Yesterday I had a doctor's appointment at a local hospital. My doctor referred me for some tests. A bit over a week ago, I got a letter in the mail saying that my appointment would be at 11:15 AM. I didn't get to make the appointment or have any say in when it was and the doctor was only in on Wednesdays so the appointment had to be a Wednesday at the time they specified. I also had to rearrange three things to make the appointment because if I had to change it, there was no knowing when I'd get another appointment.
Anyway, I left my apartment a few minutes past 10:00 AM. I stopped to get cash and a litre of water. I got to the train station and had to wait 20 minutes for a train. Finally, one came and I took it to the stop I needed. Since I am directionally challenged, I went in the opposite direction that I needed to go. So, I walked for a few minutes and got to the sea. I turned around and then followed the map to the hospital. I got there about 11:20. I then waited in line to "check in" until 11:45. I then waited until about 1:15 to be seen by the doctor. One of his registrars (still don't know really what they are) saw me instead of the person I was referred to. He read the referral letter and I recapped what my concerns were. He then handed me a bunch of paperwork for a ton of routine blood work and put another referral into a different basket. I was in his office 5 minutes at the most.
After leaving his office, I went down to where blood is drawn. I had to take a number and they had one of those displays showing what number they were currently on. So, I waited some more. Since I was freezing by the time my number got called and it is difficult to draw blood from me anyway, I had to run my hands under hot water so that the lady could get blood out of them. She then drew the blood and I got to go home. It was 3:00 PM by the time I got home. Now I get to wait 4-6 weeks to go back to the hospital for more tests...
Showing posts with label health care. Show all posts
Showing posts with label health care. Show all posts
Thursday, February 15, 2007
Tuesday, January 16, 2007
Hospitals
No one likes to go to the hospital. Last week, my friend M was in the hospital. She went to swift care on a Monday with a really sore/stiff swollen neck and got sent to A&E (ER). She sat in A&E most of the day and finally got admitted. She got to the A&E in the morning and didn't get a bed until past 5:00 PM even though she was admitted to the hospital.
While visiting her in the hospital, I was struck by the differences in hospitals between here and home. Actually, and Norway for that fact. First, the standard "rooms" are less than private and don't really allow privacy of any sort. There were about 8 people in one room with only the possibility of a curtain between them. This is about what the ER was like when John went to the hospital at home. The room also only had 1 TV which my friend couldn't see if she had wanted to watch the television. No radio. While, these may not seem like big deals but if you are stuck in bed all day, what are you supposed to do? There was also only one bathroom for the 8 people!
When my friend wanted to call a nurse to raise or lower her bed (no electric beds that raise or lower head/feet by pushing a button), she had to reach a good way out of the bed and could have fallen partially out! She also had to wait ages after hitting the call button. My friend finally got a private room (which she had insurance to pay for it) by shedding a few tears to the ward sister and begging. I am willing to bet that the hospital will charge for the private room.
On many days, this team of doctors came around to examine M and monitor her progress. We were there one day when they came in. They went around to each bed, sometimes pulling the curtain, others not. When they got to M, we left to give her privacy. When we came back, M reported that the doctors asked a few questions of her and the talked about her case and her like she wasn't there! So much for patient centered care.
Another issue I have with hospitals in Dublin is the cleanliness. One that I went to appeared to have dirty floors. Nurses didn't wear gloves. People were so close together that germs could easily spread. The one that M was in had hand sanitizer all over for people to use. It appeared clean and they sanitized the bed before M was given it. That is reassuring since the winter vomiting bug and MRSA are pretty common in hospitals here.
In Norway, John's room was private and they brought an extra bed for me. They brought food for me (since he couldn't eat). The doctors talked to us and they even assigned nurses who spoke English to his case. They explained everything well. They also wrote a letter and sent his records with us to take to his doctors. The best part was they had no idea what the cost of the treatment/hospitalization were because they never charge citizens. About a month later, we got a bill and it was about 3,000 for 2 nights in the hospital, a CT scan, various blood work, and IV fluids/pain medicine!
At home, most people I know who have been in the hospital had private or semi-private room. They all have their own TV, radio, and beds that they can raise and lower themselves. Call buttons are integrated into the bed so there is not straining to call a nurse. Doctors talk to you, not about you in front of you. Nurses come to check on you and take your vitals (this didn't happen much for M or the client I visited in the hospital: he barely even saw doctors). The rooms are clean. The floors are clean. People wear gloves and follow Universal Precautions. And it costs. A lot.
