Saturday, November 01, 2008

LA GALERA O L'OSPEDALE

“Everyone”, runs an Italian saying, “does their time in la galera [prison] or l’ospedale.” As it is just over a week since I "escaped" from the latter institution, I feel it is time to describe it.

To begin at the beginning: since August, I have been experiencing episodes of balance loss; nothing much at first but then they became more frequent. By 9th October, I was only getting to work because kind friends took me there and collected me and I fell over 4 times during that week. I had also lost weight dramatically, without dieting, during the same period. Finally my GP decided that the best course of action would be for me to go into hospital for a week or so, as all the necessary tests could be done quickly and on the spot. This meant kennelling Simi suddenly and I was most upset about this, as by the 14th, when I was admitted, I was so scared I had some awful neurological thing that I feared I would never see her again! But I knew it was the only thing to do so off she went to Mr Enzo’s establishment and in I went.

Let me say at the outset that I received excellent physician care and I cannot praise their thoroughness enough. Indeed, I would go as far as to say that the only way you could get such a complete check-up in the UK would be to pay for it. I was always treated as an intelligent person and test results were communicated to me straightaway. I very much appreciated this courtesy.

Very little, then, of what I have to say below is intended as criticism; I just think that some of you might find the comparisons interesting.

In Britain, the first thing that you lose when you go into hospital is your dignity as you are weighed, prodded and immediately called by your first name. Here, you retain the dignity of signora but the first thing that you lose is your privacy: Imagine, now, a 4-bed women’s ward, with ample lockers and hangers for your clothes plus a normal bedside table-cum-locker each. Yet there are no screens or curtains! When one of you is to be examined or treated all visitors are asked to leave the room but everything happens in full view of the other 3 patients. The old lady in the bed next to me was too ill to be moved for a surgical procedure, so this was carried out in the ward. Not even for this was she afforded the privacy of a screen. The other 2 patients slept through it; I pretended to read.

The next day, the old lady was sent home to die. I really felt for her family, as I had lived through anxious, sleepless bedside vigils such as they kept when my mother was so ill, but I never had to wash or change her when she soiled herself or the bed. Yet night after night relatives did this and more for their loved ones, even turning and lifting them and administering treatment. In fact, the whole system works on the assumption that you have a relative there. I can see the human side of this, but I do not think that male relatives should be allowed to spend all day and all night on a women’s ward when their loved one is not that ill [or female relatives on a male ward]. It can make things awkward for other patients.

Mind you, the lack of privacy has its funny side. All information is conveyed to you within earshot of your fellow-patients and the kindly lady opposite me took great pride in being able to reel off everybody’s symptoms and diagnoses for the benefit of any newcomers. The correct response to this, I learned, is to utter “Pazienza”, “È così [“That’s how it is”] or “Siamo qua” [“We are here”]. You absolutely must sigh deeply for dramatic effect before saying the last of these and you must have your hands placed firmly in your lap whilst you speak.

Now, I was not incapable of getting to the bathroom but I nonetheless found it a precarious expedition! For one thing, could someone please tell me why there are no toilet seats on any of the loos in the entire hospital?! This didn’t seem to bother anyone else [“pazienza”, etc] but for someone as wobbly as I am these days it made life more difficult! And I found myself crying from fear of falling every morning as I attempted to shower. The nurses [2 for the entire ward of 7 rooms] just do not have time to accompany you while you do your ablutions! Please do not infer from any of the above that the nursing care is poor for it is not; there just isn’t enough of it.

Visiting times [largely ignored] are 07.30 – 08.30 [presumably so that relatives can help with bathroom visits and bring in food], 12.30 – 2. 30 and 6.30 – 8.30 pm. Only the Italians could visit a hospital and behave as they would at a festa, with children bouncing on the beds, the women gossiping loudly and happily and the men forming their own little “gossip groups” in the corridor. And perhaps it isn’t so bad for the patients after all. I felt rather sorry for the visitors, actually, as only one hard little chair is provided at each bedside; not even the patient has the luxury of being able to sit in an easy chair for part of the day! I certainly did not lack visitors myself, with wonderful and loyal friends coming in every day, bringing gifts and taking care of practical needs such as washing. One day, nearly all my women neighbours turned up, including the lady who took a year to acknowledge my greetings after I moved in here. I was most touched by that. There had obviously been some sort of “neighbourhood conference” as no one had seen me or the dog for a few days and they had noticed that my shutters remained closed. So along they came, determined to find me!

