Category Archives: Health care

Sabato

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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 five.

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Short post since not much has changed. No word about my transfer.

It is a brilliantly sunny day. Cool and crisp. Very autumnal. It’s my favorite time of year so I am hating that I’m missing it. We DO have a door to a balcony in our room. It allows lots of sunshine to come in. Cheery.

Today’s lunch was fish. Well, it IS after all, Friday in Italy where they hang onto Fish Friday religiously. 😋 It was pretty good.


I’ve joked while here that this is my Italian lesson for the day along with my ginastico or PT exercise. I’m speaking more than I’ve ever spoken before. I’m definitely getting better and no one laughs at my attempts. If I could just stay here another month or so I’d be fluent! Just kidding!!  But seriously, I think it will help me be less self conscious about speaking when I get back home. This is an unexpected extra. This morning a patient came up to me speaking German. So I responded in German. THAT surprised him 😅. Anyway, that’s it from Casa di Cura for today!

Rehab – Day four

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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

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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.

Ginocchio intervento 2 – knee operation 2

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This will be a brief post just to update on how I’m doing.
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So the day arrived to check into the hospital. We arrived at 4pm as instructed. The orthopedic floor was full so I was put on the floor above. I had a nice quiet room to myself. I had broth for dinner.

Next morning I woke early and waited and waited for the surgery. Finally got wheeled off about 10:30am. First big surprise was they did the anesthesia differently. I had known I would get an epidural which numbs you from the waist down. The last operation they used mega tranqs to make me sleep and did the spinal in my sleep. This time it was done while I sat on a table! It was scary more than painful but it did hurt. And when they wanted to use gas to make me sleepy I said “I don’t want to hear, see, or feel what is going on!” Make me sleep. They did.

I woke on the way to my room. I guess I got there around three. The doctor came and explained the entire old prosthesis had to be replaced. The other one was defective. This was interesting news. They did give me morphine for the night. And another pain killer the next day that was different but strong. I’m afraid I was woozy and I don’t remember it well.

The next day the doctor visited and lifted my leg and bent it slowly. I was actually amazed at how far he could bend it with no pain. They put me on the bend machine which repeatedly bends the knee to a percentage of flex for an hour. Twice a day. And the flex increases daily. But I’m up to 70% with no pain. I am so happily surprised that this is so totally different from my last experience.

Next post I will give my impressions of the hospital experience and compare with the last one. It’s pretty entertaining.

Packing…

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When a person goes to the hospital in Italy they must bring everything they think they will need…and then some! In some areas of the country this even includes bringing your own toilet paper. On my last hospital stay I didn’t need to bring that, but I did need to bring my own coffee cup if I expected to have coffee in the morning, and my own cutlery. I also had to provide my own water.

Since my trip this time will be over three weeks long (!) I need to bring a lot of things. I have a little bag which I filled with things to improve the horrible food. Like olive oil, vinegar, salt and pepper, and hot sauce. Maybe this will help. We’ll see. I also have soap and a wash cloth and towel. And a bowl to use as a basin. I am bringing the noise canceling headphones we have. I had some last time and they were invaluable since my roommate had the TV on from 7am to midnight, tuned to bad Italian TV of course. I’m also bringing my own pillow. Better than the hard-as-rocks hospital pillows.

For the rehab I need clothes I can wear to work out. I got some capri length pants with wide legs so my knee will be easily accessible. I need to bring gym shoes and tee shirts too. Of course, I can get Luther to bring anything I find I need in the meantime.

Here is the array of things I’m bringing.

Note the cup, spoon and cutlery!

These are the things I’m bringing to fight the horrible, bland hospital food. Olive oil, hot sauce, balsamic vinegar and salt and pepper. I should be all set I hope.
So today is the day I check into the hospital at 4PM. The surgery is tomorrow morning. I’ll try to post later on the rest of the story!

Now for something less cheerful

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As some of you know, my initial operation in January 2018 to replace my knee was less than successful. In April of this year I consulted with a new doctor, Dottore del Citerna. I had met him twice previously in consults about both my knee and hip. If I had understood the system better he would have been my initial doctor. But I did not understand. I had thought I must go to an in-system doctor. So I chose Dottore Trinchese. He practices at Silvestrini hospital, the big university medical center in Perugia. It is where my first surgery was done. When I chose him I did take time to get recommendations and looked up his reviews.

I don’t really fault Dottore Trinchese with anything. The knee was problematic before the surgery. I DO fault him with not admitting there was something wrong when I went for a checkup six months after the surgery. I knew there was something wrong! He said not. So I kept on. Eventually it got worse, not better. So that’s when I turned once again to Dottore del Citerna. He examined me and he thinks it is the ligaments and muscles which are not holding the kneecap securely. But he won’t know for sure until he does the surgery.

