Saturday, August 15, 2009

Baby arrives 5 weeks early...the rushed trip to India

Baby decided to arrive 5 weeks early. We got a call at 11:00 PM congratulating us on a healthy baby boy, and I flew at 7:00 AM the next morning. My first night of no sleep in a very, very long time. I’m sure many more to come. Spent most of the night packing and making sure the place would be okay while we’re gone (it will). My wife and I were in different cities, so we traveled separately and I arrived first.

The baby was in the NICU and on a respiratory, which nobody mentioned to us before I physically talked to the pediatrician. Because the baby was born five weeks early, it’s lungs were underdeveloped. The doctor calls it Hyaline Membrane Disease which is the same as Respiratory Distress Syndrome.

Many things to relate, but in largely chronological order…

After landing, I call Dr. Kadam who basically says to goto the hospital and get a room. Which is about what I expected. Nothing about the baby being in NICU (which I didn’t know yet).

On this trip, I didn’t have a driver lined up at the airport. Good news – there is a counter where you prepay for a taxi, the very last thing you do before you exit the airport - about 2 yards from the airport exit (oh, and there are about 6 currency exchange counters here if you need them, although ATMs are pretty widespread outside as well). They quoted me 230 Rupees for a ride to Hiranandani in an air conditioned taxi, which seemed reasonable compared to all my other taxi rides. I then went outside and had to find the taxi parked among a large throng. Some guy helped me find the taxi, I gave him a 30 Rupee tip, he asked for dollars. I left it at 30 Rupees.

On the way to Hiranandani, the taxi driver stops for gas. This doesn’t happen in very many countries. But, as I looked at the queue of taxis waiting for gas, several others had passengers. So I guess it’s not uncommon either. More interesting, my taxi used CNG (compressed natural gas), not petrol. When I was taking a picture of the CNG filling process, my limited English speaking taxi driver gestured me not too use the phone and made an explosion sound and hand gesture. I then saw a sign that said to turn off your mobile phones while filling (in addition to not smoking). Overall, it was more like filling up your propane tank (for your bbq grill) than filling up your gas tank. This smallish taxi took 170 Rupees worth of CNG. I have no idea how far that would get him. And the line of cars waiting to get a fill was long. We probably waited 15 minutes.

Of course the traffic was bad. And, the taxi driver didn’t know where the hospital was once we got to Powai. I realized this when he asked me if he should go straight or turn right. (This actually happens frequently in India, although usually the taxi or rickshaw driver stops and asks someone.) That’s when I started paying attention. Fortunately, there were enough signs to basically find the hospital, along with one quick stop asking a friendly person on the sidewalk to confirm we were on track. We were on the right track the whole time. I never did figure out if the taxi driver could read the signs or not.

The taxi driver said “tips” when we arrived. Since aside from the detour he’d done a good job, I gave him a tip of about 150 Rupees. I mean, how can he be living on a 1 hour trip that cost about US$5. With the tip, it still cost less than having someone pick you up at the airport. Although the taxi was probably 20 years old, so less comfortable (but more local) than arranged cars you’ll get picked up in.

The hospital is a hospital and not a hotel. They haven’t caught on to the Thai medical tourism thing. So, not surprisingly, there’s really no concierge to help with your luggage. They do a security check of your baggage before you go inside, although it’s a bit cursory, and you’re not going through a metal detector (like you would at the Marriot).

Good news, we got a room at the hospital. I had no idea if this would be easy or not. I think we got lucky, someone was just checking out of a suitable room. We got the Single plus room. Turns out to be a hospital bed and meager couch (that’s the second bed) for about 4500 Rupees a night. And it looks exactly like a hospital room. Two can sleep in the room, although one is sleeping on the couch. Filling out the paperwork to get a room was about 45 minutes. Had to prepay a deposit of 25,000 Rupees for the room. The room wouldn’t be ready for an hour, so they asked me to wait. I asked where I could leave my luggage, and there really wasn’t any place. I ended up leaving it under the information person’s counter.

Neesha, who’s in charge of “public relations”, also came out and said hi. The best I can figure, “public relations” means “customer service”. She said the hospital could help with the birth certificate. Seems there’s a new guy in charge at the municipality, and a “rushed” birth certificate now takes around 10 days, rather than the previous 3 days. Well, that will make for a longer stay. I wanted to learn more about the best (fastest) way to get birth certificates. She said she’d stop by my room later in the day to discuss further. More on that later.

So, as I walk by the nurses station they amazingly know who I am because they say the surrogates name as I walk by. One of the nurses shows me the room and gives me the disinfectant to use before holding the baby. I’m pretty sure I asked if they were going to bring the baby, but I’m in the room and waiting for the baby for a half hour when I go out and ask the nurses when they’ll be bringing the baby. They have an attendant walk me down to the NICU. The nurses (sisters) there say I can’t see the baby until I’ve talked to the pediatrician. I’m then walked over to the pediatrician (Dr. Bijal, is nice but is at times rushed like everyone else) who tells me the baby is in the NICU (which I’d sort of figured out since they took me to the NICU), had excessive grunting (a form of breathing difficulty when born) and is on a respirator to make sure he’s getting enough oxygen. I ask a few questions and wrote down the big words for later Internet research.

