Another one of my fears I have about living over here is medical care. Our base doesn't have a hospital. It has a clinic. At the clinic you can be seen for most basic things (a physical, medications, cold/flu), but anything more than that you are referred to a German doctor. I have given myself many pep-talks about how Germany is not a third-world country, it is an industrialized nation, so therefore the healthcare should be similar to the standards I'm used to. Despite my pep-talks, I have been afraid that while I'm over here I will have to utilize German health care. In a reoccurring theme, I got to face one of my fears and spent the weekend in a German hospital.
To spare details which no one really needs to know, I will generally say I was having "stomach problems." These stomach problems were severe enough to warrant seeking medical attention. That, and I was supremely freaked out. We arrived at the hospital in Bitburg, which is about 15 km from our house. Since many military personal and dependents have to get treatment off base, three of the local hospitals have Patient Liaison Officers, or PLOs. The PLO is there to help translate and to be your advocate to try and make your experience as pleasant as possible. As soon as we walked through the doors of the hospital we simply said "PLO" and literally within a minute the PLO was there. She was wonderful. She helped get us checked in, got me paperwork to fill out in English, and then stood right by my side to help translate as the doctor was starting her examination.
Here was where I first noticed a difference between US hospitals and German hospitals. In the US, if you were to go to the ER with the problem I had... they would examine you, maybe do a few tests, and then give you some meds and send you on your merry way. In Germany, I had barely finished filling out my paperwork and the doctor stated she was going to have to admit me. What?! Um.... okay... I guess? Is there really a way to protest that? I got admitted to the hospital on Saturday afternoon. They drew some blood and did a few other minor tests... but then mainly left me alone. And I truly mean alone. I was in a room by myself, and after they served me dinner (which was a piece of bread, cheese, and bologna with a pear) no one ever came back to check on me. In the US there is always a nurse or someone popping their head in, checking your blood pressure, checking your temperature, poking you with something... just generally bugging you. Here... nothing. What if I passed out? Or had a seizure? Or... something? No one would have known. I was a bit disturbed by this.
I knew the language barrier was going to be a challenge.. and it was. Most of the staff could speak some English... but trying to translate medical terms into English seemed to be a challenge. So there was a lot of fumbling/bumbling to try and tell me what they were going to do... followed by some crude pantomiming. I would say I understood what was going on about half of the time. The other half, I was just surprised by what happened next. They kept giving me an IV drip of something... I never quite got what it was... I think it was suppose to be something to help my stomach. What was surprising was the IV was a glass bottle. In the US you always get a plastic bag looking thing... but here it was a little glass bottle. I felt like I was in a hospital from the 1960s. Who uses glass? Then again, Germany recycles more than ANY place I've ever been... so maybe it has something to do with that? I found it interesting.
The biggest, and probably most disturbing, difference with a German hospital is the lack of infection control. Most people probably aren't even aware of "infection control" in American hospitals as it just happens so naturally. Maybe I'm a bit hyper-sensitive to it because it is something we also do in dentistry... that and I'm a germ-a-phob. But the idea of it is you wear gloves whenever you are going to touch either a bodily fluid or a mucus membrane, and you cover areas which may get "splattered" by bodily fluids. You also disinfect everything after you use it, unless it's disposable. Which is why people wear gloves, why things are covered in plastic, and why they throw things way or use a disinfecting wipe afterwards. It is not just for your protection, but for the protection of the healthcare provider and the person after after you. The nurses in the German hospital would wear gloves to draw blood/start and IV... and that's about it. A nurse was detaching an empty glass bottle of mystery medical fluid from my IV and put a new stopper in the end of my IV. A little bit of blood dripped out of the end of my IV. She used her bare hands to pick up a piece of gauze, wipe away the blood, then put the bloody gauze in her bare hand and walked out of the room. GROSS! Another nurse didn't securely attach the tubing for the mystery fluid to my IV... and some bloody fluid dripped out onto my sheets. She also used her bare hands to clean it up. I was super grossed out. In the US you also see nurses frequently washing their hands, or as soon as they enter a patient room they will use the disinfecting foam/gel/mist in the room. Never saw that happen in this hospital. If the nurses wash their hands, they're not doing it where I can see it. The language barrier made it a challenge to ask them why they weren't wearing gloves, or to ask them to put some on. I decided this was not the time for me to try and single-handedly change the hospital glove policy.
