Sick in a foreign country

October 14, 2007 3:53 PM

My stepfather is currently hospitalized in France, where he had a series of transient ischemic attacks this weekend while on vacation with my mother and sister. They were scheduled to fly home next week, though chances are high that will get postponed at least a few days on doctor's orders. I'm trying to be as much help as I can from an ocean away. What practical aspects of being hospitalized in a foreign country should I be thinking of / helping with?

What I've got covered so far:

*Logistics of air travel in his condition - my mother's talking to the doctors about the medical aspect of this, and I'll be researching with the airline to see what sort of documentation/whatever they need to accomodate him.

*Extended petsitting at home beyond what they lined up before they left - this is taken care of.

*Dealing with any special needs he has after he gets out of the hospital for the rest of their stay, since none of them speak much French: We're going to see how this goes. Most of the people they run into, including their hotel staff, speak good English. If it turns out they're having a lot of trouble, I'll fly out there and help out with my rusty-but-functional French until they're able to come home.

Are there other practical things like this, either to be dealt with there or here at home while they're away, that I might be able to help with from a distance or that we might all be overlooking in our various levels of emotional distress?

posted by Stacey to health & fitness (15 comments total)

Getting medical notes and contact details for followup enquiries for his doctors at home.
posted by i_am_joe's_spleen at 4:12 PM on October 14, 2007

Double-checking that any drugs he's prescribed are available in the U.S.

Does he have a regular doctor at home that you should contact and update?

Maybe arranging, as much as you can, for any special needs he may have once he's home? Is he going to need to avoid stairs, for example, and so will need a sleeping space on the ground floor? Will he need a cane or some other help with walking? A special diet that you could shop for or find cookbooks to support? (None of these may apply, of course; just throwing out things I might want to ask about.)
posted by occhiblu at 4:23 PM on October 14, 2007

Making sure that they (or you) collect all the paperwork necessary for their insurance company (especially if they had travel insurance or are somehow not currently covered by their regular insurance).
posted by occhiblu at 4:25 PM on October 14, 2007

Bring home a copy of the brain MRI, by hand. Have someone take it on the plane with them. If they offer it on a CD, make sure it's DICOM format. The films are better.

Another thing that's useful is the discharge summary from the hospital. Even if it's in French a doc can usually get some information from it.
posted by ikkyu2 at 5:30 PM on October 14, 2007

He needs to get home and have surgery on his artery promptly. This happened to my dad some years back while viiting me in nyc. The doc wanted to operte right away, but he delayed the operation in order to get home and consult his personal doc. In the meantime, he had another tia and needed the surgery anyway. The operation is fairly simple and if he is healthy otherwise he ought be up and about in no time- my dad left the hospital the next day. If the french docs are reluctant to release him, or if flying is deemed dangerous, he ought consider having the surgery there, recovering for a week or so, and then flying home. In that case, a really good translator will be needed. I think the best course would be get out of the hospital, get home, and get back in the hospital and have them arteries scraped out good.
posted by vrakatar at 5:47 PM on October 14, 2007

What the hell, vrakatar, have you reviewed the carotid ultrasound in this case? TIAs have more than one cause; most of them have nothing to do with carotid stenosis.

It amazes me how widespread is the belief that one lay experience with a single case makes a man into a doctor. In this case vrakatar is wide off the mark.
posted by ikkyu2 at 6:10 PM on October 14, 2007 [2 favorites]

all the above advice is good. i don't know if he does need surgery, as above, but if he does, i agree that he should do it in france and not wait to get home. it's 1st-world medicine, they'll take good care of him.

for things you can do immediately, how about getting their house cleaned up and stock the freezer with meals? also, before they get home, stock them up on perishables like milk, bread, and produce. fill up the tank of your mom's car and if their bedroom is upstairs, make up a bed downstairs for your dad. that way they can concentrate on being home and not worry about household things.

i'm sorry this is happening. i hate being away from my family when they need help.
posted by thinkingwoman at 6:16 PM on October 14, 2007 [1 favorite]

If anything, his care might even cost a lot less in France. I know that the doctors and care I was given in Austria (without insurance) for my ear cost less and at times seemed even better than the care I got in America (with insurance) after I returned.

