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7 May 2016 / leggypeggy

Poor John and his poor foot in Cuba

Emergency room in Cienfuegos

The emergency room had bed for about four people

We’re back in Australia for a bit, so Poor John went to the doctor yesterday to make sure all is okay with his right foot.

Just a few days ago, he thought everything was fine but, on the flight home from the Americas, he felt some unusual twinges in the ‘offending’ foot, so booked a follow-up appointment (more about those results below).

If you follow this blog, you’ll know that about a month ago, his foot was hit with excruciating pain. He managed to limp to the bus station in Playa Giron, and we set out for Cienfuegos, where he was urged to get it checked out.

The person who egged him on (besides me) was the hostess at our homestay. Elodia is an endocrinologist and works at the main hospital in Cienfuegos.

After inspecting his foot, she said, It’s gout. Go to the International Clinic and get them to check it out. They’ll be able to help. So after breakfast we flagged down one of those fancy taxis and headed to the clinic.

Cuban apartments

Sights we saw on the way to the clinic

Over our many years of travel, we’ve had some experience with medical clinics and this was probably one of the most basic. For starters, the entire office was being renovated (lots of ladders and workmen) and we snaked our way through the mess to the exam room.

The news wasn’t good.

Yes, it seemed like it might be gout, but they couldn’t/wouldn’t diagnose without a blood test. A test could be booked for the next morning, and results might take awhile because the sample would have to be sent to the hospital. And even if it was diagnosed as gout, the clinic didn’t have the medicine on hand. That would have to come from the hospital, too.

Such a lot of to-ing and fro-ing. While we could have returned the next day for a blood test, we couldn’t afford to wait for an unknown number of days for results and medication. Never mind, we said, we’ll figure it out as we go along.

After this not very promising news, we headed back our homestay.

We didn’t see our hostess again until the next morning at breakfast. She was most dismayed to learn the clinic couldn’t help. She inspected Poor John’s foot again and said, You must go to emergency. I’ll meet you there later. First finish your breakfast. And she whizzed out the door.

Elodia has excellent English, but her husband speaks only Spanish. So when it came time for us to catch transport to the hospital, we recruited him for assistance. Sadly, no fancy taxis were cruising the area, so he flagged down a passing horse cart.

horse cart in Cuba

Ambulance Cuban-style

My Spanish isn’t very good, but I knew he negotiated a trip to the hospital for 2 CUCs (or about US$1 each). So off we clipped and clopped. When we arrived at the hospital, the fellow wanted an extra CUC because the horse had had to go uphill the last two blocks.

Okay, I’ll be honest here. I think that’s what he said, but I can’t be sure.

I countered with—in English—you made a deal at the outset and knew where we were going. The horse might not have known there were two blocks uphill, but you did. And gave him just 2 CUCS and he didn’t argue.

And then we (well Poor John) hobbled into the hospital. The place was packed and I couldn’t see a single sign pointing to emergency. I started asking about emergencia, but no one reacted.

Then a teenager hobbled in with her mum. She obviously needs emergency, I said to Poor John, let’s follow them. The girl hobbled to the elevator, which wasn’t working, and then struggled up the stairs. Poor John did the same.

On the next floor, everyone seemed to hover around one window, so I told Poor John to stay put while I investigated.

Sometimes it helps being a ditzy-looking, non-Spanish speaking, wild-haired woman. I muscled my way up to the glass window where a woman seemed to be taking requests.

After a few minutes, she acknowledged me, and I think I said in broken Spanish, my husband is sick. She asked a question, which I didn’t understand, but I said Si anyway.

We were ushered straight into a room with a vat for mixing plaster of paris. That’s when it dawned on us that we were in the Broken Bone Department.

Oh crap, I said elegantly and, about that time, Elodia appeared, scolding us for not coming to emergency (urgencia) at the back of the hospital. Geez, I never once thought of urgent or urgencia as the word to look for. And if our horse cart driver had been told to take us to the back entrance, he ignored the request because it would have been yet another block uphill.

It turned out that emergency was waiting for us. Doctors and nurses (one gal spoke English) set upon Poor John almost immediately. In the end, he answered heaps of questions, had various blood tests and an x-ray.

