Thursday, April 23, 2009

Have Pump, Will Travel

8 years, today.(pumpiversary, whoo hoo!)

And I'm traveling to another country this summer, for the first time ever.

England, for about a week.

And Denmark, for another week.

I'm marginally worried about having a serious hypo because I don't know a word of Danish but my hubby's relatives know quite a bit of English,and my hubby knows some Danish so that's really an unfounded fear. Besides, Danes are very intelligent, most speak several languages, of which English is certainly one of them. From a diabetes standpoint, I don't have much to worry about. It will be quite odd, being in another country where I can't understand anybody...unless they take pity on me and switch back to English. I'm trying to learn a few phrases, just because I really need to. My other concern, healthwise, is how I'm going to arrange to get a magnesium tank-up over there. Because going without, is not an option. Nor can I get a double dose prior to the trip, at the max I'm only good for 9 days between them and I start turning into a complete electrolyte mess and doing that in Denmark would be an unmitigated disaster bar none. They are both civilized countries but in the UK, someone is more likely to know what the heck is going on=better communication=solving in an orderly,efficient manner. We all speak English, after all. And making the timing of infusion such that it could be done on the "off" day,we're going through a tour group(while in the UK),and then on to Denmark.

If you think our system is a grand and glorious mess, try cross-country-ing it-I think there is no greater headache. I'm just a clueless American,not knowing as to how to go about this, so first step was to contact a London nephrologist who I'd heard about on a mailing list.
Emailed said London neph, he actually responded and said it was virtually impossible to have arranged via any sort of NHS facility unless it were an emergency.(aka person actively dying) Recommended a private facility.

Which begs the question...people who have to arrange for needed medical services, such as dialysis-how the heck do they pull it off, getting medical care in another country?

The answer came, in the form of another email reply...stating how X hospital would be happy to accommodate my need for haemodialysis (they took the "nephrology services" to mean I needed dialysis) and could I please fill out the 12 page medical report( prescription from physician, Certificate of MRSA/Virology Report medical clearance form,blahblahblah), sign, and MAIL it(faxes= a nono). That's what dialysis patients have to go through. I don't have the energy for that and I'm not on dialysis,I can see why they really wouldn't want to do much traveling(on top of feeling like crud)

Next step, was to the insurance company. That went surprisingly well,services out of country are covered just like in network(country) with the exception of having to shell out the entire cost up front and then be reimbursed. I really hope they don't charge like they charge in the States...a 4.5 hr session at the infusion center costs about $1,800. Of which, 80% is covered until you hit the deductible, then 100% is. Maybe I will have hit my deductible by then. Regardless, it will be expensive. It doesn't matter where you have it, you just have to find a doctor/facility willing to do it. Except the public (aka, what the masses go to because it is free or nearly so) hospitals don't want to do it unless you show up on death's doorstep, in their emergency room, having convulsions. Even if you could pay, apparently.

I still don't know as to whether any other type of physician(over there) came prescribe magnesium infusions, GP's (or endos) over here will not touch that issue with a ten foot pole and instantly refer you to a nephrologist or simply ignore the issue entirely. That is the situation I found myself in, in the middle of last year and I wish never to be in that boat again. You could have convulsions,funky arrhythmias,and collapse on the ground and they wouldn't care. It's a nephro thing and out of their scope of practice=not their problem. Maybe its not quite as stringent over in the UK, since they don't get sued by patients. So I asked him a few more questions regarding it, I hope he responds. While waiting on that,emailed most of the private London hospitals and most of them have responded with stony,dead-end silence(not knowing what to make of this American oddball). But money talks,and I don't see why it couldn't be arranged, why it even matters whether its NHS or private beats me. They get their money,(I get reimbursed) they're happy,all is well with the world. Unless the NHS is like some sort of Veterans Hospital,club members only,all others need not apply.

This is one time when handling diabetes will be the proverbial cakewalk...compared to the other medical issue. Regardless,I'm not going to let either one stand in my way of having a great time-I'm really looking forward to my time abroad!

1 comment:

Scott K. Johnson said...

Wow! What an exciting adventure! I am sure that everything will go pretty well for you, and that you will learn (and report back to us?) a lot from the experience.

Maybe even some blog posts and tweets from "abroad"?