On being acutely ill and far away from what we know

Waaah, we wanna go home! (40)

On Monday, November 7, Amy got a sore throat. The next day, Scott lost some hearing in his right ear, a problem which cleared up after an antihistamine.

Those innocuous symptoms turned into cases of Covid (diagnosed via at-home testing on Saturday, November 12) that were severe enough to have us contemplating emergency medical care.

Scott has spent a fair amount of time over the last ten days trying to think through how things might have been different had we still been in St. Louis.

For one, we managed to dodge Covid fairly comprehensively since it became a thing people knew about. We are now even more convinced than we’ve ever been that we had Covid before there was testing for Covid. We were pretty sick with comparable symptoms back in March, 2020. Since then, we’ve been fine.

Our lifestyles in St. Louis made it as easy as possible to steer clear of the disease. Scott worked from home for a while and even after school was back to in-person he commuted there alone in his car, had his own office, and his job didn’t involve being in a classroom. Many of his families chose to meet virtually and the school first mandated then encouraged masking, so he was rarely in a closed room with people he didn’t know well. We streamed church services and wore masks when in-person gatherings resumed. By the time we left the U.S., though, we’d stopped masking at the grocery store and in church.

What would things be like if we were still in St. Louis? It’s hard to say. We’re not aware of what Scott’s former school is or is not doing these days regarding Covid. Are more people masking again in church and at Schnucks (grocery store)?

Here in Lisbon, masking on public transportation and in farmácias was required until August 27. Almost everyone did mask and even after the rule was changed there continued to be a few masks here and there. Right before we got sick, Scott thought maybe he was seeing an uptick in mask wearing on the Metro again - public health officials began in late September to “recommend” that masks again be worn in farmácias and public transport facilities. In some farmácias, the pharmacists wear masks; in others, they don’t.

There’s no way to tell where we may have picked up our cases. We’ve both been unmasked in church, on the Metro, on buses, at the vet, and we’d even been to a restaurant or two in the days before symptom onset. We could absolutely have been more careful. Would it have mattered? No way to know.

What is unquestionably different, though, is how things were once we got sick. We could have managed a short drive in a car to, say, pick up a few essential grocery items. The thought of walking to Pingo Doce and back was pretty daunting, though, so we finally gave in and - for the first time ever - ordered groceries online.

Online Grocery Delivery

Our Glovo experience was pretty much exactly what we thought having someone else shop for us would be: we got lettuce with a terrible expiration date. (The following day. Last time he’d gone shopping, Scott found multiple bags that were good for over a week.) And when the toilet paper we requested was not available, there was no option to get a different kind; we got no TP. We did end up with enough food to get us through the worst of the illness, though.

We’re glad online grocery shopping is an option. It’s not one we plan to use again unless in similarly dire straits.

Farmácias

Another thing that feels very different here is that pharmacists have a lot of power. There are farmácias every couple of blocks around Lisbon. Near as we can tell, they’re all independently owned and operated - there may some loose affiliations but nothing like a CVS or a Walgreens.

The closest one to our apartment is 290 meters basically due south. There’s one literally on our street, 450 meters due east. There’s one 450 meters due west that’s not far from our nearest Pingo Doce.

On our first night in Lisbon, when we arrived without luggage thanks to Air Canada’s shenanigans, Amy ventured out to the closest farmácia to try and get a couple of days’ worth of some essential prescription medications to tie her over until our bags resurfaced. The pharmacist referred her to a clinic where she could see a doctor and obtain a prescription. A couple of very helpful local friends suggested she try a different farmácia rather than go to a clinic. That advice didn’t make sense at the time. It does now. Since then, we have gotten prescription medicines without a prescription at both of the other nearby farmácias.

So when we first started developing what we thought were cold symptoms, Scott visited the friendly folks at the bottom of the hill and asked for a recommendation for cough medicine. After a brief back in forth in a combination of English and Portuguese, he returned with some mucus thinning tablets and a couple of types of cough drops. Later, in a different neighborhood, he got Actifed over the counter and, later still, Amy went back for another cough controller. And when our friend Tim was kind enough to venture to yet another nearby farmácia on our behalf (you’re a lifesaver, Tim: choose your flavor!), we realized that the very same Ricola cough drops that Scott paid 3,50€ for at the bottom of the hill were 2,99€ at a place 400 meters due north of us. Do prescriptions also vary in price from store to store?

The new-to-us medicines purchased in the last week by three different people from four different farmácias.

Emergency Care

The biggest difference, though, may be in what happens when self-care is no longer sufficient. In the U.S., there are urgent care clinics. We greatly preferred those to emergency rooms. The care we’ve gotten at these facilities has been more than sufficient - even terrific at times.

Here, there appears to be nothing comparable to urgent care. And emailing Amy’s current GP is not an option. So if we need help quickly, we must choose between an emergency room at a public hospital vs one at a private hospital. Reports we’ve read from other expats vary widely in terms of wait times, costs, and experience with English-speaking doctors at both types of places. Some folks are in and out with laughably small bills, others wait for hours and are sent along to different facilities when they do manage to see a doctor. There are too many variables to factor in to make an educated guess as to what would have happened had we opted to seek help during any of the stretches where Amy had trouble breathing. And, frankly, that’s kind of terrifying.

That’s all for now.

Love from Lisbon,

Scott & Amy