So that’s the back story. My surgery is scheduled for September 27. I am now lasered in on it. All this spring and summer I’ve concentrated on the 3 major trips I had planned. I had put the surgery off until after them. Now, nothing stands between me and it. 😳 There are some differences this time. First, my doctor is private. Second, the hospital is different. It is smaller and part of it is private. I am still on the Italian Health care system so it will cost nothing. I hope this means the hospital experience will be better than the big, busy University hospital. I guess we will see.

Last week I went in for my pre-op tests. It took six hours! Everyone was very nice but there were interminable waits between each procedure. The hospital is called Casa di Cura Liotti. It is rather dreary and right in the busy middle of Perugia.

I was waiting in one of the waiting areas and saw my doctor arrive. He came back through again on his phone. The next time he came over to me and asked me if I was pronta? Or are you ready? I said no, not really. But I was impressed that he recognized me after seven months and spoke to me. I don’t think that would have happened in the US.

Now I have to pack for my ordeal. Next post about what I’m taking 🙂.

Not good news

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If you follow my blog you’ll know that I had knee replacement surgery here in Italy in January 2018. I learned a lot about the Italian system before and after the procedure. I learned all about what to expect when you go to the hospital. And what to bring with you, which is very different here.

2018 Knee replacement part 1
2018 Knee replacement Part II
2018 Knee replacement Part III

I learned that the nurses don’t help with many basic things like bringing water. Or ice. They do blood pressure, medications, take blood for tests, basic bed making and body wash. But for your personal self, it’s on you to have a wash cloth, water, soap, a basin and toothbrush, toothpaste etc. for personal clean up. For anything like this you would need a helper. A family member or friend. Odd but true. Different hospitals have different rules. And, of course, very few people speak English. It makes for a lonely time without being able to speak to anyone.

OK so, my operation last year was fine, the PT in hospital was good, if painful. No opiates or pain killers in Italy. I was released but didn’t really understand I was supposed to go into in-patient rehab for 3 weeks. When I found out, this floored me. I couldn’t face it. After being in the hospital for a week I wanted only to be home. So I didn’t go. We arranged a nurse to help with re-dressing the incision. And hired a private therapist for PT in house. And all went ok.

I was told it would take 6 months to a year to recover. So I waited. And did my exercises… and I was in pain. Especially going up and down our 56 stairs. I returned to the doctor 6 months after the operation with concerns about how my knee “looked”. There was a malformation in my opinion. But the Dottore said all was well. Tutti va bene. So. I waited.

Now, more than a year later I am still in pain. Rising from a sitting position and doing stairs are quite painful. And getting more so. I decided to consult another doctor. I knew him from previous consults. I like and trust him. He sent me for X-rays of specific sorts. I returned and he said I need another operation. There are three issues. First the kneecap is skewed to the side because the ligaments and muscles are not holding it in place correctly. Second the top part of the prosthesis is too large for me. Last the bottom part of the prosthesis is slightly twisted off center. He said I could get lucky and they would only have to repair, realign the ligaments and muscles over the kneecap. But if the other two things seem to be an issue I’ll need an entire new implant. He will only decide once he can see it. Sigh. I have to lay this at the feet of the other surgeon. 😡 Not what I wanted to hear but I expected it, I guess.

My doctor asked me when I wanted surgery. I was taken aback. Last year I had no choice. The doctor put me in the queue. It took about 7 months and I had no real choice for the date. This doctor seems to have his schedule in a book he keeps and is able to pick dates. I will never understand this crazy health system here. Since I have multiple trips planned this year. And I don’t want to cancel them. First a week trip to Sicily in April. Then a 10 day trip to the US for my nieces wedding in May. Finally a special anniversary cruise in the Greek islands in July. I decided to choose end of September, after my friend Eunice goes home from a visit.

So I’m scheduled for surgery on 27 September, in Perugia in a small clinic/hospital and I will be in a total of 18 days. To include rehab. This time I will stay in for the entire rehab. It will be easier if hard to be in the hospital that long. I’m sure not looking forward to it! But it is what it is. On the bright side, I’ll lose weight! Food is awful in hospital.

The news for my blogsters is that I will share another exciting hospital stay experience with you. This time to include all that in-patient rehab! 😳 and Hey! I will learn more Italian.

Meanwhile I’ll enjoy spring in Umbria. And hopefully I can enjoy my upcoming trips. Fino a dopo i miei amici!