Navigating the Health System for the First Time

 We had registered with the NHS, and I figured out getting my endometriosis medication. I haven't yet received the call from the NHS gynecologist (it has been more than three months...) who was supposed to follow up with me to manage my case - not just prescribe me medication. 

We are incredibly fortunate to have private insurance that covers pretty much everything, so I have explored parts of the private system as I try to figure out my back. I have gone to Physio, an Osteopath, a Gynecologist and will soon go to a spine doctor. We have also had our teeth cleaned and checked (did you know that this requires two separate appointments here? One for cleaning and one for a dental check. The cleaning was about 3x the cost of the dentist!). The osteo wasn't able to help me, so he said make sure everything is right with my uterine innards before I go to a back doctor. 

The gynecologist I went to was recommended from my doc in Newton who is a global specialist in Asherman's syndrome and endometriosis etc. He was super expensive (but it was covered). And the experience was so interesting. He wore a suit, not a white coat. No mask. There were no stirrups on the table - just a table. He was a MISTER (Mr not Dr). I asked about that, and he said in the UK you become a doctor and then if you're a surgeon you go back to Mr. Apparently it started when barbers (hair) were surgeons. Doctors were those who gave herbal medication, but if you needed surgery, you went to a barber who was trained with scissors. Apparently the red and white swirling thing out front of the barber used to be a cloth with blood to show that the barber was experienced. (Googling to see if I can find sources and ). It was 780 GBP to see the doctor, get blood tests - including an expensive one bc I have a big cyst and they are testing for cancer in my blood - negative - but more than 100 GBP for that test alone. That is a lot more than a less fancy gyn. But it doesn't compare to the 8,000 that it cost to replace my IUD last year IN THE DOCTOR'S OFFICE. So there's expensive, and then there's the USA.

As the weather turned colder, I realized I should figure out what we do when we get sick. I emailed a mom from the neighborhood and school (the woman who loaned us the space heaters), and it turns out when you are sick you do NOT go to your GP. They only help you with ongoing issues or vaccines or something like that. When you're sick, you go to a private urgent care or the NHS A&E (Emergency Room). (Though I just googled, and it seems that there are at least some public urgent care clinics. The woman at the private urgent care yesterday told me these are our options. Hm.). This sort of means you don't have a doctor who is managing your care...

The same woman also gave me the name and number of a private pediatrician. I understand he makes house calls and DOES manage the kid's care.

Two Thursdays ago, Koby threw up (in class - that sucks, but he doesn't seem to care!). He was fine the rest of the day, had a few cold symptoms but was FULL energy, eating, playing football non-stop, and I sent him back to school. Friday (8 days after that - he had had a runny nose the whole time, and it was also the day our heat didn't work), I picked him up at school, and he was coughing a bit. Saturday morning he seemed a bit better, but still coughing. He went to soccer and a birthday party (wrong decision, but we didn't know at the time). Came home and was really coughing a lot. And that night he got a fever. I'm usually low key when my kids are sick. JUST a fever and I wait 3-5 days before contacting a doctor, but I remember a pediatrician told me once that if the kid has a fever AND another symptom you should deal right away. We waited Sunday just to see if he resolved. Sunday night he had a fever, so we let him sleep in on Monday. 

When he woke up after 9 on Monday he had 101.9 temp and an AWFUL cough. He had been up a lot that night coughing. I called the pediatrician office the woman had recommended, and waited for a call back. After an hour or so I decided to just take him to the private urgent care in the same hospital as the pediatrician. 

Side note - it's one thing to take a sick kid to a doctor in your own car. It's also ok to walk to the doctor. But we are a half hour walk away, and he could not walk (2" of snow and he was legit SICK). We called an uber, put on a mask, and he didn't talk or cough in the uber. I felt bad, though.

We got to urgent care, registered and waited about 5 minutes - not even enough time to get through Stuck by Oliver Jeffers. We got taken back to triage. While there, we got a call back from the pediatrician who said they could see him RIGHT NOW. Boom - the triage nurse walked us there, and we waited about a minute before getting into the doctor. He examined Koby and said that given what he saw (red throat, swollen glands, congestion, cough, fever, lethargic) and how much is in the community, he is almost sure it is Strep A. (He said testing for it takes a while. I'm not sure why I didn't press this further). He said he would treat it with amoxycillin. He said no real downside. He said if it responds to the antibiotics, then it's Strep A, and he will likely get better quickly. If it's not, then it is a virus, and there isn't much we can do anyway. He said this antibiotic is not likely to contribute to him becoming resistant bc he isn't on it a lot and also because it's not a strong one. Fine. 

