I never thought I’d dread a free foot massage…

…but I do now.   I just got back from physiotherapy, which I have twice a week.   I don’t do any walking in PT yet.  What these appointments consist of is the physical therapist pulling and pushing my big toe joint  in ways it doesn’t want to go yet.  I call it “the most painful foot massage ever”.

The pink is where I would like to move. The blue is where he thinks I should move. I found the screw on clip art. Not sure if my screws are that big or not but I imagine it to be.

Above is a diagram of it.   I figured I’d spare you an actual photo of my feet currently.  Not that they are doing bad….in fact, today marks the 8 week birthday of the new joints.  However, because of the modified way I am learning to walk, they have like 17 blisters apiece from where my tennis shoes rub them differently.   It’s not attractive.  You don’t want to see that on your Thursday morning while enjoying your coffee.

My physio is a Swiss guy and so we spend the half hour of torture talking about the differences in Swiss and American culture in a combination of English and French.  Things like:

-Mexican food – I talk about this a lot. So much so that every time I go, he asks me if I am making Mexican for dinner.  He thinks this is bizarre that we make Mexican.  I don’t think he has every had Mexican.  Or else never been ripped away from a favorite food group and implanted into a new culture who doesn’t have those products.  Or else he’d understand.

-Coca Cola – he asked me if I drink a lot of Coca-Cola since I am from America.  I told him that when I was a kid that I drank a 2 liter a day, but now I refrain from the stuff. I think that maybe I helped build this stereotype up about the US with that comment.

-The state of Kentucky and the fact that people there don’t eat Kentucky Fried Chicken but they did just win the basketball championship.

-Skiing differences between here and the US.

-American politics.  We talk a lot about the election. I find it remarkable that people from other cultures know so much about the US government and current events.  It inspires me to want to soak up knowledge and know more about others.

-How much Swiss stuff costs.  I think everyone agrees with this generalization.

-The different approaches to food in Europe vs. the US and how much Gabe and I appreciate the change of offering and are glad to pay more for better food.   For more on my opinion, read this previous post.

Since I have gained a bit more mobility through PT, I am expanding my exercise routine on the days I don’t have sessions.   Like by doing quasi-yoga.   I call it quasi because all I can do is downward dog and a little “walking the dog”.   But still, its progress!!

I have 5 more weeks until my bones heal and settle.  Here’s hoping for more patience with PT and increased flexibility until then!

 

Rolling….

Post by Lauren

Because of the limited mobility of my feet, it was much easier to ride in a wheelchair for the longer distances when traveling with Gabe’s family.  I have gotten permission to walk up to 30 minutes at a time (at a snails pace) but I am supposed to keep them elevated the rest of the day if I walk that much.  By riding in a chaise roulant (French for “wheelchair”), we didn’t have to stop and take 1000 breaks.  It is also easier for Mama Mia when doing long long days of tours and exploration to ride in the same style.

Hanging out in the courtyard of the hospital where Van Gogh lived / painted.

However, wheelchairs are not common in Europe.  Or so we are guessing by the stares we received while riding in them in the three countries we visited.   Not kidding that people would stop in their tracks and look.  For extended amounts of time.

In Zermatt, we guessed that maybe thought it had something to do with the thought of ski accidents since it is a huge winter sports town.  Maybe it scared them for what was ahead on the slopes the next day.   I joked with Gabe that if someone asked, I was going to tell them that it was a result of heli-skiing on the Matterhorn.

Attracting curiousity in Zermatt

In Milan, as Gabe pushed me along the streets of the fashion capital, we realized that this particular accessory also garnished a lot of looks.

In Nice, an 8 year old girl rollerbladed backwards for an entire minute so she could continue to gawk as we strolled/rolled down the Promenade d’Anglais.  I was worried she might collide and need one herself by the time the viewing was over.

I wonder why wheelchairs aren’t as common in Europe?   Maybe its the difficulty of cobblestones or lack of access to elevators & handicapped bathrooms due to older buildings?

