The Lucknow Sentinel, 1980-11-19, Page 29—M in an updated abbreviated sum nary of your:
medical hstory which details (1) all surgical procedures .
and their. outcome, (2) all medical problems such as
hypertension, diabetes, heart attacks, :etc., (3) drug.
allergies, • (4) 'current treatments for active mediCal '
problems and (5) the name and telephone number of year
doctor.
—Take with you enough medication should yen develop
"travelers diarrhea". Most medications are torescrip- -,....
tion only.
°BY Gregory DeYore, mg
l[n 1979, 36 million Canadians traveled , to. fereign
countries' On business or pleasure. According ' to govern-
ment• officials, no records are available as to the number
of Capadians who died. while traveling abroad or became
seriously ill. slit the. United States t hoWever, where
approximately 30 minion travel abroad each year,,11,000
died in 1979 and an estimated 1 million suffered , some
'form ofilIness or injury and an-unterd ,number required ••
emergency medical evacuation back to.the United States.
Although billions of dollars will be spent for
:transportation, betel accommodations; sightseeing tours
and souvenirs, few travelers have considered : the
astronomical personal cost should they become seriously,-
in. or even die while abroad. Unfortunately, as in Most
countries, governmept or private bealth insurance dees •
riot cOyer many of the expetises inetirred. Last ear alone
-111TEe'rfureas-fat-e-s-thaoSfekaieded TNin mil lion dollar's
for those requiring evacpation .becauie of illpess, injury
or death. Equally disconSerting iS the' realizatleh that
often neither the Canadian government, nor Other,
governments for that matter, can be of assistanee to the
"stranded traveler". The following illustrates what •
might await.the stricken voyager who is unprepared for a
Major medical emergency abroad. The events are true
and did not happen 'to a friend or colleague,'but to our
family in late. 1979.'
The phone rang at 6 a.m. I answered it, wondering
which •patient was calling. The voice was barely audible:
",Greg; it's Morn, how are you?" "Fine", I replied as niy
thoughts quickly came into focus. My parents had left for
Tahiti three days before for",their dream vacation. I
Wondered why she was dalliiig, and then, before the •
words were uttered, I knew .somethitig was, seriously
wrong. "Your father had a massive heart attack a few
hoiirs ago and was flown from .a small island to Tahiti. He
is in a French hospital. I would like you to call the doctor
and speak to him since you speak French. Your dad is in
a let of pair., and they are not giving him much pain
medication." -Mom," I replied, catch the next
froM 'New York' to Tahiti' and he there AS.' sogn as
•
possible.
The •DC-10 landegat 2.30 a4n.•in Papeete, Tahiti, less
than twenty hours from our first telephone conversation.
-1 met my mother who looked ashen, for she had not slept
in days. As .1 entered my father's room, it reminded me of
many'pietures 1 had seen of hospitals at the tern off the
century in the United States. The loom had an odor of
nilt,Sty alcohol: It was dark gray, A pitcher, smelling, of
old urine, was lying oPeitt. on the tray next to a glass of
water, There was an antiquated cardiac monitor with no
alarm in one corner of the room and Fa.porta,ble cardiac
defibrillator in the other. I beheld a mice-healthy
55-year-Old man lying in bed with surikep eyes and an
aura of impending death on his face,--agonizing•in pain,
pleading for me to do something. It was a pitiful sight. I
was his son, and yeftWas a physician arid could not let
my •emotions interfere.
I quickly turned to the nurse in the dimIklighted room
-anti-asked--h-erin--Frerich-whdt he Was receiving for pain--
medication and when it had last been given: She replied
th athis_-1 a s t medication haeLbee:n five how's ear-lice and- —
that it was similar te-codeine. I suggested that she give
him a stronger narcotic, which she reluctantly did. In a
sport while he began to relaX and finally dozed off to
sleep. A few hours later I met with my father's physician,
discussed the diagnosis and his plans for management.
Although we entertained some management alternativ-
es, I did not want to offend him, knowing that would only-
make things difficult 'and would accomplish nothing at t
the moment.
I asked for permission to read the medical record and
examine my father. This was granted. I noted that his
blood pressure was 200/130. He, had evidence of an.
inferior wall myocardial infarction on the ECG. On
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.Lucknoiv .SentInet% Wednesday, November 2G,. rao.--,T,ge.
a family-nightmare
examination of his heart and lungs, .I found that he was in
florid Congestive heart failOre. This explained why he
was.So short of breath. I asked for the doctor, but he was
not available. I asked to review the chest X-ray taken on
admission, hut was told that one had never been
'obtained. I then requested that the nurse , contact the,
doctor and tell him 'of my findings so • that adequate
medical treatmept could begin. A few hours passed. ,
While I was out' of the room the ,doctor returned with an
inferpiefelifinala my *nether, "Tell your son that this
is my hespital, my patient,. and that he will not tell me
'what to do," My mother's reply;,,.. "Tell him yourself."