Dr. Bijal asked where we were staying and I said here at the hospital. She seemed pleasantly surprised, which told me not everyone does, and that she thought it was a good idea (at least for us).

Then I go back to the NICU, wash my hands, put on a gown, put on a mask, put on a hair net, put on sterile slippers, disinfect my hands again, and finally go in to see the baby.

Poor baby. Tubes going in and out, mostly for food and air. I look at all the machines. Trying to decipher the numbers. Heart beat around 170, a bit high. Oxygen absorption at 98%, seems good. Breathing rate erratic jumping between 50 and 90, not so good. Some kind of glucose at 9.5 (mls per hour?). And the respirator set at 36% Oxygen. Two other babies. I feel sad for the other baby’s parents as well.

I then head off to report to the family. I’d learned that there are publicly (free) computers on the 1st floor in the health check area. So, I can gmail folks. It turns out the machines are locked down so I can’t get photos/video uploaded through the USB port or any other method that I can think of. Nor can I connect my laptop straight into their LAN. The folks were nice enough to call one of the IT guys, who came down after 20 minutes, logged in as an admin, bluetoothed the files over, and made them available for me. Now that was good service. Although I don’t think I can do that every day, or even ever again. More on email/Internet access later.

Also worked on getting a local SIM card for my unlocked phone. Good news, you can get SIM cards. Bad news – you seem to need ID and a sponsor to get one. So, I got an Aircel SIM card. Probably the wrong thing to do as it turns out because they’re still new in Mumbai, and the hospital doesn’t have top-up cards. Oh, and the sales guy’s friend is now my local sponsor after providing him a tip ($5). During the process we also had to leave to get a photo, which was also required for the SIM card. It took about 24 hours to get activated.

With the room, you get meals. Choices are India, Chinese and Continental/Western. And, they’re not bad. We went for the Indian food – it’s actually pretty good. I’m sure the locals find it much too bland – it is not spicy. Western breakfast had omlette, bread, corn flakes and papaya. Indian lunch was soup (spinach, I think – a bit bland which means it was probably healthy), chicken (not masala, but something like that), dhall, some other kind of naan (I get them confused), yogurt, a sweet cream-of-wheat like desert, and an Indian vegetable dish. Indian dinner was soup (don’t remember which kind) and three dishes – a vegetable, a dhall (lentils) and a meat (chicken) along with desert, fruit cup and naans. You’re not in the U.S., so if you need Western sized servings, you’ll need more food. If you’re fine with normal sized servings, you’ll be fine. One set of meals comes with the room (breakfast, lunch, dinner). You can special order a second set which seems to cost about 180 Rupees per day. Quite a deal.

Talked to the Dr. Bajil in the evening, who seemed to indicate that the baby wasn’t improving as fast as she’d like, but that the lung situation was relatively mild and we didn’t need to rush anything. This seemed to confirm some of the Internet research which seemed to indicate it often takes a few days to get a baby of the respirator.

Being exhausted, I fell asleep early and woke up early.

Well, the bathroom still didn’t have the towel I’d asked about the night before. It did have something the size of a dish towel, which was enough. They’d also given me soap, tooth brush and shampoo. Kind of hotel-like in that regard.

I decided to go see the baby at 7:30 in the morning. That’s when I learned there are visiting hours, and they’re 5:00 PM to 7:00 PM. Which I guess makes sense. But they also said mothers could visit outside those hours, but fathers could not. Disappointing. But, with some sweet words, they were kind enough to let me in (I won’t be able to do that again either). I tried to be helpful and hold our baby boy while he was trying to pull the tubes out of his mouth, marveling at what was before me. Our baby boy.

I had my questions for Neesha and called her about nine. She said she’d stop by my room in a half hour. Two hours later she appeared. I am not currently cut out for the India sense of time and wasn’t so happy. She knows Prashar, who is the other guy that can do birth certificates, and says it will take the same amount of time either way. Among other things, I also asked her about the wifi that the brochure I got at check-in talks about. I’d been trying to connect, but wasn’t working on any of my three wifi enabled devices. She called IT. Their line was busy so she gave me their number and asked me to call them back. I call them in a few minutes, and they say they’ll be down in 15 minutes. After 45 minutes of no-show, I start calling. Busy and no answer. At an hour and fifteen minutes I get through to them again, and they they’re waiting for the outsourced wifi company to call them back before doing anything (such as visiting my room as they said they would). I told them I’d been waiting for them and they told me they were sorry.

Then a mystery visit by the nurses. “Please go down to the NICU now”. Since I’ve been in the room for about 4 hours, they probably could have called me directly. They wanted me to sign paperwork to give consent for an umbilical catheter. Like most places in the world, the paperwork I sign says that I’ve been fully briefed on what they’re going to do. I hadn’t, so I asked several questions. They were satisfactory enough, so I signed. Then the NICU folks told me I had to go settle the bill.

Since billing is largely by pre-payment, I had to get caught up on payments. So, more money for the Surrogate’s stay (probably at US$4,000 for her four stays total, including delivery), but haven’t paid anything for the baby’s stay yet.

And that’s where we are so far…

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