Getting Sick Abroad | Seeking Medical Care in the United Kingdom
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In general, we try to be incredibly careful when it comes to our health, but especially when we’re traveling long term. First, because a cold, flu, or injury could ruin the best of days. Secondly, because we’re traveling internationally and medical care depending on the country (language, laws, cost, etc.), could be challenging to obtain. While the chances of getting sick on a two week vacation to an exotic location is possible but minimal, getting sick on a yearlong adventure to dozens of countries is almost inevitable.
In an effort to not get ill, we’ve been diligent about washing our hands, keeping a distance from people who are obviously sick, applying antibiotic ointment on even the most minor scrapes, and taking care of our bodies and minds (rest, meditation, stretching, etc.). Additionally, in an effort to try and avoid injury, we’re cautious or avoid physically precarious situations, like hiking off trails, traversing steep inclines or declines, and maneuvering low ceilings and overhangs, to name a few. Furthermore, to proactively mend injuries we apply muscle ointments, stretch, and try to get plenty of rest. In this regard, our travels have been interrupted very little by illness and injury, although we haven’t been able to escape all incidents (we're human after all!). We’ve each had minor colds, scrapes and bruises, and aches and pains. Out of either good fortune, or our stubbornness, these incidents have had very little effect on our travels (with the exception of injuring our feet in London) and fortunately, natural remedies and over-the-counter medications have been sufficient to regain our good health.
As we mentioned, our high attentiveness to staying healthy isn’t just to keep our adventures going, it’s also because getting medical care is challenging, primarily because we’re quite unfamiliar with the medical system of each country we visit. As we visit a new city and likely a new country every few days to every few weeks, we honestly haven’t taken the time to research the medical system in each location and how we as foreigners should traverse it, if we need it. Many European countries have Universal Health Care, which simply put, means that citizens receive free healthcare (paid for by taxes), however, this doesn’t necessarily mean that foreigners will receive the same benefits. For the most part though, any person can be fairly confident that they’ll receive the necessary medical care, despite their nationality or financial means.
Now with all of that being said, we think you can guess what’s coming…
Just a Common Cold
While in Prague Czech Republic, Shannon started to get a sore throat and runny nose, and immediately we ceased physical contact, no hand holding, kissing, sharing of food or water, etc. This is common practice for us, as the last thing we want is to spread our cold to the other person. Shannon started to take medication and rest, and over a couple of days the symptoms seemed to move from her sinuses to her throat and lungs. She begrudgingly, and at Sergio’s insistence, started gargling warm salt water and inhaling the steam and moisture from the boiling salt water on the stove (imagine a DIY inhaler).
A few more days passed and Shannon seemed to be healing from her cold and by the time we left Prague and moved on to the United Kingdom she was nearly back to 100%. However, a small dry and tickling cough seemed to linger. She ignored it, but Sergio was persistent in making sure she attended to it. (Shannon here: It’s annoying in the moment, but oh how I’m grateful for his care and persistence!) We carried on normally for the most part, and continued sightseeing and working.
Roughly, three weeks passed from the onset of the cold and we’d made our way to a house sit in Leeds, UK. We explored the area, seeing many of the beautiful attractions in Leeds. Plus, we had the comforts of staying in a home (on a house sit) with the company of Percy, an independent cat that, once he warmed up to us, started following us around the house when he wasn’t sleeping next to us or on his bed. And, while we admit, it’s a tangent, we must comment on how adorable he was. He immediately had Shannon wrapped around his little ‘paw’, as she succumbs to any pet that cuddles with her, nudges her for attention, and as we learned on this house sit, follows her around. Most notably about Percy, was his routine of drinking water. We made sure he always had plenty of water to drink in his dishes, however he much preferred drinking directly form the tap and would wait next to the kitchen sink for us to turn on the water to a slow stream. Moreover, we found it quite comical that although the stream of water would always hit his nose when he first started to drink, he seemed to always be surprised by it!
Okay, back to the story at hand! A few days into our stay in Leeds, a Saturday morning to be exact, Shannon woke up with a small earache in her left ear. She thought little of it, until it was worsened by her shower, causing her to be in quite a bit of pain. For a bit of background, Shannon suffered from frequent and severe ear infections as a child, nearly having to have drainage tubes placed in her ears. As an adult, she’s come accustom to doctors remarking on the scar tissue when they look into her ears with an otoscope. All that being, she hasn’t had an ear infection since she was a child.