Anyhow, just another culture difference we are learning about.

My new kicks

Post by Lauren

Check out my new shoes. My surgeon jokes they are my new Jean Paul Gaultiers. He thinks its funny but I know they cost just as much as a pair of Jean Paul Gaultiers* so the joke isn’t as funny to me.

New shoes!

I also get cannes anglaises. It means crutches. Sort of. They are different than the US kind**.

The shoes plus the crutches redistribute my weight, allowing me to walk very short distances by myself. They are little miracle workers, considering that I have 2+ inch incisions on the side of both feet. I’ll do you a favor and not post the image of those.

I can walk 5 minutes every hour. At the pace of a snail. What this means is that I have to be super efficient with what I do. I keep a little list at my side of what I am going to do the next time I can walk….eat, go to the bathroom, grab the remote that is out of my arms reach, etc.

The rest of the time I do this:

This is like 20 CHF of vegetables.

Everything is going awesome with recovery. We are lucky to have had so many caring friends come visit. More on that later this week!

*this is a famous fashion designer. Apparently more famous in Europe and with people with more income than us.

**A few years back, my friend broke her leg on ski vacation in Italy. I remember her mentioning only getting half a crutch when she was released in the hospital. The cannes anglaises type is actually the only option they have here in Europe. I don’t mind it at all and find it easier than the ones that go under your shoulder….at least with my condition of having two bum feet.

Gratitude Friday: The Swiss Pharmacy

Post by Lauren

One thing I am recently grateful for is the Swiss Pharmacy. I had a few prescriptions I had been dreading taking in. I was almost positive the interaction was going to go badly with my French skills.

However, it turned out to be one of my most pleasant experiences yet!

I walked in and presented my four prescriptions, including one for crutches (yes, you have to have a prescription to get crutches).

The guy took my prescriptions, typed it in the computer quickly and walked back and got them all out of separate drawers that the computer indicated. In less than 5 minutes. For four prescriptions and crutches! How awesome is that?

This particular pharmacy handed my prescriptions back with their stamp on them and a receipt. So, I have to bring it back in for refills. Not a big deal.

What else should you know?

–In Switzerland, you must have a prescription from a Swiss doctor to get medicine. You cannot use a prescription from a different country.

–You must file the claim with your insurance to get funds back, this isn’t taken out up-front.

–They do not keep your prescription on file in a computer for easy transfer on refills. They either give it back to you, or file your prescription and make a tick mark when you use one.

–If you are visiting or new here to Switzerland, you should note that grocery stores and convenience stores don’t sell OTC medicines like they do in the States. You have to go into a Swiss pharmacy. But don’t worry – there are a ton of them, one on every corner. When we first moved, our real estate agent jested that she had a client once assume the Swiss were more sick because of the presence of so many pharmacies. Not so; just a different system. Kinda like how you can by alcohol or beer at the grocery store in some US states and not others.

–There may be a Swiss Pharmacy on every corner, but they are not open after 6pm or on Sundays. You can always go to the airport pharmacy if you are in a bind!

–The Swiss pharmacy has over the counter meds as well as high end lotions like L’Occitane.

–This Swiss pharmacy doesn’t have all types of OTC medicines that Americans are used to. If you are an expat, bring 2 years worth of your favorite cold, tummy, and painkiller medicines. Sometimes when you are sick, its easier to just have what you know and like vs. navigate the best substitution in a foreign language.

 

Navigating International Insurance and The Swiss Clinique

Post by Lauren

In Switzerland, you don’t go to the hospital for planned procedures such as delivering a baby or foot surgeries. You go to a Clinique. No, not like the make-up counter. A Clinique is like a cross between a doctors office and a hospital. And then add in a little high end hotel.

In Switzerland, they are very cautious. They don’t take chances. So, I wasn’t surprised when my doctor indicated that I would need to come in the night before to spend the night at the Clinique. Nor was I surprised when I found out I would stay four nights there.

I had a bit of trouble trying to convince my US-based insurance of this.