While visiting her in the hospital, I was struck by the differences in hospitals between here and home. Actually, and Norway for that fact. First, the standard "rooms" are less than private and don't really allow privacy of any sort. There were about 8 people in one room with only the possibility of a curtain between them. This is about what the ER was like when John went to the hospital at home. The room also only had 1 TV which my friend couldn't see if she had wanted to watch the television. No radio. While, these may not seem like big deals but if you are stuck in bed all day, what are you supposed to do? There was also only one bathroom for the 8 people!
When my friend wanted to call a nurse to raise or lower her bed (no electric beds that raise or lower head/feet by pushing a button), she had to reach a good way out of the bed and could have fallen partially out! She also had to wait ages after hitting the call button. My friend finally got a private room (which she had insurance to pay for it) by shedding a few tears to the ward sister and begging. I am willing to bet that the hospital will charge for the private room.
On many days, this team of doctors came around to examine M and monitor her progress. We were there one day when they came in. They went around to each bed, sometimes pulling the curtain, others not. When they got to M, we left to give her privacy. When we came back, M reported that the doctors asked a few questions of her and the talked about her case and her like she wasn't there! So much for patient centered care.
Another issue I have with hospitals in Dublin is the cleanliness. One that I went to appeared to have dirty floors. Nurses didn't wear gloves. People were so close together that germs could easily spread. The one that M was in had hand sanitizer all over for people to use. It appeared clean and they sanitized the bed before M was given it. That is reassuring since the winter vomiting bug and MRSA are pretty common in hospitals here.
In Norway, John's room was private and they brought an extra bed for me. They brought food for me (since he couldn't eat). The doctors talked to us and they even assigned nurses who spoke English to his case. They explained everything well. They also wrote a letter and sent his records with us to take to his doctors. The best part was they had no idea what the cost of the treatment/hospitalization were because they never charge citizens. About a month later, we got a bill and it was about 3,000 for 2 nights in the hospital, a CT scan, various blood work, and IV fluids/pain medicine!
At home, most people I know who have been in the hospital had private or semi-private room. They all have their own TV, radio, and beds that they can raise and lower themselves. Call buttons are integrated into the bed so there is not straining to call a nurse. Doctors talk to you, not about you in front of you. Nurses come to check on you and take your vitals (this didn't happen much for M or the client I visited in the hospital: he barely even saw doctors). The rooms are clean. The floors are clean. People wear gloves and follow Universal Precautions. And it costs. A lot.
Monday, April 10, 2006
Random thoughts
This Friday was my friend J's 30th birthday. She was dreading it but ended up dealing pretty well, or at least it appears so. Her boyfriend came out for a long weekend, which definitely helped. On Friday another coworker hosted a little get together for her. We then went to the pub next door to their place. It was more of a traditional Irish pub. It was dark, chairs didn't match, and it had sofa type seats in one area. I liked it.
On Saturday, we went to the local. It is different than more traditional pubs but I still like it a lot. Their beer selection is excellent and it has a character of its own. They also have about 5 different ciders. I decided that I should try them all. I have one left to try. While there, we saw the guy who sells the only decent Mexican food that we have found so far in Dublin. He sells food and salsas at the Temple Bar Market on Saturdays. He was there with his family so we had the waitress take him a drink. It was fun because she was obviously flustered by us. First, we fight over who should pay for drinks, then we buy a seemingly random guy one. It was fun and he recognized John as a customer. He thanked us on his way out.
On Saturday, J and her boyfriend went up to Howth to wander around. They went in and out of pubs since it would suddenly downpour for a few minutes and if you were outside, you got soaked. Anyway, they said that they were in this pub and it was playing American music over the speakers. They stopped playing the music a couple minutes before a tour bus pulled in. They then had some musicians (I think) play traditional Irish music. The group had a drink, left, and the regular music went back on!
On Sunday, I had to get a prescription filled. I used to pay about $40.00 a month for this medicine at home. It was available in generic for about $25.00 but my doctor didn't want me to take it because it is slightly different. Anyway, I got four months worth here for 7.50! That raised the question that I ask myself a lot (and is a huge political debate in the States): why are drugs so expensive back home? Ok, this is an older medication and my doctor told me that it had actually been taken off the market because it was too cheap (why didn't they just raise the price then?). All of my medications are cheaper here but comparatively, this one is far less than the others. I wonder why.