Attempting Natural Remedies to Avoid a Trip to the Doctor
Important! We must point out that neither one of us are medical professionals, we haven’t attended any medical courses, or had any medical training. We’re only able to rely on our common sense, the information we’re able to gather from various resources, and our life experiences. We, in no way are giving medical advice, and if you find yourself in a similar situation, you should seek professional medical advice immediately.
Our best tool in our tool box when it comes to a situation we lack knowledge on (medical or otherwise), is research. We’re fortunate to have the internet, but if needed to we could go to the library and fire up our distant memories of the Dewey Decimal System. In this case, we turned to the internet and our research was twofold; first, what were we dealing with? Was it an ear infection, and if so what type: inner, outer, or middle ear? Second, what remedy options did we have, and could we heal it ourselves without direct medical attention?
From our reading of ear infections, we gathered that Shannon was experiencing either a middle or outer ear infection in her left ear. Her symptoms included pain in the ear canal, pressure in the ear, loss of hearing, and difficulty adjusting to a change in pressure in her ear, like changing her orientation from laying down to standing up and vice versa. Thankfully, after reviewing symptoms, we were reasonably confident it wasn’t an inner ear infection.
DIY Remedies (at home or over-the-counter)
If you’ve ever looked up DIY (Do It Yourself) remedies online, you already know that the internet is a world unto its own and there aren’t many limits as to what you can find. Therefore, it’ll be of little surprise that we found everything from very reasonable recommendations to some outlandish suggestions for healing ear infections. On that note, to be honest, we even tried something that some people may have considered to be a bit on the outlandish side of the spectrum. Also, keep in mind that we didn’t know what a trip to a physician in the UK would cost or entail since we were foreigners. Ultimately, we wanted to avoid it if possible. So, with the warning made that we were stubbornly set on trying to heal Shannon’s ear pain, here are the treatments we considered (and the two we tried at the end of the list):
- Olive Oil – Place a couple of drops of medicinal grade olive oil into the ear canal. Make sure to keep your head turned to the side and let it sit for five to ten minutes. Since the cause of the ear infection is most likely bacterial or fungal growth on wax build up in the ear, it seems logical that relief could be found if the offending wax is removed from the ear.
- Tea Tree Oil – Tea tree oil has antifungal properties, therefore you can place a few drops of pre-diluted tea tree oil into the ear canal in an attempt to kill any fungus that could be the cause of the ear infection. It’s important to note that you want to use a reputable brand of tea tree oil that’s intended for use on human skin. Additionally, concentrated (not-diluted) tea tree oil can be harmful, so proceed with caution, or better yet avoid it altogether!
- Lemon Juice – the acidity of lemon juice may kill bacteria, therefore you can try to place a small amount of lemon juice in the ear canal and let it sit for five to ten minutes, before turning your head to let the ear drain naturally.
- Salt – Salt also has antibacterial properties, so another possibility is to dissolve it in lemon juice (described above), and let it sit in the ear canal for five to ten minutes before turning the head to let the ear drain naturally.
- Garlic – Like tea tree oil, garlic has antifungal properties. Therefore, with the intent of killing any possible fungus in the ear, press fresh garlic and extract its natural oils. Place a small amount of the pressed oil into the ear and let it sit for five to ten minutes before draining it.
- Vinegar – Finally, one we tried! Similar to lemon juice, the acidity of vinegar creates a harsh environment for bacteria, killing most of it. Additionally, we were reassured when we’d found ear drops at Tesco that contained the active ingredient (acetic acid), which is vinegar. We opted to place a few drops of distilled vinegar (online remedies varied in the type of vinegar recommended) into the ear and let it sit for five to ten minutes. Shannon then turned her head and let the vinegar drain naturally. She found the vinegar started cold in her ear but quickly became rather hot.
- Heat – Lastly, the second one we tried! Apply a hot water heating pad to relive pain. It relived Shannon's pain, however we’re not sure if it did anything to reduce her infection.
