Down with the sickness in Germany
July 24, 2013 10:09 PM   Subscribe

I am a US citizen on vacation in Germany. I have bad stomach cramping. YANMD but what should I do here?

The day before my trip I had a minor upset stomach. The day I left the stomach cramping was severe accompanied by diarrhea. I treated it with Ammodium with stomach cramping. The next day I felt somewhat better but ate cautiously, but was constipated (likely due to Ammodium). Then that night after an airline dinner the cramping was the worst its been. I'm in severe pain.

I googled my symptoms and it seems like standard 2 day stomach bug but I'm getting to day 3 with no relief. I don't know if I'm getting better. I don't know if my insurance will cover me in Germany.

I don't have any other symptoms, no fever etc.

Advice needed please.
posted by arniec to Travel & Transportation around Essen, Germany (22 answers total)
When I was an American military wife and moved to Germany, it was common knowledge in the American military community over there that everyone got the flu shortly after arrival and it was waaay worse than the American version. I believe the hypothesis is that it is worse because of the higher population density leading to more intense evolutionary pressure.

I suggest that unless you have reason to believe it is something else, you assume that's all it is (and assume German flu for an American comes from a special plane in hell and will drag out a bit) and treat it like the flu with a bland diet, etc.

Diet (Brown University)
Diet (Live Strong)
posted by Michele in California at 10:23 PM on July 24, 2013

Find a way to see a doctor there. It's often a matter of paying a small amount (not the amount paid in the U.S.). The times I've needed to see doctors Europe it's generally cost about the same or double my insurance co-pay at home, despite having no insurance there. Do you need help finding a doctor where you are? (In which case, a town or city would be useful.)
posted by Margalo Epps at 10:25 PM on July 24, 2013 [1 favorite]

A pharmacy will have a sign that looks like this. They will likely speak English and may be able to provide you with something without a prescription. If not, they can recommend a doctor.

You should be able to see the doctor without using your insurance. Healthcare in Europe is not the clusterfuck we have in the US.
posted by Gringos Without Borders at 10:27 PM on July 24, 2013 [4 favorites]

Response by poster: I am in Essen. There is an Urgent Care facility that I am researching

I was sick before getting there so I don't think its so I me special German strain
posted by arniec at 10:27 PM on July 24, 2013

Does your insurance have a non-800 number that you can call to check if they do cover you? That might help give you some background info, at least.
posted by jaguar at 10:32 PM on July 24, 2013

Does your insurance have a non-800 number that you can call to check if they do cover you? That might help give you some background info, at least.

Don’t waste your time worrying about your American insurance. The doctor will see you without it. Get treatment now!
posted by Gringos Without Borders at 10:34 PM on July 24, 2013 [1 favorite]

Oh, yes, I didn't mean to imply you have to abide by your US insurance coverage (and I have also heard much anecdotal evidence that agrees with the idea that seeing a doctor even without any insurance in most of Europe will not cost you very much). I just meant that if the OP is in info-gathering mode, calling the insurance company might provide another data point.
posted by jaguar at 10:36 PM on July 24, 2013

When I was an American military wife and moved to Germany, it was common knowledge in the American military community over there that everyone got the flu shortly after arrival and it was waaay worse than the American version.

Common knowledge? I was in the US Military in Germany for over four years and this is the first I have ever heard of such a super flu.
posted by Gringos Without Borders at 10:38 PM on July 24, 2013 [1 favorite]

Best answer: This is completely anecdotal, I am not a doctor, this is not medical advice: I had a male friend who got traveler's diarrhea when in Southeast Asia, and he remembered that I had told him that my PMS/Midol medication helped me with abdominal cramps as well as uterine cramps. He asked his female traveling companion if she had any Midol, she did and she gave him some, and it fixed him up pretty quickly.

If I were to remember this anecdote while traveling, I would probably follow Gringos Without Borders' advice and head to a pharmacy.
posted by jaguar at 10:40 PM on July 24, 2013

This is not "German flu". (1) There's no such thing, and whatever apparently passes for common knowledge in the US military on this issue is nonsense (2) The OP was ill before they arrived in Germany. This is not German flu or any other kind of Delhi belly-type traveller's illness.

Having said that, and while I'm sure you're fine, if you're on day three of a stomach bug then you should see a doctor.

The German healthcare system is not quite the socialist utopia you might be treated to in this situation in, e.g., the UK, so do clarify payment first. But even if your insurance doesn't cover it, assuming you only need to see a GP, the full cost to you is likely to be of the order of your GP copay back home.
posted by caek at 11:02 PM on July 24, 2013 [5 favorites]

Find someone to help you and don't worry about the insurance for now. Generally speaking, health care in Europe is much more focused on helping people in need than it is in the US. If you need care, they will help you. You can work out the details later if necessary.

I tried to find the nearest embassy or consulate, because that would have been my first suggestion. Sadly, there's nothing near enough to you anymore to be of use.

I don't know whether you speak German, but here is Google Translate's stab at what I would suggest: Ich habe starke Schmerzen in meinem Magen. Können Sie mir helfen, einen Arzt zu behandeln?

Basically, my advice is just seek the help you need. You've found an urgent care place: go there.

Worry about the insurance later... it probably won't even be necessary.

Good luck, and feel better!
posted by trip and a half at 12:37 AM on July 25, 2013

I suggest you go to a pharmacy as pointed out above. Even if the pharmacist doesn't speak English, you should get something over the counter if you can describe your issue:

Stomach cramp: Magenkrampf
Diarrhea: Durchfall
Constipation: Verstopfung
Since 3 days: Seit 3 Tagen
I already took Ammodium: Ich habe Ammodium genommen (and it didn't help) und es hat nicht geholfen.
I need something prescription free: Ich brauche nicht verschreibungspflichtige Medikamente.
I need a recommendation for a doctor nearby: Ich brauche eine Empfehlung für einen Doktor in der Nähe.