Meals, apart from breakfast, were quite good. I’ll never know why the Italians, who produce arguably the best food in the world at other repasts, either neglect or make such a mishmash of breakfast. At 7.30 am a horrible, dark brew masquerading as “tea” was brought around, and into this evil-looking gruel people happily dropped slices of fette biscottate [French toasts] and ate it as if it were the consommé du chef. For lunch there would be a choice of pasta or soup, plus a meat or fish main course with a contorno [nearly always green beans]. Then you would get some fresh or “cooked” fruit [ not stewed, as you might imagine, but the whole fruit cooked to soften it]. In the evenings there was always the same nourishing, vegetable soup, served with bread and a choice of ham or cheese. The nurses would bring the food to you, but not clear it away so again, if you were bedridden, the system depended on your having someone there who would do this for you. You also got a bottle of mineral water every day, but not a glass to drink it from! – You were expected to bring your own supply of plastic beakers. At least in this hospital you were provided with plastic cutlery at each meal; I have heard of hospitals here where you have to take in your own.

Oh, I am forgetting one very important detail for my lady readers! One of the doctors had the eyes of handsome Mubbs from Holby City!

Well, there you have it: I survived and am now home with” Dr Simi”. And the diagnosis? It seems that I have advanced osteoporosis and it is this that is at the root of everything. I knew, of course, that if you have osteoporosis, you are likely to break something if you fall; what I had not realised, however, was that the condition can so debilitate you that it can cause you to fall in the first place. So if anyone out there has knowledge or experience of this, I would be really grateful to hear from you.

Meanwhile, I am still tired and weak, walking with a stick and certainly cannot work next week. The future looks uncertain but at least my brain is working – or so they tell me!

I would like to take this opportunity to thank the Italian medical system, all who took care of me in hospital, my kind GP and all the friends, on and off line, who have been so very kind, concerned and supportive.

34 comments:

Anne in Oxfordshire said...

Oh WL what an ordeal you have been through..must of been very frightening. So pleased your neighbours came to see you, at least they noticed that you and Simi were not around..don't think that would happen here.

Look out in the post!!

Love to you and Simi x

Yborchild said...

I'm so sorry to read of the time you've been experiencing. I'm very familiar with osteoporsis. My mother had a very severe case of it and I too have the first stages. There is medication which can help reverse the bone loss. One, alendronate,the brand name Fosamax by Merck and another ibandronate sodium,brand name Boniva. The Fosamax is taken once a week and the Boniva once a month.
In addition to the medication exercise in the form of stretching, weight-bearing, and aerobic(walking,swimming).Taking exercise at a slow gradual but consistent pace is wise.
Diet is the third important component. A calcium supplement is recommended and a healthy low fat diet rich in veggies,fruit fish etc.
I myself started with Fosamax and have switched to Boniva. There is tons of information on the internet on these products. There are some possible side effects.
During the time I've taken them my bone density has improved however I have just discontinued the Boniva because I'm uncertain if a neck problem I had recently experienced is connected to that medication.
I have an appointment this Tuesday afternoon with my doctor who I have come to learn is somewhat of an expert on this subject. I plan to discuss my concerns at that time.
In the meantime I do hope you can get ahold of one of those medicines because the side effects if they are going to occur do so only after years of continual use, but do a good deal of help in the begining.
Good luck to you. I will continue to check in on you to see how you are getting on.

jmb said...

I'm sure that you are very glad to be home Welshcakes after that experience. While you say that the medical care was good, the nursing care certainly was not adequate, by any standards. I am sure those nurses are quickly burned out in such a overworked situation. Relying on relatives to pick up the slack is not a good system for I am sure you are not the only one who has none nearby. In addition they are not trained and that is really important for certain things.

One reason perhaps for no curtains is that they could harbour infection but here they are changed regularly.

The important thing is you are out again and hopefully, slowly but surely you will regain your health now that treatment has commenced. Best wishes and hugs to you and Miss Simi who I am sure is glad to be back with her Mum.

old and angry said...

Not being a medical man, there is little in the way of advice i can offer you,except
Stay warm (i asume in Sicily this is easily managed.)
Eat well (judging from your posts this last year,this too is easy for you)
Above all, avoid situations where you can put yourself at risk ( i assume even in Sicily you get wet and icy pavements this winter)
Keep blogging...i need my daily fix of all things Italian.
My best wishes

Saretta said...

