Monday, December 5

Explorations in French Health Care! (Or what I did on my vacation!) – The Health Care Blog


By MATTHEW HOLT

This is a personal story about this blog’s publisher (me!) but it has just enough health care stuff to keep it relevant!

This year I finally got invited on the annual mountain bike ride run by my friend JB and his ex Taiwan/Hong Kong buddies. I’ve actually been practicing and training most of the summer and arrived pretty confident even though I knew it would be tough. This edition is in Provence in France.

Before it all went wrong

And then…..2 hours in on the first day it turns out I was too confident…

Back in 2002 I smashed my knee snowboarding into a tree. When I told him my dad said ” You silly twit”

I actually was a silly twit this time too. I was on a new bike (a rental) that was actually much more advanced than my usual one and had a feature I had barely practiced with (a drop seat) that requires a new technique. It had rained heavily the day before so it was wet (& living in California I have very limited experience mountain biking in the rain), and I was behind the pack as my chain had come off. (There was a guide sweeping the rear who fixed it for me). So when I got to the first challenging down hill slope I didn’t do the sensible thing of stopping & walking to the bottom to check it or do what 75% of the group did and walked their bike down it, I just thought, “I can do that’ and plunged down it. Not quite sure exactly why I fell but I went over the bars slightly to the right (luckily missed a tree) & hit the ground on the downslope hard on my right side. In any sport any one of new equipment, new environment, new technique means you should err on the side of caution and I had all 3, yet just went for it! Very bad decision!

After I got up I thought I had just badly winded myself. The guide helped me back on the bike & I rode on. For the next 5 miles or so he helped push me up the steeper bits of a climb (he had an eBike). I actually did a slightly less challenging but still tough downslope section & a friend gave me a big dose of Tylenol at the next stop point. I actually crashed again after that (slipped on a wet rock) but landed ok on my elbow which was padded (as were my knees but not my torso) and only had some slight scratches but I made it to lunch feeling sore but OK.

After lunch I got lost and ended at the back of the pack again but the next 10 miles were a steady climb on a fire road/jeep trail & a nice path through a forest but nothing too tough. I then got lost (again!) and ended up going through a village missing the steep downhill I was looking forward to. The day was 30 miles and about 3,000ft of climbing–so not nothing!

After a night of beer, painkillers & great French food, I actually slept OK & assumed it was a bruise. I got up & cycled off with the pack the next morning, missed another turn (you should be sensing a pattern here!) & was close to the sweep guide at the back of the pack when about 5 miles in we got on some nice single track that went up and down. At this point every time I had to pedal intensely to go up a short slope or every time I hit a root or a rock, it really hurt.

That single track ended with a vicious rocky downhill that I walked (and I found out so did most everyone). When I got to the drinks break (about 8 miles in) I told the guides I was in too much pain to go on. As it happened another rider in the group (73 years old!) had crashed and hit a wall and had a deep wound in his arm. So he was being taken to hospital. I said I’d go along to check out the French health system and I’d try again tomorrow.

We started at a pharmacy where the head pharmacist told the guide that my fellow rider’s wound def needed hospital treatment & we went to a local Clinique (mini private hospital) which had a small urgent care department. The med asst (who was also the receptionist) told us the wait was 2 hours & the guide asked him if I could get an x-ray while we waited. Yes we could.

We went over to radiology depth where my wait was about 45 mins. We were told the cost would be less than 100 euros. I went in to the Xray room, followed the charming rad tech’s instructions to jam myself this way and that against the machine & was out in 5 mins. 20 mins later we got the bill (52 Euros) and the x-ray on film.

The picture is the result of my visit to the French hospital system. While I’m keen on studying other health systems, I wasn’t intending to take such a personal look…

Then we went back to urgent care. The med asst had cleaned up my fellow rider’s wound. The doctor said no need for stitches for him. Then he cleaned up my minor elbow wound from that second fall. Then the doctor came in. He squeezed my ribs and talked in fast French with the guide. Then said to me that he would find the place it hurt & he did.

Exam rooms all look the same!

Then we left the exam room to his office where he had the x-ray on his computer & showed me the rib that was broken (c9).

He printed out a paper prescription (no eRX as far as I can tell) for tramadol, acetaminophen & naproxen. By the way only Tramadol of that lot is prescription in the US. He then dispensed great French medical advice. “Don’t bike for 4-6 weeks, because if you fall again you will puncture your lung. Instead enjoy the wine of Provence!” He then got out a credit card machine & charged me another €52.

French Rx

So for you health care nerds that’s €104 for x-rays, diagnosis and consultation. We went back to the pharmacy to pick up the drugs. They only had 2 of the 3 so I was actually able to use the same paper Rx to get more of the same drugs plus the missing one the next day at a different pharmacy–even though I told the second pharmacy I had filled the rest the previous day. Total cost was €15 which I guess is similar to US as they were generic even though they weren’t OTC. There didn’t seem to be any electronic link between pharmacies (Wonder what would have happened if I’d been prescribed opiates?)

French pharmacy

Anyway back to the poor patient….

Despite the wine & the drugs I assume the bruises had started to come through as that night was very very grim (lots of pain, barely any sleep, getting everyone else to carry my bags, get stuff off the floor as i couldn’t bend over, etc). So no biking and after that I rode in the support van, practicing my appalling French with another guide and going to supermarkets each day as we bought the food for lunch and the wine & beer for the evening (25 old men drink plenty!). Instead of burning fat riding 30 miles a day I definitely put on weight this week!

A week later I am still noticing the pain but I can sleep. I can carry my own luggage and the muscle spasms that came out of nowhere seem to have calmed down. It still hurts a little when I cough or laugh too hard. So I’m trying to avoid COVID-19 (got my bivalent booster 2 weeks ago) and anyone too funny!

When I get back to the US I will be investigating those instant inflating jackets that horse riders wear and see if anyone has a mountain biking equivalent!



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