Travel tips and know-how?

[nanfromsactown]

Hey all,

I'm waiting for Dr. Zeegers to review the updated medical stuff I mailed to him on Friday. Once that's done, I'm going to wait for my grandson to be born (our first!) and then make plans to travel to Germany (Betaklinik in Bonn) for my ADR. I am all the things everyone who has had this surgery have been...scared, anxious, excited, relieved, the list goes on.

But I need practical advice and tips from anyone who has been to Bonn or anyone who has gone overseas for surgery at all. I've done my share of International travel, but never for a medical reason. What do I need to know? What do I need to take with me? And what do I need at home for my return?

I seem to remember some discussions YEARS ago about pain management over there for those of us on high dose opiates. Does anyone have anything to add about that? Feel free to PM me anything you think should be private, or post an answer to this thread for anything that might help others.

Has anyone rented an apartment in Bonn? I did that on a trip to Rome and it was awesome, especially since I have particular dietary needs to attend to.

Thanks everyone! OH, and say hi to my sister, melissal, who is here learning whatever she can because she is going with me!

[annapurna]

Laura and I have posted a number of times about travel to Bogen and Munich. Substitute the cities and much of the advice remains the same: pack light, use Germany's transit system rather than drive, plan on coming home with less stuff than heading out. If you have specific questions about medical travel or Germany, feel free to PM or even let us know if you'd like to call us. We've not been to Bonn but have spent a whole lot of time in Germany for backs and knees.

[nanfromsactown]

Bumping my original post up to ask another couple questions:

What equipment will I need after surgery, when I get home? Will I need a raised toilet seat? Handrails in the bath tub? Other items which might bring any comfort?

Is the recovery from ADR much like a fusion recovery in terms of pain after surgery? I know that may be a hard question for anyone to answer because most people haven't had both surgeries.

I am getting anxious. Dr. Zeegers initial review of my new xrays shows suspicion of hemisacrilization on the right. This is new and just makes me want to get to Germany faster to stop the deterioration. I don't want this to mean I have to be fused at that level (L5S1) but I also know that fusion is not necessarily the enemy! I'd prefer to have my disk height restored with ADR. I also have another new finding, what he is calling "micro-instability" at L45. I've been able to brag for years that I don't have instability, so I guess that ship has now sailed! fair warning to others, don't let it go too far before you get fixed!

Thanks to anyone who can calm my fears/anxiety and support me through this process of WAITING. I hate it.

[nanfromsactown]

Finally. My ADR is scheduled Nov 30 in Bonn with Dr. Zeegers.

I've had a very exciting couple of weeks with a new grandson being born, and also finalizing the surgery with Dr. Zeegers.

Dr. Zeegers has been world class in evaluating my case. We had many long conversations about options. At first blush, he thought that if I had a PLIF fusion here in the states, it would be covered by insurance and he thought I would have an "ok" outcome and would save me money, but after I explained to him that I'm responsible for everything having to do with my low back, we got down to brass tacks about the surgery and possible outcomes, and decision making. I've had several abdominal surgeries, so there is an increased risk due to possible scar tissue. He wanted me to know those risks were there and that the approach could be difficult. His thoughts are that I can have 2 level ADR, or one level ADR with fusion at the second level, or end up with PLIF if the ADR approach is impossible. Obviously, since I am not in Germany, he cannot examine me to know exactly what the landscape looks like, but I did send him a series of photos he asked for, and after more review and careful consideration, he feels there is an excellent chance I'll end up with ADR. The decision about whether to do a hybrid or 2 level cannot really be made until he is looking at my spine, in surgery. I am leaving it in his very capable hands. He IS going to use a vascular surgeon for the approach, usually they are just on call but in my case, to make it more likely I get ADR, we'll just use the surgeon. Dr Zeegers is very, very careful. That's why his outcomes are so good. He has had only one patient that he had to stop surgery because the approach was impossible, which tells me he picks his patients carefully! I told him I'd rather try it than not, and that if I end up with a fusion I'd rather have him do it anyway.

So, my date is set for November 30. I have waited almost 16 years, and I am really looking forward to being on the other side and getting off narcotics!

On that subject, my next pain dr appointment is a planning appointment to get my meds lined up to take to europe, both for travel and for the post op, out of the hospital period.

Does anyone know a good way to transfer money to Europe where I can get the best exchange rates and not pay an enormous transfer fee? PM me if you do.

I'm excited!!

[jss]

Nan,

That is all GREAT news! You're going to do great in surgery and you're going to come out with two ADRs! I know you've got to be excited about getting some relief after 16 years... Wow. I can't wait to start reading your post-surgery updates.

When we went to Barcelona in 2009, we didn't pay anything to convert money from dollars to Euros. I put all of the money that I though we'd need into our state-side checking account that had an ATM card attached to it. Then in Paris and Barcelona, every several days I'd go to an ATM machine with our ATM card and withdraw euros. The only fee was $3 charged by the Spanish bank for use of their ATM. We exchanged about $2500 that way. I've not done that in Germany, but my sister has without issue.

