Tag: Spanish Medical Care

It was a dark and stormy night

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Well, it was actually a dark and stormy afternoon. And it was the day that I realized the theme of this week should be ‘The Appointment to Make the Appointment’. We hit the ground running this week.




Our first annual medical exams since we’ve been here – actually, we were way past due before we left so it was time to go get a check up and all the commiserate tests. We’re both over 50 now so the tune up and oil change takes a little more work. Blood tests and ultra sounds. It requires multiple doctors and the process here is a little more round-trip intensive.




First, we go to the clinic to make the appointment because we can’t do it over the phone – being Spanishly challenged. Then we go to the appointment and meet with the doctor. Whichever doctor it is orders tests. We go to where we are going to have the tests. Then they tell you when you can return to pick up the results – they don’t just send it to the Dr. who ordered the tests. Then you pick up the results and return to the doctor to make an appointment to review your results. Etc. Rinse and Repeat.




Jeff got lucky this time because I went to our English speaking family practitioner first. I happened to mention that Jeff would be making an appointment himself to see him. The Dr. felt he would save him some time and gave me all the blood work orders for Jeff too. So he got to skip two steps right out of the gate. When he complained about going to the Dr. after his tests came back I wanted to punch him.




Today, I had an appointment to take the examination for the driving theory test at the Jefatura de Trafico. I made it the week before we left for Brazil online and I have spent every day since doing nothing but studying the book and taking the online practice tests.  OK, that and watching a Breaking Bad marathon but you can do both at the same time. I know I’m ready because I’m passing nearly every practice test I take. But what I wasn’t prepared for was the test of getting to the test.




I had even attempted a dry run. This week I had to go get my psychological/medical fitness certificate. The clinics are across the street from the Jefatura so I knew where to go. It took 10 minutes, during which time they asked if I was depressed, tested my eyes and made me play a video game where I had to keep the two bars on the screen inside the winding road. Twenty six euros later and I had my certificate.




Since I was right across the street, I thought I’d go check out the Jefatura de Traffico and learn the system and ask for the remaining forms I required. Just so I’d be ready today. The security guard is brutal on the ‘taking-of-the-number’ business. I was not getting past him to ask a small question – without the requisite appointment. So no dry run.




Today – test day – Jeff came with me and we went early. I wanted to make sure I had plenty of time. I’d gotten my passport photos at the machine in the subway and I had all the copies that Spanish bureaucracy requires. Everything in triplicate. But getting into the equivalent of the Department of Motor Vehicle early is not allowed. Seriously, you can’t get there early – just at your appointed predetermined time. While I was in line waiting to learn this little tidbit from the militant security guard, I found my Irish friend, Donna, happened to be in line in front of me. She was swapping her driving license out – because EU citizens just exchange theirs with a form and and fee. Me? I have to act like I’m 15 again.




So after our unceremonious booting out of the Jefatura (the guy actually wagged his finger at me and said ‘No!’), we went across the street with our tails between our legs to have a coffee and to wait until the machine, that gives you a number the security guard checks so very closely, will spit out a ticket that gives you the privilege to sit down and wait. And wait. And wait.




Finally, we decided to leave the safety of the cafe to brave ‘El Securidad’ once more, and success! The ticket has 3 letters and 3 numbers. Then you sit and wait, looking up at screens every time the bell goes ‘Ping!’, checking your ticket against the information on the screen. It’s like playing Keno. When other combinations would come up and it had a common letter or number to mine – Jeff would comment on it. When my number came I almost shouted out ‘BINGO!’ but he was on to me and whispered ‘Don’t do it.’ So I held back.




Up I went to the window with my documents and copies in my plastic folder. Just like everyone else here, you go to no official building without your plastic folder full of everything you have ever documented since the beginning of time – this can include your baptismal certificate. The gentleman who helped me was very nice. He looked at what I had brought and then took my Residencia/NIE card back to have it examined by someone else and they had a long discussion about it. I was having flashbacks to the Spanish Embassy in Los Angeles. If I had to conjure bank statements I was going to scream.




Then, he came back and brought forms with him. He typed alot, glued my photos to a form, and more typing. Then he asked me when I wanted to take my test. 




‘How about now?’ I told him. I’m not sure why he thought I was there.




‘Oh no. Today you pay. You take the examination on December 3.’ He looked at me confused that I didn’t know this was ‘the appointment to make the appointment’. The test will be at a place several miles outside of town in a couple of weeks.




