Category Archives: Healthcare

36 Hours and a Bionic Implant

I suppose it is time to talk about this.

Through last winter I (Ashley) was feeling very breathless, I put it down to the smoke and air pollution, used ventolin, it seemed to help a bit.  Then in late January when I was in the UK I started having chest pain.  I put it down to the severe cold and since the discomfort wasn’t particularly disabling and stopped if I rested I did not think too much of it.

Then once back in Selçuk I decided it was probably a good idea to go see my family doctor.  Things happened fast.  An ECG was done, she was worried about it so an ambulance was called to take me to the local hospital.  They did more tests and another ECG.  This resulted in another ambulance and then being blue-lighted to Medical Park, a big private hospital in Izmir.  They did some more tests, wired me up for monitoring, filled me up with some pills, and scheduled an angiogram and potential angioplasty for the following day.  I’m not sure what all the pills were but they made me drowsy so I don’t remember a great deal.  I Know Hilary was there, I know lots of forms were signed, I know some bits were explained to me, and there are some gaps.

Next day after more sedation I get taken in for the angiogram, during which they followed up with an angioplasty fitting one stent.  This was followed by a few hours in a Cardiac ICU before later that evening being moved back out to a more regular ward.  This was good, I did not like ICU, though to be honest I slept through some of it.  At least on the regular ward Hilary was able to be present so I had some company and the sedation had worn off.

The following morning I got to see the cardiologist again, was told that one artery was 90% blocked, that a medicated stent has been fitted, that there are some other arteries with a  bit of build up but nothing to worry about.  I was told to lose weight, watch diet, put on a regime of pills, clopidogrel, aspirin and a statin, and sent home.  They said to rest for 24 hours and then return to normal activity, and obviously if there were any problems to go straight back, and with planned follow up in one month.

I spent 36 hours in a modern and swish private hospital, with state of the art equipment and everything that could be expected in terms of care, a major physical intervention, and time in ICU.  The cost to me, zero, all picked up by the Turkish state health insurance I pay.  The care was generally fantastic, though to be honest these days it all runs through clinical pathways.  The doctors did what they needed to do and seemed extraordinarily competent.  The nurses do less than they do in the UK, here family or friends are expected to attend to basic stuff, what they did do they did efficiently and by the book.  It’s tick box nursing, but at least they followed the protocols and if there was reason to escalate they did so.   It was my first (and hopefully my last) major encounter with health care here in Turkey, all I can say is the standard of care was fantastic and as said all picked up by state health insurance.

I’ve lost weight since then, 5 kilos or so, something which needed to happen.  The cholesterol is down and where it needs to be.  Lifestyle changes have been made.  Clopidogrel is a pain in the proverbial, if I cut myself I bleed more, but I’ll be on it for a while.  I’m now on follow up every three months and the doctors are very happy with my progress.   So all good, onwards and upwards to new things in life.

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Three countries in a week

Greek-visiting-dog

 

We had a busy week after we got home from the Greek trip on which we lost the camera. Hilary had some health check ups at the State Hospital in Kuşadası and we sent off for her residence permit (ours expire in different months due to a complex set of circumstances which involved an official thinking he was doing us a favour rather than making our lives more complicated). Actually getting a residence permit here in Turkey is a great deal easier than it used to be. It can all be done online and through the post and we now both have permits for two years – so no more of that hassle till 2019!

We then headed to London for a flying visit to family. Really only a long weekend but it was good to see them. Home for one day (just enough time to throw the clothes in the washing machine) then we were back to Lesvos. The very nice lady who was selling us the house had arranged to be out for a week so that we could visit the noter together and do all the legal stuff. It all went very smoothly and our estate agent took us all out for a very fine lunch to celebrate.

Next day we got the water and electricity put into our names. Then we moved into the house. The day after that we opened a bank account and got a mobile phone. Though, actually, the bank account was not properly opened as according to Greek law, you have to put 10K euro into an account to fully open it and that could not be arranged until we got back to Turkey.

