Category Archives: doctors

Corona Virus

Since this all over the news I thought I’d do a quick update. There have been 60 new cases in the past 24 hours in Lombardia. Also two cases in Florence and one in Palermo. These are the first in Tuscany and Sicily.  Total cases nearing 300. Seven people have died, all of them elderly or with compromised immune systems. The provinces affected are closing schools and canceling events. They are advising people with symptoms to not go to the emergency room but call their doctor or the health department.

People here in Umbria seem calm and nothing has changed. We have had no reported cases. But that could change. Some areas are reporting runs on food and water. We went shopping today and it was quiet and the store was fully stocked. So all is well in our region for now.

Doctors, and wineries, and la cena – Oh my!

Yesterday was a Very Busy day and I want to share it with you.

It started out pretty early. We had an appointment with my knee surgeon at the hospital for X-rays. It was the standard 45 day post op checkup. I’m happy to say I’m fit as a fiddle. I’m now cleared to walk normally up and down the steps, which I did with very little problem. I’m very happy!

It was a pretty day (mostly) with a lot of fall colors and watery blue skies. Not too cold. To go from our house to the hospital in the city of Perugia we can take the SuperStrada around the city (faster but busier), the road that goes through the middle of town (tiny one way streets) or the pretty 2 lane road through the mountains. So, on the way to the hospital Luther took us through the city. On the way home I chose the mountains.

The road goes by a winery and agriturismo we like so we stopped to buy some wine. They also raise pigs which become prosciutto. Here’s the big ole sow. The piglets had run inside. The pens are super clean, and have inside and outside parts.

We also stopped at a place we’ve been passing all the years we’ve been here. It is an enormous castle and a beautiful golf course. We were looking for the restaurant that was supposed to be there. We drove up to the castle which is shuttered. Word has been it was supposed to be an upscale hotel, they also advertise condos for sale. For a long time it was covered with scaffolding but it had been removed a year or so ago. Yet still it is not open. Somebody put a lot of money into this property with the 18 hole Trent Jones golf course.

Castle

Old olive groves surround the castle

The golf course. We don’t have many golf courses in Umbria, or Italy, for that matter. It had a number of people playing. The sign at the entrance says welcome in Italian, English, German, and…Russian. Tells you who they are hoping to attract.

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We had been invited to la cena (dinner) by our friend Vera. She is such a gem. Her suocera (mother-in-law) was having a big dinner for friends and family. No special occasion that I could discern. I was a little reticent but decided I need to mix more so we said we’d come. Vera said not to expect much. It was a down-home feast with the contadini (contadino means farmer) so local folks – working people, farmers.

I will tell about it in pictures 🙂 Here is Vera and her suocera.

The meal was going to be in the garage. As garages go, it was a nice one. Here is the cinghiale who watches over the scene.

I asked what the wires across the ceiling were for. I was told they were to hang the grapes that they dry to make Vin Santo. It is for personal consumption. The grapes are allowed to raisin to get sweet before they make it. They don’t make it every year so no grapes were hanging.

What garage do you know that has a crackling fire? It was for warmth but also for roasting chestnuts at the end of the meal.

Beside the fireplace inside sat Silvester, the ancient Tom Cat. He’s 13 years old and never been to the vet. Not castrated…Italian men don’t allow “cutting”… he didn’t want to be bothered or touched. When he moved it was the slowest I’ve ever seen a cat move. He must be hurting 🙁 But he did seem to be enjoying the fire’s warmth.

Just outside is their big forno (wood oven). And the outside fireplace. Both were roaring hot.

Here is the pork liver (I am fairly certain I’ve never had pork liver before) that had been cooked for both the crostini and the secondo, much to Luthers dismay. Not really, there was plenty of food and he tasted it. We were surprised Italians love liver so much!

The meal begins with crostini. One, liberally dosed with the new olive oil, the other, fegato (liver). Very, very rich!

Beginning the polenta. Two kinds of corn meal…Add to the boiling water,  bring to a boil again and continuing adding hot water,  “til it is right”, cook, stir.

Takes a LOT of stirring to make polenta

The polenta is pronounced ready.

To go on top, a luscious ragu. It had simmered for hours and hours in the biggest pot I’ve seen in a home kitchen! It was pork bits. All sorts with bones and all. Plus lots of sausage. By now the meat was off the bones. They scooped the meats out and put them on a separate plate.  Then they took the tomatoes, which the meat had simmered in and scooped it into a separate dish. Rich and mouthwatering.