What could I do? Storm off? It’s just how it is. But I was a little disappointed. I was ready. I was psyched up. I memorized the manual on two continents and 24 hours in the air. I had asked Jeff over the last 48 hours one hundred times if he thought I was going to pass. I peaked too soon! But now I have a packet of all the forms and everything I’ll need in a couple of weeks. I am resigned. Jeff was less than happy.




We went home on the subway and when we got to the Benimachlet metro stop it was clear that the storm outside had become something of an issue. The water was pouring  down the stairs like a waterfall. I hid my packet of precious stamped theory test documents – including my new appointment time – under my rain coat and made a run for it. I took a video so you could see how much rain we’re talking about.








I had thought about wearing my Hunter boots today. It was raining after all. But I just wore my little green rubber ankle Boggs. My go-to rain boots for a Seattle rain. Today, they were woefully inadequate. I needed fishing waders – no kidding. By the time we got home with the rain coming down sideways, both of us were soaked to the bone. Like someone had sprayed us with a hose for 5 blocks straight.




‘We have to stop!’ I shouted at him half way home from the Metro station.




‘Why? We can’t get any wetter!’ Jeff wisely shouted back. And of course, he was right. But everyone on the street was laughing. Movie rain is like that. We’re all in the same boat, or swimming in the same ocean, I guess.




When I got home, I saw this lithograph I had bought at an artist gathering in Sao Paolo and it made me smile. Something about it struck me at the time and I stuffed it in my already bulging bag for the trip home – Jeff just shaking his head. So today, it seemed appropriate since my own umbrella was in the exact same position. A premonition of sorts.







I’ll have to remember the lessons of this week when we start our residency renewal in a few months. And allow enough time to make ‘the appointment, to make the appointment’. Hopefully, that day it will be a little less wet.

Random Crap

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Everyday I learn new things. Most of them are small but this one was sort of large so I thought I would pass this and some of the other stuff we’ve gleaned lately. Because when things are different, it helps to know about them in advance so as to avoid confusion and delay.

I went for my follow up with the surgeon last night, after having the tests in the morning. In the US, the test results are automatically sent to the Dr. who is authorizing and requesting the tests. In Spain, that is not the case. You are sent the results – just like in the US – but you are expected to print the results out and take them to the Dr. He doesn’t have access to your test results for privacy reasons, unless you give him the hard copy.

So Emilie and I went to the appointment and waited – they squeezed us in – and found that I had no way to access the information and that the Dr. was expecting me to bring a hard copy. I was his last appointment of the day so going home to get my ID and password wasn’t an option. So I’ll have to go back for another appointment.

Of course, they apologized to me for my own mistake. The nurse and Dr. felt terrible about it all and I learned something new that I’ll never forget. So there was goodness all around. I told them not to worry.

Today, Jeff and I tried a new grocery store. I have never lived in city with so many different grocery stores so close to our house. In NYC, Chicago, or SF you’d have one choice of grocery store, and it would be very small and very expensive. In Seattle, living in the city was a desert of grocery stores. Although I know that’s changed a bit now with City Target moving in, and some others.

But here is the SuperCor, Carrefour, Super Carrefour, Mercadona, Super Mercat, and now we discovered the Consum. We started noticing Consum’s around the area and they looked like small stores. But while the entrance may look small, there is a HUGE store lurking behind. So we did a big shop there today.

We walked the aisles and it’s now become our favorite store. Why, when there is so much choice in grocery shopping would we choose Consum upon which to bestow our custom? Well, there are a couple of considerations here. Consum wins the award for best layout most resembling a Safeway or QFC (Kroger store) in the US. Things are just where you would expect them to be. That’s a novelty in every other store we’ve shopped in. You might remember my near ‘bleach v. laundry detergent debacle’ of mid-March.

Jeff likes that they have shelves and shelve of different kinds of tostadas. Those little toast things that you use as a tapas delivery system, or in his case, to dip into olive oil grown from ancient trees, for a mid-day snack. He’s become an olive oil and tostada snob, apparently, and shaking up his tostada selection is a top priority. He was in heaven.