These conversations took place over the course a week, but I have condensed it for you as well as deleted the multiple tear-sessions by yours truly that they induced:

“Hi. I need a guarantee of payment because the hospital either needs this or 20,000 swiss francs from me upfront*. I had been told that I should contact your agency to secure this documentation if a need ever arose.”

“Okay…we can help you. Please tell us what you are having done.”

“I have severe arthritis in my toes. I need a chilectomy and an osteotomy. This was supposed to be done in March, but my surgeon just fit me into a cancellation spot and the operation will be next week. Sorry for the short notice but I really need this quickly.”

“Okay we will work on this. No problem.”

(days pass)

“Hello. I want to check on the status of my guarantee of payment. My surgery is in four days.”

“Ma’am, these things take time. Likely another week before you will hear back.”

“But I don’t have time!!! I just got an appointment with a world renowned surgeon who just had a cancellation. My feet hurt…I am in pain…I have guests coming……I can’t wait until late Spring!”

“Wait, Ma’am. Why do your feet hurt? We have noted you were having a colon operation”.

(lots of resulting explanation occurs)

“We don’t understand….why do you have to stay in the hospital so many days? In the US, we see in our computer that this is outpatient”.

“I agree….but I live in Switzerland. If you have a baby here you stay in the Swiss Clinique 7 days while in the US its 48 hours. I am not going to get a surgeon to operate on me and release me. Since you specialize in international medical insurance, doesn’t the computer indicate this is different in certain countries?”

“You’ll have to get your surgeon to write us a letter saying why you have to spend the night. Maybe you can make an appointment with him to write the letter.”

“It took me 3 months to get my first appointment with him!! Plus his office is closed…. its “Ski Week”** in Switzerland! Every person in Switzerland is on vacation. There is no way he can get this done in the timeline.”

“You must. Or NO guarantee letter for you.”

(frantic calls and detective work to find doctors’ personal contact info. Many butchered French conversations and Google translated emails later, I contact the doctor over email and he agrees to do the paperwork and fax it on his vacation)

(call insurance company Friday to confirm they get his fax he sent the day before)

“Ma’am, it takes 48 hours for faxes to reach our computer system. You’ll have to get back to us in 48 business hours. Monday end of day, maybe.”

(2 more days)

“Hello. You are working on my case. You should have received the doctors letter by now. Just checking on the status.”

“Ma’am, be advised that your case is with the medical review committee. These things take 10-15 business days. Please check back then. ”

(Supposed to be admitted the next day. I loose my s&^% on the insurance company)

Later that day, I got my letter. Thank goodness.

And no wonder that the insurance questions it. Here is just a cross section of my meals while staying in the Swiss Clinique, all standard:

 

 

 

A dessert also came around at 2pm each day with coffee.  The cream was always steamed and piping hot.

Sparkling water is on demand. Oh, and I can’t forget the Swiss made pen we got as a gift:

Regarding forms and documentations, EVERYTHING, must be translated from French in order for me to understand and sign. All pre-op, insurance, and post-op instructions. Google Translate has really been a good friend of mine lately. I’ll no longer complain about having to fill out paperwork in my first language.

Speaking of French, communication at the Clinique has been a bit challenging. Of course, I do not expect that the staff know English at all since this is a French-speaking country. And I do study French regularly. However, in medical situations: explaining levels of pain, what is wrong, and interpreting post op instructions clearly, it can be a bit challenging.

The first time they were trying to teach me how to walk with my stabilizing boots and crutches to get to the bathroom, I couldn’t do it. We tried to communicate in my tres mal français where to put the weight so I could improve my technique. I kept misunderstanding, so it took a while to master.

I have been improving because my roommate is a Swiss woman in her mid-seventies who is very chatty. She told me I can come visit her at her house when I can walk and we can talk French again.

In summary, the medical care is FANTASTIC here. If you think you might undergo any type of procedure in Switzerland, just be prepared for battles with your insurance and a crash course in French translation.

