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Someone asked about Dr. Anguizola at Ning, but I decided to cross-post my response here.  Hopefully, this will be useful to those who do not have medical insurance here in Panama. 

Dr. Anguizola's office is at Mae Lewis Hospital.  He became my cardiologist when I was admitted to Regional Hospital in David on February 23 of this year.  He is now my regular cardiologist.  I have great respect for Dr. Anguizola - I think he is an excellent cardiologist.  His office phone number is 774-2453 - but his staff speaks only Spanish. 

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For those who are interested in my experience related to my mild heart attack in February of this year, here is my story...

I am a 74 y/o expat who moved here from Sonoma County in Northern California in early 2012.  I am a permanent legal resident of Panama, and have an E-Cedula (Panama's national ID card for non-citizen foreigners).  I have have no medical insurance in Panama.  My Medicare Supplement plan includes a $2,500 deductible, and I would have to go to Florida or elsewhere in the U.S. to use it.

I suffered a mild heart attack on February while carrying my stuff in to the BCP Center for the Tuesday Morning Market.  I became weak and dizzy, so I took everything back out to my car, and drove to Dr. Chen's office.  Dr. Gomez quickly had me lie down on the patient bed, ran an EKG, determined that I was having a cardiac "ischemic event"  - reduced blood flow to the heart muscles.  That visit cost $120.  Dr.Gomez called the 911 ambulance (my choice - minimal equipment, but a free ride).  They arrived soon, took me to the Regional Hospital in David.  (A better-equipped private ambulance would cost $250.)

After another EKG in the "coronaria" (coronary emergency unit), it was determined that my condition was not that serious, so I was on a bed in the very crowded coronary emergency area for about 12 hours.  (A new, bigger hospital is being built on the property, which will be a big help with the capacity problem.)

Although the coronary emergency doctor at first thought I might go home the next day, it was later decided to admit me.  I was moved upstairs to a six-bed coronary care room and confined to bed with not even bathroom privileges.  I was hooked up to a modern, high-tech heart monitoring machine.  After three days, I was disconnected from the heart monitor, and moved to a regular room on the cardio floor, still confined to bed.  On the 5th day, I was allowed to get out of bed and discharged after my sixth day.  Hospital cost for six days - just under $900. 

Dr. Anguizola's discharge orders for me included 30 days of not driving, resting at home, and not doing any kind of exercise of work.  My 30-day supply of 7 different cardiac medications cost $44 at the regional hospital pharmacy. 

My first follow-up appointment with Dr. Anguizola at his Mae Lewis Hospital office including an EKG and 1/2 hour consultation cost $75. Future appointments at 3-month intervals for now will be $50 or $60, and getting prescription renewals without seeing him costs $10.

My next appointment was for an echocardiogram (ultrasound), which cost $175, and no issues were found. 

A week later, my last follow-up appointment included a  stress test (EKG while walking on a treadmill) and some irregularities were found.  Dr. Anguizola recommended that I have an angiogram done.  I was quoted approximately $4,000 for an angiogram here in David, and $15,000 for an angioplasty if necessary.  He also said that I could probably get by with longer-tern medications, which I am doing for now. 

I am pretty much back to normal, and very impressed with the medical system and the medical professionals here in Chiriqui.  I am currently taking cardio aspirin ($7 for 30 tabs at Farmicia Revilla, $8 for 1,000 tabs via Amazon, which is $7 per month vs about $5 per year.)  My very low dose statin (Vastatina) is available at the public clinic pharmacy for $1.20 per month, and I had to show my cedula to get it.  (I don't know if having a cedula is a requirement.)  However, they don't carry my angina med, which is $15 per month at Farmacia Revilla.  My drug costs will be about $18 per month after I get the cardio-aspirin from Amazon. 

I am the first I know of in my family to have a heart attack, but the care and medical services here in Chiriqui are excellent, and I appreciate what they offer for such a reasonable cost. 

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Dr Anguizola is also my cardiologist.  He is very thorough and most definitely not a pill pusher - he will prescribe what is necessary, but nothing more.  While his secretary is not good in English, just asking for a " cita" will get you an appointment.  When you call, just have the Spanish practiced for "an appointment on Wednesday please" or whatever you need.  He is usually in the office after 3 pm Mon to Fri and I think, mornings Saturday.  Sometimes busy so you may have to wait a few days to see him, but he will make room in an emergency situation.

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David, if you can go to the U.S. and have a follow-up echo, that wouldn't be a bad idea.  A friend of many people here was grossly misdiagnosed because of very poor images from crappy equipment.  The doctor, patient, and hospital will remain unnamed.  It was not your doctor or your hospital.

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7 hours ago, JohnF13 said:

Dr Anguizola is also my cardiologist.  He is very thorough and most definitely not a pill pusher - he will prescribe what is necessary, but nothing more.  While his secretary is not good in English, just asking for a " cita" will get you an appointment.  When you call, just have the Spanish practiced for "an appointment on Wednesday please" or whatever you need.  He is usually in the office after 3 pm Mon to Fri and I think, mornings Saturday.  Sometimes busy so you may have to wait a few days to see him, but he will make room in an emergency situation.

When I was diagnosed by Dr. Chen with a heart arrhythmia and told to see a cardiologist, I went to Dr. Anguizola's office because my research indicated that he was by far the best in David. I was told the soonest I could get an appointment was six months. I got in earlier only with the intervention of a Panamanian friend who knows him personally. He's very, very busy and, I understand, has cut back on his patient load. I agree with everyone that he is an extraordinary doctor. I have to go in every three months for an EKG as well as periodic lab work. Yes, the wait in his office can be long. I always take a good book and all the patience I can muster.

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5 hours ago, JudyS said:

David, if you can go to the U.S. and have a follow-up echo, that wouldn't be a bad idea.  A friend of many people here was grossly misdiagnosed because of very poor images from crappy equipment.  The doctor, patient, and hospital will remain unnamed.  It was not your doctor or your hospital.

I am confident in Dr. Anguizola and his equipment, but I truly appreciate your concern and suggestion, Judy. 

Dr. Anguizola's echo-cardiogram instrument in his office at Mae Lewis Hospital is modern, and he was there handling the probe and doing most of the imaging himself. 

While in the hospital, a fellow patient in my room had an echo-cardiogram done, and I could watch the procedure from my bed.  It was set up by a medical technician and then the cardiologist stepped in to do the exam.  It was an amazing instrument that looked to be brand new and state-of-the art.   The combination of heart pumping sounds sound and image quality was truly remarkable. 

(In my younger days, I was a U.S. Navy Hospital Corpsman for four years.  Later, I worked as a lead technician in the development of dual-lumen cardiac catheters for one the world's first direct-reading blood oximeters.  Later still, I worked in sales and tech support for Jandel Scientific's scientific graphing, statistics and video measurement software, and communicated with research doctors around the world.  I am comfortable with my assessment of the equipment and the doctor's.)

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  • 1 year later...
  • Admin_01 changed the title to Cardiac Emergency Care and Followup in Chiriqui...

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