CM Bournigal in POP vs CMC in Sosua

[Bred]

Came back home from centro medico Bournigal in Puerto Plata yesterday after staying there for 3 days and almost lost my leg due to negligence at CMC in Sosua. I have been living in Sosua since well before they opened CMC but will never be back there again.

Short story. Got an insect bite around a week ago. Eventually it got infected so badly that I started to feel pain when walking, and I rushed to CMC on Saturday AM.

1st they did not want to accept me at the emergency unit and sent to "consult with the doctor" first. Of course, the doctor was not there yet. Waited 2 hrs to be accepted. As usual, paid 300 Pesos (instead of 200 listed on the bill for insurance company), no receipt (as usual). After the consultation - up on the 2nd floor to an operating room - same doctor, Jonathan Ramirez Almonte. Under local anesthesia got the fuss out, cleaned and stuffed with gauze bandage and told to come back tomorrow Sunday) at 10 AM. Waited another hour for the bill and was surprised that not everything was covered by the insurance. Extra 1500 Pesos in a separate "Recibo" without a signature.

By the evening pain increased and the foot swelled. Was taking the meds prescribed by the doctor on time. In the morning rushed to CMC well before 10 a.m. hoping the doctor would come a bit earlier (forgot I was in DR). The foot was huge already. Stayed in ER for 2 hrs (!!!) till noon, question the staff when the doctor finally comes? Was lied several times that the "doctor already on the way". At 12-15 was attended by some woman who saw me from the time I arrived in the clinic - she said the doctor is not coming and she would clean the wound. She did, stuffed with more bandage and told me to come back tomorrow (Monday) by 10 AM.

By the evening pain increased and I could not even walk. By morning pain became unbearable and a friend rushed me to Puerto Plata - centro medico Bournigal, instead of CMC. Was received there at ER promptly by English speaking doctors. Blood test showed 20 (whatever) white blood cells - a lot more than normal according to the doctor. There was quite a bit of dead tissue around the wound. Under spinal anaesthesia got 2nd surgery and cleaning (reading now from final diagnosis - "desbridamiento amplio" and "facitis pierna"). Spent 3 days (2 nights) in a very nice room (TV, fridge, air-conditioning) and great care.

The total bill including the room was around 45.000 Pesos. Paid the difference in cash - 4.430 Pesos. Was released from the hospital yesterday in the afternoon.

Tomorrow morning will go back to Bournigal to remove the drainage tube. Can already walk now.

Probably would be without the leg if returned to CMC on Monday morning.

 

[AlterEgo]

OMG, do you know what bit you? *Scary story. *Hope you're better soon. *

 

[Garyexpat]

And friends thought I was crazy (probably true) when I had a bite on my leg and cut it open myself dousing with Hydrogen Peroxide, applied antiseptic ointment and took some antibiotics.

 

[mido]

Oh boy, that looks like a brown recluse bite. Better get some real help really soon!!!

 

[dv8]

wow. i'm sorry you've been though so much pain and stress because of that. hope you heal completely soon.

my personal opinion about hospital care is that i'm better off going to santiago for anything that is not killing me on the spot. obviously in proper emergencies you head to the closest clinic and keep your fingers crossed. i've heard both good and bad things about bournigal, glad it worked for you.

keep yourself hydrated and rest. things will get better.

 

[malko]

Wow dude !!
Nasty insect bite !!
Glad you are better !!

 

[the gorgon]

Oh boy, that looks like a brown recluse bite. Better get some real help really soon!!!

my thoughts, exactly. i think Bournigal knows what they are dealing with. those are some really bad boys...if improperly diagnosed, the results could be tragic.

 

[Neargale]

I hope you recover fully, rapido!

It looks like you went to Bournigal in time!*

Good that you have friends close by to bring you to POP and (I assume) look after all the animals!

All the best!

 

[the gorgon]

i am relieved to know that at least a few people knew what they were doing, and took correct action. i have seen people suffer devastating illnesses from these spider bites.