Cuba is known for the high quality of their doctors. The country may suffer huge sanctions by the USA, but they send their hugely qualified doctors all over the world.

At the hospital, Poor John had excellent care and dedicated attention. The emergency room was amongst the most basic I’ve ever seen, but it was also spotless. The doctors, who were often accompanied by students (the sign of a teaching hospital), were conscientious and professional. The students were attentive.

After some hours, the results came back. His uric acid levels were okay, so no gout.

The questions continued. When did you break your foot? Never. So it’s got to be an infection and here are scripts for powerful antibiotics. Take them for eight days.

We were definitely puzzled. There was no break in the skin, so how could he have an infection. Nevertheless, we paid the bill (165 CUCs) and headed out with the prescriptions.

I can’t remember how we got back to the homestay, but Poor John decided to rest his foot while I did a city walk with Elodia. You can see some of the highlights here.

The end result
Poor John took two kinds of antibiotics for eight days. Over time and after leaving Cuba, the ‘infection’ subsided, but we both wondered why the antibiotics were so slow to make a difference. He had a few more twinges during our 19 days on a cruise, but mostly everything was fine.

So what about his appointment yesterday?

Many people consider Dr Kingston to be one of Canberra’s best GP diagnosticians. Her opinion, and I think she’s right, was—It was gout. Just because your uric acid levels are normal doesn’t mean a thing. You can still have gout.

The big downside in all this was that he got the wrong meds from the outset. No wonder it took so long for the antibiotics to ‘kick in’.

Cienfuegos main shopping street

The pedestrian shopping street in Cienfuegos

 

85 Comments

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  1. draliman / May 7 2016 7:21 pm

    Nasty, I hope he’s recovering now. I get gout attacks every couple of years or so and just chuck down Ibuprofen, but my brother and dad take regular tablets. It’s amazing how terribly painful it is.

    Liked by 1 person

    • leggypeggy / May 7 2016 8:50 pm

      So many people say how painful it is. Glad it hasn’t hit me—YET!
      Poor John is fine now, and it’s interesting that he got hit with gout because he doesn’t drink any alcohol.

      Liked by 2 people

      • Rhonda / May 8 2016 7:20 am

        My Dad didn’t drink at all either, but he regularly had flare-ups of gout. It’s apparently a myth that it has anything at all to do with alcohol consumption! Anyway, I remember that he was in agony when it hit, so John has my sympathy. Poor John!

        Liked by 1 person

      • leggypeggy / May 8 2016 9:04 am

        He appreciates the support.

        Like

  2. starrywazzoh / May 7 2016 8:21 pm

    Feel bad for John (and a shame Cuban diagnostics didn’t live up to expectations) and I hope he has recovered, but this is an engaging tale, well-described and I “couldn’t put it down”!

    Liked by 1 person

    • leggypeggy / May 7 2016 8:52 pm

      Maybe the medical journals that talk about gout beyond uric acid levels didn’t get through the sanctions.

      Liked by 1 person

  3. ralietravels / May 7 2016 8:23 pm

    To be clear, I don’t support the blockade. Having said that, one of the many sad things about Cuba’s medical system is that Cuba charges for those doctors it sends all over the world but doesn’t pay the doctors except a minimal stipend. It is a source of revenue for the country. The sad result is that many of the younger doctors find it better to stay in the country where they are sent or use it as a jumping off point to go to another country – a talent and skill drain on Cuba that probably isn’t worth the revenue the country gets. But they do get lots of good publicity. And my sister-in-law in Costa Rica has a fine doctor as a result.

    Liked by 1 person

    • leggypeggy / May 7 2016 8:54 pm

      You are so right. Doctors in Cuba make something like $30 a month. No wonder they provide homestays, which earn them about $30 a night.

      Like

  4. Heather Sjoberg / May 7 2016 8:56 pm

    Really enjoying your blogs Peggy! And it brings back lots of memories of my own trip in Cuba. I am back in Darwin now – after 3 weeks in Melbourne/Perth – and can’t believe that it is raining cats and dogs when it is supposed to be the dry season! Very best wishes to John for a fast recovery. Heather Sjoberg

    Liked by 1 person

    • leggypeggy / May 7 2016 9:02 pm

      Poor John is totally fine now, but gout can hit at any time. We desperately need rain in Canberra. Can you send some? Please?

