Jennifer’s Health Care Odyssey

If you saw my previous post: Albanian Health Care System posted on August 9, 2025 you know I injured my neck by spending a lazy Sunday reading a book. I was stretched out on the couch with my neck resting on the arm of the couch.

During six weeks of physiotherapy at ABC Clinic with little to no improvement in pain the doctors needed to find a pain reliever that wasn’t harmful to my mildly compromised kidneys. Ibuprofen was definitely on the Do Not Use list. They referred me to a nephrologist (a kidney doctor) at the American Hospital, asking that the doctor recommend a safe med to manage the pain while the search for treatment continued.

The ABC Clinic doctors also referred me to a cardiologist to evaluate the compatibility of the blood pressure meds they prescribed with my kidneys.  

I have to say, as much as I appreciated the convenience and service my United States’ Kaiser Permanente health plan provided, I was disappointed to find that no Kaiser doctor had told me that my labs indicated a kidney condition. If that condition isn’t managed, it could lead to kidney failure and a life sustained by weekly dialysis treatments . . .

This was true until I connected with my new Kaiser doctor, Larry Joe Edwards (the best!). On my first visit he reviewed my medical record and asked me how I was doing with my “kidney disease.” What?!

He told me to drink lots of water to keep my kidneys operating at their current midlevel function and referred me to a Kaiser video class on what foods were good for the kidneys and which foods were bad. (Avocado was one of the bad ones. Sigh.)  

In any case, I had no idea these ABC Clinic doctors’ search for compatibility of my kidneys with the medications I was taking was the beginning of an odyssey. That eventually involved eight medical specialists, each of whom ordered a battery of lab tests to create a baseline of my current condition. As a bonus, there were two dental practitioners involved, too.

NO LIFETIME MEDS FOR ME!

I have always prided myself on my excellent health through healthy eating, exercise, a variety of supplements, and avoiding prescription drugs. I was in my early forties when a doctor told me I needed a beta blocker because I had a prolapsed mitral valve. I did a little research and learned the condition is usually not life-threatening. I said “No” to introducing a life time pharmaceutical into my daily routine. It did motivate me to pay more attention to my exercise regimen to strengthen my heart.

I noticed how pharmaceuticals often multiplied. Sometimes more medications are prescribed to offset another medication’s side effect. I saw how the elderly in my family had as many as ten or more medications by the time they were in the sixties. I vowed that would not be me.

MAYBE ALTERNATES WOULD BE USEFUL

I became interested in alternative medicine, going so far as to become a Certified Aromatherapist, a Certified Clinical Hypnotherapist, and Emotional Freedom Technique (EFT) practitioner, and Reiki practitioner. I got massages, regular chiropractic treatments, Color Therapy, and Bach Flower Remedies.

I was open to antibiotic use for treatment of a sinus infection and a bladder infection now and then, but that was it.

I was proud to be one who “never gets sick” and even more proud that I didn’t take prescription drugs. Truth be told my main source of medicine was essential oils. I remember one time I had a sore on my leg that wasn’t getting any better and went to Urgent Care. I received a prescription for an antibiotic. I threw away the prescription and dug through my many bottles of essential oils looking for my bottle of blue chamomile. I found it and applied it to the sore four times a day for probably four days and the sore healed quite nicely.

I chose a lifestyle of supplements, exercise, and healthy eating that included smoothie meals that contained things like flax seeds and chia seeds prepared in my top-of-the-line VitaMix blender, and fresh fruit and vegetable juices processed with my top-of-the-line Nama juicer. These expensive machines were a testament to my serious attention to my wellbeing.

SIDE BAR: My commitment to juicing was inspired by Joe Cross, an Australian who travelled the US for sixty days touting the value of juicing and demonstrating his weight loss and eradication of a terrible skin disease.

I wanted to be in the best shape possible when arriving in Albania. I knew we were moving to a country where walking was a big part of the culture. Once Covid was in the rearview and the gym reopened, I made a commitment to five days a week at the gym making it through the thirty-minute circuit followed by a couple of miles on the treadmill or recumbent bike.

Oh, did I mention, I hate to exercise, but love being healthy and feeling great. Five days a week at the gym was the price I was willing to pay.

This paid off big time the first few months in Albanian as we were acquiring our essential basics. I was so proud of myself.

WELL, TIMES CHANGE…

My resistance to prescription meds changed when I had a cardiac event seven years ago and had a stent inserted. I was prescribed three blood pressure management medicines at the lowest doses available. That has stood me in good stead — until my ABC doctors became concerned about the effect of the blood pressure meds on my kidneys and referred me to the cardiologist.