 

[Debbie Short]

Did anyone mention MRSA? That does not look like a bug bite. MRSA looks like a spider bite but is actually a antibiotic resistant bacterial infection.Did they take a culture to know what kind of meds to treat it with? If not treated correctly it can be deadly. Hope you got the correct antibiotic and heal well.

 

[chico bill]

i am relieved to know that at least a few people knew what they were doing, and took correct action. i have seen people suffer devastating illnesses from these spider bites.

Gory photos, but I had a similar incident from a black widow, after crawling under a house in shorts about 16 years ago. Nowhere near that ugly however.
I keep a clean exacto knife and follow the Rolling Stones' advice: "Let it Bleed".
If you aren't squeamish cut the bite deep, the sooner the better after the bite starts to swell and itch (sometimes getting to a doctor takes too long).
And keep a tube or jar of draw-out-salve, hydrogen peroxide and a week's worth of Amoxicillin in the medicine chest.

 

[Harleysrock]

I really don't know how CMC stays open, completely incompetent.
I think I will start writing all these stories down. I don't think most people know how dangerous it can be going there.

I am glad your leg was able to be saved.

 

[Meemselle]

I have never been a patient at Bournigal; I was only there accompanying a friend of a friend through the psych ward. See my blog.

While I am cognizant of the many, many failures at CMC (and egregious ones) I have to say that in my 8 stays at CMC and my (probably) 20 visits to the ER, I have had very good care.

I hasten to add that none of these stays at CMC were the result of normal health maintenance, but were all the result of emergency situations. After my first visit there (the 2nd year I was here, when I was hit by a motorcycle and wound up with multiple fractures in both legs, a foot in shreds, and a wound that became necrotic), I visited Dr. Bones in CT, and he said he wouldn't have done anything differently.

I know the backstory; I know the scandals. I would absolutely prefer to go to Bournigal or HOMS, but since all of my medical issues have been emergencies, I am grateful that CMC is 10 minutes from where I am.

 

[beeza]

Did anyone mention MRSA? That does not look like a bug bite. MRSA looks like a spider bite but is actually a antibiotic resistant bacterial infection.Did they take a culture to know what kind of meds to treat it with? If not treated correctly it can be deadly. Hope you got the correct antibiotic and heal well.

Debbie sounds like she knows what she's talking about. *Look up MRSA here, the infection you catch in hospital*http://www.mayoclinic.org/diseases-conditions/mrsa/basics/definition/con-20024479

 

[Uzin]

I hope you fully recover soon, I had a similar issue a couple of times, once was bad but not as bad as this.

I think this is some insect that actually hardly bites but may be walks on the skin, it's not the poison of the insect that causes it but the infection that results from it - or maybe the insect carry this type of flesh eating bacteria. First it looks like a small/red boil, after that goes away the infection starts, almost invisible, under the skin (just a bit red), most people won't notice it before it gets large and looks bad.

I also used Hydrogen Peroxide but that made it worse ! I then bought high quality antiseptic spray to clean and antiseptic cream to put on it afterwards, must get all the yellow puss out and clean completely before it gets any better.

I think it is quite dangerous if left untreated, some people do better than others some worse, my friend also got it in Sosua, twice, had to go to a clinic to clean it (not CMC, small one on the strip). It takes a month to completely go away even if looked after properly, nasty !

I wish we knew what it is....

 

[lesia787]

I had a similar leg infection and was treated fast and well in CMC. May be it depends on the doctor. Unfortunately, I don’t remember the name of the surgeon but he was very preoccupied since the swelling and infection was already bad (as a result of my own negligence and waiting when it just cures itself) Seguro didn’t want to approve it fast (ma?ana as always)
and the doctor was so angry talking to them on the phone and making the things move faster. I’ve been at CMC many times and no, they are not perfect at all but I totally agree with Meemselle that it is much better that we have it so close.