To serve, the polenta goes in a plate, add meat and sausages, and top with rich tomato sauce.

Two long tables. All men at one, all women at the other – hah! (Kids were upstairs) Very typical. After a while Vera and I moved over to the men’s table. There is no rule or prohibition to sit together. But the men and women prefer to talk of men’s and women’s things so why sit together?

I had fun. It had been a long day and I was pretty tired so we had the dolce (dessert) and headed home before the chestnuts were roasted. A very traditional, home cooked meal that couldn’t be beat! And a unique experience.

One week home

Well, I’ve been home a little over a week. It’s been good. I had most of the week free. I shopped at the market Saturday and Wednesday. I met up with friends for caffè. I had a Campari spritz with Luther in the piazza and walked to our new, very sleek and glitzy pizzeria very nearby named FOXX. I pronounce the pizza first class.

Monday I went to Prosperous to make an appointment with the doctor for PT. I saw him Friday and liked him. He admonished me to keep using my crutches. So I will. I’m set up for PT Monday-Wednesday-Friday ongoing – start Monday (tomorrow).

Saturday I went back to Perugia and my doctor removed my punti, staples. I thought I’d be happier but actually my knee hurts more. But I also went to the grocery store and our special butcher so maybe that’s why it’s more painful…

Pictures  near our butcher in Bosco. I’ve always loved these views. More soon!

Sabato

Today is Saturday. There is only a half day of therapy today, and none tomorrow. I have NO idea how I’ll amuse myself for a whole day here.
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This morning after raising all sorts of ruckus yesterday, I had il Capo Dottore, his name is Berrettini. I finally put my glasses on so I could see his name tag. And also both of the Dottore Del Citernas father and son. Turns out there is no way I can transfer between facilities within the same Region. I wish I had just known that at first. Che casino as they say here, which means, what a mess! I can check myself out at anytime though. And if I want I can go to Prosperious as an out patient, walking over for daily sessions. I think I’ll have to pay for them if I don’t want to wait for the system to find a place. That’s OK. I told il Capo I would like to be released on Friday. Just a week, which I can handle. So, the saga ends. Italia – 1 Hamptons – 0
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This morning I was a bad girl. I went to ginastico and they put us in the room with 7 beds. And instructed us to point our toes up and down. Well I did that for a long time. Quit and waited. Finally someone came back and put a big rubber roll under our knees and we were instructed to do leg lifts. So I did about a bazillion of those. Finally I quit. I sat and waited maybe 15 minutes and then I got disgusted. It was such a waste of time. So I left. On the way down the hall I met an employee on the phone. He got excited I was going on my own. But I told him I was perfectly capable of going down an elevator on my own. They insist on escorting us for some reason. He asked me to wait and I did. Then our PT guy, that I had waited so long for, came out of the elevator. I said finito, and he asked if I wanted to go down on my own. I said si. And went back to my room. I wonder if there will be any repercussions from me doing this. I hate to wait and hate to waste my time. Bad l’Americana!!
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Today’s lunch was good enough. Bow tie pasta with ragu, chicken cutlet and peas. Pear for dessert. I put hot sauce on the chicken 😋

This next week will be more of the same so you won’t hear much from me til I’m sprung outa this joint. Except for any interesting observations or decent or interesting meals. Thanks for following along so far. Ciao!

Rehab – Day four

Il Capo Dottore came by as usual this morning. He speaks good English. He’s married to an American woman from San Diego. He confessed he was unhappy that she is a die hard trump supporter. I’ll say no more. I relayed that Luther went to Prosperious and they told him they would call the hospital here and arrange for my discharge. One guy said it probably wouldn’t happen until Saturday. I guess it doesn’t matter since I’m getting PT here. And I’ve told Luther to stay home until I’m discharged since I don’t need anything. No sense in making him drive all the way down here.
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PT today was a hoot. The PT therapist had about 11 of us there. The lady next to me began to give him (he looks to be late 30s) her recipe for a chicken dish. I was thinking, only in Italy. He was noting it down while we were warming up. So he asked l’Americana for a recipe. I had just been talking about cooking Mexican, Thai, Indian so I decided to give him my Chicken Fajitas recipe. It is simple enough and doesn’t require a lot of strange ingredients. He was happy.
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My roommate, Francesca was slated to leave after PT today. But just before she was coming they realized they had never removed the staples in her incision. So she stayed and I went up to PT. I was afraid she’d be gone and I wouldn’t be able to say goodbye…and I was right. She was gone when I came back. So sorry. She and her family were lovely. Her son would cut her meat, open the bags with the utensils and the Grana Padano bag for her soup or pasta, and peel her fruit. Sweet, taking care of la mamma. I’ll miss Francesca, we were truly the odd couple!