This post may not be of interest to any other than my family or someone considering moving to Albania. On the other hand, there may be curiosity of how a simple quest to find a pain reliever for my neck pain that was safe for my kidneys and to verify my current blood pressure meds were safe for my kidneys caused me to embark on a journey weaving in and out among eight medical specialists at American Hospital #3 and the condition known as temporomandibular joint (TMJ) syndrome showed up in the middle of this odyssey. That sent me to a dentist who referred me to her dentistry professor.

NOW THE FUN BEGINS…

There are three American Hospitals in Tirana. The doctors speak English or they have an interpreter present during office visits. We chose American Hospital #3 because it’s the closest to us. It is a 1,600 lek round trip hospital taxi ride (about $18.50 at the current exchange rate).

If you’d like to see what the hospital looks like Google American Hospital 3 Tirana. If you don’t read Albanian click the English icon to see the text in English.

Imagine Each Medical Specialist I Encountered is Represented as One Playing Card in a Deck of Cards

I never saw the doctors in order, fixing one condition at a time. There were always overlaps and side tracks. The best I can do is list the “players” and my experiences with them. You just need to know that every time I was at the hospital it was like a fresh shuffle of the deck as to which specialist or specialists I’d see on any particular day.  

But there’s excellent news! Just so you don’t think this stuff is all gloom. With American Hospital, often a specialist will see you that day. You get escorted to the doctor. If the doc wants labs, you get escorted there. It’s a fast lab and you’ll get results. Then the doctor will evaluate and prescribe. There are two pharmacies in the hospital parking lot (Blue Farmaci and Gold Farmaci), and we have five pharmacies within a block of our apartment.

Is it affordable?  Is the sky blue? YOU BET! For example, an MRI will set you back about $150.00, unlike the $12,000 you’d be charged in the USA.

THE SECRET: ADOPT THE RIGHT ATTITUDE

I consider my health care odyssey / journey / voyage as a game that is played by regularly shuffling the deck and laying out the card(s) of the medical specialist(s) actively engaged in the game at that moment. That would be a pretty good representation of what life was like during this slice of life while navigating my health care.

Every doctor I visited for the first time generated a request for lab tests—multiple blood tests, an EKG, wearing a heart monitor (three different times), a visit to the Radiology and Imagining department for a CT scan, ultrasound, and two MRIs followed by sitting around waiting for the test results and then chugging back to the doctor’s office for further instruction.

Or, I could also go home and return after I got a WhatsApp call saying my lab results were ready for pickup. I’d pick up the lab report and then sit and wait to see the doctor. This could take 45 minutes to an hour or more, but it’s competent and cheap, and far more caring than US health care.

Of course, almost always there was a prescription that needed filling at the pharmacy when I got home. As I mentioned, eventually Barry discovered there were two pharmacies adjacent to the hospital where I could get a prescription filled, which was a time saver.

IT’S A LONG DANCE, BUT THE DANCERS ARE GOOD

For the next seven months I shuffled appointments between “the players” and the lab tests.

I will say all the medical specialists were thorough in getting the full picture of my current condition before offering even the simplest advice. Fortunately, all the doctor visits and tests are extremely affordable. I was glad to have the most current condition on record for future reference if necessary.

I did my best to arrange doctors’ visits or picking up test results for when I’d be at the hospital for a physiotherapy session to minimize the 1,600 lek taxi round trips to the hospital.

If you’ve read this far you may be curious to know what all these doctor visits and lab tests were about. Or maybe not 😊 Your choice . . .

SPOILER ALERT: I am doing just fine as of now! The dance goes on, but the docs are good, caring, and consistent.

NOW FOR THE DOCTORS — IN NO PARTICULAR ORDER

Nephrologist (kidney doctor)

The nephrologist ordered blood tests and a 24-hour urine test. She wanted me to return to her when all the tests were done. The hospital guide escorted me to the lab for the blood tests.

The lab was a two-chair lab with two nurses in attendance, but there was practically no waiting. This was quite a contrast to the twelve-chair Kaiser lab and the ten or twenty-minute wait to get called in to “take a chair.”

I’d grown comfortable with the Kaiser phlebotomists’ stealth-sticks that I could barely feel. At my first Albanian lab visit one nurse was doing the “sticking” while another nurse was speaking to her in Albanian. The draw was a little painful and left a bruise so I think the one doing the draw was a bit new at it. Still the procedure was tolerable. All future blood draws were as painless as any I’d had at Kaiser.

