Turkey time again!

To recap three years worth of posts about me and health …

Before 2009 I was more or less a health system dropout.  Then in 2009 I had issues with my heart.  I went to Turkey and got my heart fixed, then I came back to Reno and soon was again … a health system dropout.

Reno Heart Physicians (RHP) will write prescriptions for only one year, so I have had to return to them twice in the intervening years.  They charge a good chunk more more each year – $250, $290, $310.  Costs keep rising, and since they are a for-profit company that means charging more money to sick people because god forbid they should cut into their profit margins … and there you have the American health care system in a nutshell.

Each time I’ve visited the doctor she says I really should get an echocardiogram. Since that would be $900 off my credit card, I’ve declined.  Please just thump me and listen to your stethoscope and make the best judgement you can – you know, like they did before echocardiograms.

So now here we are, summer of 2012, my meds are running out and it’s time for a visit to RHP.  I keep thinking about that echocardiogram and the general notion of having better information on the state of my health.

Now, the other piece of the narrative is that when I wrote my Turkey doctor an update email in 2010, I complained to him about the $900 echo, he cleverly told me to come back to Istanbul and he’ll do it for free!

So … after my mandatory period of stewing about this without doing anything about it, I finally write an email to Dr Cicek.  He says groovy let’s do it (I paraphrase…) and hands me off to the International Relations folks to handle the details.  Within a couple of weeks we have it all ironed out and I have my reservation to leave SFO on October 16 and return on the 29th.  The extra flight from Reno to a real airport is always annoying, so this time I’m squeezing in a Martha-visit at both ends by driving to visit her then flying from San Francisco.

Also, a completely un health-related event was that planning for this trip caused me to actually pull the trigger on getting an iPhone.  I had already done exhaustive research on smartphones twice over the last 2-3 years, so I’ve front-loaded all my usual decision stress and dithering time.  I’m well past the two-year contract on my little dumbphone, so this was a simple matter of going to the Apple store and buying it and picking a plan.  So easy once I decided to do it!

It was all a little too sudden. I had a mere two days to get used to my new phone before heading off into the wild blue and turning off my brand new cell phone service.  But the iPad had trained me on most of its quirks, so it was no big deal.   It worked out quite well.  I was able to leave my camera at home, as well as the camera battery charger, and the dumbphone battery charger, because the iPhone and the iPad share the same charger.  Excellent!

I am not excited about this trip.  I don’t really want to do it, I’d rather be cruising around the west in the ole van, doing some version of my beloved Fall Colors Tour.  But I’ve built it up in my mind as something I really must do, so here I preparing to go to spend two weeks in Istanbul …

Getting There (Oct 17)

Leave Reno on Monday, drive to San Rafael, spend the night at Martha’s.

Hang with her and Tyler all day Tuesday.  I talk her into driving me to the airport, so late afternoon we drop the van off at the Marin Airporter lot ($4/day) so it will be there when I get back, and off we go to the airport.  I still have a bad attitude about the whole thing.

Pretty easy flight, leave SFO at 9pm on Tuesday, Munich Airport mid-afternoon Wednesday (lost nine hours), finally arrive Istanbul midnight on Wednesday (lose one more hour).  Fifteen hours of flying, two hours of waiting and ten hours of time change comes to 17 hours of actual time and 27 hours of clock time.  Erhan picked me up and drove me to the hospital, just like two years ago!  Pretty much everybody who was at the hospital three years ago is still there now.  Not much job mobility in Turkey I guess.

One thing that is different from two years ago is that there is a hotel at the hospital – the Titanic Comfort Hotel :)))  The name is not meant to imply that the comfort provided is titanic, rather there is a chain of hotels named Titanic, some of which are very big! The little boutique hotels in their chain are called comfort hotels.  It’s a cozy little two story place, maybe 40 rooms, about 100 yards from the hospital.  I don’t know if they chose the name with knowledge of our English association with the doomed ocean liner, but Titanic it is!

Doctor Day – Thursday

Asleep 1:30am-ish, awakened 8:30 for the medical marathon I came here for.

This was a very long day of shuttling from doctor to doctor.  More or less in order, here’s my stops:

• eye doctor – I think the most tightly wound of the doctors I saw.  She did not like my contacts, told me I have “dry eye” whatever that is, prescribed two kinds of drops.  She was a little high strung for me.
• ENT doctor – Pulls a big nasty wax plug out of my right ear, tells me I will breathe easier on my right side than my left.  She was cool.
• organ scan – I thought this was the echocardiogram, but this is a different kind echo, checking out the organs. My first clue should have been that he was rubbing his wand around my guts rather than my heart. In my limited experience echo techs are happy people who like their work.  They do medical stuff but not icky medical stuff.
• hand me a bottled water – Drink it and pee in a cup.
• chest x-ray
• lunch! – hospital treat, in the cafeteria with all the doctors and nurses.
• oncologist – the dreaded finger up the butt, prostate is enlarged but not evidently too scary.  I agree to a biopsy until I find out it’s $2,300 and extremely uncomfortable, so I take a pass on it.  I liked the doctor, even though he gave me the worst news of the day.
• treadmill – I do very poorly compared to the strapping 30-something Turkish fellow on the next machine.  I really am terribly out of shape.
• interview with a GP who kind of ties it all together and interprets the results.  Most organs normal, I have a fatty liver, but not too fatty.  Cholesterol is surprisingly normal. I will not bore you with the rest of details, but they are available on request :)
• a little break to walk outside and across the parking lot to the little pharmacy to fill the prescriptions I have been given so far – two kinds of eye drops and two kinds of skin cream.
• echocardiogram – Ah, finally my freebie!  This technician is cute and chatty and we have fun.
• interview with Dr Cicek – He is very pleased with his work, the valve is working “perfectly”, no regurgitation.  He thumps me and listens to me.  He thinks I am basically ok, I just need to lose the gut and get more exercise, which I could have told myself without flying to Turkey, duh.
• dentist – The dental office bills separately. It is distinctly more of a profit center than the other stops.  Ms Dentist doesn’t bother with x-rays, she just bangs on suspicious teeth (rap!  “does that hurt?”), and within about six minutes of settling into the examination chair she’s knocked out an invoice for cleaning, replacing amalgam fillings and a nighttime grinding protection retainer.  This invoice is conveniently viewable on a tv monitor over my head so I can stare at it while she bangs and pokes some more.  I punt on the fillings and cleaning, but I’ve had the nighttime grinding thing (bruxism) for a few years.  My preference is always to go at causes rather than symptoms, so I have made half-hearted attempts to somehow chill out the tension I must be holding by meditation.  This hasn’t worked worth a damn, so I’m going to go for the retainer to at least protect my teeth from damage if I can’t stop myself from doing it.  She took the impression for that and I’m on my way.

