Checking out the Saudi medical system
We began Ramadan with a rather impressive pair of incidents ...
Act I
Peter spent the evening of Friday 5th September in the Emergency Department of a Riyadh hospital – and for the first time in many years he was actually the patient! The good news is that it was for something quite minor - on Friday evenings he has been playing basketball at the compound and on this occasion he badly dislocated the middle-left finger. Fortunately Peter has been well-behaved and hasn't posted the photo on Flickr. We looked up our health insurance details and located a nearby hospital, and then he headed off to try out the local medical system.
Peter's experience in the hospital emergency department was amazingly good. He arrived at 8:30pm and in 1 hour he'd had a set of X-rays taken, discussed the results with the doctor (a minor fracture), and had some analgesic and local injections. It then took just 20 minutes to finish the reduction and take some more X-rays, followed by a 20 minute wait for the opiate to wear off so he could drive home! The costs after insurance were also excellent - about US$20 hospital fees, plus US$1 for some ibuprofen at the pharmacy.
On Saturday night Peter went back to visit a doctor at the hospital's outpatient clinic. The doctor reviewed the X-ray pictures and couldn't see a fracture, so he abandoned the splint altogether.
Act II
We had a much more serious drama on Saturday morning, which started for us when the school nurse rang at about 8am. She told us that Owen had fallen in the playground before the start of school and had bumped his head. She said that he had very little idea what had happened; she was going to observe for another 30 mins but if he didn't improve then he shouldn't go back to the class. Peter is only working 10am - 4pm this month (one of the upsides of Ramadan) and so he drove with Maree to collect Owen from school.
It was immediately apparent that he had concussion - from subsequent reading we agree that this was moderate concussion. Owen was confused, dazed, upset and had lost his short-term memory. He was as eloquent as ever, but was unable to store anything in memory – after only a few minutes he had forgotten what he'd been told and was once more noticing that he was sore and asking what had happened. He also had no memory of pretty much everything in Saudi Arabia - during the drive home he asked which hospital we were leaving (school!); was startled by the amusement parks that we pass every day on the freeway; looked bemused by the extensive earthworks and rock piles; and then was really surprised by the heavy security at the compound entrance - "where are we?" We were relieved that at least the interior layout of the house was familiar for him.
We read some more and decided that in this state it was best for him to stay at home and rest, and that there was no imminent need for hospital - although at least Peter had done the ground work the night before and so we now knew exactly where the hospital was! Peter headed off to work and Maree had a gruelling day with a confused and somewhat distressed young lad. At 1:30pm he commented for the first time that he was really sore and so Maree gave him a low-dose ibuprofen tablet, which helped significantly with his distress level. Liam got home from school at about 3:30pm and was able to talk about what had happened - they'd been playing chasy on some equipment with other children, and he'd had been accidentally knocked off balance and fell all the way to the ground. We think he probably fell about 1.5m and may also have bumped his head against other equipment during the fall.
In any case the discussion with Liam seemed to help - Owen commented that he had 'just woken up' on the couch at this time and was quite lucid from that point on. He had a memory gap of about 8 hours, but otherwise had fully recovered his normal memory functions. His later afternoon progressed very well and so we decided that there wasn't an immediate need for a hospital visit. He ended up going to sleep at his normal bedtime and slept very well (unlike his parents!); in the morning we woke to find him reading as normal!
We kept Owen at home on Sunday for a quiet day, and we also talked with his teacher about avoiding sport or active play for the next week - something that is very clear in the literature about concussion. She was very supporting, and so on Monday he looked to be in excellent shape and headed off happily to school once again.
On Tuesday morning Owen woke with a headache. This was clearly still within the normal range of experiences, but we decided that it was sensible at this stage to have some further medical follow-up. During Ramadan the outpatient clinic at the hospital opens at 11am and so we sent him off to school for most of the morning before collecting him and taking him to see a doctor. We had a nasty paperwork surprise at the hospital – it turns out that each individual requires their own medical insurance card and so the clinic would not accept him under Peter's cover. After an hour of talking with various people we ended up having to pay the costs directly and will then have to get them reimbursed.
The actual check-up went very well; the doctor was a lovely Syrian man who was effusive about how much he’d enjoyed a visit to Sydney. He did a thorough series of checks and was very happy with Owen’s state; in the end he ordered an MRI scan to be sure but was confident that there wasn’t any further issue.
We weren’t able to have the scan until the following day and so we headed back again on late Wednesday morning. Owen found the MRI very claustrophobic and so the technician asked Maree to comfort him by holding his leg, while Peter went into the control room with him. Owen complained after each imaging set was finished but did pretty well really; at the end of it all he looked fine but Maree had developed a very bad headache from the ear-splitting noise, and was extremely nauseous. She had forewarned Owen that it was a very loud experience, but commented that this machine seemed much louder than the ones she’d experienced in Melbourne.
The best sort of ending ...
The whole saga was wrapped up at the start of the next week (Saturday night) when Owen and Peter each had their follow-up appointments at 9:15pm and 11:30pm respectively - did we mention that the opening hours are strange during Ramadan?! We were delighted to find that Owen's MRI was completely normal, and he was also very pleased to be allowed to do PE again. Peter's finger is still slightly swollen but is apparently recovering well, although it will still be quite a while before he can play basketball.
