Tag Archives: medical

Bits and pieces

30 Nov
It has been a long time since I posted to Good Day Rome. How to catch you up on our busy month?
We started with an outing on Ognisanti (All Saints’ Day) November 1. It was a spring-like start to November and we were not alone, but it was divine to walk among the ancient aqueducts yet be so close to home.  Click on any picture for a larger view. 
Ric had a couple of eye doctor appointments, including one with a doctor who specializes in the vitreous gel of the eye and the retina.  (Narrow focus.) This doctor said no further treatment was needed (yea!) but that he should have frequent check-ups. Va bene.
In sharp contrast to last year’s memorable and wonderful event, we choose to spend a quiet Thanksgiving this year: no cooking. I made a turkey breast on Sunday prior and we ate some excellent meals during the week, but on The Day we ate a decidedly Italian lunch at our favorite trattoria, following  a visit to the Norman Rockwell exhibition that is currently in Rome.  
We hardly recognized Antica Taverna when we arrived for lunch on Thursday! We have been eating there for years, 90% of the time in their delightful outdoor area, under the sky in summer and in the enclosed, heated “annex” in winter or rain. The Mayor of Rome, Sindaco Marino, has waged war on what they call tavolino selvaggio or “wild tables,” and has made the restaurants in the centro storico pull their tables to a minimal protuberance. The motorini can go through and cars can pass through the ZTL practically knocking pedestrians out of their way, but the tables have to be cut back. Even in Piazza Navona they have receded.  This new regulation severely restricts the small restaurants like AT that have more than 50% of their seating outside. Jobs were lost in this stupid move, but I doubt Marino will be mayor for long so perhaps the tables will go wild again.
I also started a new blog, Our Weekly Pizza, to chronicle our ongoing mission. Please take a look. If you like you can subscribe, or you can find it on Facebook , Google+ and Twitter.
We are wrapping up November with Christmas preparations. The holiday movie season kicked off with our annual viewing of “Planes, Trains and Automobiles” on Wednesday, and our extensive  collection (I think 28) Christmas movies is queued for viewing. The apartment is decorated except we do not yet have a tree. Hope to pick one up tomorrow. (Much more of a challenge than you might think.)  We have two trips coming up as well: Venice in early December and hiking in the Dolomites over Christmas. I will be sure to post some photos from those expeditions.
What have all of you been up to?

Public Service Announcement

16 Oct

This is a PSA: Eye exams are not only for updating your prescription. Get an exam by an ophthalmologist each year to save your sight and sanity. End PSA.

Dear Readers,
Many of you know that Ric recently had a torn retina and consequently our long-planned trip to the U.S. was cancelled.  For those to whom this is news, read on for our status and latest encounter with the Italian medical system.
We were supposed to fly to the U.S. on October 11. Planning to buy new eyeglasses while there (costono un occhio della testa* in Rome), we made an appointment for a week before the trip with the doctor we have seen before. His office is a marvel of apparatuses for examination and treatment, and as with so many situations here the doctor does all the tests himself. There is no nurse nor technician in the practice: only two doctors, and a receptionist who sits at a small desk with a phone and an appointment book.  She is a model of efficiency in this thriving practice. It seems like barely controlled chaos, yet everything functions smoothly.
Not Ric's actual retina, but very similar to pictures taken by his doctor. Fascinating!

Not Ric’s actual retina, but very similar to pictures taken by his doctor. Fascinating!

