Sunday, January 26, 2014

Injury in Tuscany

This past December, I had a bit of an accident.  Somehow, it had slipped my mind to write about it, so I will make up for it now.

We were blanketed in a thick fog for quite a large percentage of days in December.  It's not all that unusual, but it really did give me a bit of a case of cabin fever, since I was unable to get out and walk like I had grown accustomed to doing.

I was thrilled when for the second day in a row, it was clear and sunny.  I planned to head out and walk to Sant'Angelo a Lecore, where Simone's shop is located, and get my hair done.  I gleefully emerged from the apartment and started walking along the country roads, taking the same route that I always had before.

It was a gorgeous day.  The sky was blue and the birds were singing.  I took in the gorgeous scenery along the way:  the vineyards, olive trees, cypress...and breathed in the clean Tuscan air.

The sky was gorgeous that morning!
Walking past Villa Castelletti, I watched a vintage Porsche turn down the street next to it.  Gorgeous.

All of a sudden, as I stepped with my right foot, it hit the edge of the road, causing my ankle to roll and I ended up falling on my hands and knees before rolling over onto my back.


I laid there for a moment, wishing that I could just stay there for awhile, but knowing that there would be cars around, I didn't want anyone to think I was dead at the side of the road, so I pulled myself up.  I noticed first that the knees of my jeans were torn (which really irritated me, since that was the pair that actually fit me well).  Then I noticed that 4 cars had stopped and people were getting out to assist me.  This blew my mind. Coming from where I do in the US, if you're lucky, maybe one person would stop.  Maybe.  Here - everyone who saw it immediately stopped and came to my aid.  A young couple on their way home from the supermarket were the first to reach me.  They asked if I was ok, what happened, and where I was going. Surprisingly, I actually understood them (since my Italian skills are not that great) and I was able to communicate back with them as well!  They offered to take me to the hospital, but I told them that I was fine and so they drove me to Simone's shop instead.

I sent an SMS text to Simone when I was on the way, telling him about the accident.  When I arrived at the shop, I thanked the couple profusely and crossed the street to wait for Simone to arrive.  Once more, they asked me if I was ok and that they would be happy to take me to the hospital, but I said no and thanked them again.

I stood at the door to the shop, which was locked, and called Simone.  He said he was 2 minutes away and would be there soon.  I was fine standing there.  My ankle hurt quite a bit, but I felt ok for the most part. Once Simone arrived, however, that quickly changed.  He pulled in and as soon as I saw his face looking at me with concern, I started to break out into a cold sweat.  I began to feel nauseous and could barely function.  Simone jumped out of his car and asked me what happened.  All I could manage to say was that I needed to sit.  At that point, I was afraid that I was going to be sick and I didn't want to open my eyes or talk.  Simone opened the door and sat me in a chair.  He grabbed his first aid kit and told me that he was going to run out to his car to get his phone, since he left it there.  While he was gone, I realized that I was going into shock, so I lowered myself onto the floor and elevated my legs on a chair.  I almost immediately started to feel better.  Simone came back inside and was rather surprised that I was lying there.  He put a cold compress onto my ankle and I told him what happened.

My view from the floor.  It hurt.
By that time, my ankle had started to swell.  Simone kept saying, "it's BIG!" and that I should go to the hospital.

Now, being an American and having worked as a nurse, I am used to how the US healthcare system works. A trip in an ambulance can cost about $1000.  If you have insurance, you will probably be charged somewhere around $150 (depending on your policy) as a co-pay for simply walking into the Emergency Room.  Tests, medications, etc, will cost you even more. If you don't have insurance, an ER bill will be incredibly high (well over $1000 for a minor problem, going higher and higher as the severity of problems increase).  Knowing how it is in the US, and knowing that I didn't have insurance, I couldn't imagine how much a trip to the ER in Italy would cost me.

Simone said he would go and ask the misericordia and ask them for advice.  He was gone a few minutes and when he came back, I asked them what they said.  He said that we just had to wait until the ambulance arrived.  I panicked.  How would I be able to afford this?  I started to cry.  Simone knelt down beside me and told me to not think of the money at all.  I was more important than money and I needed to go and have a doctor look at it.  He told me that the ambulance service was free, so not to worry about that at all.  I started to feel a little better after he told me that, plus my ankle REALLY hurt a lot and I was worried that it might be broken.

