Man is an animal suspended in webs of significance that he himself has spun...

Thursday, June 7, 2012

The Adventure Thus Far

Been sticking very close to the Flophouse recently.  In fact, I was pretty much confined to the couch after having spent the better part of Tuesday morning at the hospital being fitted for my very own "chambre implantable" model Celsite ST215 by B. Braun.  This is a handy little device that was inserted in my upper chest on the left side by the pros at the hospital René Huguenin in St. Cloud. Its purpose is to be the conduit through which I will be receiving doses of chemotherapy - first session this afternoon.

The story of how I went from looking for a job (and I'd like to think being very close to getting one) to being a regular at one of Paris' best cancer treatment centers is probably old hat to anyone who has traveled down this road but I'll give you a short recap anyway.

It all started with my family doctor in Versailles.  I was, as they say, healthy as a horse (never sick, walked at least an hour a day, lifted weights, followed a low-fat diet devoid of baguettes) but I had nevertheless felt something that I thought was bothersome enough to bring to his attention.  The consultation was short and we both agreed that it was probably nothing.  But just to be sure he sent me over to a radiology clinic where "nothing" turned out to be "something" that was interesting enough to get me an appointment tout de suite at the Institut Curie/Centre Rene Huguenin in St. Cloud, a community on the outskirts of Paris.

There was never a doubt that it was cancer - the question was what kind, how far it had progressed and what would be the most appropriate treatment.  The discovery process took a few short weeks where I underwent a series of tests that included ultrasounds, blood tests, biopsies and a full PET scan.   In relatively short order the verdict was in.  The good news was that the cancer had not yet spread elsewhere.  The bad news was that what was there was not to be trifled with:  stage II breast cancer which had spread into the lymph nodes on one side.

Once my family doctor (my "medecin traitant") had the diagnosis in hand he prepared my application for what is called ALD (Affection de Longue Durée).  Let me explain.  When I was unemployed I was still covered under the national healthcare program and this coverage continues as long as I am jobless and even for some months after my unemployment runs out.  This coverage is not however 100% - there are co-pays for which we were fortunate enough to have private insurance through my spouse's employer.

When a serious illness strikes, an application has to be submitted for full coverage (the famous ALD) to the local Security Office where it is examined by a government doctor who then grants (or not) access.  It can take some time for the paperwork to be processed and, on the advice of my doctor, I submitted my application in person. At the very same time I went on what is known as "arrêt de travail pour maladie" which means that my unemployment is suspended for the time I am ill, Social Security will pay a small daily stipend in the meantime, and my unemployment will be waiting for me once I'm well enough to start looking for work again.

I went in for surgery in early May.  It went very well.  The hospital was not fancy but it was bright and cheery.  I had a room that was set up for two but a second person never arrived so essentially I had a private room.  The food was pretty good too -  tasty bread and an outstanding "potage" (soup).  There was even a "goûter" (snack) every day at around 4:00:  tea and madeleines.  The staff was just amazing.  I think I will remember for the rest of my days the cheerful guy in the bright surgical cap who wheeled me into the operating room and the surgeon who simply stood over me and patted my arm gently as I went under.

I was in for under a week and was then sent home under something called HAD (l'hospitalisation à domicile) which mean that a nurse came every single day to my home to check my vitals and my scars. While I was healing I received the letter from Social Security office granting me the ALD 100% coverage which means that from now on there will be no bills.  All I have to do is present my national healthcare card (Carte Vitale) and it's all taken care of.

For years my worst nightmare was becoming seriously ill in my host country, France.  Not because I lacked faith in the healthcare system but because I was thousands of miles away from what was once most familiar to me.  To my surprise and relief, this experience is not turning out to be a "cauchemar."  The care I am getting is not only very competent but compassionate as well and the center's procedures are carried out with amazing efficiency.  I am also blessed with a good network here of friends, family and former colleagues. And thank goodness I speak the language so I can speak directly to my caregivers without having to draft my children or spouse into translating.

