Surgery & health care experience in Prague pt1: appendicitis

Posted by : on Mar 24, 2023

Why you may want to read this article
Healthcare and Insurance flow
- Insurance
- Additional private clinic
First Surgery - Appendecitis
Hospital room & Attitude & Language barrier
Conclusion

Why you may want to read this article

I am a Software Engineer at Microsoft that was born in Ukraine and relocated to Prague in 2022, now it is about 1 year since I relocated.

Lately, in Prague, I had appendicitis that ended with surgery, then I had another complication surgery. Besides that, I had a couple of surgeries in Ukraine.

Health care was always for me the MOST important criterion for choosing the country for relocating to, and it is so now. Unfortunately, usually, people rate healthcare by money (e.g. it is great - you don’t need to pay).

I am more thorough in healthcare rating and overview because good healthcare keeps me feeling safe and happy. Usually, I prefer overview healthcare first of all by quality, waiting time, and then money (maybe this is because I am not living in USA xD).

This article will be useful if you are relocating to Prague, or considering relocating here - because I will provide my experience of emergent surgery in detail covering:

Language barrier - here in the Czech Republic, not everybody speaks English
Quality - what was done, why I got complications, and how it relates to international protocols. On top of that, I will provide the documentation that I got.
Costs and bills
Attitude of healthcare personnel - in the past, I had an experience with rude doctors that seemed to me did not want to treat people at all.

If you are afraid of what happens when you have appendicitis, all symptoms, etc - it will be useful for you as well.

On top of that, I am an experienced carrier of chronicle problems with my stomach, and I have feedback about taking care of my stomach here, if you are interested - please let me know in my Telegram/Instagram (you can find it in the About section).

All the documentation I will present here is in Czech Language. I will put reference to translation in English from Google Translator, so it is not 100% accurate but those who are interested will get the idea.

Healthcare and Insurance flow

Let me describe the general flow of health care for me at Microsoft in Czech Republic.

Insurance

There is one kind of monopolistic insurance - VZP insurance - well recognized in Czech Republic. It has private and public insurance.

Since I am an employee at Microsoft I must be enrolled in public VZP insurance (that is paid by employer). Public VZP insurance covers almost everything except cosmetic stuff and some dentist services.

I have heard stories from people when doctors did not accept them because they did not have VZP. Although I have heard stories that people asked to pay by themselves - and were accepted.

I cannot say for sure, because I had only one situation when I paid by myself in hospital (when I was in Prague as a tourist). I was accepted by doctor, but they did not do blood tests that they needed, because I did not have family doctor. For 1 visit I paid about 100-150 dollars.

During this story, I paid nothing for the healthcare services I got except the pharmacy I bought for use at home (antiseptic, bandages, painkillers).

Additional private clinic

As Microsoft employee I have free membership (or plan) in private clinic called ‘Program H Plus’ here.

But it is not totally private self-contained clinic. I have my family doctor here. When it comes to specialist doctor appointments - sometimes this is Program H Plus doctor, and sometimes this is a doctor in Public Hospital. Besides that, among the services of H Plus - they try to find you English speaking doctor, and usually, they successfully do it, and I am thankful for that.

In case of emergencies, it is almost always public emergency hospitals. Since H Plus has contract with Microsoft - they have emergency line as well (English speaking). This emergency line will tell you what to do, where to go, etc.

First Surgery - Appendecitis

I started my sick leave at work earlier before surgery, so let me put this in chronological order.

20.12.2022

I got cold, coughing, fever, running nose. I got sick leave at work.

25.12.2022

I almost recovered, symptoms were disappearing.

26.12.2022

Symptoms

The day X. I have my own health diary, so that’s what I have for this day:

Now I’m using more advanced symptom tracker Symptom Diary, that can track all the pains, symptoms, medications, food, and sport activities. It is much better health diary than just plain notes.

As you can see I have used just Google Docs, but now I created my own application called Symptom Diary, where you can track your pains, symptoms, medications and other health related entries with analytics, search and export.

Since I have chronic problems with the stomach - sometimes I might have some random pain in my stomach, I consider this as “Fine, again random stuff because of nothing, let’s suffer a little and then it will get better”.

I had about 3 suspicions of appendicitis so far, so I have known all the possible symptoms.

At 7:00 - I realized I have some pain inside my stomach and belly in general. By that time I did not suspect appendicitis, I was not sure about the epicenter of pain, no fever, no vomiting or nausea.

At 9:00 - I realized that the epicenter of my belly spilling and burning pain is in the lower right side of the belly. Whenever I touched it or pressed it - the pain increased. At this time I realized that it is possibly appendicitis. The pain was about 20 out of 100.

