Monday, June 13, 2011

SE - Stockholm

June 13                 Monday                               Sweden                                                Stockholm                                         

So I should probably start this entry with a statement that I spent much of the day in hospitals.  As my disclaimer for this website notes: I write this blog really just as a journal for my own memory, which means I don’t try and censor much.  That’s why pretty much every day contains at least one reference to attractive women… I’m admittedly fond of that gender.  But I also won’t keep my medical history or conditions secret if they’ve been an important part of my trip.  So be warned… this includes mentions of butts and conditions that can happen anywhere but just happen to involve my butt.  So yeah, now you have been prefaced...

I couldn’t get much sleep… it was like I was on a rotisserie with how much I was spinning around, the whole night trying to find a position which wouldn’t hurt.  It felt like my butt was on fire, to which yes: queue all the jokes you wish.  My dream was just as strange, perhaps enhanced in that I was sleeping on a boat… I was on some sort of island consisting of a bunch of spokes of land around a central mountain, as if a bunch of fjords around all its sides.  I was just trying to find a place to sleep but couldn’t find anywhere good to sleep… each time I’d wake up back to the real world, I was still only half-way conscious… just enough to spin a bit and then right back to the same dream.  But my spin in the real world would likewise affect my rotation around the island’s edge.  It was weird, to say the least.

My first destination upon waking was the hospital – the only one my insurance company’s website had listed as an option.  I could no longer lie down, sit, nor even walk without feeling like someone had a flame upon my right butt cheek.  After a somewhat excruciating walk, I arrived and was elated to find that they all spoke English well and that I was able to coherently share my self-diagnosis as well as my medical history… particularly my part about not having a spleen.  Not having a spleen puts me at a particularly elevated risk from bacterial infections, with a several hundred-fold increased risk of, you know, death.  So that’s bad.  So I like to make sure that the medical folks know I’m in a bit of a different league when it comes to infections.

A couple days prior I’d used the power of Google and Wikipedia to track down my own self-diagnosis: a Pilonidal cyst.  Trust me, don’t look it up… but just in case you do: I can at least say my butt does not look as bad as whatever the goo is in Wikipedia’s picture.  Wikipedia said they’re generally a result of sitting too much… and considering I have more-or-less a desk job and a desk hobby (processing photos takes far more time than taking photos): that certainly put me at increased risk.  They’re particularly found among young men and apparently there’s some evidence to show that high bursts of activity & sweat can aggravate the issue.  So yeah, I hit all those marks.

To give some idea of how it felt: for the first week it felt like I had a tuft of hair stuck in my crack (hey, I’m male: it happens)… usually you just take a wide stride or sort of spread ‘em a little bit: it frees things up.  But this one never seemed to get freed.  By the second week it began feeling like there was something poking me.  Yes… poking me in the butt.  Go ahead and laugh: I’ve actually been pretty amused by the inherent humor of it all, too.  It was just in the last day or two where the pain really began.

So it turned out my self-diagnosis was correct.  Another win for Google and Wikipedia and a proud moment for my own medical capabilities… but that meant I needed surgery.  Though it also implied it wasn’t the sharp rocks or anything like that, after all.  But yeah: surgery.  While they could do small-scale surgery at that place, mine was apparently big enough that I had to be referred to another hospital.  Fortunately both hospitals were about a 5 minute walk from the Metro.

It took me a few moments to find the emergency room, but soon enough I was checked-in and seated, and but a few moments later: my initial checkup was complete & I was seated again.  To clarify the timescale here… I spent perhaps 15-20 minutes at the first hospital’s reception simply because they had to create a Swedish identity for me so they could log me into the system.  Then I waited about 30 seconds before the nurse called me.  The check-up took about 5 minutes, a doctor’s review took about 1 minute, and then we broke for lunch as the surgeon was doing the same.  An hour’s lunch later, I’m back and wait for about 5 minutes before meeting with the surgeon.  My time with the surgeon and doctor was only about 5 minutes.  Now onto the next hospital: a packed ER and I only wait about 1-2 min before I’m called to check-in, which takes about another 1-2 min.  I proceed to another waiting area, wait about 2-3 min for the receptionist to appear, 30 seconds later I’m directed to a small waiting area nearby.  I wait for only about 2-3 min before the surgeon’s assistant calls me for the check-up, which takes about 5 minutes.  So far: very short wait times, very fast processing times, and the whole time through I feel like something is getting done.

Then the assistant tells me that it could be several hours before a surgeon is available.  He says I can wait in the waiting room or I’m welcome to go out, so long as I inform someone.  Several hours… yeah, that has the potential to be a long time.  But at least he told me several hours.  In America you’re just told to return to the waiting room with no idea of whether the scale is minutes or hours.

At least I can say that if ever there was a place to need medical attention, I sure lucked out with being in Stockholm: clean, modern, quick, orderly, and best of all: English-speaking.  Even the prices weren’t shabby… my insurance only listed the first hospital, but I kept a copy of the referral to the second.  I paid up-front and can pursue reimbursement from my insurance, but all-in-all it actually wasn’t too bad.  I’d say it was a total of $500 for the nurse’s checkup, doctor’s review, and the surgery.  Seriously: that ain’t bad; I spent more than twice as much on my camera, and I suppose I should say my butt is more important than my camera.  It’s tough for me to say that, but all logic says that should be so.