Most doctors will treat you regardless of insurance, as will hospitals (though you likely wait a lot longer when going to the emergency room) and offer you to write a bill, if at all.

Edit: Native speaker - but the google translate above looks fine too. Use that or Bing if you need more phrases; most pharmacists will be able to guess what you need if you describe the main issue. If you are allergic or resistant to any meds, write a list to show them.
posted by MinusCelsius at 1:09 AM on July 25, 2013

If you're still looking, I found this GP who speaks English on

Dr. Darius Heinemann
Florastraße 1
45131 Essen
phone: 0201 - 22 21 67

If you have trouble explaining your symptoms to the front desk (might not speak English):

starke Schmerzen = severe pain
starke Krämpfe = strong cramps
Magenschmerzen = stomach pain/cramps
Durchfall = diarrhea
Verstopfung = constipation
bisher genommene Medikamente = meds taken so far

"Ich habe starke Schmerzen in meinem Magen. Können Sie mir helfen, einen Arzt zu behandeln?" = I have stong pain in my stomach. Could you help me treat a doctor?"
posted by travelwithcats at 1:11 AM on July 25, 2013

I think you should go to a doctor. I have had some practice going to doctors in Germany without good insurance. Here is what you do:

Most doctors in Germany have office hours, which means you can go without an appointment during that time and see the doctor. Office hours are first come, first served, and the hours are usually posted on the practice's website. Find a Hausartzt or an Allgemeinartzt (that's a GP) in Essen who is not a private practice (ask someone at an Apotheke, or look on the internet). Find out their office hours. If the office hours are 9-12, then try and arrive at 9 am, because that way you won't have to wait as long. Bring your passport, whatever health insurance documents you've got, and 100 Euros in cash (you won't need that much, but just to be safe). If your insurance won't cover your visit, the doctor's visit will probably cost around 30 Euros (that's what it costs in Berlin). I pay for monthly medicine out of pocket in Berlin, and it puts me back 40 Euros, so I imagine any medicine you have to buy will be in the 10-20 Euro range.

I hope you feel better!
posted by colfax at 2:15 AM on July 25, 2013

Pro tip: If the consultation hours start at 8am, tro to be there by 7:30am. Often the office is open around half an hour before the doctor comes in, and the wait will be longer if you get there later because more people will be in line. To a lesser extent the same will be true if you go in the afternoon.

If you're looking for a doctor online, remember it's spelled Arzt (no t before the z). Many GPs are called Arzt für Allgemeinmedizin or Facharzt für Allgemeinmedizin.

Gute Besserung!
posted by amf at 3:37 AM on July 25, 2013

If you are staying at a hotel have you asked the front desk for help? I got sick on a business trip once (though it was in the US) and the hotel had a list of nearby doctors. And they called me a cab to take me.
posted by interplanetjanet at 5:55 AM on July 25, 2013

Days of abdominal pain might mean something other than a bug. I'm nthing that you should ask the front desk about a clinic, doctor or hospital so you can get checked out.
posted by third rail at 6:50 AM on July 25, 2013

I have a relevant secondhand story.

An ex of mine got horrendous food poisoning when he (this was before I met him) was in Europe. He was in Romania at the time, on Easter, and nowhere was open. He was having...issues.

Apparently he managed to befriend/receive the pity of some wealthy German girl at the hospital, who helped him get a flight to Germany and then arranged for her dad to send a car to pick him up from the airport and rush him straight to the hospital. ...Where he spent two days hooked up to an IV and being given drugs. He gave the German hospital his (US) health insurance information and his (US) contact info. He got better, continued on his trip, and didn't pay anything to the hospital.

A few weeks later, when he returned home, he had a bill from the German hospital for about 800 bucks waiting for him. They billed his insurance (a fairly robust BCBS plan), actually did get some money from the insurance company, and then billed him the remainder.

So yes, it is possible that your insurance will cover some of your expenses. But my ex could have died in Romania--he needed a doctor regardless. You are sick. You are in "severe pain". You need to go to the doctor.
posted by phunniemee at 7:10 AM on July 25, 2013

the pity of some wealthy German girl at the hospital

that should read "at the hostel"

sorry, missed the edit window
posted by phunniemee at 7:21 AM on July 25, 2013

Make sure you do a stool culture with whatever doc you end up with. It could be any number of things, like giardia, c. Dif, cryptosporidium, etc, and the lab results will help determine the treatment. If it's one of these, immodium isn't going to help. Good luck!
posted by PSB at 7:32 AM on July 25, 2013

Go to a clinic (Klinikum) and they will treat you.

My experience, from 2005: I tripped and broke the fibula bone in my leg in Mainz in 2005. Asked at the hotel where to go, they directed me to the nearby clinic. That night they x-ray'd me and fixed me up with cast, non-infecting medicine and crutches; I was told to return the next day. Upon return, we dealt with the bill. My insurance was deemed irrelevant (I didn't have any travel), so they charged me about 230 euros. As I figured it would've been $1000 just to get in the door of a USA emergency room, that was fine with me.
posted by Rash at 8:16 AM on July 25, 2013

Response by poster: Thanks all! I ended up taking the Midol recommendation and it got me through the worst of it.

The advice about just going and being prepared to pay was helpful but I gave it a day more of medicine and it thankfully passed and I had a great trip illness free.

Thanks again for the advice! It was comforting while far from home!
posted by arniec at 3:02 PM on August 5, 2013 [1 favorite]

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