Definitely agree with starting to talk to your doctor here though, and with making sure the medications are available here. Different countries use medications that are sometimes totally different than ours, and sometimes they are the same medication but they just go by a different name. Google is your friend when it comes to figuring this issue out.
posted by miss lynnster at 6:30 PM on October 14, 2007

Yeah, I should have noted that I am not specifically asking for advice about his condition because you guys are not my doctor or his doctor, or probably doctors at all. (That said, if you are by some chance the apparently very nice French doctor taking care of my stepdad this weekend, thanks!)

Having surgery there is definitely an option on the table at this point, but tests are still being done and for now he's being treated with blood thinners. I'm told his doctors seem great and are answering my mother's questions very thoroughly, so I'm trying to concentrate on the practical day-to-day stuff and let them handle the medical.

These suggestions are great so far - thank you. I know a lot of it seems obvious, but none of our heads are really in great practical-thinking space this weekend, so please keep 'em coming however obvious they seem.
posted by Stacey at 6:31 PM on October 14, 2007

that was helpful, ikkyu2. please try to remember this is askmefi, not slam the layperson. that being said....

"The underlying cause of a TIA often is a buildup of cholesterol-containing fatty deposits called plaques (atherosclerosis) in an artery or one of its branches that supply oxygen and nutrients to your brain. Plaques can decrease the blood flow through an artery or lead to the development of a clot. Other causes include a blood clot moving to your brain from another part of your body, most commonly from your heart."

keyword: often, meaning most of the time.

anyway stacey, it sounds like your step-pa is in good hands and well supported, i just think that he'll recover more quickly and your whole clan will get a better, less scary idea of what is going on with his health the sooner he gets home. when you see him pinch his cheek for me.
posted by vrakatar at 7:18 PM on October 14, 2007

Since it's "educate the layperson" day, vrakatar, you should know that most of the arteries that get plaque buildup in them, such as the anterior, middle and posterior cerebral arteries, and their tiny branches like the lenticulostriates, can't be safely operated on. Those arteries are never operated on for TIA.

Thanks for the quote, though. Maybe I'll use it the next time I'm teaching neurology to a med student.
posted by ikkyu2 at 8:51 PM on October 14, 2007 [2 favorites]

As well as petsitting look into anything else they need extended. The main one I'm thinking of is holds on newspaper deliveries or mail, although there may be other things like a lawnmower guy or a pool maintenance person that needs sorting out.

Also, will they have rent or utility bills coming due before they come home? It would suck to get back and find the power has been cut off for example. Looking through their mail would give an idea of what's going on in this regard (read what's on the outside of the envelopes then talk to your folks about them). Sometimes I cut this stuff really fine when I travel and an extra few days can make a difference.

I like the idea about stocking the fridge too. Having to go grocery shopping straight away is always a pain and I'm guessing doubly so in this case.

Good luck to your Dad. Your parents are lucky to have such a thoughtful child.
posted by shelleycat at 9:18 PM on October 14, 2007 [1 favorite]

Make sure that you take on the role of keeping any friends and family in your home country updated, and passing any good wishes/messages of support that come through back to your Mum, step dad and sister in France. It may mean a lot to them to know that the people they care about and who care about them are aware of what is happening and are thinking of them, but they probably won't have the ease of contact people which you do at the moment.

Good luck to you and yours.
posted by helenfin at 4:16 AM on October 15, 2007

When he'll fly back, paperwork is not enough. Have his US doctor talk directly to his French doctors.
posted by bru at 8:06 AM on October 15, 2007

Ensure that your father's doctors understand his travel plans and sign off on his fitness to fly. Flying does effect the body, most importantly blood oxygen saturation. If something happens at altitude, options for intervention are obviously limited.
If possible, set up a call between your father's doctor from home and the doctor treating him in France.
Confirm that a copy of all medical records will be available for your father to hand-carry home, including all imaging studies on CD if possible.
In the case that your family's stay in France needs to be extended, contact the airline and explain the situation. I have found that in this situation they are willing to change tickets without a charge if there is a letter from a doctor.
IANAD but my job is coordinating medical assistance for international travelers. Feel free to contact me with questions - email in profile.
posted by dreaming in stereo at 12:31 PM on October 15, 2007