My long day is finally over.  Back to the hotel for a nice long sleep.

Bus Hell Day – Friday

To complete the picture of yesterday I should mention that Burcu was my International Relations Department handler.  It was she was the one who woke me up, who met me at the billing office and shepherded me from waiting room to waiting room.  She had spent some time in the Bay Area, so we had some things to chat about.  When she was called away to fight other fires elsewhere (and those folks always have many things going on), my backup handler was Javid.  There was a nice guest appearance from Murat, my buddy from the first trip who has moved up the ranks to big-time manager, much too important to spend the day managing a single patient.  I am flattered that he squeezed in a quick lunch date with me. (yes, I am a smart-ass :)

I mention this because an ongoing project with these folks yesterday between doctors was to figure out what I should do with myself for the rest of my ten (actually 13!) days here.  My basic plan is to get a room somewhere on the European side for the rest of my time and just explore.  We decide that Taksim is the area in which I should stay.  A quick hotel search reveals that there is another Titanic Comfort Hotel in the area, and since I’ve enjoyed this one I decide to try that one.  The International Relations staff reserves me a room there, so that is the plan.

I spend the morning tying up loose ends from yesterday – show my contacts and glasses to the disapproving eye doctor, get my retainer fitted, hand in that poop sample I wasn’t able to produce yesterday, then of course the all-important paying of the bill.  Mid afternoon Burcu puts me on the hospital shuttle bus and off I go.

The ride to my hotel turned out to be a pretty horrible experience – a perfect storm of Friday night traffic and a driver that wasn’t bright enough to figure out how to plan a novel route and who was way more interested in giving rides to his friends than getting me anywhere at any time.

• 3-ish – Leave in the hospital van.  A couple of ladies in the front with the driver, a couple of farmer dudes in the back seats, and a few airport-bound Germans and me in the middle.
• 4-ish – Arrived at the Suayide hospital annex.  Just sat there for about 1/2 hour, we were there so long that everybody got out and wandered the sidewalks. We took on a couple of more folks who rely on this shuttle to commute home to the western European suburbs..
• 4:40-ish – Finally left Suaydie, made our way across the bridge to Europe, and dove into the Taksim district traffic to deliver me to my hotel.
• I notice people becoming increasingly agitated, people yelling at the driver, the driver yelling back.  Finally, someone hands me the driver’s cell phone, and there is the voice of Burcu!  The airport folks are afraid they’ll miss their planes, so can we please bail out of delivering me and instead deliver folks to the airport.  I say that’s fine, folks gotta make their planes.
• 6:10-ish – Drop off the airport folks.  They seem happy, so i guess they’re on time.  That leaves the two ladies in front and the two dudes in back, and me and the driver.
• After a few exits we leave the freeway on an extremely congested avenue where we sit in traffic for about 40 minutes to take the ladies to the main bus station.  The driver and the ladies make their affectionate goodbyes.
• 7-ish – We struggle on along in various bumper-to-bumper traffic jams, just me and the driver and the two dudes, who have now moved to the middle and are being pretty animated with the driver.  I have no idea what is going on, haven’t really for the whole damn trip.
• We get to what I now know was a metro stop for the T1 train, in the Fatih district (I will walk by here eleven days later).  We stop, driver opens the doors, but the dudes get really agitated and won’t leave.  It’s a busy street (as all are the main streets, all the time) so we can’t just sit there arguing, so we drive on, but there is serious yelling going on.  I don’t know Turkish, but I know pissed off, and these men were seriously angry.  More yelling.
• A little after 7 – the driver pulls over and turns off the engine … and just sits there.  This is when things went from tiring and mildly annoying to genuinely worrisome.  We weren’t going anywhere!  The dudes yell, the driver yells, and eventually I yell, because I’ve been in this traveling shitshow for going on four hours and now we have just turned off the engine, apparently because these rubes can’t figure out the big city.  Finally, the driver called somebody, handed the phone to the alpha dude.  They talked, and finally they took their giant suitcases and got the heck off the bus!  And finally there is no one else on the bus but me and driver so I am hopeful that he will finally take me to my hotel.
• A little before 8 – The driver stops on a broad avenue, no hotel in sight.  We get out, and wander down the hill looking for the hotel which we eventually find on a steep little side-street after a few wrong turns.

So, about five hours to get from the hospital to the hotel.  Half again as long as it takes to drive the 220 miles from my house in Reno to San Francisco.  It was creepy and strange and unpleasant and almost scary and made me so tired i just went to bed at 9pm.

… and it was a pretty crappy introduction to Istanbul …