We spent most of August at home. Both of our residence permits were safely delivered. Ashley updated his Turkish driving licence to the new format (an incredibly easy process). The guy in the Emniyet who told us what we needed to do didn’t know the url for making an appointment and advised us to Goggle for it. We now goggle for everything!  He also gave us a slip of paper which listed all the paperwork we needed.  Two new photos, a medical report from the family doctor, receipts for two payments from a government bank (the two payments totaled around 15 lira which is less than a fiver sterling) and his existing Turkish licence.  We have a new family doctor surgery here in Selçuk so we took the opportunity to visit her.  No one else was there and she and her assistants were very pleasant.  Because Ashley wears glasses, he also had to go to the ophthalmologist in the state hospital here and get a vision report.  We took all those things back to the Emniyet at the appointed time and, four days later, got a text message asking us to go back to the Emniyet and pick up the license.

What with the lost camera etc. this is not really a very photogenic post.  The picture at the top shows the dog who frequently visits us in the Lesbian House!

Catch 22

A couple of weeks ago we went off to Izmir with a load of documents all in a nice pink file to renew our residence permits. Beforehand we had researched what was needed, most of which we had to hand or could scan at home. What was left was some sort of proof of health insurance. We have GSS, the state health insurance which is managed from the SGK office. We knew it was a bit of a catch 22, health insurance is needed in order to apply for a residence permit and a residence permit is needed to have the state health insurance. We were wondering if or when this might trip us up.

Anyway, we went to the SGK office and explained we needed proof of health insurance for our applications for a residence permit. They printed off some papers, stamped them, signed them and handed them to us. We put these in our pink files and dutifully headed for Izmir. In Izmir, we took a ticket and waited in line. Just as it was about to be our turn, the office closed for lunch. But we were told to keep our number. When the office re-opened we were first to be seen and, after a bit more running round paying fees and getting the receipts copied (an enterprising gentleman has set up a tea stall and photocopy service in the grounds) it was all done and paid for. Three hours from start to finish (including the one hour lunch break). We have proof that we have applied to extend our residency and all we need do now is wait for the new permits to arrive in the post, probably according to the police in Izmir in a month or two.

Then a week before official date of expiry of our existing residence permits, we headed to the local GSK office to renew our GSS. We were told it could not be done, that we cannot be entered onto the system until we have the new residence permits. This prompted a lot of running around before we established this was actually the case, that until the new residence permits arrive we cannot renew our GSS. This is because we can’t be reinstated on the system until we have the new permit number (our kimlik numbers, which will remain the same, are not sufficient).

Of course we still need to pay the GSS premium every month, despite not being able to claim on it, and right now we are left with no health insurance. It is rumoured that should we need hospital care we can claim the cost back when we can complete the GSS renewal, but this is rumour and it is not something we want to test. It is all a bit frustrating.

We have now got ourselves some accident cover so if one of us falls and breaks a leg it is covered. If we have an accident on the bike we are covered for injuries. It also covers breakdowns, accidental damage at home and some other bits, and given how little it cost was a pretty good deal.

Next year we will start it all earlier. Residence permits can be applied for up to 60 days in advance. Long enough normally for the new ones to arrive before the GSS needs to be renewed – well in theory. It is slightly more complex for us and with a tighter time frame because Ashley’s residence permit expires a month later than Hilary’s and despite Hilary being on Ashley’s GSS policy her cover expires when her residence permit expires. So we only have 30 days to play with, which we are hoping will be sufficient. The system is still new – it only came into force in April and, at some point, new offices will be set up so that applications will not have to be sent to Ankara to be processed. Perhaps that will be in place in time for next year, perhaps not…

Little Surprises in Life

Today Ashley started the process of getting new glasses since his old ones are more than two years old and we were pretty certain the  prescription had changed.  We went with staff from the Optician in Kuşadası to a local hospital for an eye test, and learnt that for some unknown reason our GSS (Health Insurance) was no longer in place.

