No Country For Sandals

This blog is becoming a little prophetic. I write about wanting a dog and get a dog. I write about encountering snakes and then, guess what, I have a much too close-for-comfort encounter with a copperhead.

Let me explain…

Monday 30th June, Jerry and I decide to go out on ‘date night’ (I love this expression, it seems so quaint, like a hangover from the 50s). In honour of the evening, I get smartened up in a dress, leggings and wedge sandals. We put Marley in her outdoor dog pen for a few hours and head off to the cinema. As soon as we get home, after dark, I head to the dog pen to release the hound.

I flick on the porch light and see Marley sitting patiently by the pen door, head cocked to one side, big brown eyes begging me to let her out. As per usual, as soon as the door is open wide enough for her to squeeze by, she pushes past me to freedom, knocking a plastic porch table into my path as she does so.

As I kick the table back into place…wham! I feel a sharp pain in my foot. First thought: it’s a wasp. Second thought, as the pain gets worse: it’s a scorpion. I reach down to brush off whatever was on my foot and see the head and a few inches of body of a snake hiding under the table. I know instantly it is a copperhead and this isn’t a good thing.

Leaving Marley to fend for herself, I run into the house screaming: “Jerry, I’ve been bitten by a snake.” He is out by the car and all I hear back is, “Oh no.” But it’s the kind of ‘oh no’ that makes me realise this is a big deal. Jerry is unflappable usually – very sanguine, doesn’t panic. I can tell by his tone that this is something to be concerned about.

The next few minutes is a bit of a blur: I run upstairs to take some Benadryl as I had heard of someone locally doing the same thing when they were bitten. [Medical advice says don’t take any medication by the way – wait for the hospital to give it to you.] As I knock back the antihistamine I hear a loud bang: Jerry has shot the snake which had wedged itself just under the siding of the house.

Crackshot Carr took revenge on the copperhead.

As he comes in the house with the dead snake in a bucket he seems me up on my feet and orders me to sit down and stay still. [Medical advice also says stay calm and still to stop the venom for circulating around your body.] He asks me to contact our friend Bobby who is an outdoorsy kind of guy and works for Texas Parks and Wildlife. If anyone is going to positively identify the snake, it will be him. Only one problem – my iphone is broken and I don’t have his number written down. So I Facebook message his wife Angie: “Is Bobby still up? I just got bitten by a snake and jerry wants me to come over with him for Bobby to take a look. Jerry killed the snake.”

While we wait for a reply, Jerry looks in his Texas Book of Snakes for a copperhead. I then remember I had downloaded a poster once that identified all the venomous snakes in Texas (may have been a little paranoid at the time but it paid off!). That poster also advised to call Poison Control, so I do.

It’s 10.30 at night and I speak to the operator in my best British accent. “Hi, I’ve just been bitten by a copperhead and I wondered what I should do?” There’s a fraction of a pause of incredulous silence followed by a lady telling me, in no uncertain terms, that I should get to a hospital…

I am still protesting as Jerry loads me into the car. My foot is a little swollen where it bit me but no more so then when I scratch a mosquito bite. And yes it hurts but no more so than a wasp sting. As we drive to St Mark’s, our local emergency room, all I can think of is the hospital bill. I have medical insurance but even so. All those horror stories I have heard from people who have run up huge bills after being given expensive anti-venom…

By the time we get to the hospital my foot is too sore to walk on so I hop through the doors. There’s no-one at reception to check me in. I wait a few minutes, cough politely to get someone’s attention, but nothing. I am just about to start getting agitated and shout for someone when a lady sitting in the waiting room shows me where the button is to call for help. Then Jerry arrives after parking the car. He deals with the paperwork while I show the granddaughter of the lady in the waiting room my snake bite. I am a little hysterical by this point, I think. Hyper, laughing at things and generally finding it all quite amusing. Funny how the body reacts.

