The Situation
Most of you know that I have a couple bad knees that will eventually be replaced but for several years I have been getting fluid shots every 6 months to keep the range of motion going and postpone the day when surgery is needed.
Now in Italy starting 6 months and it is time for my routine fluid shots. Everyone in the US assured me this is not a problem; these shots are known world-wide and have been in use since the mid-1990's.
A contacted our International SOS service which is contracted to provide the ex-pats with a variety of medical referrals and services while abroad. My request was to find an English-speaking orthopedic dr. with experience doing these shots. A very nice nurse in the Paris office is working with me on this request. In spite of the fact that Naples has over a million people, there are no orthopedic drs. officially listed as speaking English. So she searches some more and finds a doctor near the US Army base who says he speaks English.
My first visit - Italian Public Healthcare - Yikes!
The first challenge is, all the signs are in Italian! Of course they are, but, it is a continuing barrier that confounds us at every turn. No one in the lobby or reception speaks English. So I fumble around trying to figure out what to do. Watching other people we finally figure out the system.
My appointment for 9am turns out to not be an appointment at all; this is a hospital clinic where you take a number to see the receptionist. I arrive at 8:30 and I am number 60, now serving 27! So after an hour wait, the receptionist takes my 100 Euro and sends me around the corner to wait in another room full of people. There are four exam rooms and easily 50 or more people waiting. I wait outside exam room 4 with a handwritten slip of paper that says I am number 8.
So I already know that in Italy, don't be polite and wait our turn. It is not in the culture and I will be there all week. So, when the assistant pokes his head out the door, I wave my piece of paper at him and say appointment at 9am. He takes my piece of paper and quickly closes the door, shaking his head. After about another hour of waiting, I would be tempted to leave but they have my 100 Euro!
Finally the dr. finally sees me. Turns out his "English" is not much better than my Italian, and he is lazy to try and communicate. I explain what I want, he lifts and bends my legs a couple times and after about 2 min. of total time, sends me off to get an X-ray.
Off to xray, only I find out I have to go back to reception, pay another 36 Euro (by the way -- the cheapest X-ray I have ever had!) and then go back and queue at Radiology. Another hour wait. Finally get my X-ray and the tech says to come back Wed. "No" (in my best emotional Italian attitude) "Oggi, il Medico dice Oggi" (No the Dr. says today). So he says, exasperated, 10 minutes. So after 45 minutes, I finally get my Xray and go trudging back to the doctor's exam room.
Twice as many people in the waiting area now and no visible system for figuring out who is next. So as soon as the assistant pokes his head out the door, I hop up and go over waving my X-ray. He shakes his head and says Thursday. Now, I understand that but pretend not to, and say insistently Oggi (today) and wave my Xray at him. He shakes his head and shuts the door saying Thursday morning.
I was furious and of course, disappointed in this experience. After almost 5 hours I am 136 Euro poorer and no closer to getting my shots than before. Plus, I have lost over a half day of work for nothing! Yikes.
So I dial my nurse contact in Paris and tell her the ordeal. She is very apologetic but really, not her fault. All they can do is go with the information they have. So she promises to find me someone else.
My Second Visit - Still Italian Public Healthcare?
Four days later I took my X-ray in hand and headed to another clinic in the north part of Napoli, very close to our house. I was a bit late getting there and, at first, I was concerned because it appears to be yet another hospital clinic. But this time, there is no wait at reception, and only about 5 people in the waiting area. I wait maybe 30 min. to see the Dr. Once again, his English is not much better than my Italian (which is to say, about like a 5 year old speaks) however, he is very patient, and wants to communicate. What a change of attitude from the first doctor!
With our limited language skills, we draw lots of pictures, do charades and he looks over my Xray and medical history. (The first doctor never even asked for a medical history!) Fortunately, medical terms are universal so he can understand the medications I take and the procedures I have had. He has me walk around, stand on my toes, stand on my heels, bend and contort in as many different directions as I can. He looks at the Xray and shakes his head. I can "hear" him silently thinking "Mama Mia".
He seemed very thorough, very good, and tells me essentially what my Dr. in Everett had said. I can do the fluid shots for now, but in two or three years time I will need replacements. He wants me to lose more weight (of course I know that as well) and come back in a week and he'll start my shots! Yea!
Interesting thing in Italy, he gives me the prescription for the fluid medicine, I go to the Farmacia and get it and bring back at my next appointment. I am trying to ask him about payment and he just shakes his head, and says "No preocupes". (Don't worry). Ok, so I am not worrying and leave a happy camper.
Next week, I start my shots. As soon as I am done with the shots and the knees are back in shape, off to Pompeii and Vesuvio! Look forward to the next blog.
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