      Like

      • Heather Sjoberg / May 7 2016 9:09 pm

        Well, we did try. We told the dry season to go away because it was drunk, but that didn’t work! Rained again today and forecast for tomorrow.

        Liked by 1 person

      • leggypeggy / May 7 2016 9:21 pm

        Oh bummer. We have rain forecast for tomorrow. Hope it turns up.

        Like

  5. wfdec / May 7 2016 9:03 pm

    Now don’t get cross if I’ve got this wrong, but the story as I see it is that Poor John has excruciating pain on account of undiagnosed gout and peggy goes legging off taking pretty pictures (which we all admire) even stopping the taxi to take more. Is that pretty close to the way things are. Poor John!

    Liked by 1 person

    • leggypeggy / May 7 2016 9:25 pm

      Not even close. I took the pics from a speeding horse cart or in the hospital. And I stayed by his side until he shooed me away. That’s when I went off exploring—with his blessing!

      Liked by 1 person

  6. vickgoodwin / May 7 2016 9:22 pm

    My sister is in Cuba as we speak. She was on the first cruise ship form the USA to go there. She loves the colors but is heart broken over the poverty and crumbling buildings of Havana. The people cheered as they left the ship. She loves it there! Sorry Poor John had to see the sites from inside the clinics and hospitals.

    Liked by 1 person

    • leggypeggy / May 7 2016 9:28 pm

      Luckily Poor John saw plenty of the sights. He’s pretty good at soldiering on. Tell your sister not to agonise too much over the poverty. The conditions in Cuba are way better than what we’ve seen in so many other parts of the world. Most of Africa and Southeast Asia are much worse.

      Liked by 1 person

      • vickgoodwin / May 7 2016 9:43 pm

        I will tell her. That is a sad thing to know though isn’t it?

        Liked by 1 person

  7. sidilbradipo1 / May 7 2016 9:28 pm

    My brother suffers from a similar disease.
    There are more than hundred different types of arthritis, and gout is one of these types. The gout is caused by high levels of uric acid crystals in the joints.
    As a matter of fact, arthritis is a general term that doctors use to define the situation in which the joints are sore and stiff.
    But for sure, there are different types of arthritis and each of them has different symptoms and therapies.
    Gout attacks often occur after eating foods such as oily fish, liver, dried beans, peas, anchovies or meat sauce.
    Even alcohol abuse, obesity and certain medications can worsen gout.
    In the elderly, some of the pressure drugs may increase the likelihood of an attack of gout.
    My brother follows a particular diet, doesn’t drink anything but water, takes medications carefully: things go much better now!
    Hope Poor John will recover well 🙂
    Ciao
    Sid

    Liked by 1 person

    • leggypeggy / May 7 2016 9:32 pm

      Poor John is doing very well now. He doesn’t drink alcohol and rarely has oils, but he loves some of the other items you’ve mentioned—loves anchovies. I’ll try to be careful with my cooking from now on.

      Liked by 1 person

      • sidilbradipo1 / May 7 2016 9:43 pm

        Diet is important, much more important than medications! I don’t know why but it is the mantra of all doctors my brother visited 🙂
        Ciao
        Sid

        Liked by 2 people

      • leggypeggy / May 8 2016 9:08 am

        Thanks for the advice. I’ll do more investigation about diet.

        Like

  8. Victo Dolore / May 7 2016 9:54 pm

    Oh, poor man. Gout is suffering. Thanks for sharing the story of healthcare in Cuba.

    Liked by 2 people

    • leggypeggy / May 8 2016 9:51 am

      I was very impressed with the health care in Cuba, even if the diagnosis was wrong.

      Liked by 2 people

      • Victo Dolore / May 8 2016 10:01 am

        Nothing like having to access the system to be able to judge it! Though, at least comparing to the US, the lack of meds and the days it would take to get results back seems rather frustrating.