Simone (on the right) talking to one of the medics.
Before much longer, we heard the ambulance approaching.  It pulled in and the medics walked into the shop. One of them took a look at my ankle and said that he was almost certain that it was just sprained, but that it would be best if they take me to the hospital for an x-ray.  Simone talked to them, gave them all of my information and they placed a immobilizer around my ankle and lower leg.  When we were ready to go, they put me onto a stretcher, carried me out of the shop and placed the stretcher onto a cart and loaded me into the back of the ambulance.  Two of the medics sat in the back with me and Simone told me that he was going to follow the ambulance to the hospital in his car.  We drove to the Pronto Soccorso (Emergency Room) at the Ospedale Careggi (Careggi Hospital) in Florence, which was about 30 minutes away.  The medics were very nice.  One sitting next to me covered me with a blanket to keep me warm and patted me on the arm and told me to rest.  None of the medics spoke English, but the two in the back chatted with me a little and asked me about the US and if I liked Florence, etc.

Simone opening the door for one of the medics
We finally arrived at the hospital and they wheeled me in.  A doctor walked up and looked at my ankle and asked if I was in pain (I was).  They had me move from the cart to a wheelchair and wheeled me into a smaller room where a nurse sat behind a desk to get my information.  One of the medics told him what happened and gave him my information.  While we were there, I saw out the window facing the waiting room that Simone had just arrived.  The nurse was finished getting my information and wheeled me out into the waiting room and told Simone that they would call for me when they had a room available.

We waited for probably 20 minutes before they came out for me.  The nurse wheeled me back and Simone stayed in the waiting room.  I sat in the wheelchair in an examination room for a couple minutes before the doctor came in and introduced himself as Lorenzo and asked me what happened.  He spoke perfect English, which made things easier for me.  He examined my ankle and said that he was positive that it was just a bad sprain, but wanted to make sure by taking a couple x-rays.

I spent quite some time sitting out in the hall next to the x-ray room.  While I was waiting, I watched patients being wheeled in and out.  One patient was brought in obviously from a calcio (soccer) match, as he was in uniform.  (He ended up having a broken arm and a few other issues, from what I gathered.) Eventually the x-ray technician wheeled me in and had me get onto the table.  When I got up, my ankle really hurt.  It had been ok while I was just sitting, but standing was a whole other story.  I almost cried when I had to move my leg for the second x-ray.

After it was over, I got back into the wheelchair and was taken back into the hallway.  I sat there for several minutes when finally a nurse came and wheeled me into another room.  He introduced himself as Fabrizio and told me that my ankle was not broken, but it was a bad sprain.  He told me that I should keep off of it for a week, keep it elevated, put ice on it for 10 minutes/4 times a day, and then follow up with my doctor.  He had a prescription for some medication that I could take for pain. Then he showed me my bill.

77 euros.

That equated to about $105 in US dollars.  I was practically giddy.  Fabrizio told me that since I was a foreigner that they had to charge me the full amount.  I kept my glee to myself as best I could.  If my ankle wasn't causing me so much pain, I may have leapt up and danced!  $105 for an ER visit, 2 x-rays, a diagnosis...I just couldn't believe it.

Fabrizio helped me onto the table and proceeded to clean and wrap my ankle with a plaster bandage. He cleaned the wound on my left knee and bandaged that as well.  Then he helped me back into the wheelchair and brought me back out to Simone.

I gave the paperwork to Simone and he went out to bring the car around.  He wheeled me out to the car and helped me get in.  That was an experience.  My ankle hurt even more than before.  We drove back to the apartment and then it got really interesting - I couldn't put any weight on my right foot at all.  We somehow made it up the 4 steps into the house and he helped me to the bedroom where I collapsed on the bed.  He made an ice pack for my ankle, fixed dinner and helped me eat it in bed.  Later, he carried me to the bathroom.  He really did take very good care of me.

My hugely swollen ankle, the day after the accident
Now here it is, a little over a month later and I am finally able to walk without too much of a limp.  For awhile, I had to use a cane to get around.  It hurt terribly for the first 2 weeks.  It's still a bit swollen and bruised, but it feels better each day.  I still have to take it easy, but I can at least walk around the grocery store and go here and there.  Hopefully in another month I will be well enough to take long walks again for exercise.

When Nurse Fabrizio was bandaging me up, he asked me what the differences were between healthcare in the US and healthcare in Italy.  I told him, honestly, I thought it was much better in Italy.  He was surprised, but I explained to him about how expensive it is and that a lot of people won't go to the doctor or the hospital because they can't afford it.  I received some of the best care that I have ever had at this hospital. They all were very kind and did a thorough job.

I had heard horror stories of tourists getting hurt or sick while in a foreign country.  Perhaps in other areas it is a problem, but is not a problem at all.  You will get the best care and will not have to pay very much at all, compared to what you would have to pay in the US.

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