After filling in the necessary paperwork I hop to a bed and a couple of nurses start working on me, checking blood pressure, fitting heart monitors and inserting an IV. I am impressed when I look down and see four vials of my blood sitting on my bed: I didn’t even feel it being drawn by the expert nurse.

Then it’s a game of hurry up and wait. Angie arrives, having seen my message, (what a special friend, to come out in the middle of the night!) and she and Jerry keep me occupied with jokes and chatter. Angie takes photos of my foot to send to her husband, and laughs when I say I guess I won’t be in work the next day. She also keeps a watchful eye on me. Every now and again, as I wince in pain or can’t quite catch my breath, I see her staring at me, ready to grab a nurse at any moment.

Angie photographs my foot for posterity.

I don’t know how long it took but in the end I cave in and asked for some pain medication, as well as something for the nausea. Whatever it was they shot in my arm, it felt like I had drunk a bottle of whisky. I can’t see straight and the room starts to spin. I close my eyes and listen to my husband and my friend just chatting away. It was a comforting sound.

Once I start to drift off, Angie leaves and Jerry starts to drop off in the chair. I send him home to check on Marley, who we had left inside in a bit of a hurry, and I slip again into a woozy doze. About 3am the doctor comes to check on my foot which has started to bruise and swell. My toes are numb and I can’t move them at all. But he seems reassured I am not going to have an allergic reaction and discharges me as soon as Jerry returns, with orders to rest, keep the leg elevated and with a prescription for pain killers.

Five days later, I am no longer in agonizing pain but my foot is still too swollen to walk on. I am getting about the house through a combination of hopping, hobbling on crutches and shuffling up and down stairs on my bum. The swelling has spread to my knee; my foot and leg are a delicate shade of yellow. But it could have been worse. No anti-venom required; no hospital admittance necessary. My friends have rallied round, bringing cooked dinners and cake and generally being wonderful. My family are offering lots of support via regular emails and my husband is being extraordinary by fetching, carrying, putting a chair in the bath so I can take a shower sitting down and generally just being fab.

And me? Well, after passing the first couple of days in a codeine blur, I am off the pain killers and now am having to find things to occupy my mind while my body gets back on its feet. Hence the rather long blog.

I have also been shopping online for snake-proof boots. Believe me, that’s the last time I step outside on our property in a pair of open-toed shoes. As my sister so wittily puts it, this is no country for sandals.

Healthy options

One thing I wanted to avoid when writing this blog was to constantly make ‘ours is better than yours’ comparisons between what I am used to in the UK and what I see and experience over here in Texas. I think it’s important to understand the background and the culture, and the politics, that influence these differences before any judgements can be mind. So just bear that in mind when you read what I have to say about something I’ve just experienced – my first taste of the US healthcare system.

Recently, I accompanied a friend to an appointment at an orthopaedic clinic in Texas. The clinic was in the same building as a large hospital, right in the heart of a major city. The first thing I was impressed by was the valet parking. We just swept up to the front entrance, handed over $11 dollars and the car keys and walked into the main reception area at the hospital. At the nearest large hospital to my parents’ home in Wales, also in the centre of a large city, the car park is about the size of a handkerchief, car parking spaces fill up so quickly that you have to get there first thing in the morning to bag one, and there is no valet parking. Instead, my parents catch a bus from their village to the main bus station in the town, then catch a free shuttle-bus service to the hospital. This is all well and good when it’s not cold and wet and you can walk quickly. But at least the service is ‘free’ ie paid for by the local council, from the local taxes.