Good luck, Jeff

[laid up doc]

nan -

i am currently post op day 5 from a 1 level M6 in Barcelona... i tried not to duplicate too much of what i've read elsewhere other than to emphasize a few points. here are my thoughts in response to your questions:

i wouldn't say i needed any adaptive equipment per se - but a grabber is helpful. i found one at walgreens that folds in half so it's easier to put in your luggage, and very light. barely used it beyond day 3... may use it more once my travel companion leaves on wed.

one thing i wish i had brought was a foam mattress pad - have been totally unable to find one in Barcelona. my bed is eh, a bit firm. will sleep in my own bed again Sat nt, and I can't WAIT!

i rented an apartment - a MUST imho. hotel rooms in europe are TINY and i can't imagine being cooped up like that. i got a 2 bedroom apt very central in Barcelona with a w/d, a/c, terrace, both BR with double/queen beds, comfy large couch, wifi, full kitchen for about $100/nt.

also glad i got a place where you don't need a car and can walk places - don't know anything about Germany, but it is helpful when you can walk anywhere, including major tourist destinations, even after surgery!

bought a small pill container to keep meds in for when i'm out and about, and use my cell phone alarm as a timer.

got a prepaid quad band cell phone from telestial.com for use here - actually one for me and one for my travel companion. if your cell phone uses a SIM card, you just need that... but many US cell phones use CDMA and won't work in Europe for anything beyond smart device/wifi.

haven't needed a CONVERTER just ADAPTERS - read this Electricity in Europe: Travel Voltage Fundamentals. (http://www.enjoy-europe.com/hte/chap11/electric.htm).... everything i've needed was a computer/camera battery/cell phone that works just fine w/ an ADAPTER only.

i have found that most personal care products are VERY expensive here - never been to Germany, but i'd imagine it's at least expensive if not more.

others have emphasized loose waisted pants and underwear a size up - another MUST - i looked 5-6 months pregnant when i left the hospital, now down to maybe 4 mo, haha! between post-op swelling and bloating... you will want to be comfortable. i didn't even bring jeans... and fortunately still warm enough here to wear a skirt w/ top and sweater as needed when going out to eat. i have gotten great comfy but nice looking skirts from Ann Taylor Loft in the past, as well as a zillion business casual type shirts.

"spinner" suitcase is great b/c you don't have to use much force to move it. i got a large (?29 inch) one on overstock.com for about $80.

i flew US Airways Envoy class w/ the new 180 lay flat seats - actually slept on the way here, many others have felt it was very beneficial on the return flight b/c you abdomen incision/muscles are still healing and would hurt to sit too much. iirc, delta, continental, and united also have similar seats - but CALL to make sure you book the right aircraft! US Airways, for example, only has that seat in the Airbus 330-200 aircraft, and you can only go from philly to barca on that aircraft certain days of the week.

i am fluent in Spanish so not a problem for me - but make sure you know how much English your nurses/transporters/nursing assistants will speak. i would have been freaked out beyond belief had i not been able to talk to them.

which disc are you getting? i'm pretty sure Stenum is the only place you can get an M6 in Germany. i didn't consider Zeegers b/c i wanted a titanium alloy disc with zero nickel and no chromium - Activ-L and Prodisc (as well as Charite') contain these.

talk to your surgeon in advance about his post-op med regimen - so you know what you are getting automatically and what you can ask for for pain/nausea/constipation.

as my ob/gyn friend put it - miralax early and often ;) i personally hate the stimulant laxatives (cramps on top of bloating, ugh!) and have been "going" ok w/ colace twice a day plus the miralax.

[laid up doc]

and as far as money - the money i needed to pay in advance i just wired through my bank for $45 each time. very small %age... others have used xe.com.

when you're in Europe, agree w/ jss - just use your ATM card. i found that the fees for getting money from ATM incurred about the same fees as credit card, so mixing use of both. make sure you notify your bank that you'll be in Germany, so you won't have issues using them!!!

[nanfromsactown]

Hey guys,

Thanks for all the info!

LUD, good advice about talking to Zeegers about his post op pain regimen. He has assured me they "have a lot of experience" with patients like me (opiate tolerant) but also wants me to bring my own meds for after the hospital stay. We will stay at the hotel next to the hospital. it will be easier for my husband to be close. He knows what I'm like after surgery and some nights I want him RIGHT NEXT TO ME in the hospital and others, its ok for him to leave as long as he's close.

Also, about the cell phones. Is that something I can do before I leave, ordering them online? I have tried to get ATT to unlock our phones in the past when travelling to Europe and lets just say, they aren't very cooperative. I don't really understand why the US has to be so difficult about it when the rest of the world uses interchangeable sim cards. So if I can get phones before I leave, that will be one less thing to worry about.