My exam went swimmingly and then it was Ric’s turn. The doctor made dissatisfied noises as he reexamined Ric’s dilated left eye. There is a problem and it must be fixed here tonight: The retina has a tear. 
The good news was that he could do a laser treatment to cure it, and three hours after we arrived for routine exams we were out the door with a completed procedure. No making an appointment for the next day, no delays; it was immediately accomplished at a very reasonable price. The bad news was that we were unlikely to be able to travel and Ric was placed under house-arrest pending a recheck in 4 days. He could not read, use a computer, do housework, or even take a walk or go out to eat. All he could do was watch TV. He could not even carry his own backpack out of the office, so I became the packhorse. I am sure I looked very elegant in my pretty blue dress and heels walking down the street carrying my daypack as well as Ric’s. The doctor even said “I am sorry for you, because you will have to do everything.” And so Ric watched TV and I did everything else.
Watching TV all day seems like fun until you are told it is all you can do. Luckily we have a huge movie database, thanks to our movie-collector son who set us up when we left the U.S. Ric found movies he never knew existed including some that should remain buried and forgotten. We also have Netflix streaming, and supplemented that with PBS and CBS streaming. But still…he was very bored. Not being able to go for walks was a killer. Like any prisoner, he looked forward to meals. And for the second time in 30 years together, I had to do the daily cleaning of the cat litter boxes. Che una tragedia!
Tuesday we returned to the doctor full of hope that all was well and we could go the U.S., see our friends in Portland, visit my brother in Colorado, and then attend our nephew’s wedding in New Jersey. But the healing was not sufficient and the doctor wanted to see Ric again in a week as he possibly needed another procedure.
Cancelling a trip so long-planned is arduous and depressing, an emotional roller-coaster. However, we comforted ourselves that Ric’s eye problem was caught and remedied. We have since heard stories similar to his, and also tales of horror, such as people who had detached retinas who spent 3 months lying on their stomachs to heal, able to get up only for necessary bodily functions, otherwise entertained only aurally.  If that happened, one of us would have to be put in a medically induced coma.
So we carry on, grateful for good care, each other, and the long-distance supportive comments we received from so many dear people. My office was very understanding and I was able to take time to support Ric. We will escape to one of our favorite places in Italy for a few days next week as a consolation prize and work on plans for a trip to the States in 2015.


*This is too funny in Italian and perfect for the situation: Literally “they cost an eye of the head,” where in English we would say something costs “an arm and a leg.”

La festa dei nonni

26 Sep
Every country has invented holidays. You know, those days that are more about buying Hallmark cards than about celebration or tradition. Apparently Sunday September 7 was “Grandparents’ Day” in the U.S. It was introduced in 1978 by Jimmy Carter. Other countries have adopted this invented holiday, among them Italy. No slouches in making an invented holiday a marketing opportunity, one health care provider in Rome is using the opportunity to sweep all those little Italian grandmas in for the free check-up that they richly deserve. I guess the grandpas are welcome too (the word nonni is inclusive of both nonna e nonno), but notice no alluring photos of elderly Italian nonni.
Yup, all the Italian grandmas look like supermodels who have aged ever-so-gracefully. No word on the grandpas....

Yup, all the Italian grandmas look like supermodels who have aged ever-so-gracefully. No word on the grandpas….


Artemisia does a lot of marketing. I had blood tests done there and ever since I’ve received an interesting array of ads and offers. I see a future blog post coming with some samples for you. I don’t think we have anything quite like it in the U.S., do we? 
As a side note of importance, Artemisia advertises “Aperti tutto l’anno, anche il mese di agosto” (They are open all year, even the month of August). This is a big deal because so many medical practices completely shut down for two to four weeks in August so all the employees can go on summer vacation. No wonder the beaches are so mobbed!

Naked in Italy

27 May
That title should make the read-rate for this blog go through the roof.
The other day I was in the gym. Having finished my workout I went to the very small locker room, where my first act is usually to wash my hands since I’ve been touching all sorts of equipment. Right in front of the sink was a naked Italian woman, chit-chatting with a couple of other women while she donned her black lace panties. I was not going to ask permesso to go to into the very small area by the sink, squeezing past her naked self. As she went to put on her bra, her cell phone rang and – I kid you not – she took a 5 minute call with one boob in the bra and one boob out, still blocking the sink.  I changed my clothes and went on my way, shaking my head.
Venus After the Bath, a stunning nude by Giambologna, on display at the U.S. Embassy in Rome.

