By Rhaydz B. Barcia
NAGA CITY --- It’s been three months after my father went through a 360-cervical spine surgery after having fallen from an avocado tree, thanks to a Neurosurgeon applying Neuroscience modality and technology here.
My father, Ernesto Barcia, 73, fell from an avocado tree last September 9, 2017. According to my sister Jean, our father left home on Saturday morning to visit our palay farm in Barangay Cabasan, Cagraray Island, Bacacay, Albay, but had not returned home at expected time that he should have done so.
A few hours later, a fellow villager, Robert ‘Obet’ Barrameda, brought our father home as he was unable to make it on his own.
As I am based in Legazpi City, my sister texted me about the incident which kept me worried. I immediately told her to bring our father to the district hospital in mainland for the necessary medical attention
But bad weather condition did not allow our father to be immediately transported from the island to the mainland for the medical examination, particularly the X-Ray test as a most urgent step.
Cagraray Island can be reached by motorized banca. Once on land, people take the ‘habal-habal’ type of hired motorcycle ride to their desired destination where the roads remain unpaved and suited solely for single mode of transportation.
Although there is an ongoing construction of coastal road network funded by the Department of Tourism to develop the place as one of the emerging tourism destinations in the countryside, full construction works have yet to reach our place.
Such situation makes the Cagraray District Hospital in the island not easily accessible to many residents, especially those coming from far-flung barangays.
My other sibling based in the nearby town of Malinao, Albay went outexcused herself from her afternoon class session to meet our father and other siblings in Bacacay town and help facilitate his travel to Tabaco City for better medical treatment.
But I told them to bring our father to Legazpi City instead where bigger and modern public and private hospitals are located.
At that time, I was busy with my in-depth story on overseas migrant workers as part of my fellowship under the International Labor Organization of the United Nations in partnership with National Union of Journalists of the Philippines where the Philippines is one of the few countries chosen for a pilot project on fair recruitment and human trafficking related cases.
While waiting for their arrival in Legazpi City, I told the case of my father to Kuya Cet “Anaceto “Cet” Dematera” a senior veteran colleague writing for Philippine Star and the department head of the College of Arts and Letters of Bicol University. He advised me to bring our father to the Bicol Regional Training and Teaching Hospital in Legazpi City where there are better trained and experienced medical doctors. He even likened the BRTTH physicians to tested soldiers in the battlefield.
At the BRRTH, my father was immediately brought to the emergency room. He was pallid and immobile. His face was sad while being moved along in a stretcher. Seeing my father’s condition made me feel weak but I tried to hold my tears. I held his hands and touched his head trying to reassure him that everything will be alright.
While at the emergency room, he complained about short breathing, severe head and neck pains. He could not eat well causing sudden deterioration of his body.
“I climbed the avocado tree trying to remove one of its over-extending branches as it might hit passersby, especially students, but unfortunately I was out-balanced and fell on the ground,” he told me while laid on the stretcher.
Dr. Neupane Prayas, one of the BRTTH resident surgeons, said that my father must be attached with a nasogastric tube (NGT) for his food and water intake to protect his lungs and prevent further complications.
The NGT is a tube that passes through the nose, into the nasopharynx and esophagus down to the stomach to convey food and liquid. Inserting the NGT was not easy. It took a third attempt before insertion of the tube became successful as my father gasped for breath during the process.
Papa was admitted in the hospital on September 15, 2017. It was his first time to be hospitalized. We requested for a private room but there was none available at that time. He was accommodated at air-conditioned Philmix ward with four beds capacity and a toilet.
Based on X-ray test result, Dr. Aldrin Ocampo said that Papa’s cervical spine was fractured. He recommended a CT scan to check thoroughly the extent of impairment.
Dr. Robert Angelo P. Roque of radiology division recommended that my father undergo Magmatic Resonance Imaging (MRI) to evaluate accurately the severity of spinal cord injury and details of nerve compression through imaging scrutiny.
During his confinement, Papa was complaining of constant and severe head and neck pain, poor breathing, numbness of shoulder radiating down his swollen arms even though a sequence of painkiller was injected to him but to no avail.
He was even crying due to severe pain while his teeth were gnawing. “I could not bear the pain anymore. My head is seemingly hit by a sharp knife. I might not see my grandchildren grow up anymore,” my father complained.
Medics had even given him higher doses of pain killer. But as the days went by, the pain worsened while his nerves went numb, he could no longer feel when he had wet his body.
One day, Dr. Prayas came in to the room while Papa was sleeping. He said he wanted to talk to me outside the room about Papa’s condition.
