Medical treatment in the EU

[Nelson Longflap]

So I came on holiday without my bike 

Felt a bit odd on the flight, and my first day's holiday was accompanied by an outbreak of spots around the midriff, and super-sensitive skin. So I took some photos and described the build-up in an email to my GP back in UK. He replied in a couple of hours and diagnosed shingles (or the revenge of childhood chicken pox). He told me the appropriate drug but had no idea how I might obtain them here in Funchal as they are prescription only in the UK. A trip to the local pharmacy resulted in the pharmacist confirming the diagnosis, and while the drugs are not sold over the counter in Portugal either, he could sell them if I forwarded the message from my GP, which is what I did. The anti-viral drugs do appear to have had a good effect on the rash, although I still have a fair bit of the internal pain. 

I think the whole process was an exemplar for how medical treatment can work across international boundaries. The pharmacist also made a note of the number on my EHIC card and said I should be able to reclaim some or all of the Euro 16.88 I paid. (Had I seen a local doctor first I would have been charged around eur65 for the consultancy, so the process I followed was a great money-saver.) For the sake of completeness, I'd like to be able to do this but have no idea how to go about it. As yacfers are a very cosmopolitan lot I'm sure somebody here must have been through the process. Any enlightenment would be much appreciated ... and my story will make a nice practical example of just one of the many advantages we will lose following a Brexit.

Apparently the pain can last for several months; I do hope the effect on riding is minimal. I started 2017 feeling great which prompted me to enter LEL 

[Canardly]

Suggest you enqure at your local surgery.

[Kim]

https://www.nidirect.gov.uk/articles/travel-health-and-european-health-insurance-card-ehic#toc-6

[Bledlow]

Your experience with your GP & the Portuguese pharmacist sounds excellent.

I've managed to have shingles twice (I was surprised the second time, but apparently it isn't as unusual as I thought). Both times, the worst of the pain didn't last very long. A couple of weeks, with occasional episodes for a bit longer.

I was told by doctors both times that the earlier you start treatment the less pain & the quicker the recovery, which makes sense. I caught it early both times: identified by my mother the ex-nurse first time with "Get thee to a doctor - now", & the second time I recognised it myself (one of those things that's hard to forget), & got it confirmed by a doctor at the local weekend drop-in centre*, who sent me straight to the local hospital to collect drugs to keep me going until pharmacies re-opened next day, phoning to say I was on my way. This was a Sunday evening. I was impressed.

Looks as if you caught it pretty fast, which is good. The initial improvement (& drying up of nasty little blisters) was very fast. The pain was mostly over in 10 days-two weeks or so, & I got twinges (some of them rather painful: cue sharp intake of breath from stabbing pain) occasionally for two-three weeks after that IIRC, but those were infrequent. The itching was a bloody nuisance, though.

*I said "I think I have shingles. I have (description) along this line here (indicated). It looks & feels like when I had it before." He said "Show me,"  I did. He took one look & said "Yes, that's shingles".

[Nelson Longflap]

Thanks to all, and especially Bledlow for passing on your experience - that's absolutely invaluable knowledge; shingles is not something to be ignored.  Ironically, being out here in the horse latitudes of the Atlantic Ocean meant I got the antivirals needed the same day the disease became evident; had I been in the UK I'd have been waiting a few days to get a face to face appointment

I went back to the pharmacy today to find out what I might have been charged had I been Portuguese citizen, and the answer was 'the same'. My understanding of EHIC is that I'm therefore not eligible for any refund. I also found a lot of confusion out there on the wild web about how EHIC works. The best source by my reading is
http://ec.europa.eu/social/main.jsp?catId=858&langId=en

Also helpful was
http://www.nhs.uk/NHSEngland/Healthcareabroad/countryguide/Pages/healthcareinPortugal.aspx

The rules changed in July 2014, so experience prior to then may be out of date now.

And the pharmacist said "You will get it again in a few months time". Let's hope that isn't the first week of August then

[Jaded]

So, what does Saint Theresa plan for us, in the (David) Cameron weird blue alien world we are to be thrust into.

[Cudzoziemiec]

Wow. Bad luck about shingles, but the rest seems to have gone well. It would never have occurred to me to contact my GP from Abroad (and I wouldn't know how to anyway; certainly haven't got an email for them). Hope the antivirals work as well as the diagnosis!

So, what does Saint Theresa plan for us, in the (David) Cameron weird blue alien world we are to be thrust into.

