I find it interesting which things have become scarce in Peru. Like everywhere, toilet paper flew off the shelve at the start of the pandemic. There are actually studies to explain why that happens! Thankfully, TP has reappeared in Peruvian stores with no more limits on buying it. But other things that you might not expect to be scarce have also become hard to find. I asked at about 10 stores over the last week if anyone had mustard or ketchup and finally found both today. (I got my share of 'Mustard?! Seriously? NO! Nor do we have any European white truffles!' looks from store owners) Borrowing a Cuban tactic used to give the impression that stores are full of goods, the local supermarkets fill all the space that varieties of ketchup and mustard used to fill with what they have on hand. In this case, Mayonnaise!
We spoke with the thoracic surgeon at Mayo today after a week of anticipation. She said that Mary Beth absolutely needs to have the surgery but at the moment we can't schedule a surgery because of the COVID pandemic. So pray that it will be possible earlier rather than later.
This afternoon, we had an appointment for a phone call with Meagan, the nurse for the thoracic surgeon at Mayo. Everytime Meagan called, we could hear her but she couldn't hear us. Finally I ended up calling the Mayo switchboard and got transferred to Meagan's department and we could hear each other! She went over all of the risks of the surgery, pain control, pre-op, surgery and post-op timeline, and recovery time. She said that normally there was a 4-5 month waiting list to get the operation! But with the COVID pandemic she wasn't sure what we can expect. We should know more tomorrow.
And now for something completely different:
Our oven of 20 years quit two days before the lockdown started. Since I have replaced several parts on it over the years and it still leaked a bit of gas at times, we decided it was finally time to get a new one. We are so glad it was then, as we have had to cook all of our meals at home since March 16th. Our old oven has been sitting in our back yard since then since we can't take it to the junk yard.
Before lunch, I was riding my bike to the outdoor vegetable market and saw a pickup with a bunch of junk in the back, including an oven! "Hey!" I yelled, but the driver didn't hear me, so I turned around and chased him until he slowed down for a speed bump. "You want to buy an old oven?" "Let's see it!" "Follow me!"
He followed me to our house, loaded up the oven and even paid me $3 for it! If only Mary Beth could sit at the dinner table and look out over the back yard and see that it is gone!
A doctor in Tacna (four hours away) that I've been corresponding with by email, called me today. As far as I can tell, he is the only doctor in Peru that does this surgery on adults. He learned the procedure in Spain. He does 3 to 5 cases a year on adults and seems very careful, competent and was nice to talk to on the phone. So there's another option if things with Mayo don't work out.
Not much to report. Thankfully, Mary Beth is feeling better today. She's not so dizzy and not so achy. Only her head ached today.
So what does she do all day? Since she can only be upright for about 30 seconds at a time before her blood pressure bottoms out, she mostly lies down. She moves from the bed to the couch (where she eats all of her meals) and even to a camping mat on the floor in the living room throughout the day. She listens to sermons online and talks to her parents and siblings on the phone. She reads about her condition online and watches YouTube videos about the surgery. And she's counting down the days until her video appointment with the surgeon! Pray our internet and electricity don't go out on Friday!
Happy Independence Day to our American friends!
Mary Beth says she is feeling much better today. Her body aches and head ache are better. We've worked on more exercises (moving her arms and legs every 15 minutes while lying down), different positioning of her neck (no pillow) and massages. She feels about the same wobbly-wise when she gets up.
The insurance company called to say they had found a doctor that does the surgery Mary Beth need in Lima. "Let's see, his name is, Victor..." "Gomez?" I said, helping her find his last name. "Yes! Gomez!" "Yes. I've talked to him. He only does this surgery on kids up to 17 years old." "Oh."
So for now, we are just waiting for our video appointment with Dr. Jaroszewski at the Mayo Clinic on Friday, July 10th to decide what to do. Pray that she has operating room openings soon after our initial visit with her.
Mayo sent us all of the paperwork to fill out today, which Mary Beth did dutifully despite not feeling particularly good today. She feels more wobbly today when she stands up and she's having some tingling in her hands. It seems that changing the position of her head is helping the tingling. She only stands up to go to the bathroom or to move from the bed to the couch, otherwise she has to lie down.