On Saturday, we went to the local. It is different than more traditional pubs but I still like it a lot. Their beer selection is excellent and it has a character of its own. They also have about 5 different ciders. I decided that I should try them all. I have one left to try. While there, we saw the guy who sells the only decent Mexican food that we have found so far in Dublin. He sells food and salsas at the Temple Bar Market on Saturdays. He was there with his family so we had the waitress take him a drink. It was fun because she was obviously flustered by us. First, we fight over who should pay for drinks, then we buy a seemingly random guy one. It was fun and he recognized John as a customer. He thanked us on his way out.
On Saturday, J and her boyfriend went up to Howth to wander around. They went in and out of pubs since it would suddenly downpour for a few minutes and if you were outside, you got soaked. Anyway, they said that they were in this pub and it was playing American music over the speakers. They stopped playing the music a couple minutes before a tour bus pulled in. They then had some musicians (I think) play traditional Irish music. The group had a drink, left, and the regular music went back on!
On Sunday, I had to get a prescription filled. I used to pay about $40.00 a month for this medicine at home. It was available in generic for about $25.00 but my doctor didn't want me to take it because it is slightly different. Anyway, I got four months worth here for 7.50! That raised the question that I ask myself a lot (and is a huge political debate in the States): why are drugs so expensive back home? Ok, this is an older medication and my doctor told me that it had actually been taken off the market because it was too cheap (why didn't they just raise the price then?). All of my medications are cheaper here but comparatively, this one is far less than the others. I wonder why.
Friday, February 17, 2006
healthcare
People complain about health care in the U.S. Insurance is expensive and far too many people are without it and can't get health insurance. However, health care here isn't perfect, either. I have insurance which costs about 50 Euro a month but can't use it for 6 months unless there is an emergency. A doctor visit costs 50 Euro. I realize that this is much cheaper than back home but the quality of care I have received is far inferior than I received in the States, even in an HMO. When I have gone to the doctor for illnesses, the doctor here hasn't taken my temperature.
When I went in for my sinus infection, the doctor didn't really even do a physical exam. She pushed on my sinuses and agreed I had a sinus infection. She didn't check my ears, my nose, my throat. No real physical exam.
Recently, I had an outer ear infection. When I went in for it, again she didn't take my blood pressure, temperature or examine my throat or nose. She only examined my ears. She took my blood pressure after I asked for a particular prescription. I then asked about annual exams. Well, they don't exist here. Women don't have their first gynecological exam until they are about 25 (I think) unless they have had a certain number of sexual partners. They then get an exam every three years. Basically, at my age, I would get an exam every two years. Also, after a woman has a certain number of normal exams, the frequency decreases. So, as a woman gets older (and her chances of cancer may actually increase), the frequency of exams may decrease. However, in order to keep my new prescription, I have to go to the doctor 2 times a year to have my blood pressure taken! Huh?
At least medicines are less here. My migraine medicine is a fair amount cheaper (even though I was only supposed to get one dose at a time) and my birth control is also a lot cheaper. I can even get Flonase (called something different but same drug) over the counter for less than half the price than at home.
I think the differences in health care here are cultural. First, people don't get the same amount of education in any profession here as they do in the States. I am not sure if I think it is a good or bad thing or just different. Second, and more importantly, people are far more relaxed about health here. They won't do objective tests unless absolutely necessary. People go to the hospital for more things, though.
Vetinary care here is also very different. Caineal has heart problems and fluid on her lungs. She also has some nerve problems in her rear legs. It would have been helpful to know some of these things when I got her but they only did a cursory exam. The vet didn't even do blood tests to test her kidney and liver functioning when I found her! When I had her teeth extracted, they did some bloodwork and things were fine. When I took her back to the vet after she passed out one day, the vet didn't want to repeat the blood tests and doesn't want to take an xray of her to see the exact extent of her heart condition. When I asked about it again and mentioned that my friends/acquaintances who are vets back home and the sources I found on the internet stressed the importance of an xray to determine objectively the state of her heart, the vet said she didn't see a need to do that. I can't help but wonder if Caineal gets different care because she was a stray. But she isn't one anymore. Now she is my furry four legged child. When I take her back to the vet in a couple months for her check back, I am going to insist on an xray. If she still won't do it, I think I may change vets. A mate's sister is a vet and I may go to her. I know I will be a difficult client but I want the best for my little girl. I know her time is limited and I want to prepare for how limited and make the best of what we do have.
