Monday, March 26, 2007

Getting an exit permit to leave Panama; Doctor's appointment at Hospital Nacional; Heaving, sweating and running around

Click the photo below to see a much larger version.

Long day today. We went to Panama city because I have overstayed my tourist visa and need to get an exit permit so I can leave the country. Also, Salma had an appointment for her eight month checkup.

A tourist visa in Panama is good for 90 days. Before the expiration of the 90 days, if you need more time you can go to the immigration department (take two passport sized photos and your passport) and pay a small fee. They'll issue you a laminated card that allows you to stay for 90 days more.

However, if you overstay your visa - whether the original 90 day visa without getting an extension, or the extension itself - you are technically an illegal immigrant and you can be arrested and detained, and eventually deported.

Obviously this is not a good position to be in, and I was worried about it. I spoke to Berliza Arosemena, my lawyer, and she informed me that I can pay a $60 fine and get an exit permit, whereupon I must leave the country within eight days. I asked her if I would thereafter be banned from re-entry into the country.

"No" she said. "We're not the U.S. We don't keep track of these things."

The immigration office in Panama closes early, so I had to get to my lawyer's office by 9am, and from there we'd go directly to immigration. This would mean leaving the house by 7am.

Since I tend to work until 2 am or so, this was an unlikely scenario, and indeed we did not leave until slightly after 8am - still quite good for me.

Chucking Up on the InterAmericana

In the last few months, Laura - who has never been carsick before - has been experiencing headaches and nausea when we drive the winding mountain road from El Valle down to the InterAmericana. On the last trip she felt downright queasy. We don't know if this new ailment is the product of driving a mountain road so frequently, or something to do with her recent gallbladder removal, or the result of some biological change brought about by pregnancy and childbirth.

Today was the worst of all. By the time we got to the highway she was moaning in discomfort. I thought once we got down to the long, undulating stretches of the highway we'd be ok, but on the approach to Capira, just before El Espino, Laura said, "Can you pull over?"

I spotted a little Chino (Chinese-owned mini-market) and barely pulled into the parking lot before Laura yanked open the door while the car was still rolling and threw up in the dirt.

We waited until it passed. I went into the Chino with Salma (where the Chinese lady started telling me in Spanish about how her daughter had once had a hemangioma as well), and got Laura a Gatorade and some saltines and we continued to the city, but the feeling of discomfort stayed with Laura the rest of the day.

Getting an Exit Visa

Berliza has moved to a new office just off Via Argentina, but we found the office, and rode with her downtown to the immigration office. If you've ever been there, you know the routine. Take a number, wait your turn, fill out forms, pay a fee... for the exit visa you must supply two passport sized photos and your fingerprint as well. At the clerk's window was a graduated chart showing the fees for the exit permit. The fee goes up the longer you have overstayed your visa. In my case the chart said $180, but fortunately I only had to pay $80. I don't know why. I don't question these things.

As I mentioned, now that I have the exit visa I must leave within eight days, and remain out of the country at least 72 hours. As it happens, we are making a four day trip to Cartagena, Colombia, on March 30th. It's said to be an interesting and attractive city, and is close enough to Panama that the airplane tickets are fairly cheap.

New Doctor, New Problem

From immigration we needed to go directly to Hospital Nacional for Salma's checkup appointment. Hospital Nacional, seen in the photo below, was originally a maternity hospital, founded almost a century ago, and is now a general-care private hospital with good facilities and excellent doctors. Salma was born there, and we've always been happy with the care we've received there.

We said goodbye to Berliza and tried to walk to the hospital in the noonday heat, carrying Salma, who now weighs more than 20 pounds. I thought it was only a block or two, but I quickly realized that I was mistaken. I hailed a taxicab and I was glad I did, as it was perhaps ten blocks to the hospital.

Salma's regular doctor is attending a seminar in New York, and we had made an appointment through his secretary with a doctor named Nelson Rodriguez, who we've never met before. As it turned out, Doctor Rodriguez didn't seem to know we were coming, which I found very annoying. Nevertheless, he agreed to see us at the appointed time, and he turned out to be quite nice and very knowledgeable. However, he could not speak English.