My hospital guide was waiting for me when I left the lab. She gave me a large plastic jug and instructed me to pee in the jug for the next 24 hours then return it to the hospital’s emergency department to drop it off. Of course, that’s what I did.

A few days later I got a WhatsApp notice that my lab results were available to pick up. I returned to the hospital, picked up my results, and asked the hospital guide what to do next. She took me to the nephrologist’s office and told me to sit in one of the metal chairs lined up against the wall opposite the doctor’s office. “Wait here five minutes. I will call you.” As I said in my previous blog post Albanian Health Care System (posted on August 9, 2025) the phrase “five minutes” generally correlates with the Spanish word mañana, which literally translates to “tomorrow” but in real life just means “not today.”

After about twenty minutes or so I was guided into the nephrologist’s office. I told her I had dropped off the urine sample. She reviewed my file, made a few notes, then referred me to the neurologist.

A comment about being the patient of a doctor whose English is her second (or sometimes third) language. (Many also speak Italian, a remnant from the years of Italian occupation of Albania from 1939 to 1943 after which many Italians remained in Albania providing useful services.) Sometimes the doctor will have the accent on the wrong syllable making it hard for me to understand. I often left a doctor’s office with instructions I generally understood (or at least I thought I did), but didn’t always understand why I needed the next recommended step.

This nephrologist was one that I had a hard time understanding. All I knew was she wanted me to see a neurologist (nerve doctor). I guessed it was to discover the source of my intractable neck pain that was the reason for taking pain relievers. I didn’t know it at the time but later learned she also messaged my ABC Clinic doctor and told her what pain meds were okay for me to take.

Neurologist (nerve doctor)

I saw the neurologist once and the neurosurgeon twice. The neurologist visit was very short—less than ten minutes. She ordered a CT scan and told the receptionist to book an appointment for me with the neurosurgeon.

The term neuroSURGEON brought up memories of many conversations with friends who’d had back surgeries — surgeries that either produced no improvement or just made the condition worse.

Okay, I’ll see the neurosurgeon. I’m willing to hear what he has to say. But no way in hell will I agree to a surgery. I had the CT scan and went home. What a relief!

About this time, I noticed that the tip of the thumb on my left hand had suddenly gone numb. Hmm . . .

Neurosurgeon (nerve doctor who performs operations)

When I saw the neurosurgeon, he brought my CT scan up on his computer and showed me where a few neck disks were damaged (age related most likely). That’s what allowed my nerve to get pinched. I told him about my numb thumb. He referred me to a technician who would test my nerve pathway to my thumb to see if there was a blockage.

I returned in a week for an appointment with the nerve technician who systematically applied a little device to locations on my arm. At each location, he’d give me a tiny electrical jolt. I felt each one, which indicated there was no blockage in the nerve pathway. He wrote a report to the neurosurgeon and sent me back to him.

The neurosurgeon was puzzled by my numb thumb but had no further ideas of what might be causing it, which was fine with me. I wasn’t bothered by it. It wasn’t debilitating in any way. It was the neck pain that was making my life miserable.

I was relieved when he did not recommend surgery. Instead, he offered physiotherapy. He pointed out that the hospital physiotherapy department dealt with conditions like mine every day but I was free to go to any physiotherapist I wanted. I chose the hospital physiotherapy department and got an appointment for a few days later.

Physiotherapist (wires, gizmos, and gadgets)

I had 20 one-hour sessions over a period of two and a half months.

I was introduced to the staff at the physiotherapy department and escorted to the office of the department head. He reviewed the report of the neurosurgeon and told me he recommended a series of twenty physiotherapy sessions—five days a week for the first week and three times a week after that. Each session was 3,500 lek ($42.15) or 2,500 lek ($30.11) when purchased in a package of ten. I chose the ten pack to start.

I arrived for my first physiotherapy session, was greeted by my therapist, and escorted to a treatment room. I removed my glasses, shoes, and shirt and hopped onto a massage table, lying face down as instructed.

The therapist covered me with a blanket that went from my waist to my feet and began applying tabs (like they use with an EKG) on my back, apologizing for the tabs being cold. The tabs had wires connected to them.

Once the tab placement was complete, she turned on an overhead heat lamp and activated the tabs on my back that emitted little pin prick sensations. She slowly increased the intensity stopping at a level that was effective but not painful. OMG. I think she’s using a TENS unit on me! (Transcutaneous Electrical Nerve Stimulator).

