One of the concerns people have about moving abroad is what happens when you are ill so far away from home. Being seriously ill can be a scary business and going through it in a foreign country lends an extra level of stress. In my previous post, I described the symptoms I felt when I had a heart attack in March 2014. When I awoke the next morning I was still unsure what had happened, by the end of that day I was facing a 5 day stay in a Kuwait government hospital. Here is the story of what happened next.
Mornings in Kuwait come early. The call to prayer echoes around the buildings as the sun rises. It is a feature of Kuwait that I love; there is a musical lilt to the summons to greet the day with God and, whilst I am not a Muslim, it always reminds me I am home. Working in Kuwait also ensures an early start. When we first arrived in Kuwait 5 years ago we would be up for school at 5.40 am at the latest – something of a shock for a family who thought 7.00 was a struggle in the UK!
When I woke up the next morning I felt tired and my left bicep throbbed. Beyond that I felt fine. I didn’t feel nauseous or light-headed, my breathing was fine and I had no pain or tightness on my chest. In fact the whole of the previous evening’s event seemed a little silly and somewhat blown out of proportion. What I most certainly didn’t feel was sick. In myself, other than a little tiredness, I felt absolutely normal. More than anything else, when looking back at everything that had happened during those 5 days, this was the thing that scared me the most.
I had already agreed, the night before, that I would go to the doctors in the morning. I knew something clearly wasn’t right. However, as I sat on the edge of the bed, contemplating how surprisingly good I felt, I was already trying to postpone my visit.
“I could go into school, register my class and then go the doctors,” I explained to my husband. “I’m not teaching until after first break. I’ll have plenty of time to go there and back. It can’t have been anything major otherwise I wouldn’t feel so good this morning.”
Thankfully, my husband is far more sensible than I am and immediately knocked that idea on the head. Being not only my husband but also my boss there wasn’t really a lot I could say in argument. In the long run, I am eternally grateful to him for being so direct about it. There are moments when I wonder what could have happened had I actually had things my own way!
So, we launched into our usual morning routine, albeit with me moving a little slower than usual. The boys of course were curious to know why I wasn’t going to work and I fobbed it off as, ‘mum was a bit sick last night. I’m just going to the doctors to check it out.’ Lunch boxes were safely stowed in school bags, ties straightened and my 3 boys left the house with me promising my husband that I would update him as soon I had some news. Within 20 minutes I too was on my way, not knowing at the time I wouldn’t be back for nearly a week.
As you will know from my post, driving in Kuwait is always interesting. Mornings can bring an extra challenge as everyone heads out to school or work. That morning, the rush hour was no different. A snaking line of cars stretched ahead of me. As I geared myself to face it, my left arm began to throb again. I almost immediately tried to ignore it and then rationalise it. It’s only sore because of last night, you are just more aware of it because you are using it to steer the car. I was just beginning to feel the first tingles of panic set in when I was interrupted by the phone. Upon arriving at work my husband had explained to his boss, our Head teacher, what had happened the night before. She had, in no uncertain terms, told him to immediately head off to meet me at the clinic. She had clearly had a better understanding or acceptance of what had happened even if we had both refused to see it. Even though he was less than half a mile behind me, we both knew it would be at least 30 minutes before he would catch up to me. Oh, the joys of morning rush hour!
Kuwait has an National Health system not dissimilar to the original vision for the British NHS. The service is funded by the government with patients asked to pay a nominal fee of 1KD (approximately £2.20) for each treatment, with the consultation, tests and subsequent medicine included in the price. One of the key differences between Kuwait’s NHS and that of the UK is the issue of waiting times. In most cases in Kuwait if a problem is detected, or even suspected, tests are done straight away, on the day, or at least booked to be done within the next week. Results are returned immediately and discussed with a doctor on the spot. Whilst Arabic is the main language of the country, the doctors and nurses are able to speak clearly in a range of languages. The care that is offered is available to anyone who has residency and a valid Civil ID and many expats take advantage of the easy accessibility of quality health care.