Of course, that's our problem, not his. This is a Spanish speaking country and it's our job to learn to communicate with the Panamanians, not vice versa. And we are trying.

I was able to digest perhaps half of what Dr. Rodriguez had to say. I do better with the ordinary citizenry, but a doctor of course uses a fuller vocabulary, and there was a lot I did not understand. Dr. Rodriguez spoke at length about some of the problems we are having. He listed many fruits that may help to relieve Salma's constipation, and spoke about creams that may alleviate her diaper rash. He informed us that the two things we have been giving her specifically to ease her constipation - apple juice and bananas - are actually binding. Great. Try pears, he said, or grapes, pineapple, papaya, or plums.

We spent an hour in his office, dicussing these things, weighing and measuring Salma, charting her growth, checking her diaper rash, and more. The doctor listened to her heart and lungs. He checked all her new teeth, then put her through her paces as he watched her sit up, turn over, and try to crawl. He wanted to know what foods she was eating, how she slept, and whether she was generally happy or not. He was very thorough, and seems to be a good doctor.

Salma's not crawling yet, and the doctor said that this is normal. Some babies begin crawling as early as six months, and some not until ten, but the average is the ninth month.

Salma is also in the 95th percentile for weight, so my perception that she is a little chubalub has been professionally confirmed. Laura and I agreed that we'd cut back on the cereal and fruit juice and start giving her actual fruits and especially vegetables.

The doctor said that he normally advises parents to give their babies iron supplements, as many Panamanian babies are iron deficient, but Salma's blood test from a few weeks ago showed that her iron levels are quite satisfactory, so there is no need for that.

Overall she is progressing well and if we could just get rid of the diaper rash, she'd be on top of the world.

Lunch at the Las Vegas, Chocolate from Arrocha, Mail from USA

Afterwards we caught a taxi back to Berliza's office, conducted some business with her, then drove our car to the Las Vegas Hotel to meet a friend for a late lunch. The Las Vegas, pictured below, is where we always stay when we visit Panama, and it has a good Italian restaurant with an outdoor eating area beneath huge trees.

Perhaps this trip would have been easier if we had gotten a room and stayed the night, then returned to El Valle in the morning. We've done that in the past. But there's something comforting about returning home at the end of a long day, to our own beds, our two cats, and the dinner that Rosa has made waiting on the stove.

After lunch our friend came with us as we headed out to the Farmacia Arrocha on the Tumba Muerto to fill some prescriptions, buy the latest issue of Business 2.0 (my favorite magazine), and pick up a few good chocolate bars, something we can't usually get in El Valle. The Arrocha has many varieties of excellent imported chocolate. We also buy baby wipes there, and miscellaneous household and bathroom products.

Then over to the Mailboxes Etcetera in El Dorado to check our P.O. Box, where we found several letters from the U.S.A. and the latest issue of "Parents" magazine.

Keep in mind that all of this, all day long, is done with Salma in arms (or in the car seat when we're driving). Sometimes she plays and laughs, sometimes she screams and makes a fuss, sometimes she naps and sweats on my shoulder, as I too sweat profusely from the heat of her body against mine. She tries to grab the placemats and silverware, yanks my sunglasses off my face, talks to every stranger as if he/she is a best friend, drops her toys on the ground, spits up or has to be changed, cries when she is upset or uncomfortable... she's not spoiled or difficult. She's a baby.

It was evening rush hour by this time and traffic was thick as a boa constrictor. We braked and gassed our way out to the highway that leads to the Puente Centenario (the newer bridge over the Panama Canal) and headed for home, dropping our friend off along the way.

We arrived just before dark, in time for Salma's evening bath ritual. Rosa had made spaghetti and bean salad, and the food looked good. Two parrots were calling from the trees across the street, the neighbor's chickens were cooped up for the night, a breeze was blowing, and a large oak in our front yard was blooming pink blossoms everywhere, like a young woman at a ball.

It's good to be home.