Act I
Peter spent the evening of Friday 5th September in the Emergency Department of a Riyadh hospital – and for the first time in many years he was actually the patient! The good news is that it was for something quite minor - on Friday evenings he has been playing basketball at the compound and on this occasion he badly dislocated the middle-left finger. Fortunately Peter has been well-behaved and hasn't posted the photo on Flickr. We looked up our health insurance details and located a nearby hospital, and then he headed off to try out the local medical system.
Peter's experience in the hospital emergency department was amazingly good. He arrived at 8:30pm and in 1 hour he'd had a set of X-rays taken, discussed the results with the doctor (a minor fracture), and had some analgesic and local injections. It then took just 20 minutes to finish the reduction and take some more X-rays, followed by a 20 minute wait for the opiate to wear off so he could drive home! The costs after insurance were also excellent - about US$20 hospital fees, plus US$1 for some ibuprofen at the pharmacy.
On Saturday night Peter went back to visit a doctor at the hospital's outpatient clinic. The doctor reviewed the X-ray pictures and couldn't see a fracture, so he abandoned the splint altogether.
Act II
We had a much more serious drama on Saturday morning, which started for us when the school nurse rang at about 8am. She told us that Owen had fallen in the playground before the start of school and had bumped his head. She said that he had very little idea what had happened; she was going to observe for another 30 mins but if he didn't improve then he shouldn't go back to the class. Peter is only working 10am - 4pm this month (one of the upsides of Ramadan) and so he drove with Maree to collect Owen from school.
It was immediately apparent that he had concussion - from subsequent reading we agree that this was moderate concussion. Owen was confused, dazed, upset and had lost his short-term memory. He was as eloquent as ever, but was unable to store anything in memory – after only a few minutes he had forgotten what he'd been told and was once more noticing that he was sore and asking what had happened. He also had no memory of pretty much everything in Saudi Arabia - during the drive home he asked which hospital we were leaving (school!); was startled by the amusement parks that we pass every day on the freeway; looked bemused by the extensive earthworks and rock piles; and then was really surprised by the heavy security at the compound entrance - "where are we?" We were relieved that at least the interior layout of the house was familiar for him.
We read some more and decided that in this state it was best for him to stay at home and rest, and that there was no imminent need for hospital - although at least Peter had done the ground work the night before and so we now knew exactly where the hospital was! Peter headed off to work and Maree had a gruelling day with a confused and somewhat distressed young lad. At 1:30pm he commented for the first time that he was really sore and so Maree gave him a low-dose ibuprofen tablet, which helped significantly with his distress level. Liam got home from school at about 3:30pm and was able to talk about what had happened - they'd been playing chasy on some equipment with other children, and he'd had been accidentally knocked off balance and fell all the way to the ground. We think he probably fell about 1.5m and may also have bumped his head against other equipment during the fall.
In any case the discussion with Liam seemed to help - Owen commented that he had 'just woken up' on the couch at this time and was quite lucid from that point on. He had a memory gap of about 8 hours, but otherwise had fully recovered his normal memory functions. His later afternoon progressed very well and so we decided that there wasn't an immediate need for a hospital visit. He ended up going to sleep at his normal bedtime and slept very well (unlike his parents!); in the morning we woke to find him reading as normal!
We kept Owen at home on Sunday for a quiet day, and we also talked with his teacher about avoiding sport or active play for the next week - something that is very clear in the literature about concussion. She was very supporting, and so on Monday he looked to be in excellent shape and headed off happily to school once again.
On Tuesday morning Owen woke with a headache. This was clearly still within the normal range of experiences, but we decided that it was sensible at this stage to have some further medical follow-up. During Ramadan the outpatient clinic at the hospital opens at 11am and so we sent him off to school for most of the morning before collecting him and taking him to see a doctor. We had a nasty paperwork surprise at the hospital – it turns out that each individual requires their own medical insurance card and so the clinic would not accept him under Peter's cover. After an hour of talking with various people we ended up having to pay the costs directly and will then have to get them reimbursed.
The actual check-up went very well; the doctor was a lovely Syrian man who was effusive about how much he’d enjoyed a visit to Sydney. He did a thorough series of checks and was very happy with Owen’s state; in the end he ordered an MRI scan to be sure but was confident that there wasn’t any further issue.
We weren’t able to have the scan until the following day and so we headed back again on late Wednesday morning. Owen found the MRI very claustrophobic and so the technician asked Maree to comfort him by holding his leg, while Peter went into the control room with him. Owen complained after each imaging set was finished but did pretty well really; at the end of it all he looked fine but Maree had developed a very bad headache from the ear-splitting noise, and was extremely nauseous. She had forewarned Owen that it was a very loud experience, but commented that this machine seemed much louder than the ones she’d experienced in Melbourne.
The best sort of ending ...
The whole saga was wrapped up at the start of the next week (Saturday night) when Owen and Peter each had their follow-up appointments at 9:15pm and 11:30pm respectively - did we mention that the opening hours are strange during Ramadan?! We were delighted to find that Owen's MRI was completely normal, and he was also very pleased to be allowed to do PE again. Peter's finger is still slightly swollen but is apparently recovering well, although it will still be quite a while before he can play basketball.
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