Wednesday, July 15, 2015

Stories from Past Travels

Sango Sands in far northwest corner of Scotland.
Kilchurn Castle on Loch Awe.

A Visit to the Emergency Room and a UK Doctor

Before we left on a recent spring trip our friends asked us if we had ever had to use medical facilities in the UK.  Except for a visit to a dentist to repair a crown that had come loose, we told them we had never had call to visit a UK ER.  That was like the announcer’s curse when broadcasting a golf tournament; of course, it’s going to happen now.  And it did.
One afternoon in Crieff Anne noticed that she had a very red left eye.  Upon examination we could tell she’d broken a blood vessel in her eye.  A search on the internet reassured us that it was nothing major, but with an artificial heart valve and taking blood thinners we were still concerned.  Jacky, our B&B host, thought it might be related to high blood pressure and convinced Anne that she should visit the local small hospital ER or urgent care.  
We walked into the hospital entrance at about 6:30PM and rang the bell for the emergency nurse on duty.  A sign near the bell told us to ring once and then wait.  It said that a nurse on duty might be on rounds but would be with us shortly.  It was a half hour before a nurse showed up who said the emergency room wasn’t open--this was while she was standing next to a sign which said the ER was open until 9:00PM every day.  She told us what National Health number to ring, but then said to Anne, “Oh, well.  I might as well take a look at your eye.”
In the care room the nurse took Anne’s blood pressure and noted it was quite high, 185 over 90.  She then told Anne her eye was okay and that the blood would dissipate in a few days.  We were a little shocked that the high blood pressure didn’t trigger any further concern.  It was as if the nurse didn’t want to be bothered with tourists.  
Anne’s eye did get slowly better and, except for a couple of instances of spots before her eyes, Anne didn’t seem to be troubled with high blood pressure.  Our one visit to the emergency room didn’t leave us feeling great about emergency care in the UK even if it was free.
A second visit to doctors in the UK was a little better.  In our fall trip Anne got to Scotland and discovered she’s brought the almost empty bottle of a necessary prescription instead of a newly filled bottle.  Even though she had her prescription information, the local chemists (pharmacy) couldn’t by law give her the medication--she would have to go to a local doctor and get a new prescription.  
We went to the local doctor’s clinic (next to the ER we had visited before) and explained the situation to the receptionist.  She put Anne in a queue to see a doctor.  Thirty minutes later a doctor came out into the reception area and called for Anne.  After a twenty-minute visit with the doctor--most of it spent trying to find a UK equivalent of Anne’s medication--she came out with a prescription and a bill for £70 ($120 US)--the visit would have been free to UK residents.  We paid our bill and went to the recommended chemist to fill our prescription.  Interestingly enough, the UK prescription cost about a third of what the US prescription had cost even with insurance.
Perhaps the National Health Care System in Britain isn’t so bad after all.  But I really can’t say the same for the US medical system—neither private insurance nor Medicare.  When we got home from our trip Anne started the process of getting repaid for our medical expenditures from our insurance company.  She sent all the necessary receipts we had dutifully collected and the letter I wrote narrating our incident.  It was all rejected.  After going through several appeal levels we finally got paid back for the doctor visit, less our usual copay, and an explanation of why we’d get nothing back for the medication.  It seems that Medicare will not pay for any drugs outside the country, unless the drugs are administered in a hospital or urgent care facility—if the hospital gives you a prescription that has to be filled by an outside chemist, it won’t be covered.  And our primary insurance provider follows the dictates of Medicare. Important information for seniors who travel outside the US.
Through these two experiences we’ve learned quite a bit about the universal health care system in the UK and our care system in the US.

Rain Check at Muckhart Golf Club

With no great pictures of Muckhart, I thought I'd include a picture of the New Course at St Andrews (right next to the Old Course where the Open was played).  The New Course is a baby at only 120 years old.

Muckhart Golf Club in central Scotland has three nine-hole layouts.  We booked in for eighteen holes, paid our fee in cash, collected our gear and headed out on our first nine.  Muckhart isn’t a very hilly course but the track we were playing had one hole which went up quite a bit and then the next hole came back down.  We had teed off and were walking down the gravel path when Anne slipped on the pebbly path and fell hard landing on her knee and hand in the gravel.  The damage was significant enough for us to skip the last hole and call it a day.  Sorry to say this but Anne falling isn’t unique enough to make an interesting story--there are similar events in Stonehaven, Edinburgh, and Forrester Park GC to name a few.  What happened next makes the story.  
The fifth green at St Fillans in Perthshire.