We got the antibiotics RIGHT THERE IN THE HOSPITAL and something for his cough and went home. The doctor gave me his mobile, and he said follow up with him on what's app in 48 hours. He said any questions, let him know. He said he would come to our house, no problem. He likes to manage his patients' care. It was 250 GBP. Not cheap, but not outrageous. And super interesting to have such access to a doctor. In the US it's all so guarded (and I understand why it might be better that way!).

And in the US when the kids are sick, I go home, figure out a way for Matt to stay with them, or something and then have to go to the pharmacy which usually takes a while. But to take a sick kid into CVS as a separate stop home to wait for a prescription is miserable. And anyway it's not usually ready on the way home from the doctor. For some reason it takes hours. This was truly quick and easy.

I found out that five kids out of 19 in Koby's class were out yesterday. 

He was really un-Koby all day yesterday. Didn't want to eat almost anything. Barely drank. Tried popsicles. Juice. Ice cream. NOTHING tasted right, and his stomach didn't feel right either. He was miserable. No football at all. No jokes. Just laying all over the place. Poor dude. Went to sleep at 8:15. Was up coughing a bit in the night, but slept until I went in there after TEN because I was sure he was NOT ok. His eye was half open, and he was like, "what?" He has no fever today. Still not into eating a lot - but is up for eating a BIT - drinking more. WAY happier. Still weird in the stomach. But it DOES seem like he's responding to the antibiotics. I super hope that's it and he is better. And now we know if others of us get sick, antibiotics should do the trick.

In other news, Sam had a violin and chorus concert yesterday. It was AMAZING! Sam learned violin on Zoom from a teacher they had never met, barely introduced themselves, in a class of people Sam didn't know. Not at all in person. Last year in school, the poor teacher had the responsibility for all instruments, and it seemed like most of the kids had taken private lessons, so they knew what they were doing. Sam truly had no idea, and Sam hated it. Understandably. I felt like they should make it through the year and decide. At the end of the year, Sam said they never wanted to play again. Fair. I agreed. Then we got to ASL, and in 6th grade, every kid needs to be playing an instrument. So back to the violin it was, and Sam actually went to the beginner level. Sam looks AMAZING now! It's so cool to see. 

Another neat thing was that in the chorus part, Sam was three people away from our friend, Oscar. I have blogged about their family before, but we were close in Singapore, and when we were moving to London, Stephanie was one of the key people that encouraged us to go to ASL. So it's so cool to go from having babies (actually before we even got pregnant!) in Singapore to this. Together. 

(the first pic in this post is Sam and Oscar right before they left Singapore)

Koby helping his dogs and bunny watch Thundercats with him. We are on episode 200. I swear.

Sam in the chorus concert. Oscar is three people to the right.

Singing

Sam playing violin. (on the right. In blue)

On the walk home from school drop off yesterday. 2" of snow. But look at the SUPER CUTE dragon I discovered on this roof down the street from us! Reminds me of the Figment dragon from Epcot

This house is SO beautifully decorated. And in the snow...This is on our way to school in St John's Wood (fancy shmancy)

Walk to school yesterday. Half the schools around here were canceled. Not ASL!

Our boots didn't fit! Keep those toes up to keep your shoes dry!

Outside our living room window on Sunday night. This is so pathetic, but we had been in most of the day, because Koby was sick, and all curtains were closed tight to keep the cold out (see previous posts!). Remember, I have no friends here, so the phone/social networks tell me nothing! We put the kids in bed. It was 8:30. My google clock had a picture of a snowflake. I had never seen that before. What does that mean? Rather than looking outside, I LOOKED AT MY PHONE (what is wrong with me!??), and sure enough it said "snow until 10pm." Finally we looked outside and couldn't believe it!! The neighborhood was outside and playing in it until late! Our kids went to bed (sorry, kids).

the spider webs were FROZEN and so cool!!!

Those were all on Eton Avenue, on our walk to just about anywhere from our house.

View outside the boys' room on Sunday morning

Cleaning his car windows with a credit card. No scrapers here. This was before the snow.

On the way to hebrew school on Sunday.

Our street on Sunday night

Extra Cold

While I wrote that last post there was a person from the electric and gas company here changing our meters to "smart" meters that can relay information directly to the company and also for analysis on our end. He was super nice. He said he had just been trained to install them, and this was one of his first. He did have to leave the door open for the two hours he was here, to let any gas that came out escape. It was about 30 outside. All seemed great. But cold.

When he finished with the gas, I turned on the heat, and the radiators got warm. He then checked a bunch of things on the boiler, gas stove etc, and he documented a bunch of things and then he left.