        Liked by 2 people

      • leggypeggy / May 8 2016 10:41 am

        Oh I think the US can have delays too. My nephew was part of a group that went to Ghana. He and a girl both became sick not long after their return to the US. Based on y sister’s explanation, I was pretty sure it was malaria. My sis is a pharmacist and started Charlie on a treatment straightaway. The girl went to hospital instead and it took three days for the doctors to confirm she had malaria. They wouldn’t provide any treatment until the diagnosis was confirmed so she suffered three days. Can’t imagine what the bill would have been,.

        Liked by 1 person

  9. blondieaka / May 7 2016 9:58 pm

    Poor John it is apparently really, really painful my son and mother get it..my mum doesn’t drink, my son likes tipple but chicken agreviates his but diet does play a big part..lets hope he doesn’t have many attacks 🙂

    Liked by 2 people

    • leggypeggy / May 7 2016 10:19 pm

      Gout seems to be hugely painful. Glad I’ve never had it and hope Poor John doesn’t have it again.

      Liked by 2 people

  10. spearfruit / May 7 2016 10:01 pm

    I am so sorry to hear about poor john’s foot! I am glad he is doing better now. Have a happy day Peggy! 🙂

    Liked by 2 people

  11. Curt Mekemson / May 7 2016 10:26 pm

    I’ve experienced gout, Peggy. It’s nasty. Poor John has all my sympathy. I’ve never taken medicine for it and it has pretty much gone away, for now. I just severely limited my alcohol intake from a couple of glasses of wine or beer per day down to a couple of glasses a week. I miss the drinks, but not nearly as much as I prefer not to suffer the consequences. –Curt

    Liked by 2 people

    • leggypeggy / May 7 2016 10:37 pm

      I think anything can bring on gout. Poor John hasn’t had an alcoholic drink since 1987. So don’t throw out your wine bottles.

      Liked by 1 person

      • Curt Mekemson / May 7 2016 11:45 pm

        True Peggy. But with me there seems to be a direct correlation. I’ll pretty much do anything to avoid it. 🙂 –Curt

        Liked by 2 people

  12. Midwestern Plant Girl / May 7 2016 10:42 pm

    Ouch! Glad he’s better now.
    My buddy had gout and it would pop up at odd times. If he ate just one shrimp POW thick ankles. My friend didn’t drink either. I’d say it affects people differently.

    Liked by 2 people

    • leggypeggy / May 8 2016 9:53 am

      You’ve got me thinking back to figure out what might have affected him. Could have been the lobster, which is abundant in Cuba.

      Liked by 1 person

  13. Andrew Petcher / May 8 2016 12:08 am

    Nothing worse than the gout that’s for sure1

    Liked by 2 people

  14. Laurie / May 8 2016 12:23 am

    What an adventure for the both of you! I understand gout can be extremely painful. It’s often been called “the rich mans disease” since many people can not drink alcohol or eat rich foods such as shrimp since it can bring on an attack of gout. So glad he’s feeling better.

    Liked by 2 people

    • leggypeggy / May 8 2016 9:56 am

      I’m thinking lobster might have been the cause. I can’t remember the last time he had lobster before Cuba.

      Liked by 1 person

      • Andrew Petcher / Aug 11 2016 3:10 am

        Sea food is bad, Especially shell fish. I never touch shell fish since I had gout. Pure fruit juice is bad as well!

        Liked by 1 person

      • leggypeggy / Aug 11 2016 8:28 am

        I’ll pass this on to Poor John, although I might never get him to avoid shellfish completely.

        Like

  15. Mama Cormier / May 8 2016 1:54 am

    My husband has had three bouts with gout. The first one was brought on by his chemo. Apparently when cancer cells die they produce uric acid. If episodes of gout occur periodically there is medication one can take, albeit forever, that will prevent gout from returning. My girlfriends father has been on these pills for 50 years. Hopefully John won’t have more attacks but it can be triggered by numerous things and alcohol and rich foods aren’t always the reason.

    Liked by 2 people

    • leggypeggy / May 8 2016 9:58 am

      Wow, I had no idea chemo could trigger gout. Hope your hubby is doing well now. Obviously we’re hoping Poor John’s gout was a one-off occurrence. I’ll keep everyone posted.