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Lunch was good today. Risotto with asparagus, and turkey polpette or turkey meatballs with tomato sauce and peas. Kiwi for dolce.

Once I do the second PT, which is after lunch sometime, then it is mighty boring. I’m sure it’s why they do the passaggiata everyday, get themselves out of their rooms! The evening stretches on endlessly. Sigh.

Another day

Ginastica today was much better. Good workout. Felt good to do it. There’s one lady there who had both knees done! I’d couldn’t do that. Of course I didn’t understand all the directions but once everyone had started I imitated them. One funny part is at one point I gave the thumbs up to Francesca (my roomie) for her good work. The instructor said the odd couple me and Francesca, she is from Bari Puglia and doesn’t understand Italian any better than l’Americana! I guess we are the odd couple. 😀

If you didn’t know, all regions have their own, very different dialect. They don’t necessarily resemble actual Italian at all. After the formation of Italy they mandated one language as “Italian” and they picked the dialect of Florence as the official lingua. Places like Puglia, Calabria, Sicily, Campagna (actually every region) all speak totally different languages. My roommate speaks Bariese dialect. I’m sure all her family does, as well as her friends and the people where she lives. She’s never needed Italian. I’ve listened to her on the phone with her friends and wow! Really strange language.
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Yesterday I washed my hair! It made me very happy. I had to figure out the bathroom. It is commodious and very green. Sink at one end, shower in the middle, which drains into the drain on the floor, and toilet with bidet on the wall opposite. I like this bidet thingy. It eliminates the need for the separate appliance. It allows you to clean yourself better and easier than the bidet. Quite well thought out.

Since I couldn’t get my bandages wet I couldn’t actually shower so I did it piecemeal. Start with the bidet. Go to sink and wash face and bits. Then wash hair with shower attachment. Easy peasy.
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Other news
The administrator brought a form, helped me fill it out and Luther has to take it to Prosperious. Then we will see what they say.
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Life goes on outside the hospital. Luther and I had our appointments to pick up our long awaited Permessi di Soggiorno. He went and got his and told them I was unable to come. This time it took 7 months 🙁

Ginastica Italian style.

    First off, latest news. I got a new piece of information yesterday. It’s always something it seems. So I was counting on being moved from here to Prosperious for the rehab, as you know. I had a gaggle of people in the room to include the “big” doctor. I guess he’s the head guy – il capo. He has everybody’s charts and makes decision about care. I asked when I’d be moved to Prosperious and he explained that the hospital I am in is a rehabilitation hospital and they don’t send people other places. So if I want to go somewhere else it’s on me to figure it out. Again, blindsided by the System. Luther had asked the nurse on Friday and she had confirmed I could go there but nope. But misunderstanding again. He asked can she go to Prosperious after she’s finished here? Well yes, of course I could do more after. But after means after two weeks of rehab HERE. There has been much gnashing of teeth. Should we pursue the change to Prosperious, considering we didn’t know exactly how? Or should I just tough it out here. I knew my doctor was here and that’s a consideration. But Prosperious is one of the best in the country. We slept on it.

    Any orthopedic docs in the house? This was interesting to me. A list of my new parts that they gave me.

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    Another scrumptious lunch. 😏 I could eat the pasta, but not the secondi. It was unknown fish and crustaceans and extremely fishy tasting. Not to my liking.

    Physical therapy Italian style
    So, today was my first ginastica, or Physical Therapy session. I’m finding it hard to slow down to the pace they want here. I started walking with a walker yesterday. And he told me to slow down. I naturally move fast. Italians naturally move slow. And he caught me carrying the walker once and I was reprimanded. I was not to ever walk without using it. In trouble again 🙄. This morning a gaggle of us headed upstairs to the top floor (which is orange) for a session. 5 women and one man. We laid on beds and Rikki and Francestino told us what to do. I did a total of four exercises. Blink. I think the session lasted maybe 30 minutes. The man to my left fell asleep. The lady at the far end was snoring. So what’s this going to help? Of course it didn’t hurt to do some exercises. I’m sure it did some good. If/when I transfer to Prosperious we will see what difference there is. One thing is all the ladies are in their 70s or 80s, one looked to be in her 90s, so how can they stress them too much. And the man? He did as little as possible.

