New Adventure with the Italian health care system – Part 1

New Adventure with the Italian health care system – Part 1

Saturday, October 16th, 2021

I haven’t done a new post since July. Time flies when you’re having fun. With the continuing pandemic not so much fun. In any case I don’t think that I ever mentioned that I have been having problems with a hip. This started a year and a half ago when I moved to the new house in Bologna. There wasn’t a lot of stuff to move at that point but I believe that lifting the TV (probably the heaviest thing that I had) provoked a problem with my left hip. By the time that could go to Torino to join Laura a couple of weeks later (there were pandemic restrictions on travel) it was pretty bad. I bought a cane that I’ve been using ever since. I thought at first it was a pulled muscle problem but since it persisted I finally went to an orthopedist after Laura and I moved to Bologna in July of 2020. After an x-ray he said that I would need a hip replacement and put me on a waiting list in October of that year. With a cane I’ve been able to manage well enough although having it is certainly a limitation. I changed orthopedist May of this year (2021) since the existing one had given me clearly bad advice a couple of times and I no longer trusted him. The new one is at the Rizzoli institute which is well known as a center of excellence for orthopedics. In early July I got a call to go to the Institute to have pre-surgery tests, blood, x-ray and a bunch of other things that I don’t clearly remember. The anesthesiologist has a big say about surgeries and while I was still there and all of test results came back we had a discussion of the results. She told me that there was one sticking point – I have a low platelet count. I have known this for years and when I had a knee replacement in San Francisco in 2008 they noted it and said that they would would just give me a platelet transfusion prior to the operation. They did, and everything went OK. The anesthesiologist at Rizzoli rejected that option and sent me to an hematologist. They don’t have one at Rizzoli so I went to a hospital not too far from home which seems to be the best place around here for hematology. There they said that with a platelet count of 60 (thousand per micro liter) it should be no problem but wanted to try to get to the root of the problem and gave me a list of exams to do and to return in October. I was able to get the 4 or 5 tests done within about 2 -3 weeks and corresponded with a hematologist and he then gave me an August date (instead of October) to return with the results. The tests ruled out everything other than perhaps my genetic makeup, i.e. my body was just that way or there was some kind of auto-immune condition that was limiting the platelets. He wrote a report that reiterated that anything about 50k shouldn’t be a problem for the surgery and again the anesthesiologist ignored that and said that it needed to be above 80. So I continued to correspond with the hematologist and there were only two options the more palatable one was to take a pretty heavy dose of a drug called prednisone for 10 days just before the surgery. I did research on the drug and found that while it was clearly very useful for a lot of conditions it also had a long list of undesirable side effects. Fortunately the hematologist was very available for email conversations and even a telephone call (this seems pretty rare here) and in the end I decide to take the prednisone. I started immediately after I return from a short trip to California and already had an appointment to return to the hematologist after 8 days with the drug. So on the 8th day I returned and the platelet count was 109 – yippee. I already had an appointment at Rizzoli (given that I was going to take prednisone) for 5 October. So that was pretty good. As for the side effects that I experienced there were two obvious ones: insomnia and irritability. I warned Laura about the irritability and since I was aware of it I could repress the urge to be outwardly cranky.

Oh yes, I forgot one important detail. In July I started having a problem with my RIGHT hip. In fact it quickly became worse than my left so I made an appointment with the orthopedist and when I saw him he showed my the x-ray from when I went there in early July and said “THAT is an ugly hip” so he agreed to do the right one first.

I don’t know how interesting this stuff will be to the few readers that I have but I’m going to continue anyway about this more serious encounter with the SSN – national health service and how it contrasts with my surgery experiences in the U.S.

Let me know what you think.

4 Responses to “New Adventure with the Italian health care system – Part 1”

  1. Joy Says:

    That is a lot of stuff to go through! I have a bad right knee because of osteoporosis, but can get lube shots in the knee every six months that really help. You cannot do that with hips! Is your surgery scheduled yet? You are in my heart!

  2. Joe Says:

    Thanks Joy, I hope that your knee holds up. I had a knee replacement in 2008. It was necessary but the recovery is pretty long and painful. I have had the surgery and more details will come in “part 2” which I will publish soon.\


  3. Diane McKallip Says:

    I love the ortho’s comment about the “ugly hip”!!!

  4. Joe Says:

    Yes we was pretty straightforward. I like and trust him much more than the previous guy.


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