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RK, a member of my Nu-Living Concierge Medical Practice, was traveling in the Middle East when he had an automobile accident. He sustained four rib fractures and was taken to a local hospital. The patient was in extreme pain and was given several doses of morphine and transferred to the intensive care unit. RK remained delirious and had no ability to communicate with most of the medical staff about his condition—a terrifying experience which could have been disasterous if not for concierge healthcare.
One of his relatives notified me of the situation and I asked if I could be of assistance. I was given the telephone number of the hospital room and after calling, I was connected with a nurse who did not speak English. I persisted and finally was able to speak to another nurse who was able to tell me that RK was under the care of an orthopedic doctor who apparently spoke English. I asked to communicate with the doctor and eventually was connected to him. I learned that RK was stable but still in great pain. The plan was to discharge RK the next day and for him to leave the country on his scheduled flight the evening of discharge. I did not think this was a good idea.
RK was able to speak with me and told me that he was in great pain and still delirious from all the pain medications. He told me he was dizzy and could hardly walk. He also sounded congested on the phone. He was coughing and had a low-grade fever. Once again I was able to contact the orthopedic physician and convince him that RK needed to stay in the hospital for a few more days since he apparently was on the verge of developing a serious lung infection and had no one to care for him in this Middle Eastern country when he left the hospital. I suggested that he be given less sedating pain medication so he could recover his mental faculties and also make some plans which included changing his plane reservations. I recommended that they start him on antibiotics and begin respiratory therapy to help expand his lungs, as I hoped to prevent a secondary pneumonia.
Forty eight hours later RK was much better, ready for discharge and had much less pain. He did require continued pain medications, oral antibiotics and some inhaled bronchodilators. He was able to reschedule his flight and to arrange for the airline to provide special accommodations on the plane for his injury. He and I spoke daily from his hotel room and I assessed his suitability to travel. Finally I gave him the go ahead to leave the country. After he returned home I helped him draft a letter to the airline so that he would not be charged for changing his reservations due to medical illness.
I have had several patients who were traveling abroad and who developed medical illnesses. With today's technology, applications such as Skype allow a virtual visit between me and a patient anywhere where there is Internet access - a huge advantage that concierge healthcare allows. In one case a patient of mine detached his retina while in Thailand. He was unable to find a flight back to the US and needed emergency treatment to preserve his eyesight. I set up a Skype session with an ophthalmologist who was recommended to my patient. After watching the ophthalmologist's presentation to my patient, I was thoroughly impressed, so I recommended that my patient have the eye surgery in Thailand. His eye was repaired and his vision restored.
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