SIDEBAR: Way back in the late 1980s I was a representative for a TENS company. My job was to visit physical therapy locations—everything from private practitioners to larger clinics and hospitals. I’d do a twenty-minute in-service demonstration of the effectiveness of TENS units to alleviate pain. I’d explain how the electrical current stimulates nerve cells that block the transmission of pain signals and how the electrical current raises the level of endorphins (the body’s natural pain-killing chemicals), which then trigger the body’s pain-relieving power. I told them they could recommend the unit to their patients at no cost to them or their patients. Later I would call their patient and ask if the unit was effective, and if they wanted to keep it, their insurance would pay for it.

After just a few physiotherapy sessions I recognized this TENS thing really works! Yay!

Throughout those couple of months of physiotherapy I fit in visits with the other specialists.

“Jaws” Arrives on the Scene

About halfway through my 20 physiotherapy sessions I began having jaw pain when I ate. The physiotherapist included massaging my jaw during the session, and that gave me some temporary relief.

At the end of my 20 therapy sessions my neck pain was gone. Yay! I had my follow up visit with the neurosurgeon and gave him the good news. And, by the way, my left-hand thumb was no longer numb! He had no explanation for that.

He cautioned me that the physiotherapy did not cure me and the possibility existed that the pain could come back. Just the same, I felt restored. I wasn’t worried. I vowed to be careful of my neck and if by some chance the pain did come back, which I firmly believed it would not, I’d get back into physiotherapy sessions. And that was that.  

WRAPPED UP

It was great not going back and forth to the hospital three days a week. In addition to the one-hour physiotherapy session, I had a forty-minute round trip taxi ride, which included taking time to call for the taxi, waiting for the taxi to pick me up, then calling again from the hospital and getting driven home.

During those months of physiotherapy, I coordinated my physiotherapy appointment days with meeting the other specialists. I eventually began blocking out the whole day on hospital visit days.

OK. ADD NEW DOCTORS TO THE TEAM

The Cardiologist (heart doctor)

In between physiotherapy appointments and other doctors’ appointments there was a constant “player card” shuffle. On many of my hospital trips, I often had more than one appointment.

I came prepared at my first cardiologist appointment. I had in hand my Kaiser report regarding the stent that had been inserted in an artery seven years earlier.

Just like the nephrologist, the cardiologist wanted to have a picture of my current condition before answering my simple question about the safety of my current blood pressure medicines given my kidney condition.

Well, if anything, the docs in Albania are cautious and conservative.

The doctor wrote out a lab order for blood tests (yes, more blood tests) and said she was ordering a 72-hour heart monitor. This device records the heart rate and rhythm the same as an electrocardiogram (EKG) does. Ugh! The darn things are so uncomfortable . . . but what the heck. It is wise to get a baseline in case of future issues.

THE HEART MONITOR COMES

I knew what I was in for with the heart monitor. I didn’t look forward to the three full days of electrode patches stuck all over my chest. The leads are attached to the clunky heart monitor — about six inches long, three inches wide, an inch and a half deep and attached at my waist. It probably weighs maybe eight ounces. It isn’t the weight that’s uncomfortable; it’s the clunkiness of the thing. It must be worn at all times. That means night and day. It is not to be removed for any reason . . . no showers allowed. Imagine trying to sleep with that contraption belted to your waist!

I got hooked up to the heart monitor. Four days later I returned to have it removed. I chose to wait for the monitor’s results and see what the doctor had to say. There was something about the heart monitor report the doctor didn’t like. I didn’t understand her explanations but felt assured she knew what she was talking about. She wanted a second go-around with the heart monitor. Ugh!

OK . . .

When that test came back with some worrisome recorded episodes the doctor recommended a rather invasive test that would include running a dye through my veins while some machine (CT scan? MRI?) would follow the flow to see if there was a blockage. I balked at that test so she asked if I could do a treadmill test instead.

“Perfect,” I confidently said. I’d arrived in Tirana in great physical shape and had been walking everywhere since we arrived. I got a referral to the treadmill department.

This is where I found out there is no consideration for modesty in the Albanian health care.

My US experience in receiving physical examinations goes something like this: a patient gown is offered. The nurse describes what pieces of clothing must be removed. The nurse steps out for a reasonable amount of time for the patient to undress and slip into the gown. Eventually the nurse returns to see if you are ready. Soon after the doctor shows up and exposes only as much of a body part as necessary to conduct the examine.

Not so in Albania.