When I went in for my sinus infection, the doctor didn't really even do a physical exam. She pushed on my sinuses and agreed I had a sinus infection. She didn't check my ears, my nose, my throat. No real physical exam.
Recently, I had an outer ear infection. When I went in for it, again she didn't take my blood pressure, temperature or examine my throat or nose. She only examined my ears. She took my blood pressure after I asked for a particular prescription. I then asked about annual exams. Well, they don't exist here. Women don't have their first gynecological exam until they are about 25 (I think) unless they have had a certain number of sexual partners. They then get an exam every three years. Basically, at my age, I would get an exam every two years. Also, after a woman has a certain number of normal exams, the frequency decreases. So, as a woman gets older (and her chances of cancer may actually increase), the frequency of exams may decrease. However, in order to keep my new prescription, I have to go to the doctor 2 times a year to have my blood pressure taken! Huh?
At least medicines are less here. My migraine medicine is a fair amount cheaper (even though I was only supposed to get one dose at a time) and my birth control is also a lot cheaper. I can even get Flonase (called something different but same drug) over the counter for less than half the price than at home.
I think the differences in health care here are cultural. First, people don't get the same amount of education in any profession here as they do in the States. I am not sure if I think it is a good or bad thing or just different. Second, and more importantly, people are far more relaxed about health here. They won't do objective tests unless absolutely necessary. People go to the hospital for more things, though.
Vetinary care here is also very different. Caineal has heart problems and fluid on her lungs. She also has some nerve problems in her rear legs. It would have been helpful to know some of these things when I got her but they only did a cursory exam. The vet didn't even do blood tests to test her kidney and liver functioning when I found her! When I had her teeth extracted, they did some bloodwork and things were fine. When I took her back to the vet after she passed out one day, the vet didn't want to repeat the blood tests and doesn't want to take an xray of her to see the exact extent of her heart condition. When I asked about it again and mentioned that my friends/acquaintances who are vets back home and the sources I found on the internet stressed the importance of an xray to determine objectively the state of her heart, the vet said she didn't see a need to do that. I can't help but wonder if Caineal gets different care because she was a stray. But she isn't one anymore. Now she is my furry four legged child. When I take her back to the vet in a couple months for her check back, I am going to insist on an xray. If she still won't do it, I think I may change vets. A mate's sister is a vet and I may go to her. I know I will be a difficult client but I want the best for my little girl. I know her time is limited and I want to prepare for how limited and make the best of what we do have.
Thursday, December 01, 2005
doctor's visit
On Monday I went to the doctor because I have been sick for about three weeks. I asked a couple mates for names of their doctors to figure out who to go to since I don't have insurance yet and haven't gone to the doctor here. One mate gave me the name of her doctor who has an "extended absence" greeting on her voicemail so you can't leave a message. I guess she must have gone out of practice, changed practices or is just on a really long vacation. Hmm.
Another mate recommended the practice he goes to and it is close to work. I called and got an appointment the same day! It was for 5:45 and since John is in London, I had to go home from work and walk Caineal and then catch the bus back to the doctor. So, I am waiting for the bus and take one of the 4 my mates told me would take me to Glasnevin. Well, at 5:43 I asked someone on the bus where we were because I didn't recognize the area in the dark. They told me I was in Drumcondra. Drumcondra is a little east of Glasnevin I think but busses do not go to both. So I got off the bus and started walking and looking for a taxi. I turned left on a street that seemed to be a major street. It wasn't for long. It was long and windy but headed in the generally correct direction.
Since I didn't have the doctor's office phone number with me, I called information to get the number and then called the doctor's office to tell them I was running late and was lost. The lady on the phone asked me where I was and what street I was on. I tried to explain to her that I didn't know: that was why I was lost. Finally, I saw someone in their car so I asked them what street I was on. They lady told me (I think she was a little freaked out but people tend to be helpful when they hear my accent). The lady at the doctor's office gave me directions from where I was and I got there about 20 minutes late. The doctor still saw me. The visit cost 50 Euro (same price citizens pay).
