Dreaming In Italian

The Italian national health care system (SSN) works pretty well in many ways but like any such system it has it’s flaws. I of course couldn’t help but comparing it with the system in the US. On the positive side, everyone is covered and there are few and low priced co-pays. None for your primary care physician and low ones for specialist visits. In my case since I’m over 70 I have rarely had any co-pay. In general the medical costs are much lower in Italy than the US. The prescriptions are either very inexpensive or free – imagine that. On the other side of that coin the non prescription drugs (ibruprofen, aspirin) cost much more. The pharmacies need to make money somehow. The medical care is probably about equal to that in the U.S. Some doctors are better than others and a couple times I changed the primary care physician or specialist. In general I would say that the system is less responsive since it has less money and the patient has more responsibility for his/her medical care. Add to this some quirks of Italian bureaucracy and it can lead to frustration. For instance they requested a bunch of documents that I had to obtain from the health care system itself and from my primary care physician plus prior test results, ecc. prior to check-in at the hospital. Having duly gathered everything I was never asked for several of them during the check-in process.

I was notified of the date to arrive at the hospital for the hip surgery on 5 October in a fasting state at 7:00 AM. Fasting would indicate that the plan was for surgery that day. So being punctual I arrived at that hour and went to a waiting room where there were probably 6 or 7 other people waiting by a few minutes after 7. I waited for over an hour before being called. So why can’t they space out the arrival times? The interview for all of the information during check-in was rather brusque. I had asked via email for a list of personal things that I should bring with me to the hospital that was never answered. So I brought a bunch of stuff including the few prescription medications that I take regularly. It made sense. Maybe all hospitals are this way but they would not accept mine since they were not in the bubble packs as they always come from the pharmacies here. This kind of leads into my complaint of the general lack of information during the entire process. So anyway I was in bed in a room by about 9 AM and was told that the surgery was to be sometime in the afternoon. I can’t really fault the hospital that I couldn’t have it that day since there had been some sort of operating room emergency, however it would have been nice to have that information before 5:30 PM. By that time it was pretty obvious that I wouldn’t have it that day.

The room was really pretty nice with two beds spaced relatively far apart, a bathroom, individual TVs, etc. One thing different from hospital stays that I’ve had in the U.S. is the almost complete lack of privacy. At least in the U.S. there was always a curtain that could be drawn around the bed but here there was nothing and since after the operation I was pretty much always in bed that meant also that all personal bodily functions were done without privacy other than a sheet over me.

So now getting back to the positive side of the stay. I was in the hospital for a total of 9 day. It would have been 8 if not for the one day delay in the surgery. By American standards I think that pretty long but during this time I had physical therapy twice a day for which I’m really grateful. If I had left after only 2 or 3 days it would have been much more difficult because I would have been weaker, had more pain and little experience with the crutches to walk and go up and down stairs. There was kind of a rotating cast of therapists but they all seemed pretty competent and caring except for the one who thankfully I saw for only one afternoon session. The nurses were generally caring and likeable (again with one exception who I mentally thought of as Nurse Ratched – “One Flew Over the Cuckoo’s Nest” reference).

Finally, I think 2 days before being released from the hospital I was given the date and a suggested time of my release from the hospital. In retrospect I should have asked more questions at that point which I will further explain in the third and final chapter.

One great thing is that Laura came to visit me every day. The visiting hours were from 6 to 7 PM which makes sense because the physical therapy appointments and generally other activities in the hospital shouldn’t be disrupted by visitors and frankly while it was always great to see Laura we generally ran out of things to talk about before the hour was up.

The third chapter will come soon.

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.

I don’t think that I’ve heard cicadas since I was a boy in Oklahoma. I never recall hearing them when I lived on the East Coast and certainly not in California. Here in Italy I’m told that they are present every year. This is only my third summer and I don’t remember ever hearing them here even though the previous 2 summers I was certainly around trees here and in Torino. In any case it’s really pleasant although if I lived somewhere where there were a lot of trees the sound could become pretty annoying.

Regarding the swallows, it’s a similar story. I think that I saw a few of them when I was growing up in Oklahoma but never remember seeing them after that. It’s a real pleasure to watch their flight. Often they go around like little fighter plane squadrons catching little insects on the fly.

The first year I never saw them here in Bologna but saw them almost every day in the late spring and summer when I was in Torino. When I changed houses last year in late May I was stunned to see lots of swallows around via Santo Stefano. By now I don’t see them near where I live but a couple of days ago when I was in the very center of Bologna I saw a lot of them near the “Due Torre”. One of the most recognized symbols of Bologna (the others are the fountain of Neptune and the Sanctuary of San Luca).

