The Things ... I Have Gone to the Doctor and the E.R. (Arzt and Notfalldienst)


The Things ... I Have Gone to the Doctor and the E.R. (Arzt and Notfalldienst) 

Until recently, I hadn't been in Hauspraxis or any doctors office for my own health since last November. I avoided the doctor for many reasons. When I went back home to America, I only had 45 days of fully compensated insurance coverage. So just after the new year, I was without any health insurance as a tourist, expat and American citizen. I promptly applied for coverage which would have been an adjusted price considering where I lived and my current income but I was promptly denied. That was third denial in my mothers home state which has had a lot of issues since Obamacare or the Affordable Care Act was passed. I was offered another option which would have cost me more than the highest tax bracket cost in Germany. We already pay like 600€ for public coverage in Germany because I do not work. And working in the States, barely making minimum wage and it was easier to opt out of those crazy costs. I could pay out of pocket for emergent care and hope that my German insurance provider would offer some reimbursement versus give up in excess of my paycheck for coverage I probably wouldn't have used. In early 2020, I needed some dental care and that was pretty seamless as most dental and vision plans in America are so terrible individual offices will work with you financially. And just this past week most of that out of pocket cost was actually reimbursed by my German provider. I mean it is almost ten months later but money is money. However, when I did have cold & flu like symptoms in late January and early February I chose to stay home and take care of myself then pay hundreds of dollars to be told to drink fluids and go home. 

I like to think what I experienced was Covid-19. I had a heavy chest, a high fever and my mother measured my blood pressure with her personal machine as really low. There was already a lot rumor of the said virus so I refused to go to any emergency room or urgent care facility. Thankfully, with rest and fluids the symptoms did subside in under a week. I took a few days off work. I didn't leave the house. I also isolate myself from my mother. For me being in the States without proper health coverage was a huge risk not only because of Covid-19 but because my mother is a cancer survivor. I always had to consider if I got sick how weak her immune system was and being in close quarters with her made it impossible to take shortcuts with my personal health. To maintain I chose self care in lieu of leaving home to seek medical care. Of course if I cut myself or broke a bone I would have gone to the E.R. but I would have done so alone and probably quarantined after in a hotel. Americans generally seek all medical attention at their local hospital (I am not generalizing - this is a thing) so at the height of the pandemic it was unsafe to go to any hospital. I chose to holistically prevent myself from getting sick and I also figured I had been exposed earlier in the year and hopefully had an antibody. I stopped taking NSAIDS for minor aches or pains. I took vitamin D and K daily. And when I had my shopping trips or any exposure to others I followed my outing with zinc, sambucus syrup (holunder berry here in Deutschland) and vitamin C. In Germany, I have followed the same regimen but I also have other conditions that make me reliant upon semi-regular medical care. And because I was without for so long when I returned it was like my entire health begin to fail. 

I wound up in the E.R. a few weeks ago. It was early Sunday morning and I was in so much pain I just couldn't fathom waiting an entire day until Hauspraxis on Monday. I have been bei die Notfalldeinst and im Krankenhaus before but involuntary. I was taken there in an ambulance and transported to a few places for different procedures. This time was different as I was voluntarily walking in, registering and asking to be seen. The process in itself was no different than an E.R. in the United States. However, Covid-19 made it a bit more interesting. Firstly, you cannot just enter and exit a hospital like before. Then waiting in the E.R. the seating is spaced for social distance so I couldn't lean on my husband. I wasn't given any forms to fill out like I would have had in America and maybe that is normal here as most medical excursions only involve offering your insurance card. Either way intake was quick as we were the only ones there and once seen by a triage nurse we had a room in under twenty minutes. Once in the room there was a lot of signage around wearing ones mask and not exiting the room unless asked. That was sort of new so my husband was stuck in this hot room with me and we were both confined there with masks. The doctors and nurses that saw me didn't seem to act too concerned about the virus. So many operated without gloves, didn't wash their hands and took shortcuts like answering a phone while removing an IV. And as per usual I was encouraged to go to my own doctor after a few hours of pain meds and a prescription. Upon exiting there were a few more people in the waiting room and things appeared to be very controlled. We were given a local pharmacy or apotheke that was open on Sunday and I was home nursing myself by dawn.

I made the huge mistake of going to my Hauspraxis a few days later. I have already complained countless times about doctors offices being open for whatever hours for sick people to just walk in without appointments. I had hoped the pandemic would have changed that for good and it would be much like my E.R. experience. Unfortunately, it was worse. As people were hesitant to enter the office so many lingered around the front door. Once inside the waiting room was full just after 8am and there was no ventilation. All I could hear and see were people coughing and sneezing. I was there for an infection which was not contagious or could affect others. Unfortunately, my doctors office is just too busy to ensure people aren't waiting there with Covid symptoms like fever. I strongly believe they think if they ignore people and whatever coughs come from that closed waiting room their staff is safe. But what about the people who aren't there for that sort of stuff who have to be exposed for help? This has always been my dilemma with open praxis. I get how it is convenient for Germans and it is all they know but there really needs to be urgent care for walk ins for sickly types and appointments for regular patients of record without cold & flu symptoms. Sadly, my doctor really couldn't help me and referred me to a specialist. That specialist is on holiday and I wound up in a different ER which forced me to go look for a second and third opinion. While I have not exhibited any other symptoms I am not fully better but this time around I was lucky enough to get an appointment at my Hauspraxis this upcoming Tuesday. I wonder if a secure time slot will also be a gamble as walking in? 

In total, I visited three E.R.'s and three doctors - all in the past few weeks! I feel lucky and disappointed. I would say after experiencing what I did I wouldn't try my luck on getting seen and having a positive outcome right now. I know how hard it is to self care or self medicate in Germany but there are holistic and alternative options here that are accessible to most everyone. I think I just happened to feel my worst at the best possible time for an E.R. visit. I also think my experience would have been a 180 had it been a Friday or Saturday evening. And because my doctor is familiar with me and my issues I didn't have to wait too long but imagine not being a patient of record and having to wait for hours to be seen. And no matter what precautions you may take there is always someone who is careless. There were plenty of people with their masks under their noses, wiping their faces with used handkerchiefs and best yet removing their masks to eat or talk on the phone - at the doctors! I wouldn't mind bearing witness to something like this on the train and simply moving seats. But being in pain, waiting in line and hoping to be seen, I was forced to sit in a room with these people until my name was called. I have a few more appointments with specialists in coming weeks and if things aren't better I am strongly considering leaving Germany for more attentive and personalized care. However, being here is just too high of a risk and thoroughly disappointing. Therefore, going to any German medical facility without a dire need is 10/10 risk and a 1/10 experience I would never recommend it not even to my worse enemy.