*All doctors offices and visits require upfront payment in Switzerland. You then have to file the claim and track your reimbursement with your insurance. Believe me, it’s a ton of fun. Don’t blame them though…a smart business practice.

**Our friends had their baby in the same Clinique as me this same week (so nice to have visitors!). They were supposed to have a C-section on Monday, but BOTH their primary doctor and his back up were injured while skiing during Ski Week. They had to push their delivery up a day so that the 3rd doctor could fit it in, apparently the only one in the practice who wasn’t injured during Ski Week. And yes, they stayed 7 days in the Clinique as well with their newborn!

Gratitude Friday: New Bionic Toes

Post by Lauren

Today, I am grateful for my new bionic toes. Yesterday, I had a successful operation in which the surgeon performed two procedures on both of my big toes. The procedures are a osteotomy and chilectomy.

The purpose of the chilectomy was to remove the arthritis that has been causing me pain, restricting my sports activities, and literally cramping my style for the last 5 years….seriously, you should see how many cute pairs of shoes I have had to give away*.

During a chilectomy, they scrape the arthritis of the joint. Also, the surgeon drills into the toe joint to clean out the arthritis inside the bone. Kind of like getting a “filling” on your tooth. Except for the fact that they let the foot heal itself by developing scar tissue. The scare tissue isn’t as good as normal cartilage but better than the pain-causing arthritis.

The chilectomy isn’t guaranteed that the arthritis won’t reform in the future, so the osteotomy was done to help my odds at a preventing its re-growth. In the osteotomy, the surgeon takes out a wedge of bone in the toe joint near where the arthritis was bad. The goal is that this shifts my weight from where the arthritis damaged the cartilage to an area where there is healthier cartilage. On the right side, he ended up breaking an additional bone to supplement the osteotomy and to reconstruct the foot as my cartilage was entirely missing from the silly arthritis. He affixs his work with a screw in each foot.

If you are curious, you can YouTube the procedures. However, a word of warning….Gabe did this one day and says its gross.

The foot igloo

I am grateful for being able to have the opportunity for surgery. Although its not fun that I won’t be able to walk for 3 months, not everyone has the insurance and healthcare available where they live to address issues like this.

While I have long given up the idea of running again, I am just glad that this surgery will eventually make me pain free in day-to-day activity.

Bon weekend, everyone!

* If you don’t believe me, please look at the type of shoes I had to wear on my wedding day. Birkenstocks!!!

*Luckily, I have a dear friend who has my shoe size. She continually has to justify to her husband that she didn’t buy the 10 pairs of shoes that magically appear in her closet every few months…they were sent by Lauren, in waves of realization she’ll never wear them again

Gratitude Friday: My Health

This Friday, I want to dedicate this post to my health.

Just in general, I am thankful to feel good. I realize this is quite a special thing. I have no major health problems (except needing a really simple foot surgery) and I feel better than I have right now, than I have in a long time.

I also wanted to take this post to explain my rationale for why I feel better.

First of all, I have less stress here. I explain it to others that my stress is mainly short term. A bad day is not being able to communicate or having an issue buying snow chains. Those go away fast when I either laugh it off or have multiple glasses of wine. And while I enjoyed my full time job that I had in the States, it provided more “long term” stress, as most jobs do. So this major health affecter has lessened for the meantime until I start working again.

Second of all, I think a lot of it actually is rooted in food. My husband has been on this bandwagon for a long time, but this has taken me a long time to admit the cause/effect. I am now fully there. I just had to be forced to feel the difference in my body.

Here are a few reasons why I think my body feels better with the food here:

–In Europe, they don’t really eat processed food that has been manufactured for convenience, not for nutritional value.

–In Europe, they don’t have a lot of “shortcut” food like low fat and sugar substitute types. No diet ice cream here or fat free pastries here, folks. It’s the real deal.

–In Europe, genetic engineering of animals is illegal.

–In Europe, basically all the produce is organic by nature, they don’t use chemicals or alter the seeds in any way as is done in the States.

