Patient Safety & Satisfaction Needs Improving - San Jose, Costa Rica
I have wanted to get rid of my jowls for a decade...
As recommended by Dr. Araya, I scheduled my post-surgical stay with Las Cumbres Inn. Correspondence with the reservation agent, Melanie, was easy and cordial. However, there was no one at the airport to meet me when I arrived and I had to ask one of the local drivers to call Las Cumbres to ask for the driver to come meet me. The driver, Christian, could not have been more helpful or pleasant. I arrived on Sunday the 15th and my presurgery meeting was on the 16th. I did not meet with the anesthesiologist at this time, which was a mistake.
I was given antibiotics to begin the night before surgery and was scheduled for 7am. I was in the operating room before 8 am and awoke during surgery with severe pain in the back of my neck where muscles were being attached to the bone (I think). The doctor asked me some questions, which I answered, and he said that they would administer morphine. Some time went by and I do not know if one or multiple doses of morphine was administered. I do distinctly recall Dr. Araya saying, "Don't panic, we are giving you morphine" on 3 separate occasions before I lost consciousness. I finally said, "I'm not panicking; I'm in pain and it needs to stop."
The next patient scheduled for surgery was also staying at Las Cumbres and he was taken in about 2;30. I say this because my surgery was scheduled to last 4-5 hours. I have been unable to get a surgical report from Dr. Araya despite numerous attempts. I would like to know when the surgery started, ended, at what point did the breakthrough pain occurred, how much of what medicines were administered and at what times. This is important to me since I have knee replacement surgery scheduled for this spring.
I was next conscious when someone starting putting clothes on me. I heard men saying something about my jeans and one commented he could not get them zipped. I was completely naked and recall thinking how humiliating and disrespectful the moment seemed to me, despite being wild on drugs. He had slammed me up against an examination table to get my pants on. I reached down and zipped them despite being sightless. I went in and out of consciousness until put into the van about 7pm. I was still in pain.
I was returned to Las Cumbres with severely swollen eyes and instructions from the doctor to apply ice / cool compresses to my face regularly and to walk as much as I could for circulation. On the 18th, in the evening, Dr. Araya came to see me because I felt as if sand was in my right eye. I was concerned about cornea scratching. He tapped at the edge of my eye and ripped off a solid block of caked and dried plasma on my eye, which hurt like crazy.
I had asked the aides at Las Cumbres to give me the saline and an eye cup to soften the plasma many times and was told, "this is normal." Instead of cooling my face repeatedly, little cotton disks were put on my eyes a couple of times. The aide said she would return in 20 min or so but they dried on my face before she returned. Care was sporadic during my 3 days after surgery.
I was unable to see until the day I left. I was assisted in walking on one occasion, and that was the night Dr. Araya came by to say how unhappy he was with my continued swelling. Despite being sightless, I finally figured out how to navigate my room by feel and found the refrigerator where the gel mask was located. I began to ice my face regularly and the swelling improved. Only once in 4 days was I assisted in going to the bathroom. There was no call button and I was unable to see the telephone to call the nurse or manager. One time I wandered into the hall and started saying, "hello, is anyone there? Hello, can someone help me?" I finally started knocking on doors until someone came out.
Las Cumbres' advertising is misleading in my opinion. The way it is written implies that registered nurses are on duty 24x7, which is not the case. Neither are they RNs but leave at 9pm. Unable to see, feed myself, find the bathroom, make a phone call, figure out how to take my daily meds, or anything else the staff was barely more helpful than room service. They arrived about every 2 hrs at first to take my vitals and then sporadically after.
When I asked how often to take some of the meds prescribed, each aide had a different answer. I was told to skip my antibiotic on the day of the surgery by the nurse and developed an infection later on. The experience at Las Cumbres was a nightmare and I would strongly discourage anyone from going there. Do not believe the advertising. They are located at the top of a hill far from anything else. If walking afterwards is part of your recovery, you can't do much of anything since there are no sidewalks and the hill is steep.
It has been nearly one month now and most of the swelling has subsided. Dry eyes, awful itching around them, and blurred vision have accompanied the recovery. GenTeal helped with lubrication. The neckline looks great and I think the eyes will be nice as well. At a fraction of the cost for this surgery in the U.S., I would do it again but would stay elsewhere. However, if I'd known then what I know now I would have taken the following items:
Ice bag and gel pack for cooling
Prescription meds separated by am and pm (I had to explain which meds to give me since I could not see them and hoped for the best)
Lubricating eye drops and eye patches to keep the eye from drying out.
A bottle of saline solution and eye cup. When I asked the aide at Las Cumbres for this I was given a bag of IV solution with a needle attached!!
It appears that Dr. Araya is an artist and technically competent. Where the whole experience fell apart was between his office and the staff at Las Cumbres Inn. I have asked repeatedly for the surgery report, doctor's orders, plan of care and nursing notes so that I might understand what happened. Neither Las Cumbres nor Dr. Araya have sent these records. Assuring that the patient's expectations are aligned with provider services is essential to patient satisfaction and this has been a very dissatisfying experience.