      Liked by 2 people

  16. White House Red Door / May 8 2016 2:04 am

    What an ordeal! Glad you and Poor John are on the other side of it, and have confirmed with your regular doctor at home. It does make for good stories though! 😉

    Liked by 2 people

    • leggypeggy / May 8 2016 10:03 am

      I’m glad he went to the doctor here so he’s prepared if it ever happens again.

      Liked by 1 person

  17. MeRaw / May 8 2016 4:57 am

    Really hope things are improving for your husband.
    x

    Liked by 2 people

  18. Sharon Bonin-Pratt / May 8 2016 7:24 am

    So very sorry. Hard to be ill in a foreign country if you don’t speak their native language. And now Poor John has had a round of antibiotics he didn’t need, so double ouch there. Hope he heals well and quickly.
    Wishing the best to the Cuban people. I hope the new open policy between the US and Cuba really assists the Cuban people – couldn’t care less about their government or their continuing “revolution.”

    Liked by 2 people

    • leggypeggy / May 8 2016 10:36 am

      Yes, a pity he had to take antibiotics unnecessarily but he’s fine now. And I agree with you in wishing all the best to the Cuban people. In spite of the problems we had there, we really enjoyed our time in Cuba. The people are lovely.

      Liked by 1 person

  19. Carol Ferenc / May 8 2016 7:27 am

    So glad to hear Poor John’s diagnosis and treatment are now correct. Thanks, Peggy, for sharing the update. The “Oh, crap” moment made me smile. When you have one of those on a trip, you’re probably not doing the typical tourist things.

    Liked by 3 people

    • leggypeggy / May 8 2016 10:04 am

      I hate to think how many times we have had ‘Oh Crap’ moments on our travels.

      Liked by 2 people

  20. Yvonne / May 8 2016 8:19 am

    Somehow, I don’t think you and Poor John are typical tourists!

    Definitely Poor John, that gout must hurt like the blazes.

    Hey, we’re getting some rain here in Myrtleford, I hope the same is happening in Canberra.

    Liked by 2 people

    • leggypeggy / May 8 2016 10:06 am

      Just a sprinkling this morning. Pity I forgot to bring in the laundry yesterday afternoon.

      Liked by 2 people

  21. Coral Waight / May 8 2016 8:31 am

    A very eventful trip to Cuba.

    Liked by 1 person

  22. gerard oosterman / May 8 2016 9:57 am

    That is some story. All I know about gout is that one needs a good gout stool. I am not sure but one might have to consider carrying and taking a good gout stool with future travels. I don’t know but could it be the lack of alcohol? Nothing since 1987? I always thought a nice Shiraz to be a good lubricant for aching joints. 😉
    Anyway. I can well imagine the clippity clop to the Cuban hospital. It is the stuff of travel that will be remembered forever. A good read, Peggy. Thank you.

    Liked by 1 person

    • leggypeggy / May 8 2016 10:08 am

      Thanks for the suggestion. I’m always wondering what to give Poor John for his birthday. This year he’ll get a gout stool.

      Like

  23. Curious to the Max / May 8 2016 1:24 pm

    Glad all is well that ends well.

    Liked by 1 person

  24. Joy Dostine / May 8 2016 3:58 pm

    Glad he is on the right meds now Peggy and hope it gets better soon

    Liked by 1 person

    • leggypeggy / May 8 2016 8:19 pm

      He’s doing great and doesn’t need any meds now.

      Like

  25. lmo58 / May 8 2016 6:51 pm

    Hi Peggy, I’m very sorry that John has gone through this. I somehow missed the post while you were away so am only just finding out about it. I have, however, heard how painful gout is but had no idea that it is sometimes identified with alcohol consumption. But, as you pointed out, Poor John doesn’t drink alcohol. I’m really pleased you’ve got an excellent GP and that she’s got Poor John on the right medication and that he’ll know what to do if it happens again. It’s all the more annoying I imagine given that Poor John is so fit. It’s not as if he’s the Harry Secombe sort! Best wishes for feeling much better really soon.