–In Europe, it is taboo to “eat on the go” or eat while walking, so it makes for more conscious meal enjoyment.

And its not just me. This topic has come up various times with friends here. One friend reported that she felt gross the entire time she visited the US for Christmas because her stomach had grown used to Switzerland’s foods and it couldn’t take the processed ingredients anymore. It was rejecting them. Another friend commented that she couldn’t cut the chicken into bits for a recipe at her mother’s house because the texture was so unlike the chicken she has become accustomed to here. Just this week, I met a lady who dropped 10 pounds in her first few weeks living here this Fall because of the positive change of the food.

If you are interested in learning more about this topic, I recommend two forms of media. The first is the book Food Matters, which I read with my book club. It encourages conscious food consumption to protect the environment. My two takeaways were:
–Buy things with less packaging
— Try to cut your meat intake in half to lesson the environmental impact that big business meat farming has. After reading the book, I did cut down my meat intake, using nuts and beans to replace half my protein. I didn’t really miss it.

Also, Gabe and I are big proponents of the movie Food, Inc which outlines the danger of the current systems of agriculture. It suggests that we are on a slippery slope; our concern with producing food at less cost for masses of people has altered the food in a way that makes it unhealthy. It suggests that government subsidizing of our food supply creates a few harmful scenarios.

–For example….beef and corn manufacturers lobby the government for subsidies and thus, beef and corn are more affordable in the US. Thus, a typical mid-range US family can’t afford fresh vegetables but can stock up on sodas, packaged foods and other things contained corn oil, etc that might not be a balanced diet, creating health issues. Many US families literally can’t afford to eat healthy.

–Also, in the case of meat, the demand for certain types of meat has encouraged genetic manipulation so that we are raising animals that meet the demand. One of the most disturbing scenes in Food, Inc. is one in which a chicken continually stumbles and falls over…all because he was designed for a breast bigger than he could manage.

 

 

 

However, even after seeing this 3 years ago, my coupon-cutting-self continued to scoop up only the large chicken breasts at the local Charlotte grocery store, as every 6 weeks, they were Buy 1, Get 2 Free. So I could get 3 huge packs of chicken for $9 USD total.

It’s only now that the cost equation has been taken out, as well as I am not given a choice – its forbidden to alter the meat production here – that am I now consistently eating “normal” food. Eight months later, I can feel an incredible difference. When we move back, I am going to certainly prioritize buying grass-fed, non-antibiotic meat items and organic vegetables.

Finally, the healthcare is very good here. It is very holistic in nature. I saw my first “general” doctor this week, in an attempt to solve the Cambodia food mystery. She spent an hour with me – asking every single question possible. Asking detailed family history. Information about every health issue I have ever had. Detailed questions about every part of it. It was like she had all day. But she was trying to get at the root instead of solve my surface issue.

My Swiss chiropractor does acupuncture before adjusting as a standard part of the visit. Also, he doesn’t require a pyramid of visits like my US guy did…simply just tells me to make an appointment when I hurt again. In the US, I had chiropractor appointments twice a week, acupuncture once a week and massage every three weeks to try to fix the chronic back pain that I carried – I was spending about $500/month in pain management.

In the last 8 months living in Switzerland, I have only had two visits to the chiropractor and one massage for back issues. I think its a combination of less stress & natural food that has been the remedy. Those who have seen me during my visits say that I look like a different person because of the lack of pain.

And we haven’t had a single cold here since our move. Those who know me well know that I always caught things so this is a big turnaround. This surprised me as well because of how often I am riding in public transportation, sharing air and touching buttons. However, I think its the stress and food that are helping to build my immunity.

Today’s post is not meant to be anti-US. These methods exist in the US, but they have become harder to find because of the effects of food and healthcare economics. I was lucky enough to discover it only by it being the default for us, so I just want to share my firsthand story with two encouragements:
1) If possible financially for you, don’t buy genetically engineered meat.
2) Seek doctors with holistic approaches. It can make a world of difference.

Bon weekend, everyone!