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Bacolod City, Philippines Friday, November 8, 2019
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Come To Think Of It
with Carlos Antonio L. Leonardia



I spent my MassKara weekend in the hospital and on the telephone because my 40-year-old sister suffered a massive heart attack that Friday afternoon. My previous article discussed the challenges of doing that without a cellphone signal during critical times of the day. Today we will talk about the challenges of having a heart attack in Bacolod or Negros Island.

Despite being a highly urbanized city and being judged one of the most livable cities in the country, Bacolod has none of the specialty medical facilities and equipment for heart attacks. Our doctors here can stabilize the patient and prevent them from dying with confidence if they make it to the hospital in time like my sister did, but that is all they can do as they are still very limited when it comes to the capability to intervene and treat a heart attack.

The trouble with a heart attack is that even if you don’t die on the spot and make it to the hospital, it is a continuing event that still needs to be treated ASAP. The longer it is not treated, the bigger the chance of the heart accumulating more damage. If a Negrense gets a heart attack, the best our doctors can do is give meds that can hopefully stabilize the victim as they prepare for commercially available transport to either Manila, Iloilo or Cebu. This stabilization process can take days, or weeks, depending on the patient. Those who are not comfortable with waiting, or whose situations are critical, will have to find the ways and means to get to those cities that have the necessary facilities for treatment.

The saying “Time is gold” couldn’t be more fitting than for someone with a family member stricken with heart attack in Bacolod. It may be cheaper to wait until the patient is stable enough to take a commercial flight to Manila, but the heart attack is not resolved until the diagnostics and procedure that should’ve been performed ASAP is completed. If the patient cannot wait, then an air ambulance has to be arranged or a private airplane chartered. The cheapest air ambulance we could find last weekend cost P420,000. Chartering a turboprop aircraft will set you back approximately P150,000 if you have the right connections. Those were the prices I got while shopping for options for a family or patient that was willing to pay to get to Manila ASAP.

Because of the inadequacy of our medical facilities on this island, time is indeed gold.

Since Bacolod has no cath lab, heart attack victims have no access to angiograms that can tell doctors where exactly the problem is and of course, no chance for an angioplasty that could quickly remedy the problem. All our doctors can do is manage with what they have which are mostly ancient and inaccurate methods such as ECGs and blood tests to monitor troponin levels, and of course medicines that can buy time but won’t get rid of the problem.

In other words, there is good news and bad news. The good news is if you have a heart attack and make it to the ER and the ICU, you will probably not die because of the miracles of modern medicine. The bad news is you cannot be treated properly until doctors get you to a medical facility with a cath lab and until Bacolod gets one, it will require travel to Manila, Iloilo or Cebu.

Waiting until the patient is stable enough to travel safely via commercially available options will come at the cost of the patient’s heart muscle that is constantly struggling and scarring because of the blockage(s). On the other hand, making arrangements to charter an immediate means of exfiltration will naturally cost a lot of money. Unless the patient or the family had the foresight to secure insurance forcritical illness expenses, set aside funds for such emergencies, has a jet, or is a combination of extremely resourceful and lucky, they’re going to be stuck in cathlabless Bacolod until their doctor deems it safe for them to travel commercially.

A cath lab that can allow doctors to perform an angiogram and angioplasty is not new technology and most hospitals are probably acutely aware of the number of people suffering from myocardial infarctions (a.k.a. heart attacks) on this island. And despite being practically almost two decades into the new millennium, our island still doesn’t have one.

If there is any consolation for those of us who are having palpitations at imagining the helplessness of having a heart attack on this island, rumor has it that a Bacolod hospital will be opening a cath lab very soon. Hopefully the rumor is true and the quality of equipment, service and medical care is at par with what is available in the “bigger” yet “less livable” cities of this country.

If only our medical directors and hospital administrators were fans of the Kevin Costner flick “The Field of Dreams,” they might’ve been inspired by his motto “If you build it, they will come” and they could’ve built that cath lab sooner. They probably have their reasons for not pulling the proverbial trigger and perhaps government isn’t really encouraging them by dangling the right incentives.

Hopefully the people of Negros get our cath lab soon, as well as all the other missing medical equipment we need so we don’t get heart attacks worrying about the cost and logistics of transporting our patients to travel far and distant places to seek proper treatment and save lives.*  

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