Give Me One Hour and I'll Give You . . .
A Ride on an Ambulance and into Personal and Portuguese Health Care
Okay, the timer has started. You are reading the first edition of The One-Hour Newsletter. By that, I mean I will take one hour only to write and edit. After that one hour is up, I will send it over to Ms K, who will copy edit it. Copy editing is a separate sphere of editing that just looks for typos, grammatical errors and lack of clarity on the level of the sentence. K is a very good copy editor. I am not.
So what will I talk about today?
My ambulance ride and hospital stay last night. While no one would wish for a trip to the hospital, it does provide a glimpse into the deep infrastructure of a society because health care, however it’s handled, is so important.
My ride in the red vehicle saying Bombeiros was precipitated by what I am still hoping is just a very bad leg cramp in my left thigh. It started about 6 am yesterday (Monday), when I was considering getting out of bed. As I rolled out of bed, my left thigh clenched painfully. Not an unknown event. But unlike in past instances, it did not go away after a few minutes. It went on for the entire day, if anything getting worse. I could not unbend my leg. I could barely walk.
Nevertheless, walk I did, a lot because that same morning K had taken our rented car to drive to Lisbon, accompanied by our 19-year-old son Max. He had spent the last few days with us along with five friends of his from college. We had a very full house. It had gone well and was fun.
The nice thing about our town, which is in Odemira, is that you can walk to the school, the butcher, the grocery store, the city market and so on. The bad thing, when you have a leg cramp, is that it means a lot of walking. So I walked our daughter to school and came back. I walked home from my Portuguese lesson with Paula. I walked to pick up EC and bring her home. I walked to the grocery store. By about 5:30 pm, my Iphone later revealed, I had done 10,000 steps, all on a bad leg.
Maybe that’s why, when I started to prepare a dinner of leftovers for EC and me, I began to sweat and feel nauseous. I was really struggling just to walk across the kitchen from the stove to the table. My old friend David Smith, who is in town, had helpfully sent me an article that said leg cramps could be a sign of Deep Vein Thrombosis, a potentially fateful condition.
I was more worried about what would happen if I passed out, something I have been known to do when in severe pain. I, in my best offhand voice, told six-year-old EC that if her papa happened to pass out, to leave the house and knock on neighbors’ doors for help. She took that in.
I think it was a few minutes later or ten or 15 minutes later that I began to sweat more profusely and feel faint. We were sitting in front of our plates of food. I had managed to prepare and serve them. Well, it was now or never. I dialed 112, which is the emergency number here in Portugal and throughout the European Union.
Someone answered, so points earned there. In Portuguese, I explained why I was calling and asked if he spoke English. There was some confusion. He couldn’t hear me well. Meanwhile, EC was watching me over her dinner plate.
The emergency operator switched me to another person, a woman. She was confused about our address, until I gave her the postal code. At one point she said to me, “But you speak Portuguese!” That made me feel good, even through the sweat and dizziness. I may have been switched to her so we could speak English. We continued speaking Portuguese. She told me the ambulance was on its way.
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Okay, three days have passed. It is now Thursday. Believe it or not, the run-on letters above were what I typed unwittingly after I fell asleep at the keyboard when the Tramadol the doctor had given me Monday night for pain kicked in. I hadn’t gotten to that part of the story yet.
So what was I saying?
To cut to the chase, on Monday night I did call an ambulance and I ended up at the main hospital in Odemira, about 30 minutes away. My friend David came over and watched EC. After a few hours waiting, at about 10 pm a doc examined me and sent me home, concluding that it was not thrombosis, which was a concern. Just some sort of weird cramp, the doc said. Maybe because of “nervos,” nerves. I can brag that all conversations at this hopital were in Portuguese, although maybe it was foolish of me to not try out their English. I left with some muscle relaxers and some Tramadol for pain.
On Tuesday, I took the Tramadol, and then settled down to write this newsletter. I fell asleep at the keyboard, as you know. I spent the rest of the day sleeping. That Tramadol hits me hard!
On Wednesday, I awoke and this leg of mine was still screwed up. What to do? A leg cramp that goes on for three days ain’t normal. I would have to pay attention to this rather than my priorities, which were hanging out with my friend David, taking my weekly Padel lesson, and writing this newsletter.
I first went to the local private clinic. But no doctor this week, they said. Wow. We really are in a small town. So K, who was back in town, drove me to a private clinic in Sines, the other big city. The doctor there took one look at my leg, and sent me to the public hospital in Santiago de Cacem. It is a bigger, more modern hospital than the one I went to in Odemira.
The doctors there went to work on me very quickly, once they saw my left thigh, which was beginning to have purple blotches on it. A doctor performed an ultra sound, using a hand-held wand. Then they took blood for extensive testing, and scheduled me for a CT scan. Around 5 pm, I was inside the round CT scanner.
The CT scan and other tests show I did not have DPT, or Deep Vein Thrombosis, or any other scary disease they tested for. What I did have was a “hematoma”, or internal bleeding. But why? Did I have any trauma, they kept asking me? Internal bleeding doesn’t start for no reason. I could not think of any knocks, hits or sharp pains. So after about eight hours all together in the hospital, K and I were sent home, with instructions for me to stay in bed as much as possible with my leg elevated.
Which is where I am now, although I confess my leg is not elevated at this moment.
If I had the time, I would give you more perspectives on the health care system in Portugal, and its mix of public and private. I will say I was charged exactly nothing. We are legal residents of Portugal, and as such have entry into their national health care system. I thought the hospital in Santiago de Cacem very good. The one in Odemira, not so much.
I can make a few other observations.
The Portuguese staff were friendly and accommodating, even when making us wait. I spent the half hour ride in the ambulance to Odemira discussing recipes for Acorda bread and garlic soup, with Gina, the attendant. She also told me about the best bakery in the region. And some gossip about this and that. The nurse who followed her was nice, as were the nurses and doctors in Santiago de Cacem.
I certainly prefer this to our experience in Prague. While the doctors could be nice, the nurses were dragon ladies, who seemed to feel their job was to growl at you and turn you away if possible. I compared them to the gargoyles on cathedrals meant to scare away evil spirits. In Prague, we learned you had to push back against the dragon ladies or they would eat you up.
So, here in my bed, I am left with a problem and a mystery. What was and is going on with my left thigh, to cause it to cramp up and start bleeding, and still be of little use? And how can I better it?
Tummy Time: Yes, The Fish is Fresh
Last week, because of bad weather, the city market was absent of fish and shell fish for a day or two. The tables where the vendors displayed the catch were covered over with clothes. The wind and the waves were too big, I was told, for the boats to get out.
That the boats not going out would mean no fish at all the next day told me how fresh the seafood was here.
When the fish stalls did open up later in the week, their wares seemed particularly bountiful. Here is a picture of Peixe Espada, or swordfish. It’s different than what we call Swordfish, which can cause confusion in restaurants.
I may have tasted this fish. I know it’s cool to look at. I don’t know how to cook it at home.
A final note. I reset the timer for 30 minutes, when I resumed this newsletter, and it is going off as I type this. So I think it’s honest to still call this the one-hour newsletter. I will give it a quick edit, send it over to K to copy edit, and you should be reading it very soon.
P.S. I will violate my one hour rule to give one more thing. Here is a link to a story I wrote for Planning Magazine about the death of a friend in Cuba while bicycling there. It provides a deeper glimpse into that country and its health-care system.
And I am making my final edits on Sunday, a full six days after my health event.
Hope you feel better Alex. A couple of weeks ago my back gave out on the tennis court and so I can somewhat relate to your references of barely being able to walk a few steps..