Venus After the Bath, a stunning nude by Giambologna, on display at the U.S. Embassy in Rome.

Body image and nakedness in Italy is a culture shock for American women I have spoken to. The attitude towards the body is much more open in Italy than in North America. Whether in the locker room at the gym or at the doctor’s office, unabashed nakedness is taken for granted.
Most North American men – or men from anywhere for that matter and as far as I know – don’t give a rip about taking off their clothes in front of other men. Man boobs or not, they change and shower openly from what I am told. Not so women in North America, right?
I respect the openness with which Italians treat the body. There is little or no modesty or self-consciousness, which is somewhat refreshing, but frankly I don’t know where to put my eyes when confronted with the naked conversation.  
Another time I came into the locker room to get changed before working out and a young woman came out of the toilet stall, naked but for her shower flip-flops. (God- forbid she should get a fungus while walking around the locker room naked.)  I tried to suppress my surprise but I am certain my jaw dropped a bit. As a hung-up Americana I don’t even potty at home completely naked. Naked is for the shower and certain bed-time activities. “Buongiorno! Come vai?” she said.  Where do I put my eyes?  I think I chose a corner high and to the right.
Is this narcissism? “Look at me! I am in your way and I am naked!” She may or may not have a body one wants to see naked…. And regardless, where the heck am I supposed to put my eyes?
I have become somewhat used to doffing my clothes in a medical situation, although luckily I have been able to take care that my mammographer is not a man. (Yup, many of them are in Italy. See Things Are Different Here.) When I expressed a desire to NOT have a male mammographer the nurse said to me “What do you care? They’re only breasts.” Yes, but they are my breasts, and I like to be the one to select who touches them.  After last year’s experience I made a point of selecting a facility where the doctor herself does the mammogram and sonogram. Still, when one gets a mammogram here there are no little pink capes over your shoulders. You enter the x-ray room, strip to the waist and belly-up to the machine. This is followed by a walk to an adjacent room where you get a sonogram, sometimes involving two specialists if consultation is required. And no one explains what’s going happen. In the U.S. one would expect the doctor to say “I’d like to call in Dr. So-and-So to have a look. Do you mind?” and she would buzz someone to come in. Here, a door to a busy hallway will suddenly open and someone you’ve not met while clothed will walk in and start examining your breasts with no introduction.  Thorough, though: No one is taking chances that they will miss anything. After the exam you sit there bare-breasted while having a conversation about what was or was not found.
Perhaps Italy's most famous nude, David.

Perhaps Italy’s most famous nude, David.

Whether for skin cancer checks, a visit to the cardiologist for an ECG, or to the vascular surgeon, one just slips out of the appropriate garments while chatting up the doctor and perhaps while dressing after the exam has a conversation about vacation, or family, or life in an embassy. Very convivial. Actually I like the system a great deal in that one has the full attention of the physician. But it took some adjusting to not having privacy for undressing and dressing and occasionally having a door unexpectedly open and others arrive on the scene unexplained.
The lack of privacy also extends to the pharmacy. Hell, there isn’t even a word for privacy in Italian.  Everyone hears everyone else’s symptoms and problems. You do not walk into a pharmacy and peruse the shelves looking for your own solutions or symptoms. You have to ask the pharmacist for whatever you might need. Everyone in the store will know what you came to buy. Sort of a different form of exposure.
In the U.S. we are so concerned about privacy. God-forbid someone would overhear the pharmacist give instructions on how to take an antibiotic or how to apply that anti-fungal cream! Once I had to sign a privacy statement when they gave me instructions at the people pharmacy on how to administer a medication to my dog. In locker rooms we are shy and at the doctor’s we expect gowns and drapes, introductions and explanations before anything is looked at, probed, or handled.  
It’s certainly not that either approach is wrong. It just takes some getting used to flaunting your “stuff” in public. And I still don’t know where to look when chatting up naked women in the locker room. 

Things are different here

30 Mar

Banking, shopping, mammograms: there are many differences here in bella Italia.