In the case of this treadmill test I was in full view of the room with two or three nurses busying themselves with this and that. I was asked to remove my blouse and bra. OK . . . that was necessary for the nurse to apply the electrodes to my chest. Once the electrodes were in place I was told to sit in the chair, half naked mind you, with no patient gown in sight while nurses came and went in and out of the office as if it were Grand Central Station.

After ten minutes or so a nurse took my blood pressure — which was very high, probably due to being distressed about my nakedness. She gave me a pill designed to bring down my blood pressure. In the meantime, I was extremely uncomfortable about being exposed.

When it became clear I was expected to do the treadmill test half naked, my breasts swinging in the breeze for God’s sake, people coming and going during the process, my blood pressure stayed too high to take the test. I said I wanted to go home.

The nurses gathered around wanting to know what was wrong, why I was clearly upset, and couldn’t understand what my problem was sitting there half naked. One nurse who spoke pretty good English explained why I shouldn’t be bothered with being exposed, “We are all women here.” When I wasn’t understood a feeling of helplessness crept up and tears filled my eyes. I don’t know what childhood trauma was bubbling up but the feeling was that of a helpless child who had no say over her level of comfort.

I finally was able to dress and leave, which I did thinking I’m eighty-seven friggin’ years old. I’ve had arrhythmia off and on ever since I was forty. I watched my dad be tortured to life in the last year of his life with this and that invasive and painful therapy that did nothing more than add one miserable year to his life. Forget it. I’m going home and whatever happens, happens!

NOTE: Arrhythmia is when the heart beats too quickly, too slowly, or with an irregular pattern caused by the electrical signals that control your heartbeat.

A FEW MONTHS LATER. TIME PASSES.

I was enjoying being out of the annoying loop of doctor visits, blood tests, and hanging around the hospital for hours waiting for the next thing I was there to do. In the back of my mind I carried the memory of the cardiologist wanting me to have that invasive test that I had decided against — until on one lazy Sunday when I was lying around scrolling YouTube videos on my phone and my heart started rumbling and tumbling in my chest! My old friend arrythmia that had visited me off and on for the past 45 years stopped by to say hello.

Only this time it wasn’t a passing thing. My heart kept up its rockin’ and rollin’. Okay, I guess this is for real this time . . . I am on my way to the Promised Land.”

I started breathing through my heart, preparing to make my transition when after what seemed to be about ten to fifteen minutes later, the rockin’ and rollin’ stopped and my heart was back to its normal rhythm.

Now, to be clear, I have no fear of death. You may have noticed that Earth life is hard. There is no arriving at some emotional/mental/physical place where there are no more challenges and life is a permanent delightful walk in the park. (Nirvana, next three exits.) How many earth years I have left is uncertain, But what is certain is that there are a lot fewer years left compared to the ones already lived.

And/But/Also . . . what if my heart “condition” is putting me at risk of having a stroke? Now that is something I do not want to experience.

The only reasonable course in my mind was to revisit the cardiologist and agree to have the invasive dye-in-the-veins test suggested some months earlier.

NOT SO FAST!

NOTE: A stroke is a “brain attack,” It was the third biggest cause of death in 2023. For me it’s better that a stroke kills you. I’ve watched a few friends make their way through the rocky road to recovery. No thanks!

I met with the cardiologist fully expecting to take up where we left off . . . getting that invasive test. But no. She insisted I have another heart monitor test and more blood tests. Argh! I lobbied for the dye-in-the-vein test but she was adamant with a take my advice or leave it attitude (with a pleasant smile to go along with it.)

OK. Back to the lab for the blood tests, then back to the heart monitor department to get hooked up. One blessing was this heart monitor test was for 48 hours instead of 72.

When I returned to have the heart monitor removed, I decided to wait for the monitor results. Then I could see the doctor right rather than going home and waiting to be notified that he test was available for pickup and have to come back. Blah blah blah yada yada yada.

The cardiologist reviewed the heart monitor and blood test results.

YOU WON’T BELIEVE WHAT HAPPENED NEXT

Rather than do the dye-in-the-vein procedure she just wrote a new prescription with instructions to eliminate the 81 mg baby aspirin I take and replace it with the new prescription.

She said, “I see here your hemoglobin is low. It’s at 9.2.” I asked what it should be. “12.” I asked if that could be the reason I was so tired all the time. She affirmed it. She told me she wanted me to see the hematologist.

(Oh! Happy, happy! Joy, joy! He was a very nice, gentle, and caring doctor, still the doctor consults were boring sit and wait exercises.)