    Liked by 1 person

    • leggypeggy / May 8 2016 8:23 pm

      Luckily Poor John doesn’t need any meds now, but he knows where to go when he does. We’ll hope that’s never. He’s feeling completely fine now.

      Like

  26. derrickjknight / May 8 2016 8:22 pm

    I hope the poor foot improves – it’s enough just to be called Poor John :). Congrats on not letting the ‘ambulance’ driver rip you off.

    Liked by 1 person

  27. PantryPortfolio / May 9 2016 12:35 am

    My father has gout and I know how intense it can be. Glad it is on the mend, where are you traveling next? I love seeing all of your pictures and hearing about your adventures. –Deb

    Liked by 1 person

    • leggypeggy / May 9 2016 10:08 am

      We haven’t made any definite plans yet, but lots of possibilities. Poor John sends his sympathy to your dad. He knows how it feels and how much it hurts.

      Like

  28. Rashminotes / May 9 2016 3:09 am

    Hope all is well with his foot now, take care!

    Liked by 1 person

  29. mommermom / May 10 2016 1:47 pm

    Poor guy, I feel his pain. I suffered with incredible foot pain that came went with different places on my foot. I called at my ‘phantom foot pain’. I visited many doctors and eventually, after about a year, it went away. They also considered gout and high uric acid but ultimately that was not the case either. At least that’s what they said. They were never really sure. I hope he’s passed this episode with no reoccurrences.

    Liked by 1 person

    • leggypeggy / May 10 2016 3:10 pm

      His foot seems fine now, and I suppose there’s a slight possibility that it wasn’t gout to begin with. Maybe time will tell. Good to know your ‘phantom foot pain’ has passed.

      Liked by 1 person

  30. Worlds Biggest Fridge Magnet / May 11 2016 8:07 pm

    Wow! Poor old Poor John.
    I am glad he is feeling better now but that must have been quite a worry at the time.
    Be well Poor John…!

    Liked by 1 person

  31. Sy.S / May 12 2016 8:43 am

    Prior to this post, you had written about Poor John’s foot… and it did not seem to be very serious. But now that you went into much more details and the run around in the hospital… it certainly was scary enough. However, glad that getting back to Australia, everything got sorted out and John will be all right.

    Liked by 1 person

    • leggypeggy / May 12 2016 2:08 pm

      His foot is completely fine now and we hope it stays that way.

      Like

  32. Brenda / May 12 2016 9:09 pm

    Ouch. But I loved the horse-drawn ride to the hospital. Uphill, indeed!

    Liked by 1 person

    • leggypeggy / May 12 2016 10:30 pm

      It was barely uphill—more like a gentle rise.

      Like

  33. milliethom / May 12 2016 10:16 pm

    What a to-do, and all the time, Poor John was in agony. How sad that the Cuban medics diagnosed it wrongly. He could have been out of pain so much quicker if thy’d got it right.

    Liked by 1 person

    • leggypeggy / May 12 2016 10:29 pm

      So true. No matter how conscientious the care, a right diagnosis would have helped a lot.

      Like

  34. gallivance.net / May 15 2016 1:08 am

    What a tale, Peggy. And poor John and the saga of his foot. My brother-in-law has gout and when it strikes I know how painful it can be. Hopefully, now that he has the right diagnosis, future problems can be solved more quickly.

    BTW, you may have noticed that things have been quiet at Gallivance. Our travels have been (temporarily) suspended because I blew out my knee and recently had to have total knee replacement surgery. Not fun, but I’m working hard on recovery. We haven’t forgotten about our friends and want things to get back to normal. James and I are looking forward to catching up with you and finding out what you’ve been up to. In the meantime, thanks for continuing to follow along.

    All the best, Terri

    Liked by 1 person

    • leggypeggy / May 15 2016 2:30 pm

      Oh my gosh, Terri, that’s dreadful and probably oh-so painful. I hope your recovery goes smoothly and quickly. I had noticed how quiet your blog was and assumed you must be somewhere remote. Hope you can spend your down time planning your next adventure. All the best to you, too.

      Like

  35. Thanks for sharing this article, Peggy. Cuba is country, I may like to visit one day because I am in love with their old automobiles.

    Liked by 1 person

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