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He Has Arrived!

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So, it’s been 2 1/2 weeks since the arrival of Jackson Weisbord; our lives have changed and I finally have a moment to write a blog – well quickly.

The baby was induced – sort of. As I documented before, Janet had a minor procedure early in the pregnancy that at week 37 was to be reversed. Our excellent OB, Dr. Marie Antoinette Calinawagan, told us that after the reversal in her experience the baby would arrive in 2-3 days – a week tops. A week went by and no baby. We met with the doctor again and were told that all was fine but if another week went by we would be having a conversation about inducing.

So for two weeks we were on pins and needles, expecting the baby at any moment. The two weeks went by and by then the decision to induce was an easy one.

That said, by the time we checked into Silliman Medical Center, and the induction medication was given, Janet was in reality well on her way to having the baby, but we suspect that the inducing helped speed things up.

In most hospitals in the Philippines, the father is not allowed in the delivery room, so Janet’s sister and I waited in the room we would all stay in once the baby arrived. It has an extra bed which is appropriate for the average 10 year old, but me and my old back managed. As the night progressed, our doctor called me a couple times to let me know the latest progress and she predicted that the baby was likely to come tomorrow. I went to sleep; remember I slept through last December’s typhoon. The phone rang close to midnight and the doctor congratulated me; Jackson had arrived a bit early, at 11:05PM.

At 6 1/2 pounds, he’s a handsome devil, with a nearly full head of hair. I am jealous.

Janet was phenomenal and Jackson successfully started breast feeding almost immediately.

As I previously predicted I was in love the first time I held him. I am three for three in that category.

We had inquired in advance about circumcision and our OB sent us a referral. When it comes to circumcision, the culture of the Philippines is a little different. Boys are almost universally circumcised here but it’s typically done at age 6-7. The 6 year olds have it done during summer vacation. It’s a right of passage here and I’m told that the 6 year olds compare results.

Being Jewish I do have a cultural connection to circumcision but mostly I remember my brother’s. I am 5 years older than he and I remember the rabbi (moile) coming to our house. The men solemnly went into my brother’s room and I stayed with the women in my parents’ bedroom. Then came the most blood curdling scream I had ever heard. But the deed had been done at least; the memory was fried into my young brain.

So the day after Jack’s birth the urologist came into our room. He told us that because it was a Sunday there was some question as to whether an OR could be found. But suddenly it all happened and bang-zoom Jack was taken away. Not long after a nurse asked me to come to the OR to speak with the doctor. I guess this was supposed to be father’s business.

I entered the OR where there must have been at least 10 people. Silliman is a teaching hospital so there are interns everywhere. My guess is they hadn’t seen too many circumcisions done on newborns.

I took one look at my poor son wearing a bloody diaper and cursed at myself; ‘what the hell did I do!’ The cursing got worse as the doc actually showed me what was underneath the diaper. But he assured me that in 3-5 days the boy would be completely healed and not to worry. This turned out to be true and by Jackson’s first pediatrician appointment at 1 week he was really fully healed.

I suspect in about 6 years he will be teasing his friends for what they have in store.

Janet got excellent care at Silliman. Contrary to usual notions of Philippines hospital care, there were nurses, doctors, interns, etc. coming into Janet’s room, checking Janet and the baby constantly; everything but the old father.

Because of the procedure done to Jackson we stayed in the hospital an extra day and I spent most of that day running around paying bills, adding Jackson to our PhilHealth account, finding meds, ordering Grab food, etc. I guess this was my penance for – you know – not actually having to give birth.

Now let me address what I know some of you want to know about; costs. Our OB had told us in advance that standard deliveries cost 40-50kP and that a Cesarean could bring the cost to 120k.

Janet had a standard delivery but with an epidural the cost increased to about 66k. PhilHealth paid nearly 10k, so we were out of pocket about 57k.

The circumcision was not cheap. I guess one of the advantages of the 6 year old procedure is that it is often done for free or a very modest cost. But for us in an OR with a team of docs, we were at about 27k. PhilHealth only paid 3k, so out of pocket it was just under 25k.

Many of my friends have teased me about losing sleep. So, yes I am losing sleep. Fortunately as a retiree I can catch up with a quick nap; that quick nap was 3 hours today.

We do have a lot of help and that makes a big difference. Janet’s sister is our Yaya and brother Jorre helps in between classes.

