Wednesday, November 27, 2013

Fine Whine

My apologies for my absence...I was in London for two weeks having surgery on my knees and blogging by iPad is...challenging.

Also challenging, having surgery on both of your knees.

One of the less fun parts of being in the Foreign Service can be receiving any kind of medical care. Unlike in the States, where if you have decent insurance you can get your medical issue dealt with fairly quickly, when you are overseas, it can take a while. So my surgery on the 14th was the culmination of months of pain, a useless visit with the Regional Medical Officer, a torn meniscus (actually torn in two places and cracked in a third), another couple weeks of pain, an appointment with an Estonian orthopedist (and a demonstration of how bad my Estonian medical vocabulary is), and then two and a half more weeks of waiting until we could get me to London for surgery.

Of course, once I got to London, the care was as good as any in the States. Maybe even better. The UK has socialized health care paid for by people's taxes. But on top of that, they have a private health care system that you can use if you have private insurance. We use the private system because we obviously don't pay taxes to the UK. And it was excellent.

I had an appointment the day after I arrived with a private doctor, and he then scheduled an MRI for a couple hours later. He recommended surgery on both knees, so we went to the embassy, who handled everything. They have an excellent medical unit that handled around 500 medical evacuations (medevacs) per year and they have it down to clockwork. We filled out all the forms, and because I was in the hospital overnight, the Department pays for everything and I reimburse them once I get reimbursed by my insurance.

Two days later, I was checked into the Princess Grace, a private hospital in London not far from the hotel where I stayed, also booked for me by the embassy. The hospital was great. You walk into a tidy waiting room, give them your name, and they come within five or so minutes to check you into your private room. Which includes a wine list. No, not kidding.

Told you I wasn't kidding
The room also had menus for breakfast, lunch and dinner (with a selection, including things like roasted pheasant that was actually awesome!), movies on demand (for free), and free wifi. An hour or so later, they came and got me, wheeled me into surgery and a split second later (okay a couple hours, but I was out, so it seemed like a split second), I was done. And I was on my feet by that evening.

Had all of this been done at home, or more quickly that how long it took here, I couldn't possibly have any complaints. But let me tell you that getting all that done is HARD when you are not at home. Even in England, which shares (sort of) our native language, it is still challenging. You aren't in your own environment. You don't know how best to get from place to place. You have to do things like get into cabs that are taller than most cars and the stepping into which causes your muscle to tear just a bit in your newly operated on knee (which then causes you to spend said cab ride curled up into a ball on the cab floor).

And you don't know when or whether you can return to work. Our job requires a medical clearance in addition to a security clearance. A class 1 clearance means you can work anywhere in the world. You have to have that to join the Foreign Service (because it wouldn't be fair to those already in the service to hire someone who could only serve in western Europe. We all have to do our time in hardship posts). When you go on medevac, your Class 1 clearance is suspended. And you can't return to post until it is restored. Now luckily, the medical unit at the embassy can do all the paperwork to restore your clearance if the doctor clears you, but the doctor's clearance is by no means assured. And if he does clear you, and you do go back to post, you can not go on medevac again from that post for that issue.

So if my knees for whatever reason don't heal, I am screwed. My only option would be to curtail from post (leave for good) and go back to DC. And hope there is a position for me there.

That is added stress on top of an already stressful situation.

The good news is I got my clearance back and I am home. The bad news is my knees are jacked and I will likely need replacements in the not too distance future. Other than repairing the meniscus, most of this was all as a stop gap to give me pain relief until I get them replaced in a year or so (hopefully much more than a year, but the cold, damp weather in Estonia makes them hurt so that I am not overly optimistic).

Also not especially fun to think about...metal knees in a career that has you going through airport security A LOT.

Hello, strip searches!

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