I can so sympathise with you about the Italian hospital experience, having spent about 4 months in hospital between my two at-risk pregnancies. The lack of privacy in the wards does breed a kind of comraderie, though, doesn't it? A "we're all in this together" feeling that you wouldn't get in a private room.

The important thing is that you have a diagnosis and I hope they will be able to prescribe an effective treatment for you. Take it easy, be good to yourself!

I'm thinking of you!

CalumCarr said...

Glad to see your home. What a worrying time you've been through /are in.

It's brill that so many of your neighbours visited. Don't think my neighbours would notice!

Thinking of you.

Dragonstar said...

What a time you've had! It's no fun being ill when you're alone, and you must have been so frightened. I'm glad that, serious though it is, it's not as bad as it could be.
Anne's right about your neighbours - back in Britain your absence would only have been noticed in order to ransack your flat! You're living in the right place.
Take care.
Gentle hugs!

Trubes said...

Dear Welshcakes,
How awful for you. Are you having any treatment and how are you managing to take Simi for her walkies?
My mother had osteoporosis and managed to live to a grand age. She was prescribed Calcium supplements and fortunately didn't suffer any fractures.
Lets hope there is a particular treatment that will improve your condition and keep you pain free.
Will e-mail you, take care and try to think 'positive', and if it's any comfort, you have lots of blogging friends who are thinking of you at the moment...nothing like a surge of positive thoughts to support a girl eh ?
Most of all stay cheerful!

Di.xx

PinkAcorn said...

Yipes Welsh! So glad you are home with your Simi. My nursing friends from the Philippines say bedside care is done the same way over there. Hard to imagine, it would never fly over here in the US... that I'm aware of. Too many laws like HIPPA and many patients, paying or not, treat nurses like servants...they are quickly informed otherwise.
Most doctors will say that your hip or femur will break/fracture and that's what causes the fall. I'd be more than happy to send you some literature on it if you like?
It does sound like you have wonderful neighbors and friends..I don't think you'd see as much "hands on" care like that here in the USA.
Not sure about the whole fruit issue...that is a bit odd.
Nurses have what we call ratios, 1:4, one nurse to four patients in medical floors, in the ICU where I work it's 1:2. I can't imagine two nurses to seven rooms!!!!
Welcome back!

Sackerson said...

Sorry to hear about the osteo, WL, but I have a client who was diagnosed years ago and copes, just has to take a bit more care. Best hopes and wishes for you.

Are you still working on publishing your book?

Shades said...

My mum was diagnosed with it a couple of years ago when she fell and broke her wrist. She is also asthmatic and that probably gives her more problems, she seems to get around central London without too much grief. She takes a Cab when she has a suitcase though.

Cat said...

Good to see you back. Thanks for sharing that - it was fascinating but more importantly, I hope you feel better and things pick up.

Liz Hinds said...

Just about to email you!

Whispering Walls said...

Poor you WL! Can you get HRT? That's supposed to prevent it.

Anonymous said...

Sorry to hear of your condition, Welshcakes, but I'm glad you're home in one piece and blogging again. Hope things improve soon.

sally in norfolk said...

glad your home with simi again.... do keep well :-)

Leslie: said...

Well, now you know what was wrong and you can proceed to adjust for it. Do you need to take medications? I understand that there are good ones for this condition. Welcome home and I'm glad the ordeal wasn't too difficult for you. I know I'd miss the privacy factor of a screen, even if others "could" hear what was said behind it.

Ellee Seymour said...

I'm so glad you are home safely too. I was interested to read about the Italian hospitals. I would hate not to have my privacy, but then you don't miss what you don't have.
When my father was very ill in hospital, and when David was admitted to Great Ormond Street, I was a permanent fixture on the ward too, taking food and making sure they were pain free. That's how it should be, for me anyway, for my peace of mind, at least.

Ardent said...

Thanks for the post Welshcakes.
I am glad that you are back at home and I hope with each day you will gain more strength.

I am sorry that you have Osteoporosis but at the same time I am grateful that you do not have a diagnosis which is worse.

It was very interesting to hear about the hospital adventure.

I have noticed in the last few years in Australia that men and women share the same wards. I think it is good for conversation but it can be a bit much getting in and out of bed, say if you have a sore back. One cannot really manage it lady like, if you are sick. Fortunately there are curtains, if one needs to be examined by the doctor.