Most of Italy is a bit more relaxed here pandemic wise but I’m getting a bit concerned to see the numbers of infections going up a little bit every day. It’s feeling a lot like October of last year when they were edging up and then formed a huge second wave that locked everything down. There are fewer vaccine hesitant people here and anyone over the age of 12 is eligible to be vaccinated BUT the supply of vaccines is still limited so the wait for a vaccination appointment can be pretty long. All of my friends are now fully vaccinated including Gianluca who was infected and now after having been vaccinated he’s probably super-immune. The overall fully vaccinated percentage of Italians as of this writing is almost the same as for Americans, 45%, and the goal is to have 80% by the end of September. That would be great and it seems that the U.S. may never achieve that goal due to the politicizing of the vaccine and the huge amount of disinformation. Still when I go back to California for a visit in September it should be pretty calm there.

Speaking of travel I now have a “Green Pass”. In my case it indicated that I’ve been fully vaccinated. I have a copy in my cell phone and I will take a paper copy with me just in case.

It’s a typical Bologna summer, hot and humid. Unfortunately the house doesn’t have a practical air conditioning system so we are relying on fans which makes it at least tolerable. When I say a “practical” system I must explain. Like most residences in Italy the heat for the house is supplied by the water heater (they are all tank-less and called “caldaie”) that goes through radiators.

When they restructured this apartment they used a specific type of radiator (for most of them anyway) which has a built in fan to heat up the space faster. Great idea. Then they decided that since they had that structure in place that could install one MONSTER air conditioner that can run cold water through the same pipes to supply the air conditioning.

The problem is (and we were warned by the realtor) that it is terribly inefficient and takes the better part of a day to cool the house and costs a fortune to use on a regular basis. So effectively the house is just not air conditioned. After the first month of summer we kind of get acclimated.

Just to change the subject I look often for other Italian musicians and I think that you might like Zucchero. He sings in both Italian and English and I like the way he sings. I had a hard time finding a good video. I really like “Diamante” (Diamond) and “Senza Una Donna” (Without a Woman). Which are both about half English and half Italian but couldn’t find them. So “She’s My Baby” will have to do.

And of course a bacci, quote or in this case 2:

Life is not about waiting for the storm to pass but learning to dance in the rain.
La vita non è aspettare che passi la tempesta ma imparare a ballare sotto la pioggia.

Mahatma Gandhi

The secret of happiness is not doing what one likes, but in liking what one does.
Il secreto della felicità non è di fare sempre che si vuole, ma di voler ciò
che si fa.

Lev Tolstoi

Speaking of doing things. I have acquired a hobby during the lock down of doing a little urban gardening. If interested in finding out more you can leave a comment and I’ll let you know more.😉

It’s been about 6 weeks since I did a blog post. I guess that during all of the Covid restrictions I didn’t have much to write about that seemed particularly interesting. But with lifting of a lot of restrictions (we can quit wearing masks when we are not in an enclosed space – yipee!) it was time to take a little trip.

After months of lockdowns of various severity we have been looking forward to making a little trip – just for a change of scenery. Like the trip that we made in February before another lockdown was in place. Laura suggested Faenza and also a little town, Brisighella in the hills not far away from there. It turns out that I had been to Brisighella before with my friend Liu’ but I never knew the name. There are photos of the upper town on that post. So on the last day of June we headed east for a day of diversion. Faenza is known for ceramics and we wanted to go to a major ceramics museum there. Brisighella is one of the lists of the 10 most beautiful little towns in Italy.

The google maps GPS has a serious flaw, at least in the Italian version – the instructions (as in turn here, etc.) are often truncated and/or unintelligible which makes them relatively useless unless you also can look at the map. This leads to a significant amount of frustration. Still after about 1 1/2 hours we did find ourselves in Brisighella and fortunately a part of the town that I had not seen at all on my other stop there. There’s kind of a lower town (where we were) and an upper town where the Rocca (a fortress) is. So we had a pleasant time wandering around and had a very good lunch before heading off to Faenza.

We didn’t see much of Faenza since our objective was to see the museum and then go back to Bologna before rush hour and hopefully find a parking space not too far from our house. Found the museum with little difficulty because there are a lot of signs showing the directions to take to arrive there. I must say that I was quite disappointed. It’s the way I feel in some museums of modern art. I like modern art in moderation but often find myself asking myself “What the hell is that?” and “Why is it thought to be very special?”. Still it was interesting. The next trip I’d like to go to Forli which is not much further and is said to have a great museum for Art Nouveau.

And before I leave – a couple of Baci quotes:

What the caterpillar calls the end of the world, the rest of the world calls a butterfly
Quello che il bruco chiama fine del mondo, il resto del mondo chiama farfalla.

Lao Tze

Love is a friendship that is on fire.
L’amore e’ un’amicizia infuocata.

Jeremy Taylor

What are you up to as the the world starts to open up as the pandemic subsides?