Tuesday, March 29, 2016

Adventures in French health care, part II Keith meets the surgeon

It has now been a week since the bite. I’ve been on two antibiotics for three days.

The village nurse has come each evening. She knows the house well. The owner of the house is a widow and the nurse cared for her late husband for about a year.

She knows Barney well. She can’t understand him biting me. Too gentle, too slow, too bizarre.

This morning I went in to another town, a different hospital to meet an orthopedic surgeon. He doesn’t like my hand. The swelling is down, my digits work fine, but the wound isn’t closing and the skin looks bad.

Thursday morning they will perform surgery to clean out the hand, look inside to see what is going on.

At 6:45 PM I met the anesthesiologist. He went over my history (Crohn’s, nine major surgeries, blah, blah), allergies. He says he wants to do a general. Less chance of spreading the infection systemically. He says he is ordering an EKG.

OK so now I am paying for a full operating suite, OR team, the whole nine yards. He says I will only be out ten or fifteen minutes and he guarantees a return trip.

And I have to pay him 28 euros cash for the consult.

See you Thursday.

Sunday, March 27, 2016

Adventures in French health care, Part I

We are looking after a farm on the outskirts of the tiny village of Bazoges-en-Pareds (population 1,000). Amongst our charges are two elderly Newfoundlands, a male and female. They are large, arthritic, gentle and, to all appearances, slow.

Unfortunately last Tuesday evening Barney bit my right hand. Since then I’ve been washing the wound and applying various ointments and solutions.

Barney’s owner recommended I go to the village doctor, which I did. He refused to see me without an appointment and told me to go to emerge in the closest city, about a half hour drive. This seemed like overkill. Since I have Crohn’s and children I am familiar with emergency waiting rooms and triage and process and I did not want to waste an entire day and who was going to pay for this?

On Friday our friends from Paris came for a visit. I had lots of plans for trips to the sea and eating local delicacies and drinking wine and such.

Our friends refused to allow my plans get in the way of a good medical situation.



So Saturday morning of the Easter long weekend off we all went to the hospital at Fontenay-le-Comte.

In Calgary non-life threatening emergency patients can wait four hours to see a doctor.

At Fontenay-le-Comte it went like this: The triage/reception nurse saw me immediately. She examined the wound and took my temp. She took a basic history and asked no questions about insurance or who I was. She repacked my bandage, told me I would be there about an hour and sent me to an admin lady in the next office. The admin lady apologized because she was on the phone, then took my name and address. She sent me to a waiting room. Instead of one large waiting room as in Canada, this hospital had small, semi-private rooms.

Everything was dignified and utterly lacking all the humiliation and bureaucracy of our system.

The usual array of crying children and sick folk came and went.

After about 20 minutes a nurse asked for Madame Robinson. She took me to the examination room and unwillingly allowed one friend to accompany. The real Madame Robinson had to stay behind with our other friend. (yes, it takes a village.)

The doctor had a look and told me that if you are bit by a dog you should not wait to come in. She said I would have to see a surgeon. A surgeon.

I learned if you ever get bit by a dog on your hand or similarly damage your hand the first thing to do is take off your rings. If your hand becomes infected and swells up the ring can cut you very seriously.

Of course I  did not know or think of this.

So the doctor said the tiger eye ring Yoshiko made was coming off. Not an option. One way or another it was coming off. I am just a bit heavier then when the ring was made and my hand was swollen.

The ring was not coming off.

We'll get a infirmiere in and will try with a little soap.

The ring was not going to go over the knuckle.

The nurse squirted a lot of liquid soap on my finger. Do not be gentle I told her. This ring has a lot of meaning to me.

She twisted and pulled and occasionally looked at my face to see if she was hurting me.

The ring had nowhere to go and was not coming off. One of the male nurses left for reinforcements.

So I tried. I pulled. I twisted.  I pulled AND twisted.

Nada.

Male nurse came back with a really ugly pair of cable cutters. Ugly and big. In an instant we were transported from a 21st century ultra modern examination room to a 19th century torture chamber.

Hang on, I said. One more try I said. Let's get this thing off.

She poured more liquid soap, twisted and pulled and very slowly forced the tiger eye ring over the now bruised knuckle and off my finger.

Everyone cheered. The doctor cheered Bravo and said see, once the ring saw the cutters it decided to move.

The doctor wrote three prescriptions, two for anti-biotics and one for a nurse to come to the farm daily to attend to me. Every day. Including Easter Sunday. She said I was to phone on Tuesday morning after Easter Monday to make an appointment with the surgeon. But if I had a fever I was to come back to emerge immediately.

I wondered what they did for people who were actually sick?

The nurse cleaned the wounds, put some goop on it, put some more really sticky goop on in, bandaged it then wrapped my hand and arm in gauze.

Back to the admin office the lady gave me a small mountain of papers outlining everything they did (in Canada they would never give this directly to a patient, only to another doctor) told me again everything I was supposed to do and gave me a bill - 48 euros.

Everyone assured me that ‘insurance’ would take care of everything. I don’t know what kind of insurance they have but there is no way my insurance will pay for this.

We went to the pharmacy for amoxycillin and flagyl and dressings and goop, another 46 euros.

Tonight the nurse comes to the farm to dress the wound. Stay tuned.

sweat

It’s my birthday week. Now sixty-nine and officially old, I’ve graduated from a single birthday day. Celebrate loud. Fireworks. Candles, spa...