Category Archives: doctors

Another day

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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.

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    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

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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

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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

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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.

Hospital arrival and first day

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I was told to arrive at noon today. Which I did. But last time here I neglected to take a picture of this directional board with all its colors. There are building depictions on the sides and on the floors everywhere are colored arrrows to help you find your way.
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They checked me in with much paperwork. Then I arrived in my room. It is a semi-private room and has a curtain on one side only and is very much like a US hospital. I guess it depends on the hospital. This one has nearly everything. There is toilet paper. At lunch there was plastic cutlery. There is a small shared TV. But tonight for dinner I did not have a spoon for the broth I was allowed. So I used the one I brought. They don’t provide water.

My roommate was in bad pain and I spent the afternoon listening to her cry and her husband calling for nurses. They tried a few different things none of which worked. Finally she got morphine. She’s eating and blabbing on the phone tonight. I hope they manage my pain OK. Now her husband has gotten his lawn chair and cushions and a blanket to spend the night. I had hoped it would not be necessary for me. Crossing my fingers. Poor Luther has no lawn chair.

The time is now.

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Well, tomorrow is the day. I go into the hospital at noon. I have no idea what I will be doing all afternoon since the preliminary tests are finished. I guess I’ll find out.

During the last two weeks since my pre-operative tests I’ve talked to a lot of people who have told me their experiences which all differ from one another.

In an effort to get some correct information on what to expect we visited Dotoressa Mommi, our primary care doctor. She told me the length of the hospital stay depended on how I was doing. She did tell me a little about the PT process. We have to wait until I return home then we can set something up. I’ll get instructions from the hospital for Mommi to help move forward for us. It is possible to have home visits for a while. But emphasis is that I get out of the house ASAP. The stairs are a problem. I guess we will just have to trust the system.

Going to an Italian Hospital is NOT anything like going to an American hospital. All the information I’ve gleaned so far says I will be in a ward. There are no curtains or privacy. The nurses do not provide much assistance for things like a drink of water, or help going to the bathroom. It is expected that a friend or relative will stay with you. Another difference here is that the hospital provides nothing for your stay. No water or toilet paper, you even have to bring your own cutlery, plate, cup and glass! Here is my suitcase in packing process.
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And, for a bit of good news, they finally removed all the scaffolding from the Comune building across from us. It is quite striking with its bright yellow paint and white trim, new copper gutters and downspouts and earthquake stabilization. The interior is gutted so I have no idea when that part will be even started. Maybe it will wait until the new government in town comes in. So now, I can again see the piazza. Here’s the building from our window.
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Knee surgery scheduled

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About 6 months ago, I told you I needed surgery here in Italy. Non-emergency surgery can sometimes be a long wait, as it was in my case. I got a call last week from the hospital…at long last…to schedule my knee replacement surgery. My first appointment was today, for pre-op tests.

Well, I’m back from my tests. It went well for the most part. Ospidale Silvestrini sits commandingly on top of a hill south of Perugia city. It is the University hospital, so a teaching hospital. The hospital is ENORMOUS. And a VERY busy place. We were to go to the Segretario Ortopedica. Luther looked it up and the instructions said to go to a parking lot called Menghini and find a specific door. The place has multiple buildings connected with enclosed walkways. Our building was A, third floor.

It was 7:50am and our appointment was for eight. We got there and saw a door with the correct sign and walked past a whole room of people waiting and down a hall to the Segretario’s office. Asking permission he invited us in. Suddenly, all the people in the waiting room seemed to swarm the room but he told them to wait. Seems he had no appointment for me. But I was lucky, and he was helpful. Once we told him we had a surgery date and he looked in that book and there I was, he moved to fix it. He called down for my blood work and we went down to building P.

It was a pretty long walk. There, room 17, our destination, had an open door. We asked to come in giving our name and they seemed to be expecting us. Again the waiting room was full. I was feeling we were jumping the line! There was a man and a woman there. He took my blood, she did pulse and BP. They gave me a form to fill out with my history and a number and we returned to the waiting room. I filled out the forms and my turn came and I went in to see a young anesthesiologist. He was nice and even tried a little English. He asked questions and answered mine. A little disturbing is that I may get an epidural only along with mega tranquilizers, so not a general. Man! I hope I don’t wake during the operation!

Next we went to radiology and got a number. Everywhere we went was busy but here was the busiest. They are just next to the Pronto Soccorso or emergency room. When I was called I went down and got a chest X-ray first and my knee second. The chest was because I told them I used to smoke when they asked if I had. And how much. But wow, I quit nearly 40 years ago. But still…X-ray. So all was finito and we headed home. It took about 2.5 hours. All in all, I’d say the hospital was as good as anything in the US. This is reassuring. Everyone was very nice, and patient with my Italian. I’m crossing my fingers the intervento will be as good. I am scheduled to go in two weeks for the intervento, or operation.
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My friend Angela here (I grew my corn at her place last summer) has a friend named Quintino. She calls him Quinto. I knew he brought wood to her house to split. He’d also leave it there. So I asked if he’d need a spot of work to bring me wood. Well he did, back in December and he would not take the money I offered! Un regalo, a gift he said. I said no, no carrying it all up here, and believe me, it’s heavy! So I asked Angela about how to pay him and she said block his way and make him take it. I got some more this week and this time I made him take it. He didn’t want to because I was a friend of Angela’s. Now I have way more wood than I need.🙂 oh well. Rocky has decided he LOVES fires. And Quinto even brought me olive wood. He said it was for carne…meat when I cook.

So last night I tried out the olive wood. Smooth bark and small in size, it pops like firecrackers are going off in the house. So far this has not fazed Rocky. I grilled one of the good steaks we get at Etrusco in Bosco, a town south of us. It turned out very good and I had a nice, warm kitchen.