Bronchitis

Taylor looking fine the day before yesterday

I had a bit of a scare this evening. Taylor was lying down (crouching, not flopped out on his side) and breathing very strangely.

The noise was so loud and so unlike him that it took me a while to track it down. Then he lay down completely and his eyes glazed over and started to close.

I grabbed the phone and rang our local vet. He doesn’t have a surgery but makes housecalls instead, which can be very handy. I said I thought it could be serious and he asked me if Taylor was lying down. I said yes and he said in that case he would rush over. He arrived 25 minutes later.

What he didn’t tell me till afterwards was that he’d wondered whether Taylor might have been bitten by a viper, as it’s very much the season for them.

Anyway, he put his stethoscope to Taylor’s chest, took his temperature (he had a fever), and asked me a few questions. The diagnosis was bronchitis that might have developed into pneumonia, and the treatment – antibiotics.

I was relieved because, despite not having thought of snakebite, I’d imagined a lot worse.

Vescia again

This morning we managed to change doctors in Valtopina ASL, quite painlessly, and went to the surgery in Vescia for a second time.

On the right: entrance to the Vescia surgery

The timing was perfect in one sense because late last night Clive discovered a lump under his left arm. He was able to get the doctor to examine it and she confirmed his fears that the lymph node was swollen.

She prescribed a strong antibiotic and a special cream, and told us to come back in a week’s time to see if it has reduced in size.

She also took names and phone numbers of the various characters involved in the lymphedema treatment and E112 saga, saying that she will phone them when she has a moment.

We’re very worried about the swollen lymph node because it can spell all kinds of trouble, but at least we don’t feel quite so alone any more.

New doctor

We’ve found a doctor who can’t fail to be an improvement on our last one and also the one that was recommended to us.

Unlike Britain, where doctors operate in Practices and there’s a danger of running into the one you’ve just moved from unless you change Practice as well, in Italy doctors are separate entities.

Sometimes they club together and share relatively modern and well-appointed premises, but usually the surgery (‘ambulatorio’) is in some nook or corner of an old building in the historic centre. Access is often up difficult stairs or across pedestrian-only cobbled courtyards, and there are no signs to guide you on your first visit. You have to ask a passerby, who almost invariably will ‘know’.

This new doctor has 2 surgeries, one in Foligno and the other in Vescia. Vescia is the nearest.

We went to see her yesterday evening, for a pilot visit before we make the official change. There’s no appointment system in Italy: you just turn up within surgery hours – or an hour before if you fancy a gossip - and it’s first come, first served.

When it was our turn, we found her engrossed in a telephone call. She must have taken 3 or 4 more calls during our session, and each time she knew the name of the caller and their precise requirements without looking them up, as well as remembering exactly where she’d got to with us before the interruption. (Doctors in Italy are accessible at most times of the day on their mobile phones.)

It was freezing cold: the heating wasn’t working, she explained from the depths of her fur coat.

As a woman, I do generally prefer a female doctor, and Clive isn’t bothered either way. Vescia was the nearest possibility. So far I feel very optimistic; she’s already inspired me with confidence.

Of cherries and fairy lights

I often say that the best thing about our doctor is his cherry trees.

Our very few cherries

Unlike our trees with their miserable half-dozen bird-pecked specimens, his trees fair drip with fruit, like something out of a painting of paradise.

Maybe his are a different variety to ours, or maybe they’re sour.

Of course this time of year there’s nothing going on with his cherry trees, plus it was dark when we went to his home surgery this evening. There were fairy lights all round the porch.

He had the usual words of cheer to deliver:-

“There’s nothing to be done for arthritis. It  never gets better; only worse.”

“Do you realise how much these pills are costing the National Health Service?”

Ever since we started going to see him, there’s been a frond of shrivelled leaves draped over one of his pictures. This evening I made conversation.

“Is that an olive branch?”

“Yes. It’s been there for a long time.”

“For peace?” I asked innocently.

“There’s not much peace around here,” he said.

Nor much good will toward men, I dare say, either.

Staples

The District Nurse (or Italian equivalent) visits Valtopina once a week on a Thursday.

The staples on Clive's wound near the base of his spine

Being a Thursday and also a week after Clive’s operation which is when the surgeon said his staples could come out, I thought I would ask her to remove them.

I phoned up. She told me that they don’t have ‘the material’ to do this in Valtopina, but we can go to the clinic in Nocera Umbra, a large town in the opposite direction from the city of Foligno. 

And do we have a chitty from the doctor asking for Clive’s staples to be removed? Otherwise it can’t be done.

Sigh.

I phoned up the Chief Nurse (a man) in Nocera Umbra to check the clinic’s hours and told him the name of our doctor. We attend the surgery in his home in Nocera Scalo, a very small place where the main (if not only) landmark is a railway station, but he also has a surgery in Nocera Umbra where the clinic is.

“No problem at all!” exclaimed the Chief Nurse. “Just phone him and he can drop off the chitty direct to us this morning so that everything’s sorted for when you come.”

This story illustrates very well how things so often work in Italy. Rigid bureaucracy is mitigated by a network of human contact and little shortcuts are found through the system without actually contravening it.