So let's just call this an adventure. One that I share with a surprising number of old and new friends.  Just one more way of connecting with others and making one's world ever wider.  Granted there are probably easier and more agreeable ways to do this but, hey, you take what you can get.  Carpe diem, my friends, which means never ever miss a chance to "seize the day."

13 comments:

Anonymous said...

I love even more , take heart. I always trusted the French Health System , never a doubt.

Anonymous said...

Victoria
You are in the thoughts and prayers of this anonymous reader of your blogs. God bless.

Le Chroniqueur Berliniquais said...

This is very very good news that you were so well-treated! Keep strong, I'm sure recovery will come as well.

I can't say I had so much luck on the last time I had to lie in a hospital bed, as a teenager. So it's great your experience has been so "positive" so far.

bubblebustin said...

Victoria,
I read how you came up for the name of your blog. How lucky you are to have grown up in such an environment! You must have met many fascinating (and not so fascinating) people. You have a Joie de vivre and curiosity that is in no doubt due at least in part to the that upbringing. Thank you for sharing what you're going through with us. Cyber hugs to you and if I'm even in Paris I'll come and clean your house for you, lol. ("Flophouse garden after May showers").
I know how much you like to research and did a little myself regarding Canada's healthcare esp as it relates to cancer care. I had heard on the news (but now can't find anything on the net) that my province of BC has better cancer treatment than others because of the larger array of chemo drugs available under BC Medical, and the well respected BC Cancer Agency. I found this site that explains in simple terms how Canadian healthcare is mandated and the role each province plays, and survival rates. I thought you might find it interesting in comparing one countries universal health plan to another's.
http://www.thrivealive.ca/learn/cancer_care_in_canada/
i wish you well in your chemo. I know it's not easy. Keep smiling and listening to those uppity blues women.

Christophe said...

Sending positive thoughts your way.
I am glad you have a good support system and care in a "foreign" country and that you are in good spirits. Keep strong.
Did you learn French when you moved there?
I am glad communication is not a barrier for you.

Also, thanks for describing your experience with the French Healthcare system. It bothers me that most (even educated) people here in the US label it as socialized and think that with a similar system in the US, they'll have long wait lines, and won't be treated on time with catastrophic consequences. What a misconception!
They talk about rationing care if too many people have access. This line of thought is interesting, as it shows selfishness, that I haven't seen in many areas here. I find odd that people would rather give at fundraising, than contributing to a single payer system. Again, I am not saying single payer is THE solution, as there are many things that contribute to the high cost here that would need to be fixed, but I think it is part of the solution. It is just basic maths of insurance. And I don't get why people don't understand that. If only sick people contribute, health insurance can't work. If the pools are too small, insurance doesn't work. It has nothing to do with socialism. It has to do with math, statistics and probability. I wish government advisers would rely on that to make rational decisions. I am anxiously waiting for the decision of the supreme court which should come this month.

It's true that in France you often have to wait for months to see a ophtalmologist, but here, the wait time for a dermatologist can be in the order of weeks too.
I am not saying the French system is perfect. Just that it doesn't deserve all the misconceptions it receives oversees.

I am glad you're treated there, and that at least you only have to worry about getting better, not how to pay for it. I hope your family from the US will be able to visit.

Best wishes for a complete recovery.

Christophe

Shirl and Rowan said...

Bon soir from Bastia, Corsica, Victoria, and "Good on Yer," as the Aussies would say. Thanks for sharing, and glad to hear you have made it safe and sound through the next little procedure on the Big Adventure.

As you know, my husband's life was saved by a fantastic French surgeon at Hopital Pitié-Salpetriere in Paris just a little over 5 years ago, when his esophagus ruptured. Then, as now, France's health care was rated by the World Health Organization #1, and (for example) the United States was rated #37! He stayed in the intensive care unit (the French all it "Réanimation," which I love), and spent another ten days in a private room, had a nearly six-hour operation with two surgeons and two anesthesiologists, and all the tests and follow-up care for a total of $50,000. Wow. And our US health maintenance organization paid all but about $1,000 of it. So good on the French, and a shout-out for one of the companies that some people think are evil (the "HMO"). I have always believed that it wouldn't have turned out as well, his care would not have been so standardized and excellent, and it sure wouldn't have cost that for the average American.

bubblebustin said...