Back in Texas, having dropped off the car, we went into a large waiting room, stood in line next to people with gruesome-looking contraptions of pins and frames sticking out of their legs, filled in yet more paperwork (much of which duplicated the information we’d already completed online) and then took a seat and waited. So far, so similar to my UK experiences. Next stop was the consultation. Here, we sat in a small but pristine white examination room and waited for the surgeon to arrive. He waltzed in a few minutes later with a pretty blond assistant wielding a laptop. He talked and listened to my friend and prodded at her a little while the assistant tapped away at the keyboard. How very modern, I thought! After perhaps 20 minutes, the patient and surgeon concluded that an operation was required – a partial joint replacement – and then the surgeon left, explaining that his assistant would fix up an appointment for the surgery. The next few moments took my breath away. The next available appointment for the surgery was… 6 days away! I think I must have done one of those cartoon double takes because I remember my head swivelling from friend to physician’s assistant about a dozen times! How long? Next week? Even my friend was surprised at how soon she could be under the knife! Back in the UK, my dad needed a knee replacement and waited five months just for the MRI scan which he would need before he could have the consultation with the surgeon. (In the end, he went to France for the scan). All told, he waited about 18 months for a knee replacement, during which time he was using walking sticks to get around and could barely manage the stairs.

Back in Texas: after recovering slightly from the shock, I accompanied my friend to another part of the building to have her pre-admittance check where nurses took blood samples in advance of surgery. We sat in another waiting room, and this time the experience was more familiar. We waited, and waited, and waited. Eventually I went to check on the situation and was told the paperwork from the consultant hadn’t yet arrived. Thirty minutes later, the receptionist actually went downstairs to the surgeon’s office to collect the paperwork. I was impressed. Ask a clerk to do that at our local hospital in Wales and you’d get little more than a withering look and a ‘not in my job description’ response. Thirty minutes after that, my friend completed yet MORE forms (all dupes of the previous information) and then about thirty minutes later she was seen. All the Americans waiting in the room were complaining about the wait. I just thought it was normal! I’m used to waiting that long to see my local GP (doctor) let alone to have someone actually take blood samples and the like.

When my friend came out of the appointment, she told me the physician’s assistant had incorrectly marked her paperwork – it said the operation would be on her right limb instead of her left. So much for laptops in the consulting room then! Human error can creep in whether you are typing or writing. (My dad experienced a similar problem in Wales once, this time just hours before he was due to go into theatre, when the surgeon came to see him and started prodding at the wrong leg. Dad said he wanted to draw an arrow on his leg in the end, and write “cut here” just to be sure.)

The last leg of the Texas journey provided the most obvious difference between my UK and US hospital experiences: before you could leave, you had to queue to pay. My friend’s insurance would cover most of the cost but she did have to pay a ‘deductible’ ie a contribution to the charge. When she handed over her credit card to pay the fee, it brought home to me that this is a very different system to the one I am used to.

Ah yes, the NHS… I watched the Olympic opening ceremony in London recently, thanks to the kind invite from my friend Angie to come over and watch it at her house. When “NHS” was spelled out in large letters in the middle of the stadium, I laughed out loud with amusement. I live in the middle of anti-Obamacare-land. When people describe the NHS to me they call it ‘socialised medicine’ which makes it sound like something sinister from Orwell’s “1984”.

Of course, this prompted a discussion about why Danny Boyle would honour the NHS in such a way. Well, he was pointing out great landmarks in British history and the formation of the NHS in 1948 was a great achievement. I still believe in the principle of the NHS, which is to provide ‘free at the point of service’ healthcare to everyone. The modern-day system has its problems: the waiting lists are long; the treatment you can expect varies depending on where you live in the country and there’s far too much management and red tape tying up the place. But the idea that everyone in our little island can get to see a doctor if they need to (and they’ll see them a lot faster if it’s urgent and life-threatening) without having to worry about how they are going to pay the bill at the end of it all, is one worth preserving, and definitely worth improving.

Nonetheless, I am not making any judgements on the US healthcare system just yet. Thankfully I have not had to use it so far so until I have more experience of it, I am not going to criticise or praise. From the second-hand experience I have had of it, though, I was perversely reassured that, even though this hospital was award-winning for the quality of its care, it was still as bogged down in paperwork and liable to human error as the good old NHS.