We have already had some family arrive for a visit. Janet’s mother and a couple sisters were here and Lola didn’t want to leave the baby when it was time to go home. We are already committed to having the family for Christmas so Jack should get pretty well over amped by that!

I take Jack out for a daily morning walk around our property. He genuinely seems to enjoy it. It’s our bonding time without any women. Of course by the time we get back to the house I am exhausted and happily hand him to one of those women lol.

A friend wrote me today telling me that 10 years ago “you clearly were much more in touch with what you wanted and your capacity to skillfully move towards it.” Maybe I was (a little bit), got support (plenty), got lucky (a lot), and chose Janet! Can’t wait to see what’s next!

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My PI CAncer Adventure – Lessons Learned

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Part 1

Part 2

Part 3

Part 4

Part 5

Part 6

Part 7

You can all breathe a sigh of relief. This will be my last posting in this epic tome. I’ve been home almost three weeks and my nose is returning to what will be its new normal. My oncologist has cleared me, I’ve seen my dermatologist (as I will every 6 months for the rest of my life) and I visited a cardiologist who said I was fine, with my heart just compensating for – you know, getting old. My energy is coming back. In short I expect to put this ordeal in the rear view mirror soon.

I hear expats all the time complain and worry about health care in the Philippines. So the following are my lessons learned and suggestions. Take them with a grain of salt of course. It’s your body and your money.

Get a Doctor(s): Many guys here just wait till they have a major problem or keel over and then are dragged to the ER where they get whatever doctor is on call. And then of course complain about the care or the costs. So get and visit a General Practitioner regularly. Get a check up and have your blood work done. You’ll not only feel more confident that you are not likely to keel over, you will have an entry point into the medical system who can recommend treatments, medications and other specialists when needed. Yes, you may have to visit a few GPs before you find one you like, but that would be true anywhere.

The same is equally true with specialists. As we age and our little bits and pieces age they need to be cared for. So, depending on what issues you have, find a dermatologist, cardiologist, optometrist, dentist, etc. Typically doctors visits here are cheap – so go to the specialists you need.

And BTW, if you are pasty white and older in the Philippines, you definitely need a dermatologist.

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Get PhilHealth: I am surprised at how many expats here do not have PhilHealth. Yes I understand that a few years ago they raised their rates for expats and guys were pissed off, but unless you have other medical insurance it is still a good deal. If I have done my math correctly, this year PhilHealth covered nearly 100k of my treatments.

While PhilHealth only covers in-patient hospital care, many procedures are considered in-patient. My surgery in Manila was in-patient, even though I never spent a night in a hospital. My radiation therapy in Cebu was the same.

In addition, while it is true that my PhilHealth premium increased it also covers Janet. So again, It’s a good deal you should strongly consider.

Do Your Research: It may be harder, but if you know that you need an upcoming procedure, do your research. Ask about doctors, hospitals and the best procedures available. Ask about costs although this may be harder to pin down since the typical answer will be “it depends on what the doctor orders.”

I find that Americans do a little better with this than those expats from countries with socialized health care systems. Those guys are used to “free” healthcare and are less used to a system where healthcare has different prices, just like other services. Americans are also used to being gouged by doctors and hospitals and so are often pleasantly surprised by prices here – that is if they do their research – if they don’t they can get gouged here also.

Know People and the System: The Philippines is a communal society. Everyone seems to know everyone. Most expats do not take advantage of this but you should. Here are two examples:

Last summer, after the pandemic was well underway, but before we knew what we now know (lol) I had a weird rash, unlike any I had ever had. I also was running a slight fever. After a couple of days I wondered, ‘should I get a swab test?’ But we were all still afraid of going to a hospital so I hesitated. Then I remembered that I have a guitar repair customer who is a front line doctor. Apologetically, I contacted him. We spoke on Messenger and I described my symptoms and showed him my rash. He confidently confirmed that it was not Covid and I did not need a test. An antihistamine would help, which it did. I thanked him and apologized again but he reminded me that telemedicine is the present and future.

Second story: Recently I got my 1st Covid jab. I was surprised by several expat friends who didn’t know that it was available here and complained that their local towns or barangays did not come to tell them. Remember, this is the Philippines – a communal society. Everyone knew the vaccine was available for seniors; except my few friends. So, get to know people and get to know the system. Do you know where your barangay is? Do you know your Barangay Captain? You should. Janet and I know ours and we have texted her several times over the years when we had issues and she always got back to us with answers. So know people and know the system.