Banking was invented in Italy. In fact, the oldest bank in the world is Monte dei Paschi di Siena, which is in deep doo doo over some questionable transactions…but I digress.  We needed to open an Italian bank account so we could pay some local doctors’ bills. The process of opening the account was akin to closing on a house, only more difficult. It took several days and 3 visits to the bank, but no money was deposited until the account was open and we had a fistful of documents in hand to prove it. Only then were we allowed to deposit money.

And about depositing money: We get reimbursement checks from various sources that we deposit here rather than send back to the U.S. for deposit. One day I popped into the bank with four checks, totaling about $150. No deposit slip is necessary; you just tell the teller your account number. For a deposit of four checks, 10 pieces of A4 paper are generated. Each check requires two (one for me, one for the bank), and the deposit itself requires two (same drill). I signed five times to deposit four checks. They are very nice people, very accommodating, and the experience is very personal, as opposed to the no-human-touch-required ATM deposit.  As long as our balance is correct…but many trees sacrificed their lives.

On the other hand, no trees are harmed in creation of bank statements: everything is electronic and self-service. When we opened our account, we received a random-code-generator token for secure access. It’s quite efficient and more advanced than the 3 online banking systems we access in the U.S.

Paying bills is a matter of making a wire transfer. If you want to pay a doctor’s bill, unless you are paying in cash which is quite common, you need the doctor’s International Banking Number as well as bank name. Simple and not too costly. I marched into the bank armed with this information only to be asked by the teller “what is this payment for?”  Hmmm, seems a bit intrusive and personal to ask what I am paying a doctor for. How detailed to get? I mean what if you had something rather, um, sensitive and personal done? Do you blurt out “pap smear” or “wart removal?” (Neither of which were involved I might add.)  I opted for a rather vanilla “medical consultation,” then hours later realized that without an invoice number, perhaps the recipient of the payment might find information beyond the patient name useful in matching payment to service.  Still, a potentially awkward moment; No HIPAA rules here. I’m sticking with “medical consultation.”

Campo dei Fiori

Campo dei Fiori market. Let the vendor select your produce or risk a scolding.

Shopping has oh-so-many differences from the U.S.  First, it can be rather disjointed. Megastores are few, and out in the suburbs. One may need to go to many stores to accomplish what a stop at Target would do. I like small businesses and wandering around Rome, so it’s an opportunity to poke my head into various establishments. But sometimes it is hard to know where to go to get what. Light bulbs, for example, are most likely in an electrical shop, although there are some in the larger grocery stores. Need a curling iron? Don’t try a beauty supply store; go to an appliance and electronics shop.  Cosmetics? A profumeria of course.  If all else fails, try a ferramenta, which is a household goods store with everything from toilet paper to wine glasses, but in the tiniest stores!

Store hours also need to be considered. The larger grocery stores are usually open continually, but a ferramenta or an electrical shop might close from 13:30-16:00. A large wine shop near us does this, even on a busy Saturday, as does Ric’s favorite men’s clothier. They re-open from 16:00-20:00. Since one does not eat before 21:00, these are prime shopping hours.  Even the electronics giant Euronics takes la pausa on Saturday and they close on Sunday, limiting recreational shopping. Quality of life versus consumerism: interesting concept.

At the outdoor markets, like Campo dei Fiori (think large Farmers’ Market in the U.S.) one never touches the produce. Let the nice vendor help you. Be prepared for questions like “What are you going to use them for” when you ask for tomatoes: “For sauce or to eat?” You’ll get different tomatoes based on the answer.  Or the fish monger might ask “How many people is this for,” then argue with you about whether you are buying enough. (He’ll also want to know your method of preparation.)

Rabbit babyfood

Pat the Bunny? No eat the bunny, Babyfood in flavors attuned to Italian tastes. I have not seen equine….