Just got back from Mary Beth's echocardiogram. We had hoped to measure how well her heart is pumping while lying down and compare it to when she is standing up when she gets tachycardic and her blood pressure drops to nearly nothing. On the way there I was praying that God would provide a parking spot in front of the clinic, as Mary Beth can't walk very far. There was the most traffic that I've seen since March when the quarantine began. Not a good sign for those wanting a parking spot. Just when we arrived at the clinic, a car parked in front pulled away leaving a spot at the door. God really does take care of the little details too! I sent the cardiologist a message that Mary Beth can't walk or be upright for very long, so to let me know when he was ready for her and I'd bring her in. When he was ready, we walked in, but while waiting for the elevator, Mary Beth nearly passed out, so we had to get a wheelchair.
The cardiologist tried to do the echocardiogram, but because of Mary Beth's pectus excavatum he couldn't see all four heart chambers at once to calculate her ejection fraction or stroke volume. He thought the myocardium looked healthy but it doesn't have any space to work. He said it was displaced to the right side quite a bit. He kind of had an amazed, "How have you lived 37 years like this?!" look on his face. He said we could get a cardiac MRI to calculate her ejection fraction, but we really have enough information at this point.
Perhaps the most amazing part of all was when I asked him, "How much do I owe you?" He replied, "Nothing. I couldn't do the study."
Speaking of money, I turned in my insurance claim for the month of June. It included a CT scan, a Holter monitor, lab work, medicines, specialist consults and COVID tests. Total: $367.72. Yes, doctor friends in the USA (Dr. Porter and Dr. Schmidt) didn't charge me for internet consults, but it still seems pretty cheap compared to the USA.
Great news! Dr. Jaroszewski at Mayo has agreed to take on Mary Beth's case. She will have an appointment via internet on July 10th! That's only a week and a day, so we are very thankful!
Haven't heard from Mayo yet, but they are still eating lunch in their time zone and are known for being a well-run organization, so I'm confident we'll still hear from them later today. I just talked to the cardiologist here and arranged for Mary Beth to get an echocardiogram tomorrow at noon. Pray that it clears the picture instead of muddying it!
Mary Beth is feeling weaker than yesterday. For the medical people, her orthostatic blood pressures may interest you: Supine she is 110/75 but standing her BP is unreadable. Her heart rate goes from 75 lying down to 115 standing up. This is about what she has been running since I started checking two weeks ago.
Mayo emailed to say that Mary Beth's CT scans didn't upload to their system and asked me to try again. Moments after I uploaded them again, they wrote back to say that they got them and they will look them over and get back to us.
This morning we went to the lab to get tested for COVID. Mary Beth lay down in the back seat of the SUV and did pretty well traveling. It was pretty scary being in a crowded room full of people getting tested for COVID. I mean, they have a reason to be there, right? Like they think they might have COVID? Thankfully, the lab tech came out and poked Mary Beth's finger in the SUV. Two hours later we got the results, which were the expected 'Non-reactive'. Since there are so many false positives, it wasn't a sure thing. She's actually feeling better today. She isn't feeling so completely wiped out after simple things like going to the bathroom or sitting up to eat. "I can stand for 30 seconds before getting wobbly. Yesterday I felt wobbly immediately after I stood up."
I'm trying to find out if the surgeons that the insurance company is trying to line us up with actually do this surgery in adults. They've not been very transparent, and haven't answered the questions, "How many cases do you do per year in adults?" "Do you have the necesary materials to do the surgery?" Hopefully, we'll be able to get answers to these questions soon. I was told that the chief surgeon will get in contact with me to answer my questions.
The medical director did call me, but he wouldn't answer my questions, but instead requested that we get another CT scan that shows she doesn't have COVID despite the negative tests we've done. I think they are terrified to bring in a possible COVID patient to their hospital. Of course, they are increasing her risk of contracting COVID every time they request another outside study.
Great news! The Mayo clinic in Arizona emailed saying that they would set up a video consult tomorrow with Dr. Jaroszewski, one of the world's experts on pectus excavatum. Hopefully, we won't have to wait too long for the consult. It looks to me that God is closing the door on Lima and opening the door for Mayo. Pray that He continues to guide us clearly.