    Afternoon we were all herded up to the top floor again. They let me use my crutches. This session they placed two electrodes on my injured leg and for an hour I sat bored to tears listening to the other 4 Italian women talk. These ones aren’t very old. Some could be early 50s. I need to look up the procedure to see what it does.
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    Final news flash
    Il Capo of the hospital came to our room on his rounds and in our conversation he mentioned that my surgeon had initiated a transfer to Umbertide to Prosperious! So the decision was made for us and I’m sure it’s the right one. That my doctor did this means he is fine with me going there. And this hospital is fine with me going there since it is convenient for family and friends to visit. Totally different viewpoint. Since it’s National Health, it’s not for profit so they are fine with me going elsewhere. Interesting.

Hospital impressions

Now for my hospital impressions.

Two hospitals: Silvestrini (S) and Casa di Cura Liotti (CCL). I had my first operation in January 2018 in Silvistrini. It is a huge University Medical center. Casa di Cura is a small, partly private hospital in downtown Perugia where I am now, September 2019. Here are my impressions of the two plus some other things I found interesting. Some are a bit mundane but it’s what I noticed!

(CCL) Is rather dark and dreary due to the lurid paint they use here. And they don’t like putting the lights on in the halls. (S) Was more the norm that you’d see in the US with light walls and neutral colors.

The colors they choose differ with each floor. What were they thinking? 🤭

(CCL) The beds are electric and I can up and down as I wish. You don’t know how empowering that is! (S) had cranks, and I was stuck in bed and couldn’t get to it.

(CCL) There are two beds. No curtain between them. Cozy. A bit hard to get used to but it is what it is. (S) DID have curtains in it’s shared rooms.

(CCL) Each room has a private bath to share by its two residents. (S) there was one very odd bathroom which was shared between two rooms by four patients.

(CCL) The food is not so bad. Palatable I’d call it. And with my little pack of additions it’s almost good. I don’t have a lot of appetite but my blood is low so I’m eating. (S) practically inedible.

A little different from my normal food pictures ha ha. I ate the pasta which was pretty good. Not the mystery meat or eggplant. I normally like eggplant but not this.

(CCL) All the staff are young and nice. They go about their work cheerfully to a person. Not one has been mean or short with me. I don’t have a nurse Rachett or a Senore huff n puff like last time. Way better here than (S).

(CCL) Provides water for patients and delivers it, and other help you need if you ask for it. (S) Did NOT provide any water and would not bring any. Nor could you drop something on the floor and ask someone to help you get it back or ask your bed get cranked up or down. They expected the family of the patients to do that. Two very different places.

My medicines caused a stir. I always wondered why they have their pills in little blister packs. Lots and lots of waste. I prefer the easy bottles we have in the US. Well, today I think I figured it out. I had brought my own blood pressure medicines which I had removed from the blister packs and placed in small jars. No, no, no they aren’t good if not fresh. An aha moment.

They have a passaggita in the hospital. Just like in a village! All the crutches and walkers come out and it seems like all able patients walk up and down the hall.

I have a room mate. She’s a small rotund Italian woman who had a fall which got her here. I’m guessing she’s 80. Her name is Francesca. She’s sweet and we’ve become friends. She’s been here over two weeks and I just heard she leaves Thursday. Happy for her. And, get this, she came with at least three family members from Puglia! 550km away. Her doctor said she wouldn’t get the good care she could get here. So I guess he got her set up here. I had heard the health care is much worse in the south, a definite consideration if a person is planning to move here. Just goes to show the huge difference people talk about may be true.
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More tomorrow.

