Living in Ireland: Pediatric Emergency Medicine

annisa

7 years ago

When our family moved to Ireland 15 months ago, I did what I could from a medical perspective to make sure our transition was as smooth as possible.

Today I’m going to share what I did in the hope that you’ll find my list helpful should you find yourself in a similar situation.

Then I’ll ~~get to the dramatic part~~ tell you ~~how it all went to hell~~ a story of what happened last week that showed the drastic gap in my planning that most certainly contributed to a new patch of grey hair.

BEFORE WE LEFT THE USA:

Prescriptions: Before I left the states, I arranged to “buy-out” the remaining months of our prescriptions. In our case, only one of us was taking a prescription and it was valid for another 4 months. The pharmacy told me our insurance would only cover one month at a time, but there was a significant discount for me to buy out the remainder of the prescription. I’m not sure why, but I learned it is always worth asking. This afforded me a longer grace period when we arrived in Ireland to find a doctor and get a new prescription.

Contact Lenses: We also visited the eye doctor before we left and stocked up on a year’s supply of contact lenses.

Dentist: The timing worked out right for us to all visit the dentist in the weeks right before we left the country. This gave us 6 months, barring no problems, to find a new dentist. Although, in Ireland, they seem to recommend only yearly cleanings.

Health Insurance: Because there was a gap between when my husband would be starting his job in Ireland and when the kids and I would join him, we worked with his employer to keep him on the U.S. payroll for an extra month so that we could maintain our health coverage and not have to go on Cobra. You know the minute we dropped our insurance would be the minute one of the kids broke an arm. I couldn’t tempt fate!

Medical Records: I also procured copies of important medical records that I thought we might need in Ireland. For example, immunization records.

Life Insurance: This is sort of medical related – after medicine doesn’t help you any longer. I called and confirmed that our life insurance policies were valid no matter where we resided.

WHEN WE ARRIVED IN IRELAND:

Insurance: Straight away when my husband switched to Irish payroll we enrolled in the private health insurance program his company offers. Having private insurance offers a few benefits – like bumping us to the front of the line for procedures, private hospitals, etc. Irish residents are entitled to state-sponsored insurance, but I’m not an expert on the details of how that works.

Family Doctor: Within a couple of weeks of moving into our new home in Ireland, I made a point to ask neighbors, our landlord, really anyone who would listen for their advice on family doctors or pediatricians. I took the list of suggestions and started calling to see who had availability to accept new patients. While there was nothing wrong with any of us at that moment, I wanted to be certain we were patients of record with a doctor’s office before someone got sick.

Our decision on which doctor to go with had a lot to do with who was accepting new patients and location. We don’t have a car, so I needed to find a doctor close to our house. It worked out that I liked the first doctor I saw, but I was prepared to keep searching.

Also, I had to adjust my expectations for medical care. Our doctor’s office (or surgery as they call it) is located in a townhouse. The doctor’s desk with his mountain of paperwork is in the room with the exam table. Immunization schedules aren’t as rigorous. Well child visits are few and far between. The doctor called pee/urine “waterworks.” Little things like that. And, yes, that last one still makes me laugh.

I do like that Irish doctors post their price lists on their websites. You are never surprised by what things cost (it’s not a lot, either) and we submit the receipts to our insurance for reimbursement.

999: When we moved here, I taught my kids what to do if mommy or daddy is hurt and they need to call for help. In Ireland and the UK, the emergency services number is 999, not 911. I’m not going to say this has been an easy transition. The kids had to learn a new street address, mommy’s new phone number and a new emergency number. Just the other day when I quizzed the kids, my son said 9-9-1?

*sigh* So close, but so not helpful. We’ll just keep working on it!

Pharmacy Visits: In Ireland, you go to the pharmacy for over-the-counter pain meds, cough syrup, makeup, etc. Over the course of our time here, I’ve familiarized myself with the fact that medications are called different things. Ibuprofen is Nurofen, for instance.

