quinta-feira, 10 de janeiro de 2013

Medical Care Done Differently

In the United States, if a doctor wants you to pee in a cup; (s)he has the nurse on duty give you a little cup and sends you to the closest bathroom. The nurse then labels the cup, puts it on a tray, and sends it off to the lab (either located elsewhere on the premises or at an off-site location). If the doctor wants blood tests done; the process is very similar except there are no small plastic cups and uncertain hands involved (unless it is the technician's first day on the job). 

Here in Brazil, the process is different. When the doctor wants to test your urine or your blood, (s)he writes you the equivalent of a prescription. You then take that prescription to the lab and schedule your own lab work. When the tests are done, you pick up the results and bring them/send them to your doctor. You pay the lab and the doctor separately--though, if you're lucky, both will take your insurance. 

At my last doctor's appointment, I was told that I needed to get a precautionary shot/vaccine because my blood type is Rh negative. The shot will protect my baby and any future babies from being attacked for positive Rh antibodies should they happen to take after their father who is Rh positive. I'm on-board with this concept--I certainly don't want my blood to hurt my baby. So, the doctor wrote me a prescription for the kind of shot that I need, and then she told me that it was currently very hard to find in Rio and that I might have to contact a lot of pharmacies to procure it. 

Yes, you read that correctly. Unlike my experiences with shots in the States in which the doctor sends in his/her helpful nurse with a vile (but convenient) vial and needle as thick as your arm, I will need to find the drug and have it administered by a trained professional off-site. And the fun part? I have a window of one-week in which this vaccine will be effective. 

So, for the past several days, my husband and I have been on a noble quest to find a shot that could potentially save my child from terrible complications/problems. How does the quest work? We contact area pharmacies--fortunately, Rio, has a least two small pharmacies on every street (no Wallgreens here, my friends). We have contacted over 20 by phone and walked into several to see if they have this shot... My doctor was right; it is a difficult vaccine to find at the moment. 

Finally, thankfully, today my husband called a pharmacy that has a vial of the generic vaccine (not that we were being particular about wanting the cheap stuff at this point) to sell us. This evening, the pharmacy will deliver the medicine to his parents house (they're much closer to this particular pharmacy than our apartment is) where we will be eagerly waiting to receive it. The delivery boy/girl, who will apparently be trained in the art of medicinal injection, will then administer the shot for an additional fee. I am thankful for this (even though my sister-in-law has promised me that they'll definitely administer it in the butt--I haven't had a shot administered there since early childhood, but whatever). 

What seems so crazy to me about this whole situation is that this is how medicine is done here in Brazil. Every step is specialized. Each part ix separate. All the bits are in the hands of the patient to juggle and coordinate correctly. That's crazy! But, I guess in another way, it's not crazy; it's just different than what I'm used to... Brazilians say that it is more cost efficient, that it saves time, money, and red tape; and, goodness knows, the US Medical System struggles with the burdens of time, money, and red tape...

Medical care here seems crazy, but, really, it's just foreign. And, with the help of my supportive husband, I'm learning how to work within the system step-by-step. 


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