One of those things that I worried about, but hoped would never happen, came to pass this week. I have a partial tear of a ligament in my knee, which means I’m in a thigh-to-calf splint for the next 3 weeks (potentially a month and a half . . . or an additional month and a half? There was a small language difficulty). The worst part – I live in small rural town and I cannot drive.
Well, the pain may actually be the worst part because it doesn’t appear to be customary to prescribe strong painkillers the first visit, even for a serious injury (not even Tramadol, which is what I prefer, because it isn’t as strong and is an opioid, but non-narcotic). This would potentially be ok, since I was given a prescription dose of a painkiller similar to Tylenol, a prescription dose of Naproxen Sodium and a pain relieving cream . . . except I’m allergic to soy, which I told the doctor (in French), yet I was prescribed a soy-containing pain cream. Unlike in the US, you apparently cannot just call your doctor and tell them that there’s a problem with your prescription or that your pain is not even remotely well-controlled. You can try, but you’ll be told by the receptionist that the doctor is too busy to return a call and you’ll have to make an appointment. Are. You. Freaking. Kidding. Me?!?! The doctors here will make a house visit to ensure you have your required note for missing a day of work, even for a cold, but not return a phone call. Not even to correct their own mistake. Incredible.
Now that I know that, I’ve changed my mind about continuing to see a doctor in the town 20 minutes away who speaks the best English because, as I also learned, they won’t make a 20 minute drive for the house calls. I learned this when I tried to contact the recommended nurse for my DAILY injection. This is another interesting difference from the US. I’ve had limbs splinted or immobilized before and never had an injection required. After having it prescribed in France, I looked up why this might be. It’s because they’ve studied the risk of a clot and it’s near zero if you don’t have at least 3 risk factors (I don’t), so it’s been determined that prophylactic treatment is not recommended. The French all took it as gospel that I would need this treatment (but of course you need the injection!) and joked that Americans are simply content to let natural selection take its course for the poor tiny percentage of the population that could be impacted by this.
I’m guessing it also has something to do with the fact that a daily house visit from the nurse isn’t so objectionable when the combination of your socialized health care and extra mutuelle coverage is footing the bill. Can you imagine the cost of a nurse coming to your home for three weeks to administer a daily injection in the US? 😨 Not only would people not agree to pay for it, the for-profit insurance in the US would surely refuse.
So, outside of the apparent reluctance to prescribe anything remotely suitable for the pain caused by a torn ligament, French doctors have no qualms about prescribing you the entire remainder of the pharmacy stock. This is what I left the pharmacy with:
There’s also no need for silly bottles. If you were prescribed 14 pills, they just sell you the full box of 16. Presumably nobody cares since they’re not paying out-of-pocket. Of course, if you’re not French, then you’ve probably also encountered the most incompetent branch of the French government well before you’ve needed medical care.
In direct contrast to my experience of getting my work permit issued in a week and my visa arriving promptly, plus the prefecture finding me an appointment before my visa expiration, CPAM seems to delight in it’s ability to be completely dysfunctional. First, they incorrectly told my human resources department that I was not eligible for a social number (or Carte Vitale) until I’d been in the country for 3 months. My immigration attorneys assured me that this was not true with the visa type that I have, plus they sent the link to the French government website that proved this.
It’s unclear whether the next problem was CPAM or my co-worker, but somehow this issue never progressed further until I complained to PB that I’d been in the country for nearly 3 months, paying high social taxes and for a mutuelle policy that I couldn’t use, with no Carte Vitale to show for it. He followed up with my co-worker, who possibly never tried to clarify with CPAM about my visa type. My dossier was finally sent over and, several weeks later, PB followed up again. CPAM informed us that they’d received no such dossier. My co-worker forwarded the proof that we’d filed. CPAM then miraculously found my file, which had been assigned to somebody who was out on leave of some sort. It seems that CPAM was content to leave my file waiting on a desk until whenever the person returned, but they were finally persuaded to do something with it.
PB laughed a bit while telling me that I was having my first experience with TRUE French bureaucracy. Apparently, the French just accept this as the way things are here, which could be why so many of them are in favor of politicians who want to fire a significant number of civil servants! Finally, in early January, I was issued my “temporary” social number and told that a bill of rights would be mailed to me. The mutuelle insisted that my temporary number could not be used for registering with them. Fine, I’ll continue to wait.
Well, this became a problem when I injured my knee. Even though I should have been covered from the day I arrived, because my human resources folks didn’t persist and file until December, I’m told I have coverage as of December 22. But, without a Carte Vitale, I have to pay upfront and hope that the French government will actually reimburse me.
The cost in France for an uninsured “urgent care” visit to a doctor? Twenty-three Euro. Yes, that’s the entire cost. The pharmacy, on the other hand, set me back over two hundred Euro, but that was for the entire stack of medication and the knee splint.
So, financially, the lack of proof of insurance has not been so terrible. Of course, I have no idea where to send my “factures” or invoices, in order to be reimbursed. The CPAM has quit responding to my employer when an update is requested as well (I should have pushed for my US HQ to include this in the services that the immigration attorneys were hired for – they seem able to persuade the government to actually do its job). I will say that PB has made it his personal mission this week to resolve the issue and has our HR staff working on it studiously. My understanding is that they will help me get reimbursed and to register with the mutuelle, regardless of my lack of Carte Vitale.
My fears before this experience centered more around what I would do if I were seriously injured in a country where I don’t have any long-term friendships and no family to call on. As it turns out, I was worried about something that hasn’t really happened yet. Le Américaine has helped a lot with buying my groceries for the week, driving me to the doctor and taking me back and forth to work. Alexis, who is back in the area, brought me an ice pack and is going to help with my furniture assembly. Another co-worker has also offered to pick up groceries for me or help with any other errands. A new friend offered to accompany me if I needed surgery, so I’d have an interpreter. On the other hand, PB had a brief moment of acting like I’d injured myself during the WORST POSSIBLE TIME (our CEO visited this week) just to inconvenience him, but then he recalled that I just received a large set of knives as my 5 year service gift 😈 . . . er, I mean he recalled that he generally likes me and should be more concerned that I’m injured than about the poor timing of the injury.
I have learned that there are a lot of things that are a bit of a challenge when you can’t bend one knee. Like getting up from any sitting position without something to grab on to. On the other hand, my left leg is going to have quads of steel and I’ll be able to swing my lower body around using my arms like a gymnast! My poor right quad is having a time of it though as I pulled it trying to swing my sock around and catch my foot in it like a net. I’ve decided that socks are overrated anyway. As are shoes. I posed this question on my FB, but fuzzy blue slippers are proper work attire, right?
To my relief (and surely that of PB), I managed to wrangle a sock and (untied) shoe onto my foot prior to our CEO’s arrival and have not yet had to wear fuzzy slippers in public. Which I’m pretty sure a French person would view as sufficient public humiliation to justify a home visit and a doctor’s note to skip work.😊