They also win the award for most brands I recognize (Kikomon low salt soy sauce) and an ethnic food section that contains stuff I really, really like. Mexican foods, Indian foods, Japanese foods. They’re all there and some new things I’ve never tried. They had us at ‘Ethnic Food’ section. And they have paper towels that resemble the ones I could get back home. Yes, it’s the very, very small little stupid things that matter.

Finally, they win the award for nicest checkers, and since they have an in-store Coffee bar – with really nice staff, too – it’s doubly wonderful.

We came home and Emilie is thrilled that I found Golden Grahams cereal that is one she recognizes too. So we’re all happy. I’ll be adding this to my ‘Lessons Learned’ section under ‘Looking for a little bit of comfort’. Cause right now, familiarity is a high priority on my comfort scale.

Everything has a Silver Lining

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Today I had to wake up earlier than usual and head out to the IMED hospital in Burjasott. It’s more on the outer ring of Valencia. Not far before you aren’t in Valencia City at all. The Metro goes out that way and even further. We had underestimated the time we needed to take the subway because the trains out there don’t run as regularly as they do here in the city proper. When we discovered it would take 15 minutes until the next train at our transfer point of A. Gimenez off Gran Via, we went up top and grabbed a taxi.

We had left Emilie at home to sleep. I was nervous about these tests (really about the outcome) and also navigating to an unfamiliar place, an unfamiliar hospital and then there’s the language barrier. I didn’t sleep well last night. But pulling up to the hospital, it looked more W Hotel than hospital. In fact, it was the nicest hospital I’ve ever been in. It looked like the lobby of a very nice hotel in a large city in the US and there was a check in desk and concierge – seriously. Whoever designed that place either hired someone from or spent some time themselves in an extensive Hotel Management or Hospitality course.

So we went to get checked in and I realized that I had left the orders and the papers the Dr. had given me last week, on the table at home. (I really had not slept) I told the person checking me in and she said they would need them and asked if I could pop back home to get them. The concierge ordered me a taxi and we went back to our apartment, I went up stairs while Jeff waited with the driver, got the papers and were back at the hospital in 20 minutes. And here’s the thing. THEY HELD MY APPOINTMENT.  Yes, you heard that right. They treated me like a human being. My head was spinning. I didn’t lose my place and have to reschedule. I just went back and stood in line and they did the paperwork and I was given a card with a number on it and told to sit in the rather chic waiting area with sculptures and things.

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It seems they take patient privacy very seriously here. In the US, the nurse usually comes out and calls your name. Like a fish wife telling you your flounder order is ready. This after you’ve signed extensive privacy policies that say they won’t reveal anything about you – including your name.  At the IMED they would never stoop to that. The card they give you has a number and you look up at this screen when you hear the bell and they flash the number of the person who is being served. No PII data exposed. Then you get up and they direct you back to the room where you’re having one of your tests.

So we sat down and waited about 3 minutes, my number came up (sounds ominous but it wasn’t) and they took me back. I had my tests and then I came out and was told that I would have the results in 48 hours. Except I didn’t, because I got the results in about an hour. Before we got off the Metro I had an email inviting me to log in and get the results. Sure, Google translate isn’t great for medical terms that aren’t exactly translatable. Measurements seemed understandable. This was X cm or X mm. But more than that, my confidence that these people are going to figure everything out and come up with the right treatment plan is getting higher with every interaction.

So tonight – after 5 pm – I’ll go see the surgeon again and learn what our next steps are. But the upside of the entire thing is that we got to see a new area of the city. Across the street (well, really on the other side of the freeway via tunnel) was a store that sold athletic shoes. So we decided before heading home on the Metro, we would check it out. I mean Jeff is still having to wear that one pair of shoes, since our stuff was supposed to be here yesterday and there’s been no word.

We walked over and found a place called ‘InterSport’ to be chock full of everything you might find in a US sporting goods store – minus the hunting/fishing section. We asked a nice guy if they carried US size 13 or 48/49 EU for Men. He said they did and that we should just sit down and he would bring out everything they had in those sizes. Jeff was elated.

The guy had about 10 pairs of shoes in that size and Jeff selected 3 pair that fit well. He was walking on air as we made our way back to the Metro. So happy to find a store with something that would fit, he started looking up how much real estate goes for in the area. That might be taking it too far – choosing a home based on the availability of shoes – but I kind of understand it. We all have our comfort zones and, lately, mine has been tested on a daily basis. But every time I have to tackle something that make me lose sleep or gives me butterflies I know I’m just getting stronger.

