Panama 2019 Day 12: Bad Echo

Gloria’s grandson Gabrielito, who is just turning seven, was born with Tetralogy of Fallot, a complex heart defect which used to be fatal. There are multiple levels of medical care in Panama: private pay, which is much like care in the U.S., a second tier for people who have Seguro Social — where Minga got her dialysis treatment — and a third tier for people without. That’s where Gloria and her extended family get care. Suffice to say they have the longest waits, the least access, and the least time with providers, who prioritize their time with private pay patients and Tier #2.

When Gabrielito needed surgery to repair the multiple defects of Tetralogy of Fallot, his chances of getting it in Tier #3 were remote. I paid to get him into the private system, which got him onto the triage list for a one week a month medical mission from a U.S. hospital. A team of surgeons, nurses, anesthesiologists, and other support people came for that week a month for a whole year, just doing complex heart surgeries. Even with that, Gabrielito kept getting bumped by children who had families with more political connections and influence. Finally, at about age 18 months, he got his repair.

Each year since then he’s needed an echocardiogram, and up until now the results have been okay and he’s not needed a cardiology consultation. In his most recent echo, Gabrielito’s mother Fani had under five minutes with whoever read the echo, and got the message that the echo was not good and Gabrielito might need more surgery. She is, as you can imagine, quite worried. An appointment with a cardiologist in their Tier #3 system will take many months.

I asked for help from friends in the U.S. who have access to peds cardiologists to help me formulate questions, and then I told Gloria to make an appointment with a private pay cardiologist. My guests Sally, Michael and Lynn all gave Gloria tip money for her work here in the villa, and that will pay for the visit and any tests that need to be done — plus passage to and from Panama City for Gloria, Fani, and Gabrielito. There will be enough left over for them to get food while there.

The private pay appointment is happening on Thursday. Gloria’s comment was an amazed “Look what money can do.“.

Will keep everyone posted on what happens on Thursday. There might be some delay in getting a full report, because neither Gloria nor Fani can get a copy of the echo to take to the doctor appointment. Only the doctor can make the request that the echo be sent to him.

Hoping for the best.

4 thoughts on “Panama 2019 Day 12: Bad Echo

  1. Keeping Gabrielito and his family in my prayers. He holds a special place in my heart. I know the worry that comes with having a child with complex medical issues. Please give everyone my love. I will be anxious to hear about the appointment.

  2. for Katie: As always the medical system here for the poor frustrates me. The doctor can request the echo from wherever it was done, but Gloria and Fani can’t. That likely means he won’t have it at the appointment. Whoever Gloria talked to said they would likely do an EKG, but that and an echo show different things. So there may be some delay until all of the info is in one place before a diagnosis can be made. But there is an appointment for Thursday. Am sitting with Gloria and Fani today to go over questions for doctor. Grateful for your help with that.

  3. for Randi: Thank you, and I will let Gloria and Fani know that you are praying for them. You do know what a worry this is.

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