With the presence of my two other siblings, Prayas said “your father might expire anytime because of cervical spine injury. It’s a delicate condition.”
At that moment, I felt cold water was doused over my whole being while my two siblings also froze speechless.
Regaining my senses, I asked Dr. Prayas what’s the best to be done to save our father. The good doctor said that a major operation could save him but it would be too expensive.
When I asked who will do the surgery and how much would it cost, Dr. Prayas replied there were two visiting neurosurgeon specialists at BRTTH and one of them would be handling Papa’s case. As to the cost of operation, the good doctor said he had no idea.
“The neurosurgeon will be arriving for a week, so please be at the hospital when the neurosurgeon arrives so you can discuss the cost of operation. I will inform you the date and time of the arrival so you wouldn’t miss it,” Prayas said.
On September 20,at about 4:00 p.m., a man in white robe came in to the room along with Dr. Prayas and Dra. Nieto, both resident surgeons of BRTTH.
He introduced himself as Dr. Elmer Meceda. He invited me to come to the office and explained to me my father’s present situation. Soon my other sibling, Marilyn, arrived and was briefed, too, about our father’s condition with computer images of his fractured cervical spine.
Dr. Meceda recommended a 360-implant cervical spine surgery on my father. He said that surgery will be done in Naga City as the Legazpi-based BRTTH has no C-Arm and MRI machines. The sole hospital in Bicol with MRI machine is the Naga City Doctors Hospital (NICC), a private hospital, and the hospitals with C-arm machines are the Bicol Medical Center (BMC) and Bicol Access, which are all located in Naga City.
He said the cost of operation could reach over P500,000 to more than P1M, especially if the surgery would be done in private hospital in Manila.
The amount was too big for us, even if my siblings would join together to raise the amount at the soonest time possible as they, too, have their own families to attend to. Two of my sisters-in-law were also due to give birth and one of them is set for Caesarean operation.
One of my siblings suggested to lease one of Papa’s palay farms but I resisted the proposal as we would lose at least 100 to 120 sacks of palay each harvest. Applying for loans will take time.
The idea of seeking assistance from the Philippine Charity Sweepstakes Office (PCSO) came to my mind but Papa’s case is ticking like a time bomb and we were running out of time.
Meanwhile, Papa’s head, neck, arms were in constant pain and his body was quickly deteriorating. Seeing him helpless breaks our hearts into pieces.
My siblings, relatives and few of our closest friends contributed whatever they can but still they were not enough.
With aid coming from our relatives based in the United States, we were able to transfer Papa to the Bicol Medical Center after 15 days of confinement at the Bicol Regional Training and Teaching Hospital in Legazpi City.
Before heading to BMC, we brought him to NICC for MRI. At BMC, he went through an ECG and other heart-related check-ups.
As soon as Papa’s cardiologist, Dr. Maribel Gutierrez-Cayetano, gave the green light to proceed with the surgery, Dr. Meceda set the surgical operation on October 3, 2017.
Despite some opposition from members of our family for fear of a dangerous operation, I stood my ground that surgery is the best option for Papa’s recovery. And so I signed a waiver and gave my consent for the operation.
A night before the operation, Dr. Francis P. Ferrer, anesthesiologist, warned the possibilities that may happen to Papa during the course of 12-hour operation considering his delicate condition, age and weak body. He stressed there is no surgery without risk.
“I am the anesthesiologist; two things may happen to your father during the course of a major operation, either he wakes up or he will sleep forever. So, you have to decide now while there is time to back out before the operation is done tomorrow considering that your family will be spending a big amount,” he said.
While we were at the BRRTH then, resident surgeon Dr. Aldrin Ocampo during Papa’s first day of confinement there when he was still relatively stronger told us that he would survive an operation despite the cervical spine impairment.
Dr. Meceda a week before the operation assured us that there was hope for Papa to survive and to be with us.
Despite Dr. Ferrer’s warning, I held on to my faith and offered everything to God for my father’s recovery.
On the eve of Papa’s operation, I was on the streets of Naga City even at 2:00 a.m. braving rains to purchase all the medicines and other medical supplies in different 24-hour drug stores and hospitals in the city as most of the medicines and supplies were not available at the pharmacy section of the Bicol Medical Center.
Before the medical personnel arrived, I talked to Papa earnestly, prayed together, showed him the happy and remarkable photographs of our family, particularly pictures of his cute and good looking grandchildren.