There are those who prefer to use the private healthcare available with the wide range of ultra-modern hospitals across the country. The International Clinic is one such company, situated in the busy area of Salmiya. It provides an invaluable and speedy service offering a range of medical treatments from x-rays to barium meals. In fact pretty much the only thing it does not offer is overnight treatment. We have been there for coughs and colds, to have warts removed and for my husband to have a full array of tests for a long running illness.
It was quiet when I arrived and I was guaranteed a quick appointment. My husband still hadn’t arrived when I was called and I somewhat reluctantly went in without him. Our usual doctor wasn’t available so my appointment was with a doctor I had never met before, Dr Rob. He greeted me with a smile and asked me to sit down and explain what my problem was. Even as I went through the previous evenings events, I kept hoping he would shrug it off, attribute it to a trapped nerve or something similar. I was faced with the usual questions,
“Do you smoke?” “No!” “Do you drink?” “N0”
“How often do you exercise?” “Not often enough,” was my shamefaced reply. Exercise is something I have never been able to develop a love for. I know it is something I should do but I find it hard to motivate myself or maintain a routine. I’m very good at showing enthusiasm but very bad at turning it into actions. Having been very underweight in my late teens, through no fault of my own, I was advised by a doctor not to exercise for a while. I have taken this to be a life time prescription and having yet to find a sport I enjoy. My desire to exercise is generally non-existent or at best highly reluctant.
“Mmmm…” was the reply. I squirmed with shame.
“What you are describing does sound like a heart attack,” he said, to my horror. “However, you certainly don’t look like a someone who has had a heart attack and your life style doesn’t identify you as being at risk of one. Let me check your blood pressure and listen to your heart and then I shall send you for an ECG to check what your heart is doing. We’ll also organise a blood test so we can rule out the possibility of an attack and then think about what might have caused the pain.”
He sounded so calm that I was instantly reassured and happy to forget his original confirmation. My blood pressure was taken and was fine; a little on the low side but nothing to be concerned about – I have always tended towards low blood pressure, even when I was pregnant. He listened to my heart and couldn’t find anything out of the ordinary. All in all, on the surface of things, it looked as though the possibility of a heart attack was becoming less unlikely. I went downstairs and had my ECG, which I was told looked clear, and to have my first needle of the day. As I sat waiting for my blood test I began to feel calmer; it really wasn’t as bad as I had quietly feared. Nothing to worry about.
My husband arrived at this point, looking a little harassed after his run in with Kuwait’s rush hour traffic. I explained everything to him as we sat outside Dr Rob’s office. I saw in his face the same concern I had felt replaced by a calm certainty that the situation wasn’t actually as bad as we were beginning to fear. That of course made me feel even more confident. By the time we were called back into Dr Rob’s office, I was already working out which lesson I would be back in school for and what I would need to cover with the children, as well as thinking ahead to the Cub’s Session I would be involved in that evening.
Dr Rob quickly got to the point,
“Your ECG seems to be fine but as this the first one you have had here I have nothing to compare it to so, on it’s own, it doesn’t really give us enough information. Your blood test results are back but I have to confess that I think there has been a mistake and I would like to run them again, if you don’t mind,” he said. “It will take about 30-40 minutes to get the results back. You may wish to wait in the clinic but if you want to go and get a coffee and come back that would be fine.”
We headed back downstairs, feeling slightly bemused but happy to steal the opportunity to get a quiet coffee together before heading back to work. I had my second blood test of the day and we wandered off into Salmiya high street to find the nearest Starbucks or Costa. Many expats remark on the seemingly infinite array of coffee shops available in Kuwait. Multiple outlets of the most famous brands can be found in close proximity to each other, interspersed with a range of other smaller establishments. Drinking coffee is practically a national pastime, enjoyed across genders and age ranges.
We didn’t have far to travel before we discovered a quiet cafe offering an interesting range of drinks, snacks and shisha. The decor was an odd mix of Eastern themes with a scattering of plush velvet cushions. We sat on benches beneath a white pagoda, sipping hot chocolate that was extravagantly laced with whipped cream and marshmallows. Our conversation focused on our plans for the rest of the day, Cubs that evening and our plans for the long summer holiday and the need to book our tickets sooner rather than later. In fact, the only thing we didn’t discuss was the reason we were not in school. It was almost as if we had both had accepted that it had been a false alarm. Something we would take notice of and maybe laugh about in the future,
We sauntered back to the International Clinic, enjoying the early heat of spring; comfortable in our confidence that life was ticking along exactly the way we wanted it to.