With that she marched me over to the hematologist. This was my second visit to him. The first time I was referred to him by a rheumatologist whom you haven’t met yet. But you will.

For once, I didn’t have to wait. The doc looked at my labs and said “Your B12 and iron levels are fine but your hemoglobin is low. You are anemic. The only other thing that could cause that is inflammation.”

He referred me back to the rheumatologist who had previously been referred to me by the dentistry professor. (Dentistry professor? Are you following this, because I can barely follow it?) “You need to see the rheumatologist to locate the source of the inflammation.”

OK. Sure. Why not? Fine. There’s room in my daily schedule for another day at the hospital. Argh!

SEND IN THE DENTISTS!

ACT I: THE REGULAR DDS

I visited a dentist twice and she referred me to a professor of Dentistry.

You may remember I began having jaw pain halfway through my physiotherapy sessions. That was temporarily relieved with massage. When the jaw pain escalated and I had a big squishy lump growing under my tongue I asked Barry which specialist he thought would be the right one to consult because he has a lot more medical knowledge than I do because of all the medical books he has co-authored. He suggested I start with a general dentist. I’d get a regular checkup and the dentist would know who to recommend if there were a “pre-cancerous lesion.” Same thing with getting a recommendation for temporomandibular joint (TMJ) pain.

I was due for a cleaning anyway and my taxi driver Bejkush’s sister is a dentist. He made an appointment for me.

His sister’s second language was Italian with English coming in third. Still, using pantomime I managed to get her to understand my problem. She asked if I used a bite guard (sometimes called a nightguard or mouthguard) to prevent grinding my teeth when I sleep. I said I did. She asked if the bite guard was flexible or rigid. I told her flexible. (There was a lot of pantomime in that “conversation.”)

NOTE: Barry has a very expensive guard, so it’s called an “orthotic occlusal device.” Sounds like a bite guard that went to Harvard!

She cleaned my teeth and complimented me on my dental hygiene and indicated she’d refer me to her dentistry professor.

She called Bejkush to let him know I was finished. She told him she’d be making an appointment with her dentistry professor and would let him know when it was.

BTW the cost of the cleaning was 2,000 lek ($23.96).

Later I thought about the conversation with her about my bite guard and wondered if it was part of the TMJ problem. If there wasn’t a possibility of it being a source of the problem his sister wouldn’t have had questions about it. Since I had acquired my bite guard by mail order . . . I was sent materials and instructions on how to take impressions of my teeth and how to return it to the lab and in a few weeks, I received my bite guard. Maybe a DIY mail order guard wasn’t the best choice.

I arranged to have Bejkush’s sister make me a new bite guard. I returned to her office and she took the impressions, etc. etc. etc. I think the cost was about 3,000 lek ($36.15). That’s a huge bargain compared to the $75 I’d paid the mail order company for my home-brewed guard.  

ACT II: THE PROFESSOR OF DENTISTRY

About ten days later Bejkush received word his sister had made an appointment for me with the dentistry professor who was working out of the French Hospital while his regular office was being redecorated.

At appointment time Bejkush picked me up. When we got to the hospital, we saw several sprawling buildings with people lined up all over the place and no place to park. Bejkush let me out and told me to wait for him while he found a parking spot.

When he joined me, he said he had double parked and walked me to the building where he had an animated conversation with an official at the entrance. “We are at the wrong building. It’s over there,” he said pointing to another sprawling building. We fast walked in that direction. When we got closer, I saw the sign: “FRENCH HOSPITAL.”

Again, Bejkush had a conversation with the official at the door then led the way to the doctor’s office. The whole place was jammed with mostly elderly people spilling out of the hallways . . . everywhere. Only later did I learn this was the free health care facility. It was truly dismal.

Bejkush stayed with me. When it was my turn, he introduced me to the doctor, who pointed to the dental chair. “Sit.” I told him my symptoms. He asked me a peculiar question about having pain in my arms. I said “yes.” Though his English was pretty good he was not up for a friendly chat. He gave me a prescription for an antibiotic for the squishy lump under my tongue, which turned out to be an infected salivary gland and a prescription for something else. I don’t know what it was. He told me to make an appointment with a rheumatologist (Have you heard this one, folks?) to rule out arthritis as the source of my TMJ. “Come back in two weeks.” He was clearly done with me, motioning to his assistant to bring in the next patient.

