~Juliana right before surgery~
~Juliana five hours later~
~the famous heel~
~one of four IV attempts~
~the bandages are off: one day post-surgery~
The truck came at the end of July and about one week later things were starting to feel settled around here with the necessities unpacked. Juliana got a tiny splinter in her heel and I tried to remove it with a pin, like have with Pieter many times, but she wouldn't hold still and I hoped I got most of it. Within a couple of days her heel started to swell up with an infection. There was just a tiny pinprick of an opening, so there wasn't much to do to keep it clean. We didn't have our healthcare information yet (which just started on August 1) and Ben wasn't keen on bringing her to the doctor for antibiotics, so we waited and kept trying to clean it out and released the pus. About one week later I said it was definitely long past time for some medical care, so Ben found a doctor and we went on Thursday to a pediatrician. The immediate prognosis was hospital care, starting that night, for a week, on IV antibiotics, with a surgery to clean it up. We got bounced to another pediatrician and then a surgeon all in the same day.
It was an eye-opening experience to see what healthcare would be like in Puerto Rico. The waiting seemed like it was forever (a couple hours at the surgeon), but the co-pay of $8 was minuscule in comparison to our health insurance in South Dakota. We had time in the middle of the day to go home and pack some bags for the hospital and by that evening Juliana was checked in. Even though the hospital was a bit run down, it was run very well by the employees. Our only expense for the hospital was a total of $59 - if we had been in SD it would have been in the thousands by this point. With cheaper healthcare, some things aren't provided, which we didn't expect, so I had to make another trip home to get sheets, towels and blankets. While I was gone, the nurses attempted to put in her IV port and failed in both hands. The poor little kid was so upset. I then helped hold her and they got one in the arm. We then settled down for the night, thinking about the surgery in the morning.
The nurses came in around 6:30AM to get us going and I got Juliana in her hospital gown, which she really hated, as the first picture shows (I guess whether you are old or young, those are just horrible). It was so big that we had to cut it down with scissors. Ben and Pieter came in soon and then I went with Juliana up to the OR around 7:30. Her IV port was giving her trouble, so they took that out and said they'd put in another when she was out. The surgeon always takes care of little ones first, so they don't have to wait in the morning without food or water. Jules was then sedated and about a half hour later was in recovery. They brought her down to the room shortly after that and the little girl was as loopy as can be. I laid down in the bed with her and she kept giving me little drunken smootches that were so cute. She finally relaxed and then fell asleep for a 2.5 hour nap. After that it was a day and another night in the hospital on antibiotics. The next morning Juliana had a shower with her bandages off for the first time. The surgeon came, said it looked great, and that we could go home on oral antibiotics.
Overall, it was a positive experience. Who would have know that a little splinter would be our first experience for a hospital stay? I found it interesting that most of the nurses knew very little English, but the doctors and the janitors were very competent. The one nurse that was fluent in English had been in the marines for eight years and came back home to get away from the wars. Ben and I theorized that the nurses stay in PR for schooling, but the doctors often go elsewhere and the working class/janitors probably have spent time in the US working.
Anyhow, our little girl is on the mend, with lots of down time to leave the foot free of bandages to heal faster. And now I can get back to unpacking...