I was very pleased that your neighbours visited you.

Take good care of yourself.
xx

Welshcakes Limoncello said...

Hi, Anne. Yes, it was nice of the neighbours. I'll watch for the post -thank you! Yborchild, th\nk you for this very informative comment and for sharing your story. I have been given some medication but will look up the treatments you mention. I do hope all goes well for you. Thanks, jmb. I never thought of that regarding the curtains. Simi is very happy to be back with mummy! ~Old and angry, thank you very much for that sound advice. Yes, even in Sicily we get wet pavements and, very occasionally, icy ones! Thanks, Saretta, for your good wishez. Yes, there is a certain kind of camaraderie on the wards and I was glad of it. Thanks, Calum. I'm sure your neighbours would be concerned, too! Thanks for your empathy and the hugs, dragonstar - I need all the hugs I can get! Thanks, Trubes. Got your kind email today. I do have treatment but must give it time. Simi and I are managing short walks and she is doing a fine job of looking after me. Support from blogland means lot, too. Thanks for that insight, pink. Yes, health and safety laws would mean that relatives I'd be delighted to receive any lit you have on the condition - thank you. Thanks, Sackerson. It is helpful to know that. Re book - I am trying! Thanks, Shades. That helps, too. Thanks for your good wishes, cb. Thanks, Liz. Hi, WW. I think it's a bit late for that but I do have medication. Many thanks, HH and Sally. Thanks, Leslie. You're right - I have to make some adjustments, admit I just can't do some things and also give the medication time to work. Thanks, Ellee. Of course I agree that in the case of someone very ill or a child a relative needs to be there all the time, as I was for my mum. But should relatives be doing what is really the work of nurses?

Anonymous said...

You've been tagged

CherryPie said...

I didn't know that Osteoporosis could do that either. My Mum has been taking tablets for osteo for a number of years and they have increased her bone density.

Welshcakes Limoncello said...

Hi, Ordo. Coming to have a look now. That's good to know, cherrypie.

Welshcakes Limoncello said...

Thanks for your good wishes, Ardent. Mixed wards were tried in the UK at one time but proved unpopular. I know what you mean about trying to get in and out of bed in a ladylike fashion! xx

jams o donnell said...

I'm so pleased to see you back Welshcakes. I bet that Simi was so pleased to see you. I hope that the osteoporosis can be reversed.

Nunyaa said...

I am so glad you are home, all my thoughts and best of wishes for you Welshcakes. Thank you for sharing a personal issue, this is a lovely heart warming post xx

Welshcakes Limoncello said...

Thank you so much, jams and nunya.

Ruthie said...

I'm so sorry to hear about your ordeal. :( I hope you're feeling better, and being looked after well.

It must be good to be home!

MARIA TERESA said...

hi Patricia how are you? I'm Maria Teresa,do you remember? you was my english teachers at International English School, would like speak to you, how can I contact you? thanks, bye

Welshcakes Limoncello said...

Thanks, Ruthie. Yes, great to be home! Hi, Maria Teresa. Yes, of course. If you email me at lasiciliana629@hotmail.com I will send you my phone number.

Anonymous said...

speedy recovery xxxxxxxxxxxxx
Be as well as you can , get sun on your back and light in your eyes

Welshcakes Limoncello said...

Many thanks, valleys mam. That's good advice! xx

Maria said...

I am so sorry I've been out of touch. I feel awful not knowing you were ill until now but I am happy to hear that you are in good hands.

Life with me has been beyond challenging this year and I know all too well what it means to be ill. I am not sure if I could handle the lack of privacy in the hospital but I imagine with out choice you can handle anything.

Wishing you all the best always and always! Sending you and simi ((HUGS)) from America! Have you tried looking for help groups online. I've found some wonderful ones on facebook.com You have to sign up but there are people from all over the world who not only share there stories but offer friendship as well or at least an ear when you don't know what's what!

I am on there and would be happy to add you as a friend if you sign up. Just let me know! If there is anything I can do from stateside to help I am more than happy.

Cathching up as fast as I can.

Love to you and simi!
M

Welshcakes Limoncello said...

Lovely to hear from you, M and I hope you are feeling better, too. I will think about what you say. Simi and I both send lots of love xx

Counters


View My Stats