While Anne put our golf kit into the car I went into the Muckhart GC pro shop to see about getting some money back for the second nine we hadn’t played.  The young lad in the shop (I refuse to call him an assistant) said it would be no problem and started to write me out a “Rain Check” for our next nine holes.  I stopped him and said, “Look, we’d love to play the next nine, but our flight back to the States is in two days and today we are moving to Edinburgh.  We can’t really use a rain check.”  He said, “No problem.” and continued writing out the rain check.  I told him we had paid him cash only an hour and a half ago and asked him, “Why can’t you just give us cash back.”  “This is as good as cash,” he said pointing to the rain check.  “For someone from Scotland it might be, but we’re from America.”  “That’s okay, just use it at a course in America.”  At that point I walked out without picking up the rain check.  I could hear him call after me, “You forgot your rain check.”  We drove away.

The Budapest Police

Parliament in Budapest.

On our two week tour of Germany, Austria, and Hungary we spent two days in Budapest.  It’s a very interesting city with plenty to see, but it is rather spread out.  The city has a convenient underground or subway system that allowed us to get around easily to most of what we wanted to see.  To make it easier to use the subway we purchased a two-day pass which gave us access to the subway, tram, and city buses.  
Most of the time no one asked about our tickets--you just hopped on and off when you wanted.  Most of the time.  On one particular trip coming from the subway to the surface we saw people scurrying to the ticket machines like we’d never seen before.  I found out why the hurry to get tickets a minute later. 

Enjoying the sun in park in Budapest.

As we got off the up escalator we were met by two uniformed transit workers and one uniformed and armed policeman.  One of the transit workers asked something in Hungarian and held out his hand.  I rightly interpreted that he wanted to see our subway passes.  I handed him my pass and Anne’s and smiled.  He looked at the passes and he didn’t smile.  Handing the passes to the police officer he said, “Problem.”  I said, “No problem.”  The officer looked at the tickets and he said loudly, “Problem!”  At this point I was wondering what the inside of a Budapest jail would look like and how the bread and goulash would taste.  I said nervously, “No problem,” and pointed to the date stamped on the passes.  The officer looked more carefully at the passes then handed them back to the transit worker and said with a smile, “No problem.”  The transit worker handed the passes to me without a word and walked away.

A Budapest trolley built in the early 1960s in the Soviet Union.

I found out later that the fine for riding the underground without a ticket would be about 1500 forints--$6.12 US.  

Midgies--the Scourge of Scotland

We’d heard stories, had warnings, but had never had a personal introduction to Culicoides impunctatus.  Most of our travel has been off-season, April-May and September-October.  We’d never been in the Highlands in the peak season of early June through late August. According to one book, “During the Second World War Scottish soldiers training in the Highlands branded her worse than Hitler.”  The “she” referred to is none other than The Midge.
Of the 34 different species of biting flies in Scotland, only five are attracted to people and 85% of the attacks are by Culicoides impunctatus.  Midges or midgies are small biting flies that appear in mid to late summer, especially in the Highlands and around water.  In the Northwest we would call them “No See ‘Ems” or gnats, but ours don’t bite.
September 2007 was our tenth trip to Scotland, and it was the first time for us to come face-to-face (or rather mouth-to-arm) with the midges.  When we played Ullapool GC in the northwest of the Scottish Highlands it was a wind free, overcast with light showers day.  We thought we were prepared with insect repellant, but I was in for a surprise.  By the time we’d reached the tee at the second hole we knew we needed protection.  We sprayed our necks and heads with Off! and played on.  The repellant worked fairly well, except that I didn’t think about the fact that I was wearing short sleeves while Anne had on long.  Even though I hadn’t felt a single bite, by the end of the round there were a few welts on my arms that were beginning to itch.  By that evening I was putting on the only anti-itch medicine we had by the gobs.
40+ midge bites on each arm in only nine holes of golf.

The next morning I could count more than forty bites per arm and nothing was stopping the itch.  Midge bites are not like mosquito bites which sting, swell up, itch for a couple of days, and are forgotten.  Midge bites itch for a month!  I tried every remedy available from every chemist (pharmacy) at which we stopped.  Some worked a little or for a while, some didn’t work at all.  We’ve since learned a lot more about the midges.  As far as repellents go, the Off! worked fairly well, but we’ve since heard that Avon’s Skin So Soft is the preferred repellent by locals.  One description I heard said that you slathered it on good and thick, and then any midges who do land on you drown in the lotion.
Midges like the twilight and the females, who do the biting, are most voracious at dawn and dusk.  Sun and wind are actually the enemies of the midge.  They will never bite in the midday sun and can’t fly in breezes more than seven miles per hour.  If the weather is dull and overcast, as our day at Ullapool, they can bite anytime.  Businesses have refused to locate in the Highlands because of the midges.  Scotland loses million of pounds in lost work-time a year at Highland outdoor employment because of the “wee beasties.”
     As I say, it took us ten visits to Scotland to become personally acquainted with the Scourge of Scotland.  When we next travel in the Highlands in Midge Season we will be better prepared with a good repellant, protective clothing, and as much anti-itch lotion as we can carry.