is moving wildly but he says I am fine. I have a death grip on the table, my forehead jammed against the headband and I am sweating profusely. I am thinking to myself “calm down, you’ve done similar procedures before, stare straight ahead, it’ll be over in a few minutes… just don’t f’ing move”.
After 10 minutes of “lasing”, or creating several circles welding around the u-shaped tear, he declares me done. That's it. Easy, peasy. Could have been much worse. Rest for 2 weeks, meaning no sailing. The strength of the patch comes from the scarring afterwards, not the initial zapping, so exertion is prohibited. I can walk the few blocks to class the rest of the week but only if I go slow. The rest of the time I am to sit and not do much…AKA watch movies. I should heal in about 10 days.
Some interesting comparisons to all my other surgeries/procedures: No assistant during the procedure (low overhead). No signing waivers of who is not liable if I die or become blind. I never saw an actual "medical chart" so I am not sure there is one. No prescription drops afterwards for anti-infection or anti-inflammatory. I didn’t need pain meds, but I wasn't offered any either. Before the procedure, I got a numbing drop and I am guessing another for infection (oh yeah that was the only other thing Miss Frosted Flakes did was put in drops, which she did not bother to try and explain and she almost put them in the wrong eye until I stopped her, after which she got all huffy.)
All in all, it was an experience I hope not to repeat, but if so, at least I know what to expect. I tried to photoshop the above picture to somewhat replicate it from my perspective, but it's more blurry than that. Plus the floater moves around and blurs wherever it falls as I move my eye, so it's in constant motion.
If you get anything out of reading this blog, it should be to immediately seek an ophthalmologist if you notice large sudden floaters and/or what I can only describe as snow or thousands of tiny black dots falling. If you get bright flashes or partial vision shading (I did not), that could be much worse and could already be a retinal detachment or well on its way. See your doctor the same day and do not take no for an answer, or find someone else. Here is a good link to explain retinal tears and posterior vitreous separation.
Ride to the office: courtesy of the gracious Andrea from Se Habla La Paz
Office consultation: 600 pesos
Taxi to surgical center: 80 pesos
Procedure: 6000 pesos
Taxi back home: 200 pesos
Really nice dinner w/ drinks + dessert after a difficult day: 600 pesos
Currently at about 14.5 pesos to a dollar made the entire day about: 7480 pesos / 14.5 = $515
The procedure itself was about $414. I read one blog whose uninsured retinal tear procedure cost $2000 in the states and that was 4 years ago. No telling what it is now. I am under TriCare standard, living outside the US, which means I pay for everything out of pocket. Will see if I can get reimbursed for any of it, but I'd say this was a pretty good deal regardless. My mistake was paying for the procedure itself in cash. I failed to understand that I could have pre-paid it via credit card at Dr. Ortiz's office before going to the "surgical center". The center was cash only and although I have a typed receipt, I do not have a credit card statement, so I am not sure if that will be an issue for getting reimbursed.
Just went back yesterday (Tuesday, a week later) and am healing up nicely. Doc says perfect scarring is occurring (70%) which is what makes the tear patch hold strong. The snow has diminished significantly but the floater remains. I have read about others retaining floaters for months afterwards with subsequent dissipation. Or, the floater might always be there with the same intensity or just diminished. Cross fingers it goes away! I'll go back for another follow-up in 3 months, most likely with my surgeon in San Diego in April. For anyone requiring an ophthalmologist in La Paz or Cabo, I highly recommend Dr. Ortiz.