Upon our arrival at the International Clinic we were immediately shown into Dr Rob’s office. His face was serious and his tone was grave.
“Your results are back and I’m afraid it appears that you have had a heart attack!”
I swear the world stopped spinning, just for a moment. Everything seemed to move in slow motion and I felt I was stuck in treacle, not quite able to process or understand what was being said.
“The blood test we did was looking for a particular protein called Traponin,” Dr Rob explained. “A normal reading is 0. Anything above that indicates there has been a problem with the heart. Your reading is 0.8. Now, as I said to you before, you show none of the visual signs I would expect of someone who has had a heart attack which is why I asked for the test to be done again. The results, however, are the same and clearly indicate that you have had some form of a heart attack. The next step now is to get you to Mubarak Hospital where they can repeat the tests and decide what the next steps are.”
I heard every word Dr Rob said but found it all unbelievable, as if I was watching it happen to someone else. My stomach roiled as if I was on a boat in a storm.
“I’ll bring the car round,” said Ben. “It’s just downstairs.”
“I’ve already called for an ambulance,” replied Dr Rob. “It’s the safest option. We’ll take you downstairs and hook you up to an ECG to get some readings while we wait. I can have a wheelchair brought in if you’d like.”
That snapped me out of my reverie. What was he talking about? A wheelchair? He had to be kidding. I felt fine; a little tired but fine. There was no way I was going down in a wheelchair like some invalid. Not when I could walk perfectly well, thank you very much!
“I’ll be fine,” I declared. “What is likely to happen at the hospital? How long will they want me stay?” I was trying to figure out if I would make it to Cubs later that evening.
“As I said, they are likely to repeat the blood tests we’ve done. If the results are negative then they are likely to send you home. If not, then you can expect to stay in for around 3-5 days.”
Bugger that, I thought! The whole thing was clearly a false alarm and I was already adamant in my own mind that I would be home by the end of the day. I decided that bluster and denial were my best approaches for the time being. I practically marched downstairs, determined to prove I was absolutely fine. As we entered I was rapidly bundled off by a plump Filipino nurse who saw through my charade immediately. She brooked no bluster as I was hooked up to an ECG, a sensor attached to my thumb to take my pulse and oxygen mask fitted to my face. At this point the reality started to sink in. As my husband took a moment to duck out and call school, I suddenly felt totally helpless and lost. I had no idea what was going to happen next.
Before I knew it my transport to the hospital had arrived. Two charming Arab men, whose easy manner helped reduce the natural stress of the situation, guided me into a wheelchair, much to my charaign, and took me to the ambulance. The whole situation felt surreal, it was as though I was detached from reality. The fact that I still felt absolutely fine didn’t help the situation. I didn’t want to be there, I didn’t feel I should be there, I just wanted to go home, climb under the duvet and hide from the world.
My husband throughout the experience was trying to make me relax and smile, even taking one or two photos for ‘prosterity’. I think even he felt as though I would be back home by the end of the day. I was glad to have him in the ambulance, travelling backwards on Kuwait roads is not an experience I want to repeat again.
When we arrived at the hospital I was quickly wheeled inside, given a repeat of the tests I had already had and told I would have to wait until my blood tests returned before I would know any more. As Kuwait is a Muslim country there are strict rules for the separate treatment of men and women in hospitals. I was to be taken through to an all women’s ward into which my husband was not allowed. The thought filled me with dread. I was to be in a ward, on my own, surrounded by people who’s main language was Arabic of which I could only speak a few words, with no idea of what might happen next. I tried to put a brave face on things but my stomach lurched as my husband and I parted at the door.
Have you ever had treatment abroad? What were your experiences like?
Look out for my next post about my experiences on the wards of an Arabic hospital, the interesting characters I met along the way and what I learnt about my condition.