@christophe, You may be interested in this study by Harvard that compares Canada's socialized system of healthcare to the US's. The study is a few year old, but I could imagine only a worsening in the US since then (sadly): http://www.ctv.ca/CTVNews/Canada/20060530/canada_us_healthcare_060530/

Victoria FERAUGE said...

@All, thanks so much for the comments and good wishes. Day 2 after the start of chemo and I'm actually up and able to post and have a cup of coffee. And it looks like the sun will shine today. Looks like it will be a very good day.

@bubblebustin, That's a really good link. Thank you. I was very lucky in my parents and in growing up in the Pacific Northwest. Last time we were in Seattle we actually walked by the old house there. It was purchased by some emigrants from California and we didn't like what they did with the place one bit. Ripped up the funky garden and put in turf. Blech! :-)

@Christophe, I hear exactly the same things from people back in the US. They think it must be slow and bureaucratic. Au contraire, this system can move very fast (as they did in my case) and the paperwork was minimal.
When I fist moved to France I was incapable of ordering a baguette in a boulangerie. These days I still make grammatical errors from time to time and I have a really thick accent but I can do anything in French that I can do in English. What about you? Did you speak English before you moved to the U.S.?

@Shirl, Corsica? I'm jealous. Another great story about French healthcare (and good for your American HMO as well). I just received two bills from my hospital stay (incurred before I got the ALD). One is for 75 Euros and the other is for 150. Grateful does not begin to describe how I feel these days about France overall and French healthcare in particular.

CarnetsSeattle said...

It is kind of 'funny' (cancer notwithstanding) that I have yet again the same experience in reverse. I was scared of getting seriously sick in the US, but I was 'pleasantly' surprised and except for the hefty bill (10k$ a year) I received an awesome care, and the hardest part was just to be 'alone' in a strange environment I didn't fully understand.

So now you have a hickman. I was grossed out at first but I came to love that thing. No more needle pokes. Is it one with 2 tubes dangling? If so, send me your address, I have something for you.

I am glad to hear surgery went well.

Hold on, in a year or so, it will be a bad memory.

Victoria FERAUGE said...

@Loic, you were in a good place. The UW has really good care. Yes, I find it very bizarre that you and I are having a similar experience in two different places almost exactly one year apart.
I had to look up Hickman. Wow, that looks slightly scary. I have something similar (has the same purpose) but it's a small disk with a membrane that sits under the skin. Image here http://www.lachirurgie-digestive.fr/images/5.chambreg.jpg

Hope you are doing well too. Hang in there and hopefully a year from now we can all go sailing on Lake Union.

Victoria

CarnetsSeattle said...

Ok I see.

Yeah the hickman looks scary but it's nice. There is a picture of me with mine on my blog, but I don't remember where.

I saw your thing on some friends. To me it looks even more bizarre but I guess it just takes getting used to it, like the hickman.

Yeah, in a year, sailing. I'm up for that. Done deal.

Hang in there! :)

Christophe said...

@Victoria
"I hear exactly the same things from people back in the US. They think it must be slow and bureaucratic."

The sad thing is that the reason they think it takes time to get care is because of too many people trying to get care, not because of bureaucracy. And they don't want a government run program, but the irony is that medicare has smaller administrative costs than private insurance. A lot of people are just against government run programs. I hear the same thing against USPS vs UPS or Fedex. I actually think USPS does a great job at a great price. The problem is that they need to finance in advance the cost of their retirees, and are not allowed to diversify. It is not fair to compare their deficit to private companies who don't have to fund pensions or pay heathcare for their retirees.
In France La Poste gets a lot of revenue from their banking activity, which I think offset the loss they might have on mail delivery. Here, I don't think they are allowed to create a banking activity.

I was speaking very good English prior to moving here. In France, as you know, they give quite a bit of importance to this language, and it was my favorite. I had excellent English teachers throughout my education, which helped quite a bit too, and also did several trips to England.

Take care.

Christophe

Jackie Brown said...

Bon courage Victoria !