We paid for the eye examination (at 100 lira it was not unreasonable).  It should have cost a lot less, but had we cancelled, gone to Tire to sort the insurance out, then back to Kuşadası, all the running around would have significantly eaten into any savings.

Back at the opticians we ordered the lenses, varifocal, transition, with anti-glare coating and scratch protection, at a very reasonable price.  They will be fitted, into Ashley’s existing Flexon frames, and should be ready for collection on Friday afternoon.  As part of the general customer service Ashley had his current lenses fitted into older frames, Hilary had hers adjusted and çay was provided.

Then since we were in Kuşadası  and it was approaching lunch time we went for balık ekmek in the much improved square near the fish market.  It was, as always, cheap and delicious.  We did look into the fish market just in case there might be some tuna or swordfish – unfortunately no such luck.  We did learn that the restaurant / locanta next to the fish market will cook fish bought by customers on the market.  There was a good deal of trade in giant prawns, selling and cooking.  Ashley may give this a try at some point.

We’d gone on the dolmuş in case the eye exam involved something that would make riding unwise but, once we got home with a few bits of shopping we hopped on the bike and went to the SGK office in Tire (about 35 km up the road in the opposite direction from Kuşadası).  Which was fun and games as it is market day in Tire and, of course, we couldn’t resist a couple of purchases.  Anyway, the people in the office were as puzzled as we were about why our insurance was suddenly stopped.  They checked our documents, took some photocopies, filled out a form, and  they reinstated it…

With all the issues we have had with GSS we will be checking in the pharmacy that we are both properly on the system, but they definitely did something, as we have now been able to pay our current premium.

I can see clearly now… (but it is still raining)

Feb-13-aAbout a week ago, Hilary fell over in the Artemis Temple and scratched her glasses.  She also sustained some nasty bruises but those have gone now…  The scratches were too deep to polish out and, whilst they had no drastic effects upon her vision, Hilary was due for an eye test anyway.  So we decided to get her new glasses, involving a new eye test and a new prescription.

On Monday we went to Kuşadası to visit Lara Optik.  They are highly recommended on the Kuşadası forum.  Our confidence in the place was further boosted when a friend walked in at the same time as us.  Necdet was very helpful and very personable.  He arranged an appointment at Ada Göz, a private eye hospital which offers a hefty discount for people with GSS – the Government Health Insurance scheme in which we are enrolled.

not-a-cruise-shopWe had an hour or so to spare so we went for tea at Guvercin garden, the Belediye run tea garden right on the waterfront.  No cruiseships this time of year though the harbour was not exactly empty…  It seems the US navy were in town although we did not see any sailors.

After tea one of the guys from Lara Optik gave us a lift to the Eye Hospital, whereupon we discovered that Hilary was not registered for GSS.  Ashley was registered and Hilary should have been registered as his dependent…  We ended up payıng for her eye test.  120 lira.  Not unreasonable but somewhat annoying.  For that she not only got an eye test and glasses prescription but examination, treatment and eye drop prescription for some irritation she’s been suffering recently.

Back to the optician for a discussion of options.  Hilary chose some frames and expensive varifocal lenses    All in all about what the same as the equivalent would have cost in the UK.

The next day we went to sort out the Health Insurance problem.  Not being on the system was worrying.  This involved a trip to Tire on the dolmuş.  It was market day so things were hectic.  Ashley remembered the way to the SGK office where, after we explained what we wanted, the security guy issued us with a numbered ticket.  We waited about half an hour then explained to the memur that Ashley was on the system but Hilary was not (we had taken along our translated and notarised marriage certificate, though they already have a copy of that).  At first we were told it was because we had not got the paperwork from the nüfus office in Selçuk.   We explained that we had delivered that back in September.  Then the memur who originally dealt with us came over, showed the other guy how to put Hilary on the system, put her on the system and told us that she would be on the system should we return to the hospital straight away.

new-glassesToday we went back to Lara Optik in Kuşadası to collect Hilary’s glasses.  They are purple and, she thinks, quite becoming.  As they are varifocals it will take a while to get used to them but she already notices a big improvement for reading, sewing and using the computer.  And hopefully (inşallah) in future seeing her feet and the corresponding part of the ground at the same tıme.