We hoped that what Shannon had was an outer ear infection (also known as ‘Swimmers Ear’), as the treatments above were more likely to be effective. However, we thought it more likely that she had a middle ear infection, so we continued to do a bit of research. We found the NHS (National Health System) website for the UK to be extremely helpful. Similar to the style of WebMD, it described the symptoms, causes, and treatment of a middle ear infection. It also outlined that ear infections often heal on their own, without medical intervention within four to five days. The NHS website really helped to put us at ease and realize that we didn’t need to get antibiotics right away.
In addition to continuing natural remedies, vinegar and the application of heat, we waited it out. Shannon’s ear was most painful on the first day, and subsided significantly from there. It seemed to improve at times, and then again worsen, yet the pressure and hearing loss didn’t change much over time. She experienced drainage of her ear at night, so she slept with a towel on her pillow. She was also careful not to get water in it and to dry it thoroughly after a shower. We don’t know if the natural remedies helped, if the drainage she had was a good sign or not, but her ear didn’t seem to get significantly worse over the passing days. From what we observed, it seemed to be a lingering infection, but not an emergency. However, not wanting to risk permanent damage, a severe infection, problems on a plane when flying to our next destination, or anything else, after the five days recommended by the NHS website, we sought medical assistance.
Medical Services in the UK for Foreigners
Important! This is our experience, told for your reading pleasure. We don’t have insight into the workings of the UK medical system beyond our personal experience. We don’t know if what we experienced would be the same for everyone, in every place in the UK. Someone else’s experience could vary greatly from ours and what we experienced may or may not be standard and regulation in the UK.
What do you do when you’re in a foreign country and know nothing about the health care system? We can only think that it’s the same in the US for visiting foreigners, as it was for us in the UK (or any other country for that matter). We didn’t know where to start, where to go, or what it would cost, and even though we kept asking, Percy the cat wasn't answering our questions! We concluded that we needed to figure out a starting point in the NHS, so that we could get basic medical assistance, hopefully without breaking the bank. In this case, as we usually do, we started with research online…
Non-Emergency UK Help Line: 111
Through different UK websites and the NHS website, we found a non-emergency medical phone number. We gathered that the purpose of the line was to act as a triage service (think of a nurse line), recommending people to the care best suited for their current condition. We thought this would be a good place to start, so we attempted calling the number, but unfortunately, we couldn’t complete the call. It turned out that in order to call the NHS' 111 phone line you had to call from a UK based landline or UK mobile line. Long story short, after a bit of scrambling, we got access to a UK landline and called 111. The call was quickly answered and the person on the phone was attentive. We could tell they didn’t get many foreigners calling, so it took a bit longer to get our information entered into the system so they could help us. Ultimately, after reviewing symptoms and answering the questions, she recommended we go to a walk-in clinic within 24 hours. She gave us the address and phone number, but didn’t know how much it would cost. She tried calling the clinic to ask, but they didn’t answer. She did however find a phone number for an eligibility line that would be able to answer our cost questions. Unfortunately, we called it and received a prerecorded message stating that the line had been shut down. At that point, we made the call to go ahead and visit the walk-in clinic to seek care, despite not knowing what the cost would be.
The walk-in clinic was a 'first come, first serve' clinic, so wait times could be short or extremely long. We decided that it would be best to arrive at the clinic the next morning at opening time, hopefully avoiding a long wait. Since the clinic was over three miles from where we were house sitting, it was about an hour walk. The clinic opened at 8:00 am, therefore we awoke before sunrise (sunrise was approximately 7:00 am) to make our way to the clinic. There was a short line when we arrived, but once the check-in windows opened, we waited under five minutes to be checked in. The woman at the front desk was extremely kind and answered our questions about payment. We were upfront about being foreigners and she let us know that the appointment would be free, however we’d be responsible to pay retail price for any prescriptions. Although we didn’t know what the cost of the prescription would be, we were relieved and thankful that there’d be no cost for the appointment. Our most sincere thank you goes out to the UK taxpayers!
We sat down in the lobby and waited to be called. To be honest, it wasn’t the most cheery and inviting facility, as it reminded us of a low-income community clinic in the United States. However, possibly because we arrived first thing in the morning, it was very efficient. Check-in was simple and we waited less than five minutes to be seen by the doctor. During our appointment, we didn’t feel rushed by the doctor and she was very kind and attentive, answering our many questions. She even took the time to chat about our travels and showed genuine interest on a personal level!
