Emergency versus urgent care

What to do

A while back, I woke up with nausea. Which decided not to play nice and eventually led to the worst vomiting I’ve ever had the … joy to experience. Naturally, as is always the case, bedtime is when it was the worst and it progessed to the point where it became time to get care.

But from where?

In an ideal world, I would call my general practitioner. In the US over the years, I had a few gp’s who would have gotten me in same day. But this was just worse enough that I knew I would need to be hydrated if nothing else, and even a gp wasn’t going to cut it. But let’s play it out. If I call my gp here … Oh, wait. I can’t call my gp here. I can make an online appointment for a week to 10 days from now. What about something that the nurse or nurse practicioner can handle? Like, say, a nasty cold that went into your chest and you’re wondering if you have bronchitis? Nope, still gotta make an appointment, for a week or so. There’s no nurse to call back, no nurse practitioner to see me. In this case, I’m vomiting all over place. I’m not waiting a week.

With this level of illness, I would ordinarily head straight to an urgent care. There was an explosion in the number of urgent care centers in St. Louis, and by the time we left there was one every few miles. The only questions were which ones were open and which one had what facilities. Oh, wait, they're even putting urgent cares in pharmacies now. It feels a little bit like when Dunkin Donuts¹ took over every corner.

When we first arrived in Lisbon, we thought gosh what happens if we get sick?What do we do? So we made a plan.² It's a great idea. But it was made when we first arrived and we didn't really understand how things worked. We have since (say, after this experience!) checked this plan with a native Portuguese who is a doctor here. She confirmed that our plan is solid.

Our Vetted List of Where To Go In a Medical Situation

Stroke, heart attack, life threatening issue? Calling 112 gets you an ambulance which, we understand, will generally you to a public hospital

Urgent care level of illness or injury? Private hospital emergency center

Public emergency centers have a prodigiously long wait. They also have most of the same doctors who work in a private hospital. They have the most recent and best machines. Doctors of different specialties are on site and available.

Private hospitals have much shorter wait times. Some will let you see how long on their website and it’s usually under a half hour. We’ve also heard that at private hospitals you’ll be more likely to get a doctor who speaks English, but since doctors work at both public and private hospitals … well, we’re not sure how accurate that is.

Scott got the uber and we went to Hospital da Luz, the private hospital with an emergency room. I frequent this hospital for its doctors the most.³ When we arrived, triage slapped a bracelet on me with writing. Scott says it was my name and birthdate. I also got a yellow bracelet. I figured that was my medication allergy like I usually gets. We found out later that it’s a bracelet to let everyone know the seriousness of the case. Red, yellow, or green are going on your wrist.

I can only speak to the hospital I went to, but it was not what we are used to. Instead of beds with curtains to pull around them there were uncomfortable chairs that can recline some.⁴ No blanket or sheet or pillow. Just patients staring at the patients across the aisle. I admit, that was kinda creepy. At my moment of being most sick, I don’t really want people staring at me, unless you’ve got a white coat on.

We have no experience with ambulances (praise God). We have certainly heard many third-hand negative stories. We’ve also heard a few positive third-hand accounts. If anyone has an experience with an ambulance, positive or negative, we would greatly appreciate it if you would share that in the comments below so that others can learn from your experiences. Feel free to make it as impersonal and detail-free or nitty-gritty as you like. Whatever you know will be more than we do. We’re all in this together.

There are a lot of things about health care here that are quite different than we are used to.

I can’t say the care I received was bad care. I stopped vomiting. Well, almost ;-) And they set up an appointment for me with a specialist the next day, so I would be taken care of.

That said, none of it was done like we are accustomed to. That’s a hard time to be questioning or uncomfortable with your care.

They:

• didn’t know my medical history including medicines I am taking or allergic to (yes, we’ve been to that hospital for general care before)

• didn’t give me a diagnosis

• didn’t give me information on the medication they administered

• didn’t treat me in the ways that I am used to

On top of that, I was given water. Being so thirsty from dehydration, I started sipping at it. Ten minutes later someone else came in and yelled at me for drinking water. Well then hook up the saline IV already ran through my head. The next day I remembered, oh, right, when you are vomiting, especially repeatedly, you don’t put water down there.

Hopefully you will never need this information. But if you do, maybe it can make your experience a little less confusing.

That’s all for now,

Love from Lisbon,

Amy (& Scott)

PS Yes, I’m fine now. Thanks!

A seating stool/bench in one of the hospital’s waiting rooms that is geared towards kids.

1. Ok, so that’s New England. Walgreen’s maybe? What’s the most ubiquitous store where you are?

2. Josie lovers, fear not! We also made a plan for her!

3. Not that that seems to matter. They don’t share information on one central system. I’ve found the same to be true of the other major private hospital in Lisbon, CUF.

4. You try vomiting from a sitting position. When I had to get on the floor for another round, they became very upset. The floor, apparently, is not clean. Not sure what else I was supposed to do there.