Category Archives: medical

Dealing with health issues in Italia

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I’ve avoided writing about something for a while now and it’s time I begin to chronicle this new adventure (?) Last year I began to have problems with my right knee. I went to my doctor and she prescribed anti-inflammatories and icing. For a while it seemed to improve but took a nosedive earlier this year. We are very new to the Italian health care system so are groping our way along with many false starts.

We went back to our doctor and I asked for an appointment with an orthopedic doctor. Dotoressa Mommi wrote a prescription for an appointment. And said it was urgent enough to get done in 30 days. The only available doctor was in Deruta, about 30 minutes south of us. We visited him and he was frustrated that we had no X-rays or an MRI. All he could do is proscribe something which turned out to be pretty useless. We decided to go and get an MRI on our own and pay for it. If I didn’t want to pay I could have gone and asked our doctor to prescribe one and waited (again). So we went to a diagnostic center and I paid 126€ for an MRI. Not bad.

Armed with this we could make an appointment privately with a doctor of our choice. The only one we knew was far south in Spoleto. We visited him and he read the MRI. He said I need a total knee replacement. Sigh. We paid 150€ to consult with him.

Back we went to our doctor. In hindsight we could have asked this doctor we went to privately and he could have put us into the system and done the surgery. But we didn’t understand this at the time. Dot. Mommi explained it to us. And she offered to make an appointment for us with a good orthopedic guy in Umbertide. I prefer to not have to go too far for the procedure mainly because I would like it to be close for Luther to visit.

We visited the orthopedic guy yesterday. He was nice enough and even spoke a little English. But mostly it was in Italian. He too recommended knee replacement. Second opinions are good. So he gave us a form to fill in and email to the powers that be to schedule surgery. As always, everything in Italy shuts down in August. In this case last week in July to first week in September for non-emergency surgery. So we are looking at October-November for operation. Sigh. It is a long wait.

I guess my biggest worry is communication while in hospital and rehab. But on the bright side (?) I’ll learn more Italian. We are told it’s 5-7 days in hospital and then three weeks in in-patient rehab. Seems excessive by American standards…but in America it is all about the bottom line so they kick you out fast! For me, I’m thinking by the time I’m done I’ll be able to do the stairs here. Operation will be in the very nice hospital in Perugia, rehab here in Umbertide.

Since this is what I’m stuck with I am going ahead with plans that I was kind of worried about. We have a cruise on the Crostian coast in August and have a friend housesitting. I didn’t want to cancel either. I may be stuck in my stateroom but… Then we have friends in late September and another in mid October. This will mean I can just do what I can do and I and my guests will have to deal with it.

For my everyday life I stay mostly in the apartment. I descend and ascend the three flights of stairs maybe once a day. So far, so good. Hurts but manageable. The good news is knee replacements have generally good results and are not too hard to recover from. Crossing fingers it will be so for me and I will be good as new. This will be great! 🙂

My visit to the Italian Dottoressa

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Well I couldn’t put off visiting my doctor any longer so I steeled myself to do it last week. The way the Italian health care works is like this. You go to the Sanitario office at the beginning of each year. I wrote about that experience earlier this year in this blog. At this time they assign a doctor. I was assigned to a woman doctor who was an OB/GYN as well but she would be my primary care doctor. I had gotten her name from friends who had been through a lot of health care issues and had finally found her. We all speak some Italian but when dealing with something like your health you want to get it right. You don’t want to misunderstand.

I had looked my Dottoressa up on the internet and had her hours. Off I went. After a little trouble I found her office but her hours were completely different than the site said. Dutifully I wrote down the hours that were posted on the door. Rats. So yesterday I went back arriving just before the opening time to find several people there ahead of me. I noted my place and after about 30 minutes I went in. I introduced myself in my best Italian and then politely asked if she spoke English. And she did, and it was good. I had checked my blood pressure myself and it was somewhat high so this was my primary reason to go. She agreed to put me on some medicine for it. She commented that she had not seen me in any of the bars and did I only associate with other English speakers. I got the feeling she didn’t like the expat community. She said she would speak to me in English but if she met me somewhere else she would speak to me in Italian. Fair enough!