You might ask why did not I try painkiller? REMEMBER: in case you suspect appendicitis - never take painkillers, because they can relieve the pain - but the inflammation is still in place and it could result in the wrong diagnosis. Untreated appendicitis can cause peritonitis. Untreated peritonitis can cause death.

At 10:30 - I called Program H Plus emergency (it was a public holiday). And they suggested taking a taxi and getting to Nemocnice na Homolce to the surgery department. They put address in SMS 2-5 mins after the call.

If somebody needs it - there is that place in Google Map.

As I understood this is not an emergency department, but rather a regular surgery department, but maybe I am wrong.

Arrived at the hospital

At 11:30 - I arrived at the Hospital by taxi. By the time I have arrived - the pain increased to 25 out of 100.

I am from Ukraine, on the reception, luckily, I met a Ukrainian lady as well.

It was fun, I started explaining everything in English - and she replied with “з України? Апендицит? Йдемо зі мною” (from Ukraine? Appendicitis? Come with me).

I felt a little dizzy by that time, so some other man accompanied me with the lady from reception to the surgery department (the 4th floor).

The doctor was in surgery, but there was a nurse, she did not speak English or Ukrainian, so the lady from reception helped with the translation of my symptoms, what happened, etc.

The nurse was trying to take my blood, the third try was successful.

At 12:20 - the doctor came. Kind lady that speaks English.

By that time I felt about 35 out of 100 points of pain in the right low part of the belly. I was asked about symptoms, what I ate, etc. The assumed diagnosis was acute appendicitis.

But to make sure it was decided to do an ultrasound.

Ultrasound & surgery preparation

It was a holiday. I was supposed to get an ultrasound check, and since there were other patients - for the doctor - they put me in a wheelchair to wait outside.

I waited for an ultrasound for about 40 minutes, I measured. By that time the pain was about 40-45 out of 100. I was just sitting and moaning, at that point, it was hard to tolerate the pain silently.

It was funny, cause regular patients were staring at me and waiting for the doctor, and I did not know where is the ultrasound, will the doctor come for me, etc.

At 13:30 - I got the final diagnosis - appendicitis. They brought me to the hospital’s room. I changed clothes to those ones needed for surgery. At that point, for some reason, I vomited.

I eventually got painkillers.

Surgery & after anesthesia

Important! - I have signed paper that indicates that I want to know ALL details about my health state no matter how bad they are.

At 16:00 - I was gotten to the surgery room, I got anesthesia, and a few seconds after I lost consciousness.

At 17:44 - I woke up after anesthesia, it was pretty light, and I was able to write to my parents and friends after 10-15 minutes I get back to a conscious state.

At 19:00 - The first photo after surgery:

Report about appendicitis surgery pt1 in English

By blue color, I circled the medication that I was getting. I will get back to this later.

Report about appendicitis surgery pt2 in English

In these reports, you could see my state, test results, etc. I would like to emphasize a few things.

Diagnosis:

The main diagnosis states acute appendicitis, meaning urgent surgery.

Hypokalaemia - I did not have enough K in my blood.

Other specified postoperative conditions - to be honest, I don’t know what it means. My previous surgery before appendicitis happened when I was 14 years old.

Inflammation of the esophagus - this diagnosis was concluded from my complaints since by that time I was taking Rapoxol due to chronic problems with stomach.

After surgery medication

My surgeon told me that the appendicitis was really inflamed. In the next complication surgery I got the appendicitis diagnosis stated as: flegmonogangrenozni appendicitis (you will see in the article about complication surgery).

I did not find really what flegmono (phlegmono) means, but gangrenous means that appendix tissue was gangrenous a little bit.

After I got consciousness again, I remember taking 3 medications (I don’t know the namings, except Rapoxol) during my time in the hospital:

Rapoxol - because of chronic stomach issues (orally)
Pain killers (I specifically asked nurses what is it), injection in vein & fever relief
Blood thinner (I specifically asked nurses what is it), injection in muscle

According to the report (circled in blue color) I got:

Rapoxol - explained above
Dipidolor - that seems to be a strong opioid painkiller, most probably during or/and the first time after surgery
Novalgin - painkiller as well but not opioid.
Paracetamol - I guess for fever relief and regular pain relief.
Odansetron - to prevent nausea and vomiting. This one I don’t remember. Maybe during or/and the first time after surgery
Fraxiparine - this one I guess is a blood thinner.
Unasyn - antibiotic I don’t remember as well, either I get lied or it was during or/and the first time after surgery when I wasn’t in consciousness (meaning not long course).

Since it is not my first surgery I knew some surgeons from Ukraine that did surgeries for me. For sure I asked all possible opinions on it.