It Really is That Special

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Every day  it seems we love living in Valencia more. The weather, the people, the scenery. And, lets face it, the cost of living doesn’t hurt. But the biggest things we love is the people. Everyone is so nice. I’m not sure how that is possible, but people help us with everything, every day. They volunteer to show us where to go and give us advise on how to navigate. Today was just another example.

So I went to my Dr. appointment with the specialist this evening. A night time clinic that had a lot of people in the waiting room for our particular office. The building was clean, lined with marble and laid out efficiently. We got there a bit early and I went right through the door, only to find out that you don’t do that. I sheepishly tip-toed back out red faced. The people in the chairs in the hall giggled, but we were laughing together.  Even though the Doctor’s name is on the door in the hallway, you wait in the hallway and they call you. I learned this from a couple of women who took pity on me.

After about 20 minutes, a guy in jeans came out and took a patient back. Then he came out and took me back. He’s a specialist but he was dressed casually and he swiftly determined that I needed a surgeon in his specialty, not him. OK, here goes – I thought. More delays and I’ll have to wait forever to get into see that guy. It will be another month.

Nope. He took me out of his office – Jeff was looking at us as we whizzed by and quickly followed – and marched me down the hall. The Dr had made a phone call when I was sitting at his desk and he was taking us to the surgeon. Right then. At 7 pm. The nurse for the surgeon apologized that I would need to wait for him to finish with another patient. Jeff and I looked at each other like ‘She’s kidding, right?’ She was apologizing to us – a medical professional was saying that she was sorry we had to wait. This was my first experience with this in my entire life.

She called me back into the office and I explained my situation – the other specialist had given her some of the run down – and I gave her all the things I had printed out and the questions I had. She was patient and talked through everything. She asked why I hadn’t gone to the other hospital that my original Dr. had recommended and written on the referral, and I explained that I had called the insurance company and they had sent me to this location.

‘No. They are wrong. I will help you deal with them. But you will have surgery and tests at the other hospital.’

I was confused why she was so insistent and said so.

‘It’s new and the rooms are like a hotel. You will like it there much better.’ She advised.

Well, I decided on the spot I will be doing whatever she says going forward. Finally, the Dr. was ready to see me. He was efficient and assuaged my fears. He had a certificate on the wall from NYU and is certified by the NY board of surgeons. This shouldn’t really matter to me, but it did. And the certificate next to it said he was head of surgery in his specialty at the hospital we were in.

When I left, they had all the paperwork I needed ready for me and she gave me the Dr’s card and she wrote her info on the back.

‘If you need anything, you call me. I can make phone calls for you and help answer questions. Even if it’s not about medical things.’ She smiled.

She was so nice, I had been so stressed about this appointment I teared up. She patted my shoulder and led me out. Jeff met me and I explained what had gone on as we walked home on the river.

‘You look a lot better. Happier.’ he said, after I told him everything. ‘I knew this morning you were stressed when we were at El Corte Ingles and you had no interest in shopping. You never have no interest in shopping. It made me worried.’

‘I was scared but, I don’t know how much better that all could have gone tonight. I’ve heard horror stories, when we were in the US, about health care in other countries. I mean our experience in Italy wasn’t that good. But this was first rate. They were actually kind. I wasn’t just a number. They each talked to me – like I was a person and they didn’t just try to throw prescriptions at me or see how quickly they could get me out of there. No one looked at their watch, like my 15 min appointment was up.  That surgeon saw me with no notice and I got right in.’

We were both so amazed we were in shock. Our last few years in the US regarding health care and insurance were terrible. Jeff’s motorcycle accident came with so many bills and co-pays and deductibles. I had to fight the insurance company to pay the helicopter bill. Once he was out of the trauma unit and into a regular room, they gave him Tylenol (like the kind you buy in the grocery store) and they charged $250 for two tablets. Insurance wouldn’t pay the $1800 bill to take him in an ambulance from the roof of the hospital, where the helicopter landed, to the entrance of the Emergency room. Maybe 200 meters.  And once they released him from the hospital, it took weeks to get follow up appointments with specialists and the like, and he had nearly died. Shameful.

Today, it took me minutes to see specialists. And no one blinked an eye. Medical systems can work. Who knew? I think I’m now in good hands and my blood pressure is about half of what it was this morning. I know we have moved to the right place for us and I think we will call this place home for a long time to come.

