On my recent Portland/Seattle trip, I needed to visit the Emergency Room.  Visiting the hospital on vacation was not on my vacation “to do” list but the experience made me think about vacations and health a bit differently.  While I understand my insurance coverage, I was a bit lost on how to deal with medical needs in an unfamiliar city.

Thankfully, I wasn’t injured per se  it was more of a “only happens to Sue thing” .  A week prior I had flown from Philly to Portland on a very full flight in coach.  I did get up a few times to walk to the restroom and tried to stretch on the plane as I normally do.  In Portland, I did some walking and a bit of hiking and my feet/ankles started swelling.  I didn’t think much of it, other than I was eating salty foods that I don’t normally partake in (I’m talking to you bacon!) and was not working out everyday.  So I elevated my feet like normal, hoping the swelling would go away by morning for the conference.  It didn’t but my shoes still fit, albeit snug.

When I reached Seattle, the swelling was a bit worse but there was no pain so I figured I would be ok for the day. I decided to go on the Whale Watching tour despite a week of swelling.  I kept an eye on my disappearing ankles and heavy feet (I was calling them Fred Flintstone feet)  as they seemed to get progressively worse as the day went by.  My friend was texting me to convince me to go to the local clinic for a check-up.  I didn’t want to get on a cross country flight in two days and make things worse, so I agreed.  By this time, I was out of shoes and wearing flip flops (gross photos below, not sure why I was in denial looking at them now).  The biggest worry was  Deep Vein Thrombosis (DVT) blood clots.

The local clinic was opened until 8pm.  I called and was told they had no appointments left that night but could fit me in at 9:30 am the following day.  Before I agreed to that, I asked about blood test turnaround time and was told results would be sent to my local GP.  That wouldn’t work for me as I was leaving in two days and needed to know now if I could fly.  My only choice was the local Emergency Room but first I needed to meet another friend for dinner.  Who wants to wait in the ER on an empty stomach?

Back at the hotel, I inquired at the front desk about medical issues.  Big eye opener people!  They couldn’t answer my questions:

1. Do you have a doctor on call or a preferred list of physicians?

2. Where is the nearest local clinic? Do you know operating times? Specialties?

3. Is the local hospital a trauma center? Since there are three hospitals downtown, why do you send people there?

4. Can you check waiting times online?

While they said they usually refer people to hospital X, my local friend suggested hospital Y as it would be quieter (not a trauma center) and hopefully not too long a wait (has any ER wait ever been short?).  Before dessert arrived, I searched online and called the ER to ask the current wait times.  The receptionist laughed when i said “I was wondering how much camping stuff I need to bring”.  She said that they were quite busy so pack accordingly.

My friend dropped me off at the ER at 10 pm and I checked in.  There was only one other person in the waiting room so I was hopeful especially as the triage nurse prepared my intake information and gave me my bracelet within 15 minutes.  Back in the waiting room, I found an outlet to plug my phone in, pulled out my scarf (it was cold) and starting reading my hardcover book.  Yes, I was prepared.  I  also brought a power bar, bottle of water and a few other things in my Mary Poppins purse.

If you’ve ever waited in an ER, you see and hear many stories, often sad.  Tonight, I would see the strange man walked back and forth telling everyone he wanted to die tonight (he was drunk, off his meds and a frequent guest of the ER), then he locked himself in the bathroom for a while.  Staff was familiar with him and called the shelter to pick him up but it was sad and scary at the same time. Ambulance after ambulance were pulling in this night making them even busier.  My feet didn’t quite seem important anymore.

When Jay Leno’s monologue started, I noticed the wait time, thankfully, the nurse called my name shortly after.  The ER was quite large with many rooms and I noticed how quiet and still the place was (and then wondered why I had to wait so long).  The nurse took my readings and the doctor quickly came in to examine my feet.  He agreed with me that they shouldn’t look like this.

Blood tests back, I was cleared to fly, he didn’t know why this happened as nothing stood out but I should follow up at home with my GP for more testing.  He told me to get compression socks to my knees (not to my thighs), I replied “sounds sexy” and at 1 am, he didn’t find me funny. I asked for a copy of my blood test results for my records and called a cab to go back to the hotel.

Exhausted from the long day, I quickly fell asleep but with a myriad of new questions to add to my vacation/destination research:

1. In the U.S., are there local clinics nearby? What are the hours?  Do they do x-rays on site?  Do they have a lab on-site?  How limited are they? What is co-pay?

2. Outside of the U.S., what is the process with my insurance? I’m on the hook for payment until I get home – will I need cash or do they take credit cards?

3. Do i need travel insurance? Medical evacuation coverage?

4. What if there is a language barrier?  How would I communicate?  Language app?  Translator?

5. How does the hotel address medical needs (doctors, dentists, emergencies)?  Will they send staff with you?

6. Difference in my business travel insurance vs. personal travel situation

7. What if you can’t fly home?  Are you prepared to stay awhile?  Can you easily make return flight changes?

These are just a few new questions I wrote down after this incident.  Do you have any to add?  Have you ever had a medical issue to address when you were on vacation/traveling?  What did you do?  Who helped you figure it out?