Have cash and keep it separate: Moving to the Philippines without actual cash in the bank is a disaster waiting to happen and most of us know this. What I am talking about is having a medical or emergency fund separate from your monthly living expenses fund. We have such a fund in the US. In addition, I also keep some cash in a dollar account in my Philippines bank. I keep it separate from my Peso account, so we don’t end up spending it for monthly living expenses. Figure out something similar. It doesn’t have to be huge – just enough so that you can easily access it in an emergency. The same can be true with a credit card. Most (though not all) hospitals will take credit cards, so in a medical emergency having a credit card can help.

Anyway, I hope and pray that this is the end of my medical adventure here. That said, as we get older there is a reasonable chance that there will be other such adventures. I think I’ve learned a little about navigating such adventures. Hopefully, you the reader have also.

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A Tale of Two ER Trips

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A few years ago while in Portland, Janet was sick with a strong case of the flu. Lots of coughing and fever. As always she took it in stride with good humour. But one night she announced that she’d coughed up a bit of blood. “Then we’re going to the ER,” I said. Janet resisted but I insisted and off we went.

I’d never in my life been to the ER and it was an interesting experience. About 20 people were in the waiting room. We filled out lots of forms and it was quickly apparent that we were probably the only people there who were on a paying basic (had our own insurance).

Janet waited 4 hours to see a doctor. They did draw blood while we waited. By now she was a little scared. There were TVs in the waiting room and it was the night of the 2016 election and I got to watch all the CNN guys grow more and more panicked. I love watching pundits squirm.

Eventually Janet saw the doctor and he said her blood work was fine and she had the flu. He wrote a couple of prescriptions and off we went.

A couple weeks later I got the bill – $1700. My insurance company did pay most of it but I was on the hook for about $500. I thought, ‘this is the beauty of the American medical system – the finest in the world – $1700 to diagnose the flu!’

A few days ago I got a pretty strong bug here in Dumaguete. High fever and body aches. Janet asked if I wanted to go the ER and I said no; it was just the flu. But by the 2nd night my fever hit 103 and I got a little scared. I haven’t had a fever that high since I was a kid. So at 10:30 off we went to the ER.

We arrived at Holy Child Hospital ER in downtown Dumaguete. There were no throngs in the waiting room; there was only one patient ahead of me. Within a couple minutes a nurse had taken my temp and BP. Within a few more minutes the doctor came over. He was appropriately surly as I would expect a competent doctor to be. He asked a few questions and then ordered some blood work. In the Philippines high fever means to test for Dengue Fever so that was one of the ordered tests. The nurse asked for 2300 pesos ($40) for the tests, which Janet paid.

We were directed to the lab in the building next door. Again there was only one patient ahead of me and they quickly and professionally took my blood and told us to come back in an hour. They were prompt and an hour later we had the results and returned to the ER.

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“Your Dengue test is negative,” the doctor said and I breathed a sigh of relief. Dengue can be a very unpleasant experience and takes lots of time to recover from and let’s face it, I’m not a kid. The doctor added, “It’s probably the flu. You could come back tomorrow for a urine and stool sample, in case it’s a UTI.” He wrote a couple prescriptions including one for a pain reliever that I recognised as common in the Philippines. The Ugly American kicked in. “I’m taking Advil. Is this better than Advil?” He replied to the idiot kano, “Advil’s better for pain. This is better for fever reduction.” Case closed.

The nurse asked for 900 pesos ($18) for the ER visit and we were on our way. The next day we got the two prescriptions filled for $3.

I’m on the mend now and hopefully will be fully recovered for Valentines Day. Janet deserves a nice one.

You can come to your own conclusions about the difference between a $1700 and a $58 diagnosis of the flu.

Post Script: Here’s a humorous side note. In addition to the high fever and body aches I had a strong case of diarrhea. I didn’t have my reading glasses with me and didn’t want to make a mistake with a medicine bottle so the next morning I asked Janet if she’d get me the anti-diarreal meds. She grabbed two and some water and brought them to me and I quickly downed both. She suddenly spurted out. “OMG. I gave you the wrong medicine!” “What did you give me?” “Laxatives!”

It’s been an active day 🙂