BTW The dentistry professor’s “order” to rule out arthritis put me right back in the loop at American Hospital #3. Lab work, another prescription, more roundtrip taxi rides, long waits sitting on a metal chair in the hallway. Sigh.

Bejkush fast walked me to the double-parked taxi, which was right where he left it (whew, it didn’t get towed) and we were out of there.

I am very certain there is no other taxi driver who would have done more than drop me off and wish me well. There was no way I could have navigated the office visit without Bejkush’s assistance. What a Godsend he is!

ACT III. MUCH LIKE THE OTHER ACTS

Rheumatologist (arthritis doctor) and not the first

The rheumatologist was pleasant and friendly. Her English was quite good. She asked a few questions then, surprise, surprise, wrote a lab order for blood tests. I went for the blood tests, went home, and got the message the lab results were ready to be picked.

I returned to her office where she explained there was no evidence of arthritis especially because I didn’t have the typical swollen joints, but . . . she noted some irregularity in the blood test results and walked me to the hematologist to essentially handing me off to him to carry on. (This added up to two visits to the hematologist . . . the first one was by the cardiologist and this second one by the rheumatologist.)

Hematologist (blood doctor) and not the first

The hematologist asked a few questions, ordered different blood tests and said to come back when I had the results. He walked me to the receptionist and told her I needed to go to the lab.

She escorted me through the hospital labyrinth. When I had the results and returned to his office, the blood doctor told me my tests were fine. At least that is what I think he said. His demeanor suggested we were done and all was well.

He walked me to the reception desk, told the receptionist to make an appointment for me with the rheumatologist. She did. I was back on the merry-go-round.

The day came. I went to my 10:00 am appointment the following Tuesday. I arrived at 9:50 am. And there I waited. Just as I checked my phone for the last time: 11:17 am I decided I’m done. I’ll come back another day, the receptionist approached me and told me to follow her.

Then there I stood in front of the rheumatologist. “I am back in your court,” I said. Her face was a mixture of curiosity and confusion. I explained why I was cycled back to see her. She brought up my lab results, asked a few questions, then told me she’d prescribe a liquid. I was to take exactly 1 ml after breakfast daily then come back in two weeks. The liquid comes with a handy little syringe to exactly measure 1 ml.

Today I was back to see the rheumatologist. It was no surprise she’d order blood tests to see if the prescription had changed the results.  I’ll be back in a few days to pick up the test results and consult with the rheumatologist again.

And that is where it stands today.

ACT IV. SEVEN (COUNT ‘EM) SEVEN PROVIDERS SO FAR

Back to the Dentistry Professor (I told you this was a genuine odyssey!)

Bejkush accompanied me to the dentistry professor appointment two weeks later. The swollen salivary gland under my tongue was greatly reduced but still there. I let the doctor know I had seen the rheumatologist and there is no sign of arthritis. He simply gave me another prescription for the same meds, dismissed me and told me to come back in two weeks.

The Bite Guard

In the meantime, the next time I saw Bejkush he handed me my new bite guard. It was very lightweight, thinner and more flexible than my mail order one.

Professor Tooth —he be gone!

Two weeks passed and I returned to the dentist professor. But we got there only to find he was out of the country for “a while.” Bejkush told me to call next time to be sure he was there before going out on another wild goose chase.

In the meantime, my TMJ was greatly improved. I could eat with minimal pain and sometimes no pain at all. Was the new bite guard correcting the alignment of my jaw? Who knows? Anyway, I had no impulse to go back to the dentistry professor.

The Pulmonologist (lung doctor)

All the while I was in and out of the hospital hanging around for extended periods of time I was surrounded by sick people. No worries. I never get sick. Hah!

I guess the stress of navigating the healthcare system weakened my resistance to illness. Lesson in Life: “Seeking healthcare can make you sick.”

I went to the ABC Clinic, was diagnosed with pneumonia and referred back to the hospital this time to see a pulmonologist. Sigh.

She was another one I could barely understand but I got the gist. Get this prescription filled and come back in a week. Which I did.

The pneumonia was gone but I had a lingering cough. She wrote a prescription for a cough syrup and told me to return in three days if the cough didn’t subside. Interestingly, I understood her very well. Maybe I was getting better at following the rhythm of her speech or her brain was “fresher” that day and improved her English.

NOTE: It’s called the “American Hospital” (Spitali Amerikan), but it’s good to know a little Albania (Shqip) when you go. For example “paguaj këtu” means “pay here.”