I’ve also come to accept that pharmacy staff are trained to be either very helpful or very nosy. It depends on your perspective. For instance, I bought two different types of children’s cold medicine a few months ago. The pharmacy clerk – not a pharmacist, but the lady who rings up your purchase – quizzed me about if my purchase was for two different kids? I responded, “yes, I have two kids.” Now, in all reality, I just didn’t know which, if any, medication was going to help the one kid that was sick. Basically, I was stocking up so that I’d be prepared for anything.

Also, I cannot buy a Costco-sized bottle of tylenol or ibuprofen here. I can buy 10 tylenol pills at one time. I cannot buy 2 packages of 10 pills at one time. For someone who doesn’t like to shop, this is all very annoying.

HOW ALL MY PLANNING FAILED ME 15 MONTHS AFTER OUR MOVE:

Last Tuesday after school, we went to the park. This is something we do probably 4 times a week if it’s not raining.

Our routine play time was disrupted when my 10-year-old daughter fell off the one thing all the kids climb on, but really shouldn’t. Especially when there’s a large group of them.

As a mom, you can tell the difference in your child’s cry. The I’m-pretending-I’m-a-baby cry, the my-pride-is-hurt cry, the this-hurts-but-I’m-really-okay cry, the I’m-going-to-cry-and-my-sibling-will-get-in-trouble cry, the I-didn’t-get-my-way-and-life-is-unfair cry and the HOLY-HECK-THIS-IS-REAL-PAIN cry.

My daughter had that last one. I thought her tailbone was what she had really injured, but it turns out her arm/hand was the real culprit.

This was one of those situations where you’re not going to call an ambulance, but you know your kid probably needs to be checked out. And we’ve all been conditioned to avoid the hospital ER at all costs. No one wants to go there and THEY don’t want you to go there unless you’re really, truly having an emergency. Thankfully, urgent care clinics have filled that gap in the market for the urgent, but not dying stuff.

Now, let me paint you a picture. I’m in the park with two kids, two backpacks, two scooters and no car. I’m nowhere near my house. It’s late in the afternoon and I’m trying to decide what I should do. At a minimum, I know I need to get ice and ibuprofen.

A friend (who happened to be at the park) offered to drive us to the urgent care clinic in our area. She’d been there before and knew they had an x-ray machine on site.

Done!

Going to a private clinic was exactly why we procured private insurance! Along the way, I tried to call our insurance company, but they wouldn’t let me ask my question about clinics and coverage because I didn’t have our member number – it was on my phone. So I had to hang up and write the number now. By that time, we were at the clinic so my friend dropped us off and I hauled two backpacks, two scooters and two kids up the steps and into the clinic.

That’s where I encountered THE SIGN on the door. The sign that said, in essence, as of September 1st the clinic would not help anyone that was not a member of said clinic. We were not members. I missed the window of help by 4 days. Frickity Frack.

Trying to explain this development to my daughter who was still sniffling with pain and holding her arm at a weird angle was not fun.

I called our insurance company (again) and asked them to tell me where the closest clinic with an x-ray machine was located that would help my daughter. They gave me directions to the clinic, confirmed my pediatric question and informed me it closed at 6 p.m., which was in one hour. The most efficient way to get to the clinic would be via a cab.

As soon as I hung up the call, I opened my phone’s taxi app to hail a cab. Except, I couldn’t get a cab. My app was searching and searching and no drivers were available. Just great.

I could feel my blood pressure rising while we waited, which wasn’t being helped by the fact that my son was bored and decided to start sliding down a banister in front of the clinic that wouldn’t help us. One hurt arm is all I can handle at a time!

After about 10 minutes a random cab pulls up in with a passenger. I flag the driver down and ask if he was accepting fares. Of course he said yes. I explained how odd it was that I couldn’t get a cab when I know we were close to a shopping mall. He said, “oh, I know what it was. The drivers in the taxi rank were too lazy to get out of line to go pick up a fare. They’d rather wait for shoppers exiting the mall.”

To recap. My daughter is hurt. I have one hour to get her to the clinic before it closes. The quickest way to get there is by taxi. The taxi drivers are TOO LAZY to pick us up.

Awesome.

I’d also like to mention that it is now 5 p.m., which is getting close to the dinner hour and I’d already given the kids all the food I had when we were at the park. Nothing good happens when my kids are hurt, tired AND hungry.