Never Give Up

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Sometimes things just take time. Language barriers can be a big issue. Especially when health issues are involved. Yeah, I’ve had that little issue with a kidney stone a few weeks ago. After that, I decided I was well enough to go all the way to Germany with Jeff to get his motorcycle. Maybe not the best idea, but I did it.

On the way back, I started having some issues but I took some pain meds and we made it home. We need to prepare for Emilie’s imminent arrival this Saturday and we have train tickets to got collect her on Saturday morning. We needed to get ready for that. But I have still had some pain and acquiesced to going to the Dr for a follow up.

I like my Dr. here. She doesn’t take our insurance but an office visit costs almost nothing and she has an ultrasound machine and a EKG and a bunch of other stuff – right in the office. She does it all and it’s all part of the office visit. Unheard of in the US. The tests they’ve run in my Dr.’s office would have involved nurses, radiologists, phlebotomists. Not here. My Dr draws her own blood, does her own ultrasounds and reads the results. She’s from Venezuela, spent nearly and hour talking to me on Monday and she’s great. And she’s referred me to a specialist for some complications.

I didn’t have the heart to tell her I had ridden more than 1700 km on the back of a motorcycle last week. I could hear her silent head shaking without asking me what the hell I was thinking. I felt I could avoid it. So she gave me a referral and I came home and reached out to my insurance company. I don’t know how authorizations work here for insurance and visiting a specialist so I needed to make sure I was doing the right thing. That was the first challenge.

Using Google Chrome, it translates their website automatically. But the drop down menus are still in Spanish. I did the best I could, but couldn’t find the name of the specialist she was referring me to. The phone menus are not in English calling the phone number on the back of my card. I started pushing buttons, got a guy on the phone, he couldn’t understand me and hung up on me. I took a deep breath, got a glass of wine (yeah – I know I’m sick but needs must), and dialed again. I started understanding some of the words on the menu and pushed a button. Someone came on the phone and I asked in Spanish if they had any English. They didn’t but they got someone who did.

This new person was determined to help me. Hold, checked back with me, hold – he finally took my phone number promising the ‘person in authorizations who knows English will call you back, OK?’. Well, of course I said OK. I waited 24 hours. No call back.

Today, I called again and pushed the same number I pushed yesterday. They got me an English speaker – told me I don’t need an authorization for a specialist, however, the Dr. my Dr. referred me to is not one of their Docs. So I would need to go out to the website of another local hospital and find someone who specializes in the same area.

So I did that and found a doctor that takes my insurance and is that kind of specialist, but I couldn’t make an appointment online. So I called. More menus in Spanish. I heard a couple more words I have started to recognize (and understand) and pushed that number. Bingo! I got a receptionist who listened to my Spanglish, explaining what I needed, and she was sympathetic.

‘Please call back at 4. Doctor here at 4’

I thanked her and then I called back at 4. They talked to the nurse of the Dr and they couldn’t see me but they got me in for tomorrow at 6pm to see another similar specialist. Here, Dr’s keep hours in the evening. So civilized. It means you can have a job and go to the Dr. after work. America – are you listening?

So, it just required me NOT to give up, get too frustrated, and being willing to sound like an idiot on the phone to get what I needed. And it required some very patient people at the insurance company and the local hospital to try to help me. Between all of us, we got it done.

I felt embolden enough to tackle getting some prescriptions filled at the pharmacy, knowing I have and appointment tomorrow with the Dr. The pharmacist was so helpful and explained everything. She asked a lot about my condition and wanted to help me understand what I was taking and why. Such great service and care.

Am I nervous about going to see a Dr. I will struggle to communicate with? Yes. But I’m doing everything I can to mitigate it. I’ve printed out allergy information. I’ve writing up my history in both English and Spanish (yes, using Google translate, but its the best I can do).

It’s funny – Jeff hated going to the Dr. in the US. Even for very serious conditions, he never wanted to go. But here, we’ve both been so impressed with our experience so far, we’re willing to take more of a leap of faith. Well, and I’ve researched the specialist and read the papers he’s written in medical journals and education and residency history – so yeah, I feel OK with his qualifications.

Like most things in life, persistence pays off. Lets hope tomorrow I get good news and my baby steps into the medical/insurance world in Spain can be short lived. I have too much planned for this summer. And being sick in any way isn’t part of them.