An hour after he left, I realized it had been 13.5 in our house, and now it was 13. The radiators were nearly freezing. SHIT. Landlord suggested turning the boiler off and back on. I tried that, and nothing happened. Our heat and hot water both come from a boiler in our kitchen that heats water and sends it to an insulated cylinder (we call it a tank) upstairs. The water then either goes to the radiators or the hot water supply. The boiler was working. The hot water was heating. There was gas in the house - also the stove and oven were working. The heat was not working.

I called the energy company back. Waited ten mins to talk to someone, and he said, "you'll have to call the gas pipe company to come out and fix it." He gave me their number. Five mins wait before I talked to someone there, and they said, "if you have gas in your house at all, then this is not our issue. Call the energy company back." So I did. Waited ten mins to talk to someone. She said she would look into our account and put me on hold for five minutes. Then the line cut out. I called back. Ten mins before I talked to someone. They said, "obviously we can't send back the same technician, and we don't have anyone else in your area, so obviously just call an engineer." ON THE COLDEST DAY OF THE YEAR when demand is SUPER high. ON A FRIDAY AFTERNOON. AND what the fuck is an engineer? (and her use of the word "obviously" might be what drove me to tears). Remember my previous post from about two hours before this moment when I was saying HOW FUCKING COLD AND UNCOMFORTABLE I AM ALL THE TIME, and NOW I HAVE NO HEAT. I also had five kids coming home after school and no idea what an engineer was or how to find one or how I would find time to deal with all of it since I had to leave to go get the kids. (And also I had just lost a few hours of my life when I was meant to be working). She said I can just find a local gas engineer. No prob.

I texted the landlord and asked for suggestions. He suggested the plumber who still hasn't fixed our dripping shower after more than TWO MONTHS and FOUR VISITS and at least 12 hours on the job. And also he's in Portugal right now which is why the shower is still not fixed. Anyway, he didn't respond. Landlord googled (he knew what to google - I thought an engineer was a phd) and sent some suggestions for emergency plumbing responders. After calling four, we got one booked for today morning.

It was freezing last night. Like FREEZING. I was so grateful that we had hot water. Though when I showered I didn't realize Sam had taken a SUPER long shower (which they are absolutely entitled to on a Friday night when we have no heat - I just wish I knew), so I had a minute of a warm shower and then FROZE while I rinsed everything off). But everyone else had a warm shower. I also was very grateful for my AMAZING robe that I got last year or the year before and appreciate every moment of it. Unfortunately this early morning at 7, when Matt got up to move a space heater to the main room, he somehow accidentally spilled a cup of water all over it, so it's a bit wet right now. I know, right? Poor me.

When we woke up, the warm room in our house was 11, which is 51, but upstairs where we were sleeping was truly SO SO SO cold (but I don't have a thermometer there). Elie slept in a sleeping bag for down to 30 degrees F. Koby was somehow fine with a fleece blanket only (WTF?) but was up coughing all night. Matt and my duvet is magically warm, and Sam somehow was in a nest of blankets and warm pajamas and seems fine (still sleeping at 10am). 

A SUPER nice engineer showed up at 8:30 this morning and told us the problem was with some valve that needs to open to send hot water to the radiators. Apparently some box wasn't telling the valve to open. He says it's just coincidence it happened right when the smart meter guy left. Huh. He has been here since then, and our radiators work. It's up to 14.5 (58!!) in the main room. Hallelujah. Apparently they're ordering a new box and need to come back to install it.

And luckily the World Cup games yesterday took all of our attention and distracted us from this. They were SO SO fun to watch.

Though I was the only one who truly cared about being cold. Kids barely even notice. Matt left work a bit early and got a plug-in space heater radiator (and another ASL family who lives down the street, and I had had a tea with one of the moms yesterday morning, also loaned us two space heaters, which was SO SO NICE and the first villagy experience I have had here). But Matt was just trying to keep me happy. He was fine. 

Luckily, this seems over. I can't wait to get warm.

Cold

It is damn cold out. It’s been in the 20s the past few days, and we have another week or so of it. People are telling me that 20s is not normal. Usually winter is more 30s.

When we moved here, we said, “30s! No problem! That’s like a warm winter day in Boston! We can take it – we will even enjoy it!” People said, “well, London winter is a bit different. It’s dark. It’s wet. It’s just cold.” “No problem!” we said. And believed.

Until…

We changed the clocks the week before Halloween (a week ahead of the US), and it started getting dark around 4. Now it’s totally dark at 4. The sun is JUST starting to rise when we walk to school at 7:30. Even on sunny days it seems as if the sun is either rising or setting the entire day. There is no period of simple sunshine.

But also, the sun doesn’t shine a lot. Luckily the last week HAS been sunny with blue skies, but we had weeks – or possibly nearly the entire month of November – where it was NOT sunny and there were no blue skies. It rained a lot. On and off. But a lot of on. And not just a drizzle. That I could have handled. It poured. 