As we talked I was surprised at how, how to say it…maybe unprofessional… she was at least when compared to a US doctor. She asked if my husband came to her and I said no he went to a different doctor. When I told her his name she snorted in derision. I asked her if she did not like him and she replied, “have you met him?”  I don’t think a US doctor would do that to a colleague. We talked about her daughter who has several degrees. I commented that she should be proud. She talked about the person who headed the Umbria Sanitario office who had “only a high school degree!!” and SHE was trying to tell the doctors what to do, how to save money… I commented she must know people in high places. She replied she was F***ing everyone! OKAY then. So this was my first visit to the Dottoressa.

Weather is a-changing
Fall is here. The temperatures have been quite cool but nice. The morning fog is again enveloping the big city. It usually burns off by mid-morning. The farmers are bringing in the biggest cash crop around here right now – tobacco. Everywhere are tractors with trailers full of the bright yellow leaves. Sprinkled throughout the countryside are tobacco drying buildings with ovens to partially dry the leaves before shipping to the big tobacco companies. Umbria is famous for it’s tobacco, primarily for cigarettes.

The sunflower fields are now just stubble. The corn is mostly harvested. And so are the grapes. It was purportedly a good year for the wine. Happy happy for the vintners after such a poor year in 2014. Next we hold our breath to see if the olive crop is OK this year. Last year it was devastated by an insect because the winter had been too warm to kill them off. Last year would have been my first olive harvest season. So I am eagerly looking forward to this years harvest and the production of the Olio Nuovo or New Oil. Umbrian oil is particularly peppery and grassy and brilliant green. So good on toasted bruschetta. Can’t wait.

Yesterday we had a gentleman named Marco come and take a look at our big fireplace in the kitchen. We are going to have him make glass and steel doors that fold back for it. He “said” he could get it to us by November. It is Italy after all…Our friend Vera just said to him “before Natale?” (Christmas) He laughed and said November! We shall see… Maybe I will be able to try it out this winter.

This week we have had a lot of storms rolling through. A lot of times they stay west of us, behind the mountains. The Tiber river tells the tale of what is happening up-stream. It is brown with mud and very high. I must have taken 100 pictures to get this one picture of the light show we were having.
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Follow up

So today we returned to the Dipartimento di Salute to finalize our health insurance. We could not ‘jump the line’ as we thought but this day was far calmer with fewer people waiting. After only about 40 minutes we went in to see LL.

What a surprise! She was quite nice to us. But she really opened up when we began discussing restaurants that we had been to. I guess food is a subject close to her heart 🙂 given her girth! We were given cards and assigned a doctor. We asked for the one Susan and Gary have. The only glitch is that our Permissi run out in June so it is only good until June. We have to go start up our Permissi process again and then they will extend it until the end of the year. Our doctor has hours and you just drop in. I’ll let Luther go first so I see how it goes.

On Sunday we drove to Citta della Pieve. It is very close to the Tuscan border and is a very pretty hill town. I was impressed that it was a really active place with lots of people about. Nice bars and outside spaces. Here is one of the pretty streets.

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We found one of the restaurants that we had read about called Zafferanno Pievese.

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The menu had a surprise on it. Hamburger!

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But WOW was it expensive. Note the price above. I guess since it was made from the famous Chianina beef with bernese sauce and to top it off the Famous Onions of Cannara. Perhaps it was worth the price. I resisted ordering it. Maybe if we go back. Below are our two appetizers. They were good but a lot of food. I did not care for my primi but maybe it was just the ingredients. Luther liked his steak.

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It was a fun day!