I spent the rest of Saturday hanging out in the hospital. Josh brought me my laptop and a stack of DVDs as well as some books. My friend Melissa brought me a stack of magazines and came by to keep me company for awhile. On Sunday I was told I had to wait until Monday when the Gastrointestinal doctor was in to see me. He would be the one to decide what was going on. However, they knew he'd want to do an endoscopy/colonoscopy, so I got to spend Sunday doing the prep for those procedures. For those of you who have either never had these procedures done, or you've never had a parents who has done one... let me fill you in on this. The doctor needs everything to be "cleaned out" so he can see inside of you. You get where I'm going with this? To clean you out they make you drink this nasty, terrible liquid. It is suppose to be lemon-lime flavored, but there is so much of the medication (whatever it is) dissolved in the water the water tastes almost salty and seems very thick. I used to tell my mom to just plug her nose and chug it. Let me tell you, that tactic doesn't work. The only thing you can do is just try to fight your gag reflex and choke down cupful after cupful of that nasty, terrible stuff. Ugh. After you drink that horrible stuff... well, it's suppose to "clean you out." Use your imagination. In addition to the cleansing, you are only allowed to have clear liquids. So I got to have a delicious lunch and dinner of beef broth, disgusting lemon jello (which tasted like dirty dish water so I chose starvation over the jello), and apple juice. I was a happy camper. Thrilled with life.
At this point, I was also beginning to question whether all of this was necessary. I spared you the details of what actually was going on with me physically. As I said, it was enough to freak me out. Before going to the hospital, I WebMD-ed my symptoms... and under every possible diagnosis it said "seek medical attention immediately." There is an "Ask-A-Nurse" hotline for the base, which I called and spoke to a nurse. She also advised me to go to the ER immediately. I think I made the right decision... however I guess I just wonder if I really needed a colonoscopy/endoscopy? I'm not a doctor... so I don't know, maybe that is a "standard" way of determining what was going on. However. Germany works under a system of socialized medicine. Therefore... the hospital isn't ever "making money" on anything. But. The hospital does charge out Tricare (military medical insurance) for the services it provides, and it gets paid for those. There is an... idea... or a rumor I should say... that floats around base that the German hospitals will do more things to you/for you as an American because they are getting paid by Tricare. Of the women I know who have had a baby over here, most of them have had a C-section. Which... just seems to be a high percentage. My cousin Megan had a C-section, and she told me she wasn't even really sure why she had to... the doctor just said she did. Maybe it's a coincidence... however the hospital will get more money from Tricare for a C-section than a regular birth. I'm glad the doctors wanted to get the root of what was causing my problems... but I can't help to wonder if the Tricare/money issue was a factor in their decision making process.
Monday I woke up and didn't get any breakfast... a sign I was truly going to have the procedures. A nurse came to get me, and wheeled me down to the treatment room. (Here is another fun difference between US and German hospitals. In the US unless you're very old/sick, they tend to wheel you places in a wheel chair. In Germany... they just wheel your bed everywhere.) I was in a room with lots of equipment and I realized what was about to happen. It was at this point that I got very upset thinking, "I'm in a foreign country, I don't speak the language, I don't know what's going on... I WANT MY MOMMY!!!!" Lucky for me, the two nurses and the gastrointestinal doctor who were there all spoke excellent English. The doctor explained what he was going to do, what he was looking for, and then the nurse gave me some sort of magical medicine in my IV. The next thing I knew I was awake and it was over. The doctor told me everything looked good... only the last two inches or so of my colon "had inflammation." He took biopsies of those areas to test, but he thinks they will come back negative. So ultimate diagnosis was that I had a bacterial infection... of unknown origin. The good part about all of this... I got to go home.
Josh picked me up after he got off work. We got home, and while he baked a pizza I took a loooong, luxurious shower (as I hadn't had one since Saturday morning). Then we enjoyed pizza (food, glorious food!) while watching the newest episode of Dexter online. I was exhausted and went to bed at 7:30. I slept all night with Josh on one side, both cats on the other. Oh it feels good to be home!
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