Pneumonia in Portugal

Ah, the joyful release of death…

Granted, I do not know that death is in fact a joyful release, given that I am, actually, alive as I write this.

I am simply assuming that it will be, based on this: Bacterial pneumonia is an evil, evil creature with whom I never again wish to be acquainted.

During my more-than two-week bout with this nasty little bugger, there have been moments the fever was so high and the coughing so violent… I could only imagine that death would be my sweet release.

After living in Portugal now for more than a year, I have finally had a proper run-in with the Portuguese healthcare system—and I can thank bacterial pneumonia for the introduction.

I have no idea where I picked up this ailment. I went to bed one Tuesday night a couple weeks back with a bit of a mucousy throat and trouble swallowing properly… and by Wednesday morning I was shivering aggressively with 101.5 fever, vomiting, and uncontrollable coughing.

By Friday, the temperature had climbed to 102.7.

I was sleeping 15 hours at a time and alternating between torrid sweating and violent shivering. Couldn’t stand for more than a few seconds. Couldn’t breathe without bringing on a coughing fit so violent that it alone was enough to make me vomit.

And given that I had zero appetite, all that was coming up was air and what little bits of water and 7Up I managed to ingest.

So… off to the doctor.

Now, I’ve dealt with the Portuguese medical system in the past. But all of that was generally minor stuff. A neck/shoulder issue. Head cold. Sinus infection. Like I said, minor stuff really.

But bacterial pneumonia (on my right lung, it turned out) was something altogether different.

I was in and out of the emergency room a few times over six days.

The doctor I had—I told him, “You might be the best doctor I’ve ever had.” And I meant that. He took a great deal of time with me, truly trying to understand my symptoms as well as the highlights of my long medical history. Great bedside manner, too, particularly when I started losing my lunch in his office after another violent coughing fit.

He even offered to write a letter for me explaining that I was in his care so that I could forward it to several airlines, since pneumonia forced me to cancel a trip to Asia. (The airlines didn’t care. Truly a crappy industry as far as I’m concerned.)

The triage nurse I had on my third visit was equally thorough and walked me through a nearly eight-hour day of IV fluids to stop the pain of coughing and the waves of nausea, as well as a CT scan of my lungs, blood tests, and various other procedures.

She detailed a litany of prescriptions and translated everything into English for me.

Doubling up on the antibiotic load finally knocked out the pneumonia, and by Day 12, I was finally strong enough to eat something and move around.

Though, even now, more than two weeks later, my lungs still hurt if I breathe beyond about 40% of my normal oxygen intake, the coughing refuses to die away, and I’m just worn out all the time.

But… I do not look toward the joyful release of death anymore.

Why do I share any of this?

Well, I and my colleagues at International Living regularly write about living, working, and retiring overseas… and part of that is dealing with medical needs while living abroad.

Lots of us hope or assume we’ll never need anything beyond some basic Band-Aids and flu shots when we’re living overseas. That’s certainly the mindset I’ve had while living in Europe (first Prague, then Portugal) for the last six years.

But sometimes the best-laid plans of digital nomads run afoul of reality and you find yourself in need of real medical care.

So, I wanted to share with you what that real medical care looks like in Portugal, a country that I know sits atop the wishlist of lots of Americans contemplating a move to Europe.

It’s pretty darn good—equal to any care I’ve had in the US. The equipment and the hospitals are no different than you’d find anywhere in the States. And the bedside manner is far better here, if only because doctors do not seem beholden to schedules dictated by managed care. They actually take time to talk and understand you as more than a bucket of symptoms to assess quickly, before moving on to Patient #49.

My fight with pneumonia—the three hospital visits, tests, CT scan, IV elixir, and a pharmacopeia of drugs—cost me about $300 all in.

Granted, I have private insurance, and I was at a private hospital, so that cost was basically my version of a co-pay, I guess. (I pay about $2,500 per year for Cadillac coverage for a family of three.)

Had I gone into the state system, to a state hospital, the process would have largely been free, aside from some minor costs for the meds. But in the state system it can take hours and hours—and hours and hours—to be seen. Ain’t nobody got time for that, especially when you’re praying that death spirits you way quickly.

So that was my official run-in with the Portuguese healthcare system.

I think my big takeaway is: Never—ever—catch bacterial pneumonia again.