Point 1

I have some doubts regarding antibiotic treatment, I have read from some sources, that gangrenous appendicitis should be treated with antibiotics therapy to ensure everything is okay. In the report, it states that I actually got the antibiotics, but I have asked the nurses and doctor whether I’m getting some antibiotics along with painkillers and the answer was clear - no. If It was one dose right after the surgery - I have heard about the practice of having a full antibiotic course after surgery, especially for gangrenous appendicitis. I am not a doctor - so you can check on your own how it should be, I just share my thoughts by that time. Each day I had bandaging, the doctor checked the wound and my health state.

28.12.2022

This is what the wound looked like on 28th of Dec.

Not blurred image here

30.12.2022

This is what the wound looked like on 30th of Dec.

Not blurred image here

Point 2

I wanted to go shower for sure, we had one in hospital room (I will overview hospital utilities later). For sure I asked whether I can do that, what can I wash, and what I must not. The answer was: you can wash the wound but without the soap. My surgeons from Ukraine said that it is better not to pour any water on wound at all for now. This one I don’t know, I’m not a doctor - so you could check on your own, I am just sharing my thoughts by that time.

I got to home this day. I was instructed what I should do, and what I must not do. I bought antiseptics and bandages to do bandaging each day. The recommendation about the shower was the same - I can wet it without soup but with regular tap water.

I got a diet document (in English).

On top of that, I have been prescribed painkillers (Novalgin) if I feel pain - to relieve it with them

During my time at home, I did not do any physical exercises, followed the diet, and was getting better and better.

Point 3

My surgery happened on 26.12.2022 at about 16:00. On 28.12.2022 I was told that maybe tomorrow (29.12.2022) I can go home. Before that they asked me whether I am living alone or not, do I have any close relatives here, and I clearly said that I am living alone and that I will not have anybody to help me. I did not feel perfect, and I definitely did not feel independent in regard to taking care of myself. I could not take heavy stuff, so even lifting 3-4+ kg things was with the pain. I even couldn’t tie my laces. I clearly did not know how I am going to cook myself if I cannot walk more than 300-400m. How was I supposed to take all my stuff from the grocery shop if I was prohibited to lift anything at all? Anyway, I asked to prolong my stay one more day, and then on 30.12.2022 the emergency car brought me home(they don’t allow you to take a taxi without your close relative or friend with you that I really respect and am thankful for). I managed to find somebody to live with me and I am thankful to that person as well, but without this person, I don’t know what to do, to be honest.

On the 3rd of January 2023, spending 3 days at home - I got really worse and went through complication surgery. We will talk about it in the next article.

Hospital room & Attitude & Language barrier

Hospital and utilities

I was pretty happy with what room I have and what utilities I can use.

The room has 3 beds. Beds are height and angle configurable by remote control. There is a button to call the nurse, and it is right above your head, you don’t need to get up for that.

There were regular blood pressure, fever, and general health state checks from medical personnel.

There is 1 bathroom with a toilet. There is a button to call a nurse in the toilet as well.

On top of that I should admit - the food is REALLY good, I enjoyed it.

Among utilities you have wifi, I did not use it much because I have a good mobile data provider, but it was enough for YouTube. There is a TV with remote control. You should agree with your mates about what to watch, I used only a phone.

Doctors’ and nurses’ attitude

Sometimes nurses and doctors are a little bit rude, or nervous. To be honest, I understand them, patients sometimes are irritating, you have a lot of paperwork and workload in general, you have tight deadlines, and don’t have proper sleep.

Sometimes there is some hate for Ukrainians from Czech people because there are a lot of refugees, and not all of them behave well. It is often because foreigners don’t know the Czech Language.

I am from Ukraine, and even though I got to Prague before russia invaded Ukraine, and I already had offer from Microsoft, I still sometimes felt this biased hate.

I was really happy with the attitude of all doctors and nurses. The doctor (surgeon) is really kind person, she explained things to me, asked how are you, answering my sometimes not the most clever questions.

Language barrier

I did not know the Czech language by the time I arrived at the hospital. For sure not all Czech people know English, so I was afraid I will not be able to easily communicate with doctors and nurses.

With the first nurse before surgery the lady from reception that knows Ukrainian helped. The doctor knows English better than me - so I was happy. Some of the nurses know Ukrainian so also it is not a problem for me. Some of the nurses know English, I would say it is about 50%.

But I really appreciate them all for trying to explain to me or to answer me. Sometimes they went with Google translator. Sometimes they with hands showed me what to do and I understood them.

Conclusion

I really appreciate the help that the people working there provided to me. The overall appendicitis experience could be much worse than it was.

But there are some suspicious points I have mentioned in the article. Unfortunately, I cannot judge them, because I am not an expert and not a doctor, but as an experienced patient, I can tell what I have heard, what objectively happened and what is the outcome.

The next article will be about complications that happened after this surgery, which causes me to go through another surgery. Coincidently 03.01.2023 is scheduled regular check-up appointment when the complication happened.