Yeni Dişlerim

It has been a traumatic few weeks, but finally the dentistry is all finished. Originally I had planned to have it all done in the UK before we moved to Turkey but it never happened. I had some work done in the UK, the longer term vision was to do crowns and bridges, and maybe the odd implant.

We had explored the matter a little last year when a crown fell off, saw a dentist in Kuşadası who wanted to replace everything with implants. We think he was pretty much working in medical tourism, medicine including dentistry is relatively inexpensive here. His quote was in our view extremely expensive, the work not entirely necessary, and to a point cosmetic. In the end we opted at that time to just have the one tooth fixed at a local dentist in Selçuk recommended by a friend. We wanted more time to think about options and at that time I was still entitled to NHS care.

The dentist I saw in Selçuk did a really good and pain free job so when almost a year later the crown became loose again I went back to him. It turned out that the tooth beneath the loose crown was broken so the crown could not be replaced and the broken tooth needed to be removed – not a pleasant experience. We discussed options for further treatment, we explained that back in the UK there was a plan to do a load of crowns and bridges, and talked about having it done here. We explained that we did not want a denture plate and equally did not want implants. Initially he was sceptical about the crown and bridge plan, but he agreed to look into it. He took us to another dentist in Kuşadası, who took x-rays, and was able to confirm that it was possible to go ahead with what we wanted.
After the quote last year in Kuşadası which started in excess of 500 Euro per implant and went up, and he wanted to replace 30 or so teeth, (do the math), we were a bit worried about the cost. We knew that bridges and crowns would be less than implants, but we were pleasantly surprised when we were quoted 4,000 lira for the whole job. Not inexpensive but roughly speaking a tenth of the starting price of the earlier quote.

We will spare the full grisly details. A couple of teeth needed to be removed, he corrected some work badly done in the UK including root canal stuff, and then started on the crowns and bridges. This involved multiple appointments, lots of grinding down of teeth, and follow up fitting sessions. The top first and then when done, the bottom. Today, after more than a month of dentistry, the work was finished. The dentist has done a wonderful job, no complaints at all about the work or the care he took to avoid pain, he was fantastic.

So now I have new teeth and Hilary says a new smile.

Health Insurance – Part 2 – the saga continues

There has been some talk for the last couple of years about Turkey introducing compulsory state health insurance.  We have been keeping an eye on developments, at times it seemed we would be allowed to join, at times it appeared not, at times there were rumours it would be compulsory.  From our perspective it seemed a fairly good scheme one that we would be willing to join as and when we either could or had to.

Because it was unclear whether we could join or not and we were both aware that we need health insurance of some sort we took out a local private scheme.  We knew that we may end up being doubly insured and that we may at a future point leave the private scheme.  We may well keep the private scheme anyway since it gives health insurance when travelling outside of Turkey and now that we are living here we are not, when visiting the UK, really entitled to NHS outside of emergency care.

More recently matters came to a head, with as usual a great deal of uncertainty and confusion, and in various discussion places a great deal of rhetoric.  We were about to get copies made of various documents and shove them into a file with various other notarised and translated documents, and head off to the SGK office in Tire.  The plan being to attempt to join and see what happened.

Now it (quoting the words of the British Embassy in Ankara) appears we do not have to.  The Embassy has given guidance that it appears that once a non-Turkish resident completes one year of residence in Turkey, they must apply to join the scheme.  We note the word appears with interest, but for now are going to take it at face value and at the same time continue to monitor for future developments.