So even if my insurance decides to be stingy: I’m really not on the hook for obscene amounts of money.  I mean, compare it to America… where just getting checked-in and having the receptionist equip you with a neck brace when you’re not even the patient still grants you a bill of $200… for 30 seconds… of doing nothing… to someone who’s not even a customer.  Yeah, I’m not fond of America’s medical system.  Now one-better is that if I were to have actually gone ahead and claimed by Italian citizenship by now: this would have been free.  Yeah… completely totally free.  As in I pay nothing.  All the same work but not a cent of money.  If ever there was a kick in the butt (which is extra painful at the moment, by the way) to go and claim my citizenship: this would be it.

My walk from the initial ER check-in to the OR check-in all of a sudden smacked me in the face with nostalgia.  All of a sudden all I could think of was being 10 years old and in Philadelphia Children’s Hospital again, just about to have my splenectomy.  I wasn’t scared then because I didn’t understand its risks (indeed, if I recall the story correctly: I legally died that day), and I wasn’t scared now because I knew there really weren’t many risks at all.  But nonetheless: by the time I hit the waiting room I was fighting to hold back tears (and to a degree I was failing).   Sure, it’s a pretty simple operation and I’m not even put under for it, but all I could think of was how back in Philadelphia: both sides of my entire family were there.  Here I had no one.

During the surgeon’s assistant checkup he asked me to describe the pain on a scale of 1-10, with 10 being a lot of pain.  The pain varied depending on the pressure, so I gave a 4 or 5 under conditions without any pressure; but an 8 when there is pressure.  I clarified that I reserved a 9 and 10 for, say, stabbings or gunshots… I could assume those would hurt more.  While walking to the first hospital this morning, carrying an empty water bottle, I managed to squeeze it so hard from the pain of walking that it detonated: the cap flying off in its own trajectory.  So basically: it hurt a lot.

My surgeon’s assistant checkup ended about 2:50 or so.  I wrote much of my journal update up until this point in that time, after which I switched over to playing Civilization III.  I should be working on my photos… but I’m honestly not in the spirit or mindset right now.  Civ is relaxation.

It was nearly three hours later when I had my next stage: a review by two of the surgeons.  It was here I learned that my self-diagnosis & even the referring hospital had been duped: it wasn’t a cyst at all… just an abscess.  So suddenly the sharp rocks theory, as far as I could discern was back on the table… my first guess, actually, meaning my original self-diagnosis before utilizing the internet may have been the correct one, after all.  I’m still calling that a win, just to spite you all.  I win no matter what happens; it’s my vacation & this is my writing: I win when I want to.

They told me it’d be in the range of minutes rather than hours until my next milestone, and I suppose they were right; but at a 45 minute wait it certainly felt a bit outside the league of what one would define as “minutes”.  I got my IV put in, helping to defray my mounting thirst somewhat.  Then another 15-20 minutes wait until I was called to head up to the OR, at which point people realize I’m still in my street clothes: I haven’t changed nor showered.  So back to elsewhere as I’m assigned a bed (far-left, by the window, of room 12-2) and get a chance to shower & change into ever-fine hospital fashion.  It took me some time to track down a nurse when I was finished, at which point I was told perhaps about 30 minutes until the next action point of heading to the OR.  I was to just wait on my bed.  No problem… I’ll just take a nap.  Though I did first take some time to ask a bunch of questions.

I learned that apparently my condition is actually quite common; this hospital handles several every day.  And its location is also particularly common, as it undoubtedly has a higher risk of infection than most other places of the body.  And I already knew going in that what feels like an embarrassing condition to you, as an individual, is really quite mundane to a medical professional… they’ve likely seen something just as bad or even worse that very same day.  I also asked about the seeming appearance that I’d been getting rushed through ahead of everyone else… is that because I’m transient or because I’m in particularly bad shape?  The answer: it’s just a slow day; I’ve really just lucked out.

I gave my mom as my emergency contact as she’s the only phone number I have memorized among friends & family and… well; moms are usually among one’s top choices for an emergency contact, anyway.  Her being a nurse could also be a beneficial ting.  But I did specifically mentioned NOT to call her unless absolutely necessary!  No need to have a fretting mother an ocean away for the remaining three weeks of my trip.

The naps turned into an overnight snooze when I finally gave in, at about 10pm, that my surgery probably wasn’t happening tonight.  My room consisted of four beds, of which I was its sole occupier.  It really felt like a hostel: standardized beds, free linens, meals, rotating roommates, medical treatment… well, the last one might not be too representative of most hostels.  This whole time I was starved and dearly thirsty.  The last time I’d consumed anything was at lunchtime, but even then it wasn’t much… a pretty small dish of meat, potatoes, and applesauce; but had I taken heed that it was “all you can eat per plate” then I’d have most certainly gotten more.  That first hospital’s restaurant was actually quite tasty.

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