“Remember that there is nothing stable in human affairs; therefore avoid undue elation in prosperity, or undue depression in adversity.” — Socrates
There was a strange convergence of good and bad when this opportunity to come to Ireland arose. Claude had been trying for years to find a position/job/occupation that would afford him the chance to move here. The blessed event came to pass in September of 2011 when he was offered his current position as third-party researcher at the National University of Ireland Galway. At the same time as this was occurring, I had, for lack of a better description, an attack – which eventually led to the MS diagnosis. I even cracked wise to him about how his fantastic news had to be tempered by a drastic diagnosis for me because that’s the way the universe works.
At the time we were covered by the health insurance offered by his employment in Colorado. Due to the fact that my primary care physician (a fancified term for family doctor) didn’t really know what to look for, and the subsequent fact that she referred me to an incompetent boob of a neurologist, it took 3 MRIs and a ridiculous number of office visits to finally get the diagnosis. By the time it finally did happen, I was informed by the incompetent boob that it was too late for the recommended treatment of 3 steroid infusions over 3 days. He recommended a drug that came from the manufacturer directly, something I had to fill out an application to obtain, then wait for them to process it through my insurance, then wait for them to send out the drugs and a home care nurse to show me how to shoot myself up with it. All of this was occurring while we were preparing ourselves for an overseas move.
I finally had to call the drug company about four times before I got the meds, then took them to my PCP’s office to have her nurse show me how to stick myself because the home care person was not calling me and time was running. I also discovered that the health insurance would only pay for 4 doses, never mind the fact that I was going to be moving overseas and it was going to take me God-knows-how-long to get another physician to prescribe more meds. I wasted time and money and health taking those four doses of medication, which made me sicker than I already was. The “nurse” at the drug company sympathized with my plight but could do nothing useful or helpful. Ah well, I thought, I’ll just go without until I can get into the health care system in Ireland and get my medical card.
By this time we were in Ireland, scrambling to find a place to live while Claude was starting an entirely new job. There were Garda registration cards to obtain, and a bank account to open, and there was a raft of paperwork to do for the university. I contacted the Irish MS Society and spoke to a very friendly and informative man who gave me much of the information I needed to get started with the system.
And then everything stalled. The woman at the Health Services Executive (HSE) told me to do the paper application rather than the online app because I had to write a personal letter explaining my situation. That was my first mistake. I was told I had to provide proof of residency in the form of a lease and utility bills in my name. We got that process started but it took several weeks to get all that from the cable & electric companies. We tried to open a joint bank account but they wanted so much paperwork and so much information and it was taking so much time away from Claude’s work hours that we decided to forgo that part. I was told I was to find a general physician who would confirm my diagnosis and refer me to a neurologist – I got lucky enough to find a local doc who worked with MS patients and took care of me and my needs at no charge. He referred me to a neuro guy at the public hospital. It took two months to see him…
I provided the HSE with the hosting agreement showing the one year commitment to Claude for his job, the one year lease on our home, the Garda reg cards showing the one year length, utility bills in my name, a copy of Claude’s paystub (only one at the time as he had only been on the job for one month) the application with the GP’s information and signature, and my letter begging for a medical card. I was told that I had not provided enough documentation. They needed his tax form from the university and more paystubs. Then they wanted bank statements. Then it was my American medical records. Now they’re saying we don’t have enough debt and continue to disregard the fact that I have a long-term illness and as such am entitled to the medical card.
In the meantime I have seen the neurologist, who seemed a bit skeptical about me and my story, or maybe he was just inscrutable and I read him all wrong. I just got
the feeling that he really didn’t believe my diagnosis. Maybe it’s because MS is a young person’s disease and I am no longer the proverbial spring chicken. The incompetent boob did show me the proof of my diagnosis on the MRI scans and told me it was conclusive proof, so either he really was that fucking incompetent (excuse my language) or he was right. The Irish neuro wants to do the 3-day, 3 treatment steroid infusion that the incompetent boob said I didn’t need, as well as a new MRI for his baseline. But unlike the States this treatment has to be done in hospital here. The good news, if one can call it that, is that under the public health scheme the hospital only costs €75 per day. We’re not entirely sure if this includes food. However the MS nurse I saw right after the neuro doc assures me that I will also receive physical therapy treatment and other therapies related to MS. But I have to wait for them to tell me when I am entering the hospital and I have to call the day before admission to make sure there’s still a bed for me. I’ll let you know if that experiences sucks or not – I mean, more than it usually sucks to be in the hospital.
This morning’s call from the HSE proved once again that the people who work for the entity are kind and caring individuals who have to give bad news to people on an everyday basis. I was told our income is too high, we don’t have enough expenses, then advised to produce information proving Claude’s child support obligation. When I asked the woman about getting a card simply by virtue of my long-term illness, she asked me to provide medical records. Trying mightily not to sigh audibly in her ear, I told her I had done so, by registered mail, over 2 weeks ago. She checked and saw that they did have that information and advised me to wait at least another 10 days for a determination from “management.” I have called my GP guy and asked him to provide a letter backing me up for the medical card.
Once again, only time will tell. But in the interim I am put in mind of the people in America who bellyache about socialized medicine, about what a crap system it is – and I think of my Canadian friends who tout the system and say it beats the hell out of private health care. Having been a victim of both, I can categorically state that at least the health care I have received in Ireland so far has been infinitely less expensive than the health care I received in the US. I can’t say that it’s been better or worse on either side, as I have had two really wonderful General Practitioner/Primary Care Physician (s) and two very so-so neurologists. Maybe I won’t get that medical card. Maybe it won’t matter because so far the measures I have taken to care for myself seem to be working fairly well.
Through all this I have had the support of the greatest husband any woman ever dreamed of having at her side. Perhaps that is the best medicine of all.
“You will never truly know yourself or the strength of your relationships until both have been tested by adversity.” — J.K. Rowling