My pneumonia resolved just fine. The hardest part of returning visits is the very long waits. More recently I found I can make doctor appointments via WhatsApp. Despite having an appointment, three times I’ve had to wait for an hour or more because the specialist was attending to an emergency in the emergency department. Philosophy: well, there but for the grace of God go I. If someone has a medical emergency, they need to be treated.

Now when I have an appointment at the hospital I blank out my calendar for the entire day. That’s no problem. After all I’m retired. Also, twice while I was waiting my turn for this or that doctor a hospital guide approached me to tell me I was next but there was the person after me who had a special circumstance (the first was a woman whose new born baby was waiting to be breast fed. The second time it was a woman whose son was waiting for her) and would I allow them to go ahead of me? Sure. Why not?

It was made very clear it was my choice and I would not be looked badly upon if I chose to not give up my space in line. I just gave an internal sigh and gave up my position for the person with a genuine need. No one is waiting for me, and I have a whole day with nothing else to do but be at the hospital. I couldn’t do anything other than be gracious.

In a way there is an element of enlightened self-interest on my part. Whatever I give out will eventually return to me.

Also, If Barry and I want to visit a thousand-year-old castle at the edge of town, the castle can wait another day or two to see us.

Gynecologist (female reproductive system doctor)

This was a one-and-done visit. I hadn’t had a pap smear in ages. It seemed like a good thing to do. Like all the other doctors, the GYN was very thorough in getting a baseline of my current condition by doing an internal exam using ultrasound technology that displayed my insides on a computer screen. She also did the pap smear. She told me the ultrasound didn’t reveal anything unexpected and the pap smear results would be available in a few days. The pap smear was normal.

The med tech and the gastroenterologist (stomach doctor)

I don’t remember which specialist requested the MRI. The hospital’s MRI machine is very modern. And it’s brightly lit inside. As long as I kept my eyes closed, I had no claustrophobia reactions. It was a quick test. I was told to wait for the technician to look at the MRI results before leaving. About 15 minutes later I was called back into the imaging lab. The technician said there was a shadow on the ultrasound. I was given a half liter of water to guzzle and he ran me through the MRI again.

I waited for the tech to come out and let me know it was OK for me to go. When he did, he said I needed to make an appointment with the gastroenterologist. I didn’t understand what he found that suggested a consult with the gastroenterologist but I assumed he knew what he was doing and made an appointment for the following week.

The gastroenterologist was a young and friendly doctor who spoke perfect English. She said the MRI didn’t give as thorough a picture as she would have liked to see. She told me she wanted to perform a gastroscopy (camera down the esophagus) to see inside my stomach. She said it is a routine procedure they do every day. It’s painless because they administer a sedative (not anesthesia) and I wouldn’t feel a thing.

She was right. I didn’t see or feel a thing. The test did not reveal anything serious but she prescribed some over-the-counter anti-reflux pills with the instruction to take one each morning before breakfast.

End of problem.

Pharmacist — the end with a friend

By now I was on a first name basis with Elisa the pharmacist at one of the neighborhood pharmacies. BTW just like the doctors, 99.9% of pharmacists are female. Only once did I see a male pharmacist.

Filling prescriptions at the “Farmaci” is very different than in the US. All drugs are already packaged in neat and tidy boxes. Each pill is incased in a plastic bubble on a sheet—a blister pack. To access the pill, you press on the bubble and the pill pops out. For me and Barry we pop out our pills once a week and place them in plastic pill containers with seven sections labeled with the days of the week. Fortunately, we have the time in the world to do this routine properly.

Barry points out that if they don’t have your med in the prescribed strength, they will gladly sell you what they do have. Strange! Barry needs lisinopril 40 mg, but they don’t have it. So he just bought 10 boxes of lisinopril 20 mg.

At no time does the pharmacist count out the correct number of pills and place them in a prescription bottle with the child proof cap.

The pharmacist’s job is to:

• Read the prescription (which is as scribbled as in the US).

• Search the shelves and drawers for the packaged drug. Each pill is encased in an individual bubble on a sheet of 10 to 28 doses.

• Stick a blank label on the box and write the instructions of how often to take the drug—things like “take 3 times a day after meals.”

• Ring it up.  

• Take your cash, make change, and wish you a good day. Their English is very good.

The meds are very inexpensive. The methods are a little odd, compared to the US. It’s crazy, but it’s a very good kind of crazy.

If you read this whole thing to the end, I say “Bravo!” What a trooper!

If you have any questions or comments scroll down to the comment box to leave a comment or email me at Jennifer@JenniferGrainger.com

ONWARD!