A Surgery in Portugal

Say what??

PART 1 – USA

Sometime after COVID is, I think, when I first started noticing that I was having nagging pain in my lower back. As is usual for me, I don’t initially notice pain that isn’t extreme. It was just because it lingered for days at a time that I thought, what is up with my back? I was also especially peeved as I had been feeling quietly smug when others talked about lower back pain, because I didn’t have any. I guess I jinxed myself.

I assumed it would go away with ibuprofen. And it did, but it came back. The cycle of it coming and going was getting to be a problem. Also, ibuprofen stopped working. Finally, I started seeking help from my doctor. My doctor was prepared to be helpful, but the insurance company, Aetna, shut this down. They insisted I have “physical therapy” before I could get an MRI. Of course,

1. They never said HOW MUCH physical therapy

2. How would someone know what sort of therapy to do without knowing WTF the problem is???

   
   

But I went. The PT did do an x-ray. I really wasn’t getting any relief. It seemed kind of dumb really, because I wasn't doing anything I couldn't do at home. And PT is a long-term game. At $75 a pop, it seemed dumb and expensive. I gave up eventually.

I started taking Excedrin. I don’t know why that helped, but it almost always did. Thank goodness because the whole move thing from Charlotte to Faro, Portugal would have been practically impossible otherwise.

PART 2 – Getting Help in Portugal

Once in Portugal, I started experiencing stronger pain more often. The Excedrin was still working for a while and then it wasn’t. Also, when I was having the pain my right foot would also feel like it had been “asleep” or would even get numb. Walking can be rather problematic when one of your feet is numb. I have fallen twice.

Prior to our immigration meeting we had to obtain private insurance to replace our initial travel insurance.  To accomplish this, we hired Serenity, a medical concierge company. They found us an insurance broker who provided information about private health insurance here. Turns out in Portugal if you are 60 or older, the only company that will insure you is MGEN. MGEN requires a one year waiting period for “pre-existing conditions”. I’ve always thought this was such bullshit. For one thing, many ailments START well before you’re aware of them and there’s no way to track that. And then, so what?? Why is that some kind of get out of jail free card for insurance companies? Especially if you’ve had continuous coverage. Grrr.

We did obtain SNS numbers which is what you need to use the public system here. That also entitles us to be assigned a “family doctor”. However, we were told that they don’t have any available right now and also, we don’t want to use the public system unless we have to since we haven’t been paying into the system like native Portuguese have. We are able to use a doctor that works for Serenity as our family doctor. Dr. Joana. She’s awesome! The only downside is that she’s in Lisbon. So if we have to see her in person (instead of virtually) we have to go there.

I did go see her and afterwards she prescribed an MRI. Guess what, I was able to go AND I paid 150 Euro for it. I think I can get reimbursed from one of my US Health Savings Accounts (the best thing since sliced bread).  The MRI showed basically what the earlier x-ray did.

At the L4-L5 level of your lower spine, there is a mild forward slip of one vertebra over another. The disc between them is bulging backward and pressing on the sac that holds the spinal nerves. Additionally, joint thickening is narrowing the space even more, causing the nerve roots to be crowded together inside the spinal canal. These findings may be associated with symptoms like lower back pain, sciatica, numbness, or weakness in the legs, depending on severity.

Serenity sent me information about a couple of surgeons who are in the Algarve area. I picked one and they made an appointment for me. Scott and I went to see him on July 1^st. He’s a neurosurgeon who was educated in Germany. He’s been doing this particular surgery for 15 years at a rate of about 3 per month. That’s 540 with a success rate of 98% He said that alternatively, I could go to a gym at least four days a week and do STRENUOUS work outs.

I already spend a good portion of two days a week on Portuguese lessons. The point of the suggested workouts is to build surrounding muscles. To me, that’s a short-term solution. It won’t change the fact that 2 of my disks are misaligned and that my nerves are squished into too narrow a space. I’m already 64. I think my recovery will be better and quicker now than if I let it go for some number of years. I can do a lot of strengthening exercises without going to a gym. I didn’t move to Portugal to spend four days a week in a gym. I want my life back NOW. So, I’ve decided to go ahead with this surgery… come what may.

Part 3 - Pre-Op

After some questions back and forth, on July 30th I communicated to the surgeon’s scheduler that I wanted to go ahead with the surgery. The next day, July 31, she sent me an email telling me she had scheduled my pre-operative tests for August 1, 2025. Yes, the very next day. And also, did I want to schedule the surgery for August 7^th or would I prefer a different Thursday (that’s when he does this)? Say what?

Good thing I’m retired so I could just say yes! The facility I needed to go to for the tests is the building right beside ours. Another, say what? In the email it showed the tests they scheduled and the time for each. This was actually in 2 places in the email and the times were not exactly the same. In one place the earliest test was to start at 10:50am, in the other place it said 11:15am. So I trotted myself there at 10:40am. This is how it went.

Oddly, there was not a ticket dispenser for waiting in line numbers like there is almost everywhere else. There were three reception windows. Two were occupied and the third receptionist seemed to be trying to help the situation at one of the other windows. Then there was one other man waiting. When I got up to the window where there had seemed to be a bit of a problem, the receptionist definitely seemed to be in a snit. But she righted herself quickly and started checking me in. Before she was even finished, a nurse came out and called my name.

Wow, impressive. She took me back to a room and said she was going to do the ECG. Okie dokie. There was the ECG machine and a typical table/bed thing with paper covering it and a chair. She told me to put my stuff down on the chair and remove clothes from the waist up. Then she started fiddling with the machine. I sort of glanced around looking for the paper gown. You know, right? I looked at her, glanced around again, shrugged and took off my shirt and bra. This is different. I expect some of y’all would be freaked by this. I can’t say I was, like, happy, but I’ve had enough mammograms to just get over myself.

I laid down, she attached electrodes and ran the test. It was over in minutes. I put my top back on and she took me right across the hall. This was the nurse consultation. She went over my regular meds and went over paperwork that I needed to sign (that she gave me copies of). Then she gave me some wipes and instructed me on what I needed to do the night before and day of the surgery before coming, which includes using the two sets of wipes (whole body). She also pricked my finger to check blood sugar. I was surprised because after years of donating blood, I expected it to be a hemoglobin test. I didn’t feel the finger prick AT ALL. Back in the day, they really used to hurt!

After we were done with that, she took me to another room where blood was drawn for other blood tests. Quick, efficient, not painful. Then that nurse told me to go to the reception room to wait to be called for my chest x-ray.

I hunkered down because I thought surely NOW I will have to do some real waiting. It might have been 10-15 minutes. My name was called and we walked back to the x-ray room. She had me sign a consent form (radiation, you know) and told me just to remove my bra. Phshew! She took one picture and that was it.

In case you haven’t been keeping track that was:

· ECG

· Nurse consultation with sugar check

· Blood work

· Chest x-ray

Not covered by insurance. OMG, what did that cost??

€69.60

If you’re American, can you freaking believe this? So the lack of a cover-up for the ECG was disconcerting, but it really was just minutes, and the nurse was female so I’m cool with it. Otherwise, the whole experience was quick, efficient, everyone spoke English and didn’t seem bent out of shape about it. Assuming these tests are within parameters, I think I’ll be going under the knife next week. Stay tuned.

Next Up: Part 4 - Surgery?