A Surgery in Portugal - Part 4

Me in the hospital

I realize I should start with the cost and paying for this. I mentioned earlier that MGEN (our health insurance carrier) won’t cover any of this for a year and that doesn’t end until February or March 2026.

I just couldn’t wait that long. If you’re from the US, you may know about Health Savings Accounts (HSAs). Not the spending account, the savings account. What’s the difference? The spending account is spend or lose it at the end of the year. The savings account is yours forever.

It’s one of the greatest tax advantaged things Congress ever came up with. Better than the Roth IRA. It’s triple tax-advantaged in the states. You must have a high-deductible insurance plan to contribute to an H SA. But then you can contribute up to a certain amount each year of pre-tax dollars. Most employers match your contributions dollar to dollar, also tax-free and when you need to use the money, you don’t pay taxes on any gains it may have earned. Scott and I both participated in this when working. Also, when I retired from Duke Energy they continued to contribute to an HS A for the retiree and spouse until each is 65 (I’m 64, so they are still contributing). All that to say, I’m using HS A money to pay for this.

What is the cost? An estimated €13,650.00. Yes, it’s a lot to pay out of pocket, but this has been going on too long and my activities have been so curtailed since we’ve been in Portugal, I just have to do it. I worked, I have the money. I’m doing it.

Turns out the pre-operative tests were partially covered by MGEN!

The tests were all good, so they scheduled me for August 7th. They said I’d be in the hospital for 2 nights. Much like in Charlotte(CLT), NC (where we moved from), Portugal has some regional private hospital groups (as opposed to the public system, which US doesn’t have). Like Atrium and Novant. Here in the Algarve we have HPA Saude. They have some hospitals and some clinics throughout the Algarve and the Alentejo region. I won’t go into all the details, contact me if you want more info. For this surgery I have been to the clinic next door to us, a hospital about a 10 minute drive away and a hospital an hour away. The one an hour away is where the surgery actually took place. It’s in Alvor, Portugal

I was told to arrive at 8:30am for admission. Fasting, no liquids all that fun stuff. Also, I had to pay upon admission. Coolio (snark). I used my airline miles credit card. I’ve forgotten a lot of the details from that day…. Scott and I took an Uber, arrived and got checked in without issue. Unlike in CLT they did not allow Scott to come back with me to get ready and wait. Also, the hospital “visting hours” noon — 8pm applied to him. So he was not going to be allowed to stay with me or anything. Well, ok, the dogs needed him more than I did, so yeah. He went wandering around Alvor while I was in surgery and was back when I was in recovery.

They got me ready in a fairly “normal” manner (according to my previous experiences). Then they wheeled me into the OR and gassed me. I actually remember the moment of going under.

When they were done and they woke me, there was a LOT of pain. Happily they were not stingy about the pain meds and didn’t argue with me about timing or anything. If I asked for more, they gave it to me. Eventually it was mostly under control and they took me to my room. I think the surgery itself was just under 3 hours.

This part of the story seemed pretty straight forward and uncomplicated. Oh, I did wake up with a tube down my throat. NOT HAPPY. They took it out fairly soon. My throat was sore for a few days.

When I was rolled out of the recovery room I was taken to a hospital room for two. I was there first, but later on another young woman was wheeled in and put in the other bed. Curtains were drawn around me. As far as I could tell, she spoke English and French. I wasn’t keen on the roommate scenario, it inhibits my moaning, groaning and sighing. But, what are you gonna do?

I had an IV port in each hand, a catheter and a little pouch that was collecting the drainage from the surgical wound. YUCK-EE. So the tubing went into my back and the pouch was on the bed beside me. It had a little clip so I could clip it to my gown. Lovely.

Thursday MUST be the biggest surgery day in this hospital. I tell you the place was an absolute zoo. I don’t have a lot of experience being in a hospital, but I do have some. Noisy. Very noisy. This one seemed on steroids.

Differences between US and PT hospitals noted by me in my haze:

• The staff, i.e., nurses, etc., yell to each other up and down the halls.
  

• The beeping. OMG the beeping. All these different machines they attach to people beep for different reasons and at different times. I guess the staff can’t help tuning them out to some extent. There is NO apparent impetus to turn these things off. When you’re hypersensitive to repetitive sounds in general and beeping in particular…. All I can say is it’s a good thing I was drugged. I was going mad, but not like I would have been.
  

• In the US when you ring the call button in a hospital room, generally a bodyless voice says something to you through an intercom system. Not the case at this hospital. I’m pretty sure there is no intercom. You wait and eventually you hear your beeper stop and then eventually someone comes to see what you need. I will say, on this initial visit, they were pretty good about getting to me fairly quickly. At least as far as I can remember.
  

• There was a VERY small television on the wall opposite the two beds. My roommate watched for a while, but I couldn’t hear it (good). It really was too small to see properly.
  

• I’m pretty sure Scott left before they brought me dinner. Too bad, he would have liked it. Noone every spoke to me about food, so I wasn’t expecting it, didn’t want it and had not had an opportunity to tell them I don’t eat meat. I can’t remember what it even was, except that it was a meat and I didn’t eat any of it. When they came to pick up the tray, I tried to explain that I was vegetarian. It just wasn’t taking.
  

• Sometime after dinner, they let my roommate leave. Nice.
  

• They gave me my anti-inflammatory, anti-nausea and anti-pain meds sometime after that and then actually did not check on me the whole night as far as I was aware. Still not sure what I think about that. I had my button, but what if I died and couldn’t push it??

I know this tale has gotten a bit out of order. My apologies. On the day after the surgery, I was sent home late in the afternoon. So I was there pretty much all day. More food was brought in that I didn’t want. I think I nibbled at the side dishes and fruit a little. I wanted to say, “Where the heck is the ice cream?”

The surgeon did come see me after “lunch”. He looked at everything and said the draining seemed to be letting up and if it stopped they would take the drain out and I could go home.

Later on, a nurse came, who I described some in an earlier post. He looked at the drainage pouch and said it looked good. I demurred a little bit because I thought it was still draining some. But part of me also really wanted to leave, so I let it go. Mistake number one I think.

More will be said about this.

Next Up: Part 5 – Post-Surgery – In hospital