I was angered becanse this had taken place in front of
my father. I found the doctor in the' hallwaY and had a
",'long talk" about appropriate conversation in front of a
patient as well as the managenient of congestive heart
failure. After we resolved our "cultural and professional
differences," we returned to my father's room where the
Pr-eifeh7-fifiYifeiaii-Eil.tntn=e7f my.. fithei and 745-iiCiffied
with the diagnesis. He then ordered the appropriate
medication. •
My father's condition improved slowly. He remained
for 12 days'in the "intensive care room" and another 18
days in a -private:room". During' the first part of his
confinement his toilet consisted of a rusted bpcket. My
mother tidied up the room, bought some toilet paper,
towels and soap, washed.his eating utensils, (Since they
were not always cleaned), and' covered the open urinal
with plastic so the smell Would not be so unbearable,
Attempts , to arrange for medical evacuation of ,my
father with the assistance of the State bepartment were
met with frustration. They informed us that (1)
air-ambillance transportation to the United States would
cost $2,000, then $4,000 and finally $10,400, (2) the
evacuation had. to be in .the "igational interest" and (3)
an airplane would fly from Tahiti-Hawaii-San Francisco
over a two •day period. It Was propeller driven, flew at
10,000,7 feet and was less pressprized than a commercial„
airliner. When a request for direct iet transportation
from Tahiti to San Frahcisco was pursued because the
flying time would only be 8 hours instead of 24 hours via
Hawaii, we were - informed that the • cost would be .
$72.,000; paid in full prior to'departure. Frustrated with
the "assistance" from the federal _government, ar-
rangements were made tor my father to return home on a
stretcher by commercial airliner'to Leis Angeles and then
by air-ambulance to San Francisco at a , cost of over
$8,000. Although this was less than optimal because of
the unavailability of cardiac monitoring or resuscitation
equipment, we' took 'the chariee because no other
alternatives, were reasonable.
After finally returning hoMe. my father was hospital-
ized at a local hospital in nerthern California for another
two weeks. My mother had exhausted most of their
personal savings in making arrangements for her
husband's safe return to the United States. The total cost
for hotels, phone ,calls, transportation, hospital, and
doctor bills 'approached $20,000.
After reading the account of one family's struggle to
bring a severely ill father home safely, most people can
imagine-how-their fdinily-und-friendS might respord-its-a—
similar situation. Net all travelers have a son who is a
physicia.n.orspeaks aloreign tongue,-Many- do not have
the 7finaneial resources to draw upon in such an
emergency,
What can be done to prevent this story from repeating
itself thousands of times during the coming year? The
following information has been compiled so that future
travelers might avoid our harrowing experience.
MEDICAL TIPS
--Carry a pocket copy of your most recent electro-
cardiogram which can be obtained from your doctor.
—Know the medications you are taking by both the trade
and generic names as well as the actual dosage in
milligrams, grams. etc,
After evaluating the' mkperience and 'difficulties
encountered in the above story, the following points are
of Utmost importance in obtaining coverage for
emergency medical evacuation: '
—Make sure that it pays not only for transportation to '
the nearest medical facility, but to a hospital near the
individual's home in Canada spthathea2Lshe can Ieturn
seen as possible medical aSidance, This
alleviates the possibility of having to care fora love() one
fora month or !anger in another country while awaiting
clearance to return home by a commercial airliner. This
\ also insures that the mediCal care rendered w111 not be
inferior to that which is available in Canada.
—Inquir the company providing the coverage is
underw This protects the individual should the
company be able to honor their commitments
because ankruptcy, etc.
—If death should occur, make certain that the company
not only provides assistance with making the necessary
arrangements for transportation of the body, but will
incur all expenses for the, transpertation as well.
—Is the cost of the policy affordable for the average
tourist. Beware of coverage which is too inexpensive",
You always "get what you pay for."
---DoeS the company, provide a 24 hour message center so
thatrelatives and friends can telephone toll-free for the
latest "health care information". This can save the
stricken family thousands of dollars and phone callk to
keep family members and friends posted during the
critical time period.
—Does the' company offering the aboVe benefits also
provide; under a separate package, insurance which will
cover all hospital expenses while abroad and pay for
them before leaving to return home. This is important
because most Major health plans, whether government
or private, only reimburse the patient after they or the
hospital have submitted the bill. Hospitals in foreign
countries do not honor this method of payment and
demand that all hospital and doctor bills he paid in lull
prior to releaSe of the patient. '
After much inquiry and investigation, the only
company in the world which proyides all of, the above
services in NEAR. INC., 1900 N. MacArthur Boulevard, .`
Suite 210, Oklahoma City, Oklahoma, 73127, USA.
Telephone (405) 949-2500. According to Mr. Joseph
Travis, Chairman of the board,. NEAR L IK., Will for
all costs incurred for transportation of the ill or injured
home by air-ambulance; is underwritten by Lloyd's of
London worldwide: Pays for and makes arrangements for
thtlfansportatieTti-of the liody should deaTh—o--c-cur: has
memberships which range from a single indiVidual at
$42.00, to an entire family at $48.00 for a full year
regardless of where they travel throughout the world; (I
understand the rates are increasing substantially as of
October 1, 1980), and has a 24-hour me sage center. In
addition to the above, NEAR, INC. note ers 'a separate
benefit which will pay fce all hospital expenses prior to
the return of the patient to. Canada. ,
Travelers and their families who are prepared can thus
avoid the frustrating and costly expense of being stricken
iil or injured, or even dying while away from home on
vacation or business. Unfortunately, many travelers this
season will not take the necessary precautions before
leaving and will experience their own version of a
.$20,000 Nightmare". Don't be one of them!