Let’s say it’s Monday and you left your house at 3:30 to walk a half hour to pick up the kids at school at 4, then you mosey on over to the football pitch for a 5-6pm training (that’s soccer field and practice for you Americans). You’re standing to watch and wait, along with Sam. It rains. It’s now been dark for about 2 hours, in the 30s, raining, and you’ve been chillin’ in all that for the last 2.5 hours. Then you walk about 7 mins to wait for a bus that is a half hour ride back home (it’s nearly the same amount of time to walk home, but the kids are EXHAUSTED, so to walk 38 mins after training and a long day is a lot). Toes numb. Wet. Hands freezing. Chilled to the bone. So you get home 6:45 and all you want is to warm up. You can’t wait to get inside.

But oops! Your house isn’t insulated!! So to keep the heat on all day is truly a waste of money and resources (and fuck Russia for making putting on the heat a political decision). So, it’s 13 inside when you get home (that’s 55 for your Americans). It takes about 5-6 hours to get the house up to 18, which is 64 and my goal for a comfortable house (though I would have considered that cold in the US). Luckily, I have figured out how to get hot water (turn on the hot water in the afternoon for 2 hours and we get 4 hot showers). The shower and the duvet is literally the only way to warm up. When I cook and use the oven I leave it open after to share its warmth with our house. It is truly freezing. 

In the last few days it has been UNCOMFORTABLE to work from home. I have drank about 6 cups of tea each day. I sit under my favorite blanket. With a hat and scarf. Here is me writing this blog post. I finally decided to get a bit more creative. I turned off all of the radiators everywhere but the main floor (which is the second floor in the US, the first floor here – above the entrance). I closed the French doors to the stairway. I closed every window drape that doesn’t have critical light (light critical for my mental health). I made sure the small wall that has outside exposure and is FREEZING is covered by curtains. I set the curtains above the radiators so they could keep the window cold out (they’re not “double glazed” as they call double hung windows here), but the radiators are exposed. Before, when it was dark, we closed the curtains, which kept all of the heat from the radiators trapped between the curtains and the freezing windows and didn’t allow it into the room. WTF – why are the curtains so long? No idea. Yesterday it did feel warm enough to not be uncomfortable in our main room. After about 6 hours with the heat on and all of these provisions. Blah.

I didn’t realize how much the cold and dark (and also lack of friends, social life, obligations and really anything) had gotten to me until we got back from Greece, and I felt so much better, having left. I know that London is great. I know there is lots to do here. But I am also definitely in the valley of despair part of the TOTALLY NORMAL ex-pat relocation cycle. It’s tricky. But it takes time. And warmth. And a bit of sun. And maybe a friend or two.

In other news, Matt just got back from a trip to the US. He had an easy trip, and we were really fine without having a second parent. Luckily we had no incidents that required a further grown-up. Koby puked at school a few days before he left so that was out of the way. Phew. 

We have also REALLY been enjoying the World Cup. So much fun to learn about football and cool to be in England, who is still in it, with kids who love Messi and Ronaldo, who are still in it, and we’re headed to Morocco in a few weeks, and they’re still in it too! The rest of the world sees the World Cup as a BIG deal, and it’s fun to be in that rest of the world.

Our weekends have been basically involving football, Hebrew school and shuttling kids to birthday parties, and that’s about it. Kinda disappointing as I want to get out and see stuff, but I guess that’s not happening for a while.

Elie participated in his first chess tournament (photo credit to Piyah)

I got to read two books to Koby's class as a mystery reader. He chose Those Darn Squirrels Fly South, and I chose Stuck. The kids loved them both.

This was Koby riding home from school after he puked. He had asked to stay in school. He was totally fine but maybe drank too much water? And he pukes when he is getting a cold. And he was getting a cold. The nurse said I could send him back the next day if he didn't puke again, no fever and total energy. So back he went.

So that Monday that I described above was last Monday. We got home at 7, and I threw on some eggs and pasta. I was really uncomfortable and grumpy. Kids were showering when I was cooking. I felt a bit of despair. I flipped my omelette, and it said, “BLAAAAAAH.” 

It gave me a funny frowny face that I first interpreted as “waaaah for you! Get over it, lady!” but then my mom suggested it had sympathy, and I liked that better. So it said, “waaaah. Sometimes life is cold and a bit hard! I hear you!!” (Getting emotional support from an omelet slightly reminds me of when I first moved to Singapore and similarly had no friends and made friends with the voice on the MRT and other imaginary beings).

Elie's grade had a winter show. They sang, spoke and instreumented. It was actually really good and enjoyable!

Elie and his new friend (though he still maintains he has no friends).

My rigged curtains being held up by the bible and harry potters.

letting through a bit of that critical light