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Part 4

Part 5

Part 6

Part 7

Once the decision had been made I acted as quickly as possible. I had an online meeting with the surgeon in Manila. She explained the procedure, quoted the success rate and her staff scheduled the surgery for the following week. This relieved me a little bit since the thing on my nose was noticeably growing almost by the day.

Since Janet had already had one experience leaving Negros Oriental during this pandemic, we were familiar with the process: permission to travel from the Barangay Captain, sign off from the Mayor and the police, and a health document. We had it all in a day or two and I booked a flight. Then the unexpected fun began.

I had promised Janet (and promised myself too) a nice hotel, great restaurants and shopping to compensate for the ordeal. I went onto Agoda and booked a hotel close to the hospital. The next day I got a message from the hotel that they were currently allowing quarantine guests only – guests coming from out of the country and required to quarantine – and therefore my booking was rejected.

I quickly discovered that many hotels in Manila were quarantine only. I was annoyed that none of the hotels published any such information on their websites, nor did Agoda. Others were government approved for “staycations” but those staycations were only available to residents of Metro Manila. I emailed a bunch of hotels and one by one they apologized but would not allow our booking.

I then got the bright idea to book an AirBNB. Perhaps they wouldn’t have the same restrictions. But one by one they too got back to me that they could not accept my booking for a variety of reasons. I was panicking and not thinking straight. Finally I contacted an upscale hotel, the Edsa Shangri-la, and they asked for documentation from my doctor confirming why I had to come to Manila. I submitted my doctors orders and they approved me. I nearly cried in relief and will forever be grateful to the Shangri-la, which is the best damn hotel in Manila!

Janet and I flew to Manila. The process at the Dumaguete airport wasn’t too horrible; just submission of the documents giving us permission to travel. BTW, the Dumaguete airport has never looked so clean! Normally it’s a shabby, dirty little airport. OK it’s still a little shabby, but pretty spotless. The flight to Manila was at most half filled.

Contrary to my usually cheap ways, we paid for the car service from the airport to the hotel. Upon arrival we were escorted to what used to be the hotel’s Spa (now closed), where a rapid test was performed. It was only after our negative test results came through that we were allowed to check in and go to our room.

The next day the real fun began. I was required to have a swab test to perform the procedure, as well as 3 other blood tests, an ECG and a chest X ray, followed by an exam by a cardiologist. I guess they want to make sure that, you know, you’re not going to kick off during the surgery.

The testing procedure at The Medical City in the Ortigas area of Metro Manila, was surprisingly efficient. Fall in line, show the doctor’s orders, pay for the tests, and then get the tests. Within a couple hours I’d had the swab test plus the 5 others completed.

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However I was then told that the cardiologist, whose approval I required, would not be able to see me after 12:00. This meant that we rushed back to the testing area and begged for the results to be given to us early. Fortunately I was able to get all the results (except the swab test) and rushed back to the Cardiologist’s office at 11:45. Naturally blood pressure had to be taken first. “You gotta be kidding. I’ve been running all over for 4 hours. My BP will be off the charts.” And it was! But 5 minutes later, after closing my eyes and breathing deeply and slowly to calm myself, it was closer to normal and the cardiologist saw me. Cool guy who acknowledged when I asked that his practice was way up. “There are Covid deaths and non-Covid deaths caused by the pandemic,” was his simple statement of fact. He certified that my heart was fine for the next day’s procedure, and we breathed a sigh of relief.

At that point we did what anyone unable to travel for a year would do; we hit the local mall! SM Megamall, right around the corner from our hotel, is the 2nd largest mall in the Philippines and 9th largest in the world. This place makes Dumaguete’s Robinsons Mall look like a 7-11. Significant shopping, followed by a nice Japanese dinner occurred, keeping my mind a little bit off the next day’s surgery.

Are we having fun yet?

The next morning we went back to Medical City and proceeded to what was called the Wellness Institute, a suite within the hospital. It was pleasant and upscale and could easily be confused with an American counterpart.

After paperwork, the doctor and her nurses arrived. We asked a few questions and the work began. I am certainly no expert but it all appeared very professionally done. The US-trained doctor had performed thousands of these procedures and it showed. She was very attentive to my comfort and must have asked a dozen times whether I was OK. BTW, the surgery was done with local anesthesia – lots of it.

The surgery was performed and the tumor sent to the lab, which is the advantage of MOHS micro surgery; they can get the results between 30-60 minutes and then decide whether to cut more. In this case I waited over an hour; I was to find out why later.

After a lot of waiting I just padded out to the waiting room in my surgical gown to be with Janet. The doctor arrived and told me she proposed using the skin under my eyes, aka the bags, for the skin graft. Basically I’d be getting two surgeries for the price of one; essentially an eye job. Lol.

What I found out later from Janet was that the doctor was unhappy with the samples the lab sent back and yelled at them over the phone to do it again and do it the way she wanted. Janet told me, “she’s tough.” When the revised samples came back the doctor found a small amount of additional cancer left, requiring another cut.

My doctor then showed me a photo of where the graft would go. I was stunned and for the first time scared and muttered, “Oh my God.” There was a nearly dime-sized circle on the right side of my nose. The reality of what had occurred set in. Janet was wonderful and calmed me down, reminding me that we had acted quickly and done everything possible.

“We won’t be able to use the eye skin. It’s too thin. We’ll have to be a bit creative,” said the doctor, scaring me again. So I got more anesthesia and another cut. That sample came back quickly and the doctor proclaimed there was no more cancer.

The doctor proposed taking skin from under my arm where she said “the skin was a bit sagging.” “I used to have more muscle there, doctor. But my weight lifting days are over.” So more anesthesia, a cut for the graft from the arm, stitching up the arm (first stitches in my life) and stitched the graft to my nose. The doctor proclaimed that the shape of my nose (never a particularly pleasing shape) had been saved.

A gigantic bandage was placed over my nose and the doctor gave us prescriptions and general orders and said she’d see me in 3 days.

At that point, since this is the Philippines, we were left with the need to pay. For those of you who want the numbers, this was not an inexpensive procedure. The doctor’s fee was 70k Pesos. The hospital and lab fees for Medical City were about 39k Pesos. BTW, my doctor also has privileges at a hospital in Makati and I was told that hospital’s fees would have been about double. I have PhilHealth coverage and while many expats complain about the price increase for expats that started a few years ago, PhilHealth paid about 30% of both the doctor and the hospital fees. In addition, the day before, PhilHealth paid for most of the swab test fee. So you will not hear me complaining about Phil Health! In the end I paid out of pocket about 79k plus a little more for the tests from the previous day. Thank goodness the stock market’s climbing.

More to come…