Friday, Jun 28, 2019

Hernia Surgery in Cuenca

It has been quite a week. I rode two different buses for the 8 hour trip to Cuenca from my place on the coast. It was time to see a doctor about what I suspected were bi-inguinal hernias. Sure enough that is what I had. The trip up was nice enough though. The bus stopped along the way going up the Cajas. It is always fun to be above the clouds.

Clinica Latino

Clinica Latino

My appointment with Dr Andres Astudillo at the Clinica Latino was Monday at 4:30pm. After confirmation that I had bilateral hernias, he and I talked about when he could perform the surgery. He told me he had a case scheduled for Tuesday and Wednesday mornings, and Thursday was open. I could be the second case Tuesday or Wednesday, or his first case Thursday if I wanted.

I just wanted to get it over with, so after I asked him if he felt he could do as good a job with me being his second case vs his first case of the day, I opted for Tuesday morning at 11 am. Isn’t this amazing? Where else can you visit the doctor and have surgery the very next day.

Surgery Day

I checked into the Clinica Latino located at 3 de Noviembre y Unidad Nacional at 730 am Tuesday morning. I was escorted to an area to give all my pertinent data. Dr Astudillo speaks perfect English, but the nurses in the clinic pretty much only speak Spanish. I was feeling proud of myself that I was able to answer all their questions and get myself checked in using my current Spanish abilities.

After having my vital signs taken and blood drawn, I was wheeled up to my room. It was room 307 and I was impressed, even before going into the room. Outside my room was a very nice conversational area with comfortable looking couches and chairs. In my room I found it well appointed with a couch, two chairs, a flat screen TV, a huge bathroom and shower, and of course my hospital bed. Dr Astudillo later told me that my room was part of a recent remodel the clinic had completed.

Prep Work

After I changed into the paper gown, making sure to secure any rear exposure ;-), I sat patiently on my bed. When the nurse entered she had her razor in hand.  “Uh oh”, I thought. After several minutes I was as smooth as an infant, and several minutes after that I felt very itchy as my skin reacted to the razor burn.

I didn’t have too much time to dwell on that however because the ECG machine was rolled in for a check of my heart. For as modern and up to date everything was, this machine seemed out of place. It used yellow and red metal clamps that were put on my ankles and wrists. It gave me the distinct feeling of being a convict in an electric chair.

The electrodes themselves were small, blue suction cup-like things that the nurse stuck in various places on my chest. Some suction cups wouldn’t stick until she went for the scissors and trimmed away my chest hair. After a few minutes though, I was properly “electroded up” and ready for the ECG. It showed a perfect and healthy read of my heart activity. Surgery was a go.

Propofol Is the Best

Soon I was wheeled into the operating room suite which looked clean and modern. I placed myself on a narrow metal table and the anesthesiologist began an IV. He filled my body with various medications to bring on a quick slumber. What is interesting about going under anesthesia is knowing, after I close my eyes, I would be opening them up again in what would seem like only a blink of an eye to me.

My surgery began around 11:30 am and the next thing I knew, I was in recovery looking at the clock on the wall which read 1:45 pm. I actually felt totally fine and very clear headed when I woke. I asked the nurse various questions because I wanted her to know I was with it and ready to go back to my room.

Friends Matter

I knew my friend Scott was waiting in my room. He came to see me before I went into surgery and waited until I returned to my room to make sure all was ok. Aren’t good friends the best? I figured however after 3 hours or more hanging in my room he was probably bored out of his mind and ready to go.

As much as I tried to talk to the nurse and convey I was ready to return to the room, she wasn’t having it. Finally she just told me to not talk. Sigh. While I was in the recovery room though, the nurse did show me the old mesh that the doctor removed before replacing it with the new and improved replacement mesh. The doctor also shared a pic he took internally while doing the surgery.

I was lucky. The old mesh had migrated laterally over muscle tissue so it could be removed. If it had lodged over the “triangle of doom”, which includes several arteries, the doctor would have to leave it in. I guess you don’t want to be poking around an area with “doom” in its name. At a quarter to three I was wheeled back to my room and greeted by Scott who had been patiently waiting.

I was looking forward to eating. The nurse told me I couldn’t eat anything until 8 pm. I hadn’t had any real food since 2 pm the day before. When eight o’clock finally arrived I was given a cup of herbal tea? Wtf man. Despite my best protests my pleas fell upon deaf ears. Maybe I need to learn to swear better in Spanish.

Discharge

When setting up the appointment for surgery, the doctor mandated I stay one night at the clinic. At first I balked about doing this. I was 40 years old when I had hernia surgery on my right side. It was “same day” surgery, being released home shortly after the surgery was completed. Dr. Astudillo explained to me that this hernia surgery would be longer and more involved because of having had the first surgery. His logic made sense.

The next day I was discharged and stayed at my friend’s, Aurobindo’s, place. He has a great apartment located close to restaurants and grocery stores so I didn’t have to go far for things. The next few days were more uncomfortable than painful, but using round the clock ibuprofen kept the discomfort under control.

This week turned into a week spent binging on Netflix. I think I made it to episode 17 of Limitless so far. Auro, being the good friend he is, kept me in scotch to help with the discomfort too. Like I said, good friends are important.

The Bill

My experience with the medical staff and facilities at Clinica Latino was excellent. Dr Astudillo, as well as some other doctors practicing there, are US Board Certified. I felt everyone was very competent and professional. Unfortunately I had to pay for this surgery out-of-pocket since I went outside the IESS insurance system to have it done.

The total bill came to $4100. I think that is pretty reasonable. Before I left the States I paid out-of-pocket for a colonoscopy. That bill was $5000, so I guess for a two hour surgery and an overnight stay in the clinic it is a reasonable charge. Honestly, I’m just happy to have it over.

My follow up appointment today with the doctor went well. Everything is great as far as he is concerned, which I was happy to hear. I have a lot of swelling and bruising which he says is normal for what he did. My biggest complaint? My scrotum is the size of a grapefruit. Damn man, that is just not natural, and definitely not comfortable.

Hopefully I won’t need to buy two seats on the bus going home tomorrow. 😉

Chau