Ouch.

March 13, 2013 3:38 PM

I am an American traveling in Spain and have to go to the ER. What do I need to know?

I have an infected abscessed joint and have emailed my doctor at home who said I need to go to the ER ASAP. The skin around the wound is swollen, red and painful and spreading rapidly. i need oral antibiotics and feel flu-like. Except I'm in Spain. What do I need to know about costs? What else? I'm here for a few more days, but the wound is oozing several tablespoons of cloudy, orange liquid and is excruciating. I tried a topical ointment dispensed from a farmacia but it hasn't done anything.

posted by sockorama to health & fitness (29 answers total)

Oh Jesus. Listen: going to the ER costs you $n, where n = a finite amount.

NOT going to the ER RIGHT NOW potentially costs you YOUR LIFE.

Please. Go.
posted by rdc at 3:44 PM on March 13 [16 favorites]

Rapidly spreading skin infection is at least suspicious for necrotizing fasciitis.
posted by ouchitburns at 3:48 PM on March 13

Even paying list price the ER in Spain won't cost you much. I mean and even if it did, its not like that debt will find you back to the US. And even if it did its not like you'd prefer death - right?

Just go.
posted by JPD at 3:49 PM on March 13 [2 favorites]

What do I need to know about costs?

They won't bankrupt you, US-style. Go now.
posted by holgate at 3:50 PM on March 13 [7 favorites]

From the US embassy website, but read the whole thing - on your way to the hospital:

In order to help American citizens, who might not speak Spanish, the Embassy maintains a list of English-speaking physicians in the Madrid area. The Consulate General in Barcelona and the U.S. Consular Agents throughout Spain can provide information concerning the availability of health care in their respective regions. The Department of State maintains information which may be of use should you experience a medical problem while outside the U.S.

.....

Some private American medical insurance companies will pay for expenses abroad, but most require that the patient pay the bill first, then file for reimbursement. Hospitals and health care providers will expect payment if you are not covered by the Spanish health care system.
posted by Busy Old Fool at 3:51 PM on March 13 [2 favorites]

Go. Go. Go.

This was years ago, but I went to the ER in Barcelona. I got Xrays and some painkillers. They asked for ID and nothing else. Then, several months later, I got a bill at home (US) in the mail for something totally reasonable, $94.

Just go. You may get a bill down the line. It'll be reasonable, but you can submit to your insurance at that time for reimbursement.
posted by gimletbiggles at 3:53 PM on March 13 [4 favorites]

Please let us know how things are, once you've gotten the care you need. The symptoms you describe are very worrying.

I hope you are already on your way.
posted by rdc at 3:53 PM on March 13 [1 favorite]

http://www.expatica.com/es/family/kids/guide-to-the-spanish-healthcare-system-1891.html

Some US Medical Insurance policies also cover emergency treatments in foreign countries, something to look into AFTER you go see the ER doctor. Don't muck around with infections. European doctors are usually good so don't worry about that side of things, and even if your doctor doesn't speak English chances are there is one there that does so no more excuses go now and I hope it's nothing.
posted by wwax at 3:54 PM on March 13

Thanks all.

I'm in Barcelona. I have no idea where to go!

Spreading rapidly - meaning, each day I've woken up and it's gotten puffer and redder from the day prior.

I've been keeping it clean, bandaged and dry.

I'm scared.
posted by sockorama at 3:57 PM on March 13

Good lord, go get in a cab and say 'el hospital' and 'emergencia'.
posted by Lyn Never at 4:01 PM on March 13 [11 favorites]

Here's an English language directory of hospitals and health centres in Barcelona. Eight of them have emergency departments.

You're not alone. We've got your back. Take care, and stay in touch.
posted by rdc at 4:01 PM on March 13 [3 favorites]

If you're in a hotel, they can direct you. So can any taxi. The cost will not be anything like a US ER visit, don't worry.
posted by DarlingBri at 4:02 PM on March 13 [1 favorite]

From the US Consulate General in Barcelona website
For emergency assistance after hours, American citizens may call ([phone] and ask to speak to the duty officer.