The Medical Visit
The doctor asked what Shannon’s health concern was and once we explained, she used an Otoscope to look in Shannon’s ear. Without much fuss, she determined that Shannon had a middle ear infection and that it wasn’t too serious. We asked about Shannon’s persistent dry cough, so she listened to her lungs and determined the cough wasn’t an infection or virus. It was just a lingering cough from the cold that would heal over time, or it could have been caused by drainage from the ear infection. For the ear infection, she prescribed a multi-purpose ear spray that included antibiotics, antifungal, and steroids. She went on to say that if the spray didn’t work after a week, to return and she would likely prescribe a round of oral antibiotics.
As you may imagine and if you know us at all, we wanted to take full advantage of our time in front of the doctor. We’d discussed between ourselves ahead of time what questions we wanted to get answered, so we were prepared during the appointment. With that being said, along with what symptoms to watch out for, when to seek additional assistance, and how to use the prescription, we found out the following as it pertained to Shannon’s specific case:
- It was a good idea to continue our DIY salt-water humidifier for Shannon’s cough (heating salt water to a boil on the stove and then inhaling the steam).
- The ear infection could've been caused by several factors or combination thereof:
- Reduced immunity due to Shannon’s preceding cold.
- Excessive bacteria or fungus build-up on her headphones.
- Wearing headphones for long periods of time, as they plug the ear and create an unnaturally warm and moist environment.
- Getting water in the ear and not properly drying it afterwards.
- Bacteria or fungus getting into the ear from Shannon’s long hair.
Going forward, we'd be sure to clean our headphones regularly and dry our ears after a shower thoroughly to prevent new or repeat infections!
All-in-all, we were incredibly grateful for the prompt, kind, and thorough service we received. From reception to the doctor, we never felt rushed or out of place. We thanked them profusely for their help before leaving and among ourselves we later reflected on how fortunate we’d been!
The Pharmacy and Filling of the Prescription
The clinic had given us a ‘private’ prescription for an ear spray. Private means that we’d be paying full retail price for the medicine, as opposed to the standard £8.60 price UK residents pay per prescription. We could fill the prescription at any pharmacy in town and were told the cost would be fairly consistent from pharmacy to pharmacy. We went to two different places to compare prices and they varied by less than £1. Similar to the 111 non-emergency line we called, the pharmacy wasn’t used to handling ‘private’ or foreign customers. It took them a bit of time to figure out how to process our prescription, but in the end, we got it filled without much fuss. After it was all said and done, we were shocked that we ended up paying less than a UK resident would have paid for it, since we only paid £6 for our perscription!
Shannon started the medication immediately, giving herself a dose on the street in the middle of downtown Leeds. She was less concerned what people perceived of a woman walking down the street with her head at a 45 degree angle and rubbing her ear, than she was with healing her ear. Over the next day, her pain nearly disappeared, however the hearing loss, pressure, and discharge continued. Our flight to Athens was days away and we hoped everything would heal by then. We didn’t particularly look forward to navigating our way through another health care system, especially one that was in a different language with a non-western alphabet.
We had no idea what to expect when seeking medical care in the UK's National Healthcare System. We didn’t know if we’d be paying hundreds of dollars for a private consult, or if we’d pay nothing. We’d read personal stories online and knew that either extreme was very possible. We proceeded with caution but knew that ultimately we needed to resolve Shannon’s ear infection, no matter the cost, since a prolonged infection could become very serious and result in a loss of hearing. In our case, we were incredibly fortunate to obtain medical care and a prescription for only £6, which was at the time equivalent to about $8 US dollars. We also only had to wait a few minutes to be seen, and the entire process, from the time the clinic opened to when we walked out, was under 30 minutes!
Again, we don’t know if this is a normal experience for UK citizens, or foreigners for that matter, but it was our experience. If you ever get sick in a foreign country, we hope you're as fortunate as we were. We’re incredibly grateful for the kindness and generosity we experienced and we have nothing but positive things to say about our experience (albeit very limited) with the NHS in the UK!