I don't suppose she or anyone else has a clue. I wonder if the pre-EU individual country agreements would still be valid?

[rafletcher]

So, what does Saint Theresa plan for us, in the (David) Cameron weird blue alien world we are to be thrust into.

Presumably the same as anywhere other than the EU at present. You pay yourself and claim on an insurance policy.

[Jaded]

Hmm. I wander if some kind of deal might be reached, given that most British trips abroad are to the EU.

The insurance premiums won't be the same if the health element is included back in.

[Nelson Longflap]

Here in Madeira I've been learning a bit about Portuguese history. Some of the following may be prophetic for the UK ... The First Republic (1910) didn't really have a clue how to govern and was a bit of a shambles, described as "continual anarchy, government corruption, rioting and pillage, assassinations, arbitrary imprisonment and religious persecution"; the Second Republic (1926) introduced the one party state; and the Third Republic was the dictatorship.  Seems to me the UK is already well on the way towards stage 1.

[Cudzoziemiec]

So, what does Saint Theresa plan for us, in the (David) Cameron weird blue alien world we are to be thrust into.

Presumably the same as anywhere other than the EU at present. You pay yourself and claim on an insurance policy.

But that's not the way it works everywhere. With some countries there are long-standing reciprocal agreements allowing visitors to be treated on each other's state health services.

[Russell]

I succumbed to shingles last summer in France following a reaction to a bee sting.  It was in the final days of our holiday.  It wasn't until we were on our way home and had internet that we realised it was shingles.  We did not seek medical help over there but made an appointment with our GP for the day of our return.  I survived a sightseeing trip round some art galleries in Le Havre on 4 hourly doses of paracetamol and ibruprofen.  The itching was as bad as the pain.

GP prescribed an anti viral but I suspect it was too late to be very effective.

It returned about a month later in a very mild form.  I still have the scars.

[Nelson Longflap]

According to my GP traditional painkillers aren't much use for nerve pain, something more psychotropic is what's needed. However I've found cocodamol useful in getting to sleep, perhaps because they induce drowsiness rather than for any painkilling property.

[Nutbeem]

Well done on getting fast diagnosis & treatment. As already stated starting treatment quickly makes a lot of difference with shingles.

....And the pharmacist said "You will get it again in a few months time". Let's hope that isn't the first week of August then

There is a body of evidence that suggests stress can be a trigger factor for shingles, which if it holds true might make an recurrence in the run up to LEL a possibility. Could your GP be persuaded to give you an anticipatory prescription so you're pre-armed?

Other stressful activities to avoid might include riding Perms at night, in torrential rain on heavily flooded roads 

[Nelson Longflap]

Other stressful activities to avoid might include riding Perms at night, in torrential rain on heavily flooded roads 

Hmmm - on the Sunday before the Wednesday outbreak, I did 247 km with AC Portsmouth to Wantage and back, with nearly 200km of that in torrential rain, riding through lakes and rivers with unknown hazards underwheel. It was a character-forming ride, and while I felt OK when I got back home, I'd say it counted as a pretty stressful ride ticking all three of the boxes you identify. I might have a chat with my GP about it.

Thanks.

[TimO]

So, what does Saint Theresa plan for us, in the (David) Cameron weird blue alien world we are to be thrust into.

The EHIC is not directly related to the EU, it's more an EEA thing, although Switzerland is an exception to this.  At a guess, our current agreement for the EHIC is related to EU membership, so the agreement may need to be renegotiated with the UK as an independent state, rather than something negotiated centrally as part of the EU.

Of course, we'll have plenty of time to sort this out, in the two years.  It's not as though there will be hundreds of other agreements to sort out too ... oh hang on ...

[Cudzoziemiec]

If we don't renegotiate it, travellers will be more likely to buy medical insurance. A massive win for our crucial financial sector, a vital boost to the economy for all of us! (!)

[TimO]

... and a complete failure for anyone with a pre-existing medical condition, that almost no travel insurance covers.

[hellymedic]

Fish does...
... at a price...

[Kim]

Think of it as practice for when they finish selling off the NHS.

[TimO]

Fish does...
... at a price...

Oh, that's interesting.  Up to now, I've not needed to travel outside EHIC covered areas, unless it's been work related, and their cover is more extensive.  If I do, I'll remember this, and see how much it makes me wince, compared to crossing my fingers and hoping.