One of his newest grandchildren (Al Matthew) was born in BRTTH while he was confined at the same hospital. My brother brought his newborn son quickly to Papa’s room shortly after the Caesarean operation.
At 7:00 a.m., Papa was moved out from his private room to the operating room by medics led by Mark Olayon, RN. On the day of Papa’s operation, my other sister-in-law (Mayee) was also in a hospital’s delivery room to give birth to her second baby.
The 360 cervical spine surgery following his spinal cord injury due to bad fall is a critical surgery operation. According to medical narrative, cervical spine (neck) is a delicate housing of the spinal cord that sends messages from the brain to control all aspects of the human or animal body.
Cervical spine provides a passageway for vertebral arteries to pass and ensure proper blood flow to the brain.
Dr. Meceda, a neurosurgeon specialist, performed the implant operation to fix up Papa’s fractured cervical spine through anterior cervical discectomy and fusion, self-topping screw and peek cage technology.
On that day, October 3, 2017, I found to be true enough what Henry Van Dyke had said: “Time is too slow for those who wait, too swift for those who fear, too long for those who grieve; too short for those who rejoice but for those who love, time is eternity.”
While waiting silently on the bench nearby the operating room, I could see the sad faces of patients and their assisting kin passing by in restless condition, made even more unbearable by the smell of a defective toilet within the premises.
I decided to proceed to Papa’s hospital room to change the beddings and prepare them clean in time for my father being transferred back after the operation.
Having finished with the room, I went to the Naga Cathedral to seek the intervention of Our Lady of Penafrancia for Papa’s successful operation under the expert hands of the medical team led by Dr. Meceda as God’s instruments.
I rushed back to BMC when Meceda’s partner, Dr. John who provided the technology for cervical spine implant surgery, texted me that the operation was successful. I was elated by Dr. John’s words.
I wanted to see my father as soon as I set foot in the hospital but my sister asked me to purchase first several other prescriptions needed.
Dr. Ferrer, the anesthesiologist, informed us that Papa’s heart beat rate had gone up down from 170 to 30 midway of the operation but then resurged for the better.
“Your prayers greatly helped out your father to regain back his life. It was so frightening when his heart rate turned irregular and the blood pressure temporary halted midway of the operation. He has a mission still though,” he said gladly in Tagalog.
A day after the operation, Papa experienced shortness of breathing that turned him black and wan. Oxygen machine was put in by medics while his attending physician Dr. Meceda undressed him and removed the NGT that finally relieved him from discomfort.
My father was finally discharged after 15 days of confinement here. The succeeding rehabilitation sessions were continued in Legazpi City for two more months.
After two months of being bedridden, Papa walks again which delighted the entire family, relatives, friends, and his physicians, as well.
In his good health at 73, our father could lift a sack of rice (50 kilos in weight). His healthy lifestyle and proper nutrition might have been his secret weapon. Ploughing and visiting the farm daily was his way of life and regular routine.
With Papa’s operation and hospital confinement, I’ve learned many things about the needs of both government and private hospitals. Many who suffer from cervical spine problem were unable to survive due to poverty and the high cost of operation.
Dra. Ada Angela G. Moncada, BMC resident surgeon, said if some physicians were willing to provide free medical services, expensive technology and their availability remain to be the problem.
For the professional fee alone of the Neurosurgeon, the cost is P300,000 if the operation is done in Manila. The fees are lower among medical professionals who are based in the provinces that range from P100,000 to P150,000. Anesthesiologists charge half of the Neurosurgeon’s professional fee.
The technology employed costs from P80,000 to more than P100 depending on the extent of injury. The physicians’ professional fees and equipment alone will cost the patient’s family more than half a million pesos, excluding the bills for hospitalization, medicines, and rehabilitation, among others.
Dr. Meceda one of the country’s neurosurgeon specialists, said the establishment of a foundation is needed in the country to help Filipinos suffering from cervical spine and related injuries.
According to Dr. Prayas, cases of cervical spine related injuries in Philippines are rising due to more vehicular incidents. Other cases are caused by indulging in sports, combat, and by natural disasters and brittle bones.
2017 was truly a roller coaster ride for our family with so many lessons learned following Papa’s accident.
Today, we’re welcoming 2018 with full of hope and gratitude for people who have been part and instruments of father’s second chance to live again and for God’s miracle to give back Papa’s precious life anew.
Our aspiration is for the establishment of a foundation where the PCSO and other charity organizations can allocate and pour in funds that will cater to the needs of people with cervical spine and spinal cord injury, especially those coming from the underprivileged and poor families.