They will suggest somewhere and possibly help in other ways as well in case you need it.
posted by Busy Old Fool at 4:03 PM on March 13 [2 favorites]

Even better, here's a PDF of medical services in Barcelona from the US Consulate General in Barcelona website.
posted by Busy Old Fool at 4:04 PM on March 13

Taken from my PDF above:

HOSPITAL DEL MAR - University Hospital
Emergency Services Cell: 608-571-540 English Speaking
Passeig Maritim, 25-29 - 08003 Barcelona
Gestitursa service available in this Hospital. (A private company that provides mediation services between foreign patients, hospital administration and insurance companies. http://www.gestitursa.com)

Write down the address, hail a taxi and show it to them. Call the English-speaking number, describe your symptoms and tell them you are on your way.
posted by Busy Old Fool at 4:06 PM on March 13 [2 favorites]

I don't know much about the respective differences in health care billing practices between Spain and Italy, but I had to make two trips to Italian ERs last year in two different cities because of an inexplicable skin infection in my thumb that got progressively worse throughout the trip. At both hospitals, they typed in some information from my passport when I registered and laughed when I asked them how much it would cost. I never got a bill, never even had to pay for antibiotics and painkillers, which they gave me from the hospital rather than sending me to a pharmacy.
posted by fiery.hogue at 4:08 PM on March 13

Thanks again!

It's well past midnight here, but I will certainly check back in here once treated. Thnk you everyone so much.
posted by sockorama at 4:11 PM on March 13

Most European emergency rooms will not charge anything, because the costs of administration are larger than the cost of treatment - not worth the bother. Dont know about Barcelona. But just get yourself there
posted by mumimor at 4:24 PM on March 13

I'd suggest you avoid middlemen including the consulate. Spain has an excellent health-care system, and doctors are academics who speak English. Get yourself to that doctor, now
posted by mumimor at 4:28 PM on March 13 [4 favorites]

I hope it being past midnight doesn't mean you've decided to wait till morning. Those kinds of infections can turn septic (get into your bloodstream) very fast. I assume you would prefer a course of oral antibiotics over days on an IV, yes? So if you haven't already gone, please go right now.
posted by rtha at 5:22 PM on March 13 [5 favorites]

GOGOGOGOGOGOGOGO

I have a friend who nearly died from septicaemia received from a sandfly bite.

Serious. Go, and sit in the ER waiting room until someone sees you.
posted by Sebmojo at 5:25 PM on March 13 [1 favorite]

About three years ago my husband had to go to the ER in a small town near Cartegena late at night. The first hospital we tried declined to treat him either because he wasn't Spanish or because he wasn't an EU citizen (language barrier prevented us from understanding exactly). They sent us to a different hospital, for which they provided both clear directions and a referral and offered to transport him. Folks at the new hospital all spoke English. He received anti-biotics and after-care for the whopping price of $34. Use the info provided above about specific hospitals and go.
posted by carmicha at 6:57 PM on March 13

I spent six hours in the ER in Dublin a few years ago - on New Year's Eve, and a bunch of people had to stay late because of me (it was a small hospital). After getting a fluid IV, some sort of terrible shot that I don't really remember because I wasn't conscious, but it hurt later, and you know, six hours of observation, they gave me a handwritten bill for 60 euro. They didn't take credit cards and I only had 30 euro - so all of a sudden, my bill was 30 euro.

Hopefully you've left for the hospital by now, but nthing everyone else - Europe is not like the US, and your health is more important anyway.
posted by goodbyewaffles at 9:09 PM on March 13

I really hope you're already there, but in case not, the EU number for emergencies that will get you an ambulance is 112, and it is free from any phone (fixed or mobile).

The costs will not be much at all compared to the US. Just FWIW, even though it's a different country, I went to the hospital in France for a scary infection a while back, and it added up to about 150 euros all told (hospital stay, blood tests, scans, etc.); insurance covered it. When I had a burst torsioned ovarian cyst in Finland 10 years ago, I paid 50 euros all told (surgery!!). Don't worry. GO TO THE ER.

Call 112 from the nearest phone, NOW, if you're not already in an ER. Ask the hotel front desk to use theirs, they will let you.
posted by fraula at 11:53 PM on March 13

I live in Barcelona and will help you if you need it. I really hope you have already gone to the hospital, but I've sent you a PM with my contact details.
posted by Nerro at 4:43 AM on March 14 [4 favorites]

Thanks again everyone. I went to the ER and was given antibiotics, IV antibiotics, blood work, an X-ray and bacteria culture for an abscess. I'm glad I went. The whole thing cost 300 euro. I'm still going to follow up with my doctor at home, but I'm so glad I went. Metafilter to the rescue!
posted by sockorama at 9:44 AM on March 14 [7 favorites]

Oh, thank goodness. Well done for overcoming your fear, but please don't take any chances with your health in the future.
posted by Busy Old Fool at 10:07 AM on March 14

Oh, whew! Thanks for listening to our nagging, and thanks for updating.
posted by rtha at 10:10 AM on March 14

So glad you're okay.
posted by rdc at 12:03 PM on March 14