Knee replacement in Italia – Part 2

Musings
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Normal day.
5:45 am. Time for taking blood. 6:00 am blood pressure and temperature. 7:00 nurse arrives and scans your bracelet. Gets your medicines. Administers. 7:30 breakfast lady brings coffee and dry toast, like melba, with jam. Activity levels in halls ratchet up. 8:00 they come remake or change your bed and wash you some. Around 8:30 a gaggle of medical students comes and hears about the cases. PT person comes around this time too. Lunch arrives around 12 – 12:30. Afternoon is more random. More bracelet scans and meds. Coffee break in late afternoon. Dinner comes around 7pm. After dinner more scans and night meds. Ta da. Day is done.
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I contemplated the Italian word for pain, dolore. Or painful, dolorosso. I looked up an ache. Dolore. Hmmm. Seems like they should have that distinction. Fa male means it hurts. Male is the word for bad. Pronounced mah-lay.
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Some people who stood out. Dr. Pain, the first physical therapist. Nurse Ratchet, evil morning nurse who does meds. Sr. Huffinpuff – he does stuff like move beds, bring dinner, move trash bins out, stuff like that. He constantly sighs and pants while doing his work. One blond nurse who was kind and gave me a sleeping pill one night. The nurse who complained I peed too much. Dr. Trinchese, my surgeon. I call him the stealth surgeon. I saw him in the OR and then he did a drive by visit that lasted at most 15 seconds. “Come stai. Bend your leg. Lift your leg. Belissimo” and gone.
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Random thoughts and observations
Full time monks inhabit the hospital, gliding down the hallways.
Bringing your own coffee cup is key.
Bring cutlery.
Some hospitals do not provide toilet paper. I was told I was in a posh hospital because it did provide it.
They move you around in your bed for procedures.
Some nurses are tolerant of my bad Italian, many are not.
In my opinion the food is pretty bad. They try. You get three courses. Not sure if that’s a plus or minus. Bring salt, pepper, olive oil, lemon juice, Tabasco, anything to spice it up. Next time (hopefully a long time off!!) I would not order all the courses each meal. Breakfast is a cup of your favorite drink (not wine) and a packet of dry toast (like Melba) with a container of jam.
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Stay tuned for Part 3.

Knee replacement in Italia – Part 1

Much of the following posts about my hospital stay are musings of the experience as well as my documentation of what occurred. Most, I wrote while in the hospital.
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The surgery went well. The hospital is pretty modern. Not a young building but up to date. It is also enormous. A University Hospital. I saw very little of my surgeon. He showed up for the operation. Before surgery they take all your clothes and give you a completely transparent gown! I pulled my blanket up for the ride to the OR. As soon as I arrived they cut it off. What was the point?

Returned to my room. During the operation I had only an epidural. Could not move my legs when the tranqs ran out. The surgeon prescribed a bag of morphine for the first night. Since that there were no opiates to be seen. So my intell was correct. What they gave me was ok but my pain when I tried to exercise was through the roof. I was discussing this with one or Luther’s cousins who is a pharmacist. Opiates are properly used for recovery from surgery and for a short time afterward. As she said, “the pain actually increases the fight/flight hormones and delays healing. Also makes physical therapy a lot harder. I think they were giving prescriptions for too many pills at once and not scrutinizing refills [in the US]….” European mainland countries in general do not give pain meds. They do in the UK.

My PT started the day after surgery. It involved a machine that bent your knee over and over to the most painful angle you could stand. Then leg lifts, toe thrusts, tensing the muscles on the back of your thigh and more flexing. I kinda sat on the side of the bed and stood at a walker for a second. Unfortunately the next day was Sunday and then Monday a holiday so things slowed down. I was unable to lift my leg. It was like the signal wasn’t getting there but with a little help to start I could lift it with much pain. I think this is when some codeine would come in handy 😕 the leg was extremely swollen and I was convinced that had to be a part of the problem. I wanted to learn how to use the crutches. It would give me some freedom in the hospital. That was one of the hardest things, being unable to help myself with anything. I took great pains to keep things from falling on the floor. If they did, they were lost to me. The nursing staff are not there to help you. Sure, they would bring me a bedpan if I asked but one night, I had been instructed to drink water after a shot so I had to pee, three times in around a two hour span. She let me know she didn’t appreciate it and said it was not “normale”. I told her I had had 2 bottles of water. I was no longer trying to be nice.

The other thing was the total lack of privacy. I shared my room with another woman knee replacement patient…and her husband. He literally lived in the hospital with her. He brought a small chaise longue. With blankets and pillows and slept next to her. He was a nice man who occasionally helped me with an ice refill or cranked my bed up or down (no electric bed there!). I noticed other people walking up and down the hall with these beds. They expect family members to come care for the patients. I lived with just visits from Luther but they were invaluable.

I was not ready for the loneliness of not being able to speak to anyone, even to casually chat with the nurse or aide. I discouraged visitors so maybe I must take some blame for the loneliness. Luther visited every day and I know even HE was bored. And he hadn’t been there for 5 days
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Stay tuned for Part 2.