Italian medical coverage

Sorry it has been too long since my last post. I have been thinking about how to describe the experience of getting medical coverage here. I probably can’t get it across but here goes.

On Monday, Wednesday and Friday between 8:30AM and 12:30AM the health department is open to enroll people for insurance. Susan graciously volunteered to accompany us. We arrived about 8:15AM and took a number. 65. I spent a long time looking at this so I thought I’d scan it in for posterity.

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We looked around and the seats up and down the hallway were full. There was no place where the numbers were displayed to tell who was being waited on. There were several numbered doors. Only door number 1 was handling health insurance. Coincidentally Joseph and Paul, our American neighbors were ALSO there. They had arrived at 7:40AM. We hadn’t realized you could come early. SO there we all sat along with untold numbers of Italians and other nationalities. A Large Lady in a purple tunic sweater and black leggings, heretofore to be known as LL was taking people in, one at a time. I should mention that the numbers are never called. It was up to the people waiting to police themselves. Whenever the door opened whoever thought they were next would go in.

Joseph and Paul went in and when they exited related that LL had no calculator, pencil or piece of paper on which to figure out how much they had to pay for the insurance which is 7% of your income. A small gray haired woman would come in and out and run to the front office to use the calculator. Such inefficiency!

Time passes. The Italians around us were just as annoyed that they had to wait so long as we were. It was very Kafkaesque. I should mention that around 10:30AM or so the numbers in the machine ran out. People would come in and look at the machine with no numbers, look around the hallway, look back at the machine. The gray haired lady at one time announced that when the numbers ran out they were taking no more people. So as folks came in, someone would tell them they were too late and to come back another day.

After about 3 hours (!) we got to go in. LL is said to be the meanest person in Umbertide. She apparently spends much time screaming at other people on the phone. I had brought in the statement from my Social Security as proof of my income. Luther does not yet get his so we just claimed mine. Again, the gray haired lady came in, took the figure of the income, ran to the front office and ran the numbers. 1,065.22 Euro a year. There was an issue with our Permessi because they run out in June and the insurance is for a year from January. At first we thought she was going to tell us we couldn’t get the insurance but Susan explained that the Italians raise objections but generally that doesn’t stop them from going forward. I guess they just like to complain. So we told her we’d start the process of renewing our Permessi.

Now we were told we need to take the number of Euros we owe to the post office and pay it. They will give us a receipt which we are to bring back to LL. We are told we can jump the line once we have the receipt. We decided we would come back on Thursday to pay and then return Friday.

Thursday we head over to the post office where we take a number. When Luther went to the window the lady said we needed the bank account number that the money was to be deposited into. Wouldn’t you have thought that the LL would have given us a number when she said we had to pay at the post office? But no. So we went over to the health office. We could hear voices behind door number 1. Luther knocked. The door opened a tiny crack. LL peered out and told us to come back Friday between 8:30 and 12:30. We quickly explained we needed the bank account number. She closed the door in our faces. We stood there wondering if she was coming back. Well she did, with a number written on a torn scrap of paper.

We returned to the post office and successfully paid the money. We did not go on Friday so I cannot yet tell you we actually GOT insurance. Tomorrow is Monday and we will return to jump the line and see the LL. If she does give us our insurance then we get assigned a doctor who will oversee our health. The good news is we get to do this every year!

We had some fun on Thursday with Susan and Gary. We visited a winery but we had made an appointment so they arranged a tour. We tasted the new wine in the big vats. That was interesting. It was still cloudy because the sediments had not settled. Pretty interesting. It was actually pretty good and you could tell what it would be like when it matured. They provided plates of tasty bits of food to eat as we tasted the five wines. One white and four reds. We purchased several cases and headed for lunch in Bavagna. The man at the winery called ahead and told them to treat us nice. We had a nice lunch. Sorry to say I forgot my camera!

Today, Sunday we are off to Citta di Pieve which is a nice hill town. I will NOT forget my camera today.