I’m fairly certain I can actually FEEL the grey hairs growing out of my scalp now.

Anyway, the cab driver gets us to the second clinic in 15 minutes. I hop out with the two kids, the two backpacks and two scooters to find the emergency department, which was on the opposite side of the building from where we’d been dropped off.

I walk up to the reception desk, explain why we are there and the lady says, “I’m sorry. We only take patients 16 years and older.”

*insert a whole host of expletives here*

Thankfully, I did not say those bad words out loud.

If I hadn’t felt like crying at that point, I probably would have laughed at the ridiculousness of this situation. Bad timing. Misinformation. It was a complete fiasco.

I did calmly and politely ask the lady ~~who would not help my hurt child who was standing right in front of her~~ where I should take my daughter for help.

“Oh, well, you have to take her to a children’s hospital. She can’t go to a regular hospital A&E.”

I’m not sure what A&E meant at that moment, but I assumed it was the ER.

*insert another list of newly invented expletives here*

Thankfully, I did not say those bad words out loud either. But I did text them with very angry fingers to my husband.

Just keeping it real.

In my mind, getting my child help should have been a simple process. It wasn’t. And it was made worse by me not knowing how the system worked when it comes to urgent care.

Looking back, I should have just called our family doctor. And looking back even farther, when I met with the doctor the very first time, I should have inquired about what to do if there is a non-emergency emergency. Then I would have had a plan in place and would not have carried around the guilt and utter frustration associated with not being able to get my child help. This is one of those times when it shouldn’t have been so hard and I’m lucky that it all worked out okay in the end.

24 hours after the incident, my daughter saw our family doctor. He, bless his heart, told me “if you would have come in yesterday, I probably would have told you to come back and see me in 24 hours.” I’m not sure if that’s true or if he could see the parental guilt coming off me in waves, but I appreciated the sentiment.

He, predictably, referred us to the children’s hospital for x-rays.

I also told the doctor about how I woke up in the middle of the night and asked my husband, “so if a child was stabbed in the parking lot of a regular hospital, that hospital would not help that child?” The doctor rolled his eyes and said, “I know, I know. The system is a little messed up. They probably would give the kid pain meds, but they would call an ambulance and have them sent to the children’s hospital for treatment.”

*insert a picture of me shaking my head in disbelief at how asinine that is*

We ended up having a really fantastic (if you can call it that) experience in the hospital. We were in and out with x-rays and a cast in about an hour.

I did learn that children’s hospitals in Dublin are all public. So the benefits of having private insurance – unless she ends up needing a room – are negligible.

I’m sharing this story because I want you to know I have a really brave kid. And she feels much better now.

I also acknowledge there are parents out there dealing with medical situations far more horrific than a broken wrist and my heart goes out to them because I know that burden must be indescribably heavy.

Most of all, I’m sharing this story for anyone who is moving to a foreign country. I hope you can learn from my mistakes. Kids get sick. Kids get hurt. Knowing what to do in those situations – whether they be minor, urgent or a true emergency – can help you direct your energy where it needs to go the most – to your child.

As we left the hospital on foot to catch the train home, my daughter, sporting her new red cast said, “It’s a good thing I didn’t break my leg! That would have been a lot worse!”

She found the bright spot in this situation and I’m happy she reminded me it was there all along.

In truth, she’s my bright spot.

P.S. As you can see, I’m still learning the ins and outs of the medical and health insurance system in Ireland. Things change. Our situation is unique. I am in no way, shape or form an expert. Please do your own due diligence before moving to Ireland. It really is a fantastic place. I wish you the best of luck!

If you want to know more about our experience of moving to and living in Ireland, check out these posts:

Living in Ireland: Surviving a Snowstorm

Living in Ireland: Life Without a Car

Living in Ireland: Inside My Kitchen

Living in Ireland: Christmas in Retail 2017

Living in Ireland: Storm Ophelia

Living in Ireland: That Time a Tree Came Down

Living in Ireland: Pediatric Emergency Medicine

Living in Ireland: Back After A Month in the United States

Living in Ireland: As Seen On My Commute

Living in Ireland: A Trip to the Hardware Store

Living in Ireland: Spring Flowers In Our Yard