 

[Cdn_Gringo]

Just guessing, chances are this is some variant of Staphylococcus bacteria. Our skin and fingernails is crawling with this stuff most of the time and scratching, chaffing, rubbing etc can all introduce the bacteria to a break in the skin. MSRA is a type of Staph and Staph bacteria of some kind is often a contributing cause of Necrotising fasciitis. An abscess infection is also a common form of a Staph infection which develops under the skin in an anaerobic environment until a pustule forms similar to an enormous zit.

Hydrogen Peroxide is not your best option in most cases for wound cleansing. The bubbling foaming action one sees with Peroxides is a chemical reaction that results in more tissue/cellular damage which impedes healing and scabbing.

Clean water (from your botella) and soap should be used for cleaning a wound and then rinsed well to get rid of the soap. A 2% iodine solution as a topical wound antiseptic is a good choice to apply after a cleaned wound has been patted dry but stings proportionally to the size of the wound. There are other antiseptics one can use that do not sting, the choice is yours. I like iodine, not because it stings, but because it's cheap and it just works. The iodine solution can also be use to sterilize drinking water. The antiseptic should be liberally applied to an area at least 1 - 2 inches all around the site of the wound.

The long and short of this is that hydrogen peroxide is probably not a good choice to clean a wound and may make the situation worse and aid in the infection of that wound especially in a hot, humid and dirty environment such as this little corner of Paradise.

All wounds, including an accidentally scratched mosquito bite, a shaving nick, scrape, hole in the skin etc, should be washed, dried and kept covered until completely scabbed over. If you rip the scab off, start over.

The development of a pustule will need lancing/cutting, draining, cleaning, sterilizing and a 10 day course of antibiotics in the 500 - 1000mg range from the "cillin" group of antibiotics. Any swelling, tenderness, pain and inflammation should be reduced dramatically within 48 hours or a different antibiotic will be needed. Take a pen and draw circle around the edges of any redness. If the redness spreads outside your circle, repeat. Continued expansion of the red area indicates your infection is not subsiding and you need to take action. Infection spreads quickly. Changes in the size of the affected area can often be observed within several hours, it does not take days.

Remember, any fresh break in the skin needs to be kept clean, dry and covered. Dressings should be changed as often as necessary to achieve the aforementioned conditions. Wounds large and small that are oozing need more in the way of treatment, best to see a doctor.

 

[Lobo Tropical]

Had good experience at CM Bournigal in PP.
Don't have much confidence in CMC, but if in dire straights in Cabarete-Sosua proximity helps.
I'm with dv8 for anything serious go to Santiago.
As usual in a real life threatening emergency the absence of qualified ambulance paramedics and the distance to Santiago or PP is a serious problem for the Cabarete - Sosua area.*

 

[the gorgon]

Had good experience at CM Bournigal in PP.
Don't have much confidence in CMC, but if in dire straights in Cabarete-Sosua proximity helps.
I'm with dv8 for anything serious go to Santiago.
As usual in a real life threatening emergency the absence of qualified ambulance paramedics and the distance to Santiago or PP is a serious problem for the Cabarete - Sosua area.*

there are some doctors at Bournigal who are as good as anyone else in their field of specialization. for prostate issues, Camilo Crespo is as good as anyone else on the planet.

 

[Meemselle]

10 day course of antibiotics in the 500 - 1000mg range from the "cillin" group of antibiotics. .

And what, pray, if one is allergic to iodine and all the 'cillins? Plus erythromycin and sulfa?

I'll stick with my H2O2, thanks.

I've been in CMC 7 times in 5 years, and while I was managing the hotel, took several indisposed guests there, as well. My personal experiences there included two broken legs & a shattered foot from being hit by a motorcycle, a broken wrist, parasites, and the by-now legendary dog bite. With the exception of the broken wrist, I have absolutely no complaints about CMC and found the level of care to be adequate and acceptable. My guests' experiences ranged from a reaction to a wasp sting, water in the ear, sea urchin spikes to severe dehydration from diarrhea. Everybody did just fine.

My only complaint is the addiction to IVs and the very poor pain management drugs.