The doctor was very nice and looked younger than me. She asked me a few questions, asked if I had a fever. I said I didn't know since I don't have a thermometer. She didn't take my temperture, though. She then asked if I had been pushing on my cheeks because they were all red and swollen. I explained, no but I was walking outside for 20 minutes and they hurt a lot. It hurt to eat anything, even bananas! So she pushed really hard on my sinuses and agreed I had a sinus infection. We then discussed which antibiotics I was sentitive to and tried to figure out what they are called here. She prescribed a "really strong one that will get the infection out of the bone." It doesn't look seem as strong as others I have taken and I will be on it for 10 days. She also gave me a script for my migraine medicine since mine expired.
So I went to the pharmacy to get my drugs. They gave me the antibiotic just fine and asked how I usually take my Imigram (Imitrex). Apparently the script was only written for one dose! I told the pharmacist that sometimes I need two doses and am used to getting the whole box of 6 at a time. Since everyone except the poor pay for their own prescriptions, he gave it to me after a bit of convincing. He was concerned about the price: 19.50 per dose. I explained it was cheaper than in the states and it was fine (about $25 per dose). He also told me that there is a scheme in Ireland that no citizen has to pay over 85 Euro a month for medicine. If you do pay more, you fill out some forms and get your money back! I may not qualify since I am not a citizen, though. However, a mate told me that if I don't qualify for that scheme, I can get tax back for the cost of medicine over 85 Euro a month!
Today I am home sick. I am feeling better than Monday but it still hurts to eat food that requires chewing and I am getting tired of eating soft foods. My cheeks aren't constantly burning anymore but still hurt. I realized my mates were probably right that I should take a couple days off work to rest and get better. After all, I am going to Munich early Sat. morning and need to feel better for that. :)
Another mate recommended the practice he goes to and it is close to work. I called and got an appointment the same day! It was for 5:45 and since John is in London, I had to go home from work and walk Caineal and then catch the bus back to the doctor. So, I am waiting for the bus and take one of the 4 my mates told me would take me to Glasnevin. Well, at 5:43 I asked someone on the bus where we were because I didn't recognize the area in the dark. They told me I was in Drumcondra. Drumcondra is a little east of Glasnevin I think but busses do not go to both. So I got off the bus and started walking and looking for a taxi. I turned left on a street that seemed to be a major street. It wasn't for long. It was long and windy but headed in the generally correct direction.
Since I didn't have the doctor's office phone number with me, I called information to get the number and then called the doctor's office to tell them I was running late and was lost. The lady on the phone asked me where I was and what street I was on. I tried to explain to her that I didn't know: that was why I was lost. Finally, I saw someone in their car so I asked them what street I was on. They lady told me (I think she was a little freaked out but people tend to be helpful when they hear my accent). The lady at the doctor's office gave me directions from where I was and I got there about 20 minutes late. The doctor still saw me. The visit cost 50 Euro (same price citizens pay).
The doctor was very nice and looked younger than me. She asked me a few questions, asked if I had a fever. I said I didn't know since I don't have a thermometer. She didn't take my temperture, though. She then asked if I had been pushing on my cheeks because they were all red and swollen. I explained, no but I was walking outside for 20 minutes and they hurt a lot. It hurt to eat anything, even bananas! So she pushed really hard on my sinuses and agreed I had a sinus infection. We then discussed which antibiotics I was sentitive to and tried to figure out what they are called here. She prescribed a "really strong one that will get the infection out of the bone." It doesn't look seem as strong as others I have taken and I will be on it for 10 days. She also gave me a script for my migraine medicine since mine expired.
So I went to the pharmacy to get my drugs. They gave me the antibiotic just fine and asked how I usually take my Imigram (Imitrex). Apparently the script was only written for one dose! I told the pharmacist that sometimes I need two doses and am used to getting the whole box of 6 at a time. Since everyone except the poor pay for their own prescriptions, he gave it to me after a bit of convincing. He was concerned about the price: 19.50 per dose. I explained it was cheaper than in the states and it was fine (about $25 per dose). He also told me that there is a scheme in Ireland that no citizen has to pay over 85 Euro a month for medicine. If you do pay more, you fill out some forms and get your money back! I may not qualify since I am not a citizen, though. However, a mate told me that if I don't qualify for that scheme, I can get tax back for the cost of medicine over 85 Euro a month!
Today I am home sick. I am feeling better than Monday but it still hurts to eat food that requires chewing and I am getting tired of eating soft foods. My cheeks aren't constantly burning anymore but still hurt. I realized my mates were probably right that I should take a couple days off work to rest and get better. After all, I am going to Munich early Sat. morning and need to feel better for that. :)
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