In the grocery store produce department, one dons a plastic glove, then bags, weighs, and prices one’s own produce. You won’t forget to do that more than once,because if in a moment of American-ness you get distracted and head for the checkout, the cassa will send you trotting back through the store to price the goods, holding up the entire line while you do so. Che imbarazzante! (I’ve only done it once.)

Milk is sold in shelf-stable cartons that do not have to be refrigerated until after opening, and eggs are always on the shelf at room temp.  There is a staggering variety of pasta of course, and the best tuna ever, packed in olive oil. Who needs mayonnaise? Ethnic foods (Mexican, Thai, Chinese) are impossible to find in a regular store. There are specialty shops, but I have not sought them out yet. However, if your infant likes parmesan cheese, salmon, or rabbit, there’s a baby food for that. 

mammografiaThis picture says almost all you need to know about getting a mammogram here: there is no virtually useless “gown.” Just strip to the waist and belly up to the bar. I was warned by the Embassy Health Unit what to expect, and provided a paper gown to take along, but geez, really, did I want to be la Americana there with the Italian women, the only one shielding her girls with a flimsy gown that was mostly coming off anyway?  So I went along with local custom.  But there’s one more surprise for those of us from a sheltered, HIPAA-indoctrinated, North American, law-suit inspired environment: many of the mammographers are men. 

As I entered the office of the senologist (breasts are their only business), I saw a man in scrubs with long gray hair, a little wild, who resembled an aging 60s rock musician. “Please God, don’t let that be my mammographer,” I pleaded silently.  I waited with the other women and was relieved to be summoned to an exam room by a lovely young woman; Take off everything from the waist up and so we begin. But could this be a straightforward get-it-done process? Of course not! She’d get me arranged in the machine then open the door to the adjoining suite and ask a question. She set me up again, and with my breast pressed inextricably between two plates of glass, open the door to the reception area and talk to another person. At one point she left me hanging (literally and figuratively) for about 2 minutes while she went through yet a third door and talked to someone else! At the end of the session she motioned to the chair where I had left my clothes and said I should make myself comfortable (Si accomodi usually means make yourself comfortable, have a seat;  but I now know it can also be used as for “lay back and relax”) and wait for the doctor. To me comfortable  (and relaxed!) is fully dressed, so I began to suit up. I had just put my bra on and had my arms in the sleeves of my blouse when a man in a white coat opened Door Number 3 and my tech beamed with a cheery Ciao bello! Buongiorno! As they consulted over some technical issue (I don’t know if he was a doctor or a computer technician), I buttoned my blouse and donned my sweater. Standing there awkwardly I asked if I should wait. “Sì” and another wave to the chair.

About 40 seconds later in sweeps another young woman who escorts me into the room where I thought the aging rocker was. Yup; He’s the doctor. I figured he was going to give me the “all clear” and I’d be on my way.  Huge office with a desk on one side, mammograms up on the large computer screens, which the doctor is studying. On the other side of the office is an exam table, which the nurse escorts me to and tells me to undress. I ask: “What are we doing?” “An exam” she says, perplexed. I had heard they do ultrasounds on most everyone…. So I strip to the waist again and lay down (Si accomodi!), only to be left there, half-naked and certainly not comfortable, while the doctor makes a phone call and the nurse comes-and-goes a couple of times. They ask me for my last films (not handy – they are in Oregon), and finally the doctor does the ultrasound.  I give great credit for thoroughness.  My favorite part (tongue firmly in cheek) was when he motioned bare-breasted me 20 feet across the huge office to see my mammogram close up, and then back again to the complete the exam.  My only question is why they even allowed me to dress between the two exams. I suspect an Italian woman would not do so, would know she was moving on through Door Number 1 for the sonogram.

In our own environment we know pretty-much what to expect, and I think in North America medical personnel tend to explain — maybe even over-explain — what you are to do, what is going to happen, what to expect. Here there seems to be a great assumption that one already knows what to expect. And of course in North America we have huge body-consciousness/privacy issues. Not worth having here….

I can hardly wait for a trip to the gynecologist.

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