I hate Miralax, but I have other tricks up my sleeve. Ugh. One more thing to look forward to when the narcotics go away!

Also good to know about the clothing. I had planned to bring stretchy pants but didn't think about underwear! I don't want to buy it over there! Need to put it on the list. Granny panties.

I'm getting the Activ L. Dr. Zeegers actually told me 5 years ago that was the disc he wanted to use on me so I guess he hasn't changed his mind!

I bought our plane tickets yesterday. American Airlines. It was the best fare although I still choked. The seats are not fully flat at 180, but are 9 degrees difference. Thats fine, I've flown in that configuration before.

Thanks!

[laid up doc]

i ordered my phones from telestial.com before i left. they're very basic phones, but do the job. you can get an even cheaper one from another site but it didn't work in some other countries like Mexico/other places in C America, and that's really my favorite travel region.

you get a UK and a US number, all of the time is prepaid. incoming calls on the UK # are free. i found them to be the best deal - got 2, one for me and one for my travel buddy. i haven't used it a lot, but i when i needed it, i needed it and had it!

do have a talk about the meds - i'm opiate INtolerant (just get sweaty/dysphoric, and pain still there!), so i got IM shots of a form of what is demerol in the US. only needed 2. since i've just been on tylenol and naproxen - the nsaid really for heterotopic ossification prevention more than anything. taking prilosec twice a day too - have a history of nsaid gastritis, hope i can hang in there for a month!!!

i went to target for granny panties, i will confess. just a stretchy hanes bikini style in a size up, but feel grannyish to me!!!

[Jstuckey]

Congrats on your solid plan! A couple of my thoughts:
Yes, ATT was a pain. We spent the first three days trying to get things to work right, after we had purchased the global (24.99) package. Might be a good idea to just buy a temp use phone as suggested.
I flew home in regular seats, but I was 3 weeks post op when I did. I think that may have helped. Had a hybrid lumbar fusion and 1 ADR, so pretty remarkable that I was fine without the recline seats. I wouldn't have benefitted from them. No problem sitting as long as I got up (day time flight helped to).
I changed my credit card to a no fee for foreign transactions type(Chase). They just use the day's exchange rate. That is how I paid for surgery too. And yes, do tell them the dates you'll be gone and where you'll be.
We only had a little bit of cash, and used our card otherwise. Since we didn't carry a lot of cash, we didn't worry too much about where to exchange it for the best rate. I think we did it at the airport right away.
Take it easy if they offer hydrotherapy. That is the one thing I would change about my experience if I could. It felt easy and comfortable and wonderful at the time.... I suffered greatly from overdoing it all three sessions about 4 hours later. I had to quit doing it until restarting it today at home (4 weeks post op). I think I can tolerate it now.
Prunes, prunes, and more prunes! :)

[Harrison]

Folks,

If you all find it useful, I'll create a separate forum for travel/medical tourism. I've resisted this for years; but it's not about me -- it's all about what you find accessible and useful.

;)

[Jstuckey]

Folks,

If you all find it useful, I'll create a separate forum for travel/medical tourism. I've resisted this for years; but it's not about me -- it's all about what you find accessible and useful.

;)

I think those of us that end up overseas really appreciate all of the advice. There isn't anywhere else to get it! It would be an easier way to find and contribute the info. Thanks!

[annapurna]

A separate forum would be appreciated but it shouldn't just be focused on overseas travel. Many people have posted about having to leave their local area to go to Texas Back or other facility. Some travel tips are location-specific, but a lot of the advice isn't and it would be nice to find it all in one place.

[laid up doc]

harrison -

while i don't know your motives for not wanting to have a "travel" section.... i will say that i must confess that i thought the idea of "medical tourism" for anything but dental work was sort of crazy for quite a while, until it became my only option and it was something that i could do. then i did it and...

i'd do it again in a heartbeat... i think that for people who are in such situations would benefit GREATLY from such a forum. (there is another forum that has such info - i got some info there but the list-maker had gone to Germany - so i had to dig up info allll over the web and from friends/family about Spain/BCN).

the whole prodisc vs overseas alternatives is another topic altogether! but as i think you have seen w/ my experience and others' - there are many of us for whom int'l surgery is really the only option (need for hybrid or multilevel ADR, metal allergies, device concerns). a bit early for me to say, but i think it saved my life!

[nanfromsactown]

I know I would be happy to contribute any and all travel information I could. I've traveled quite a bit just for pleasure, but I know a lot of people who end up traveling for back surgery have done little travel and could probably use the info. And if the other site has just German-specific information, then this site would be great because it would have Germany, England, and Spain among others.

[nanfromsactown]

harrison -

while i don't know your motives for not wanting to have a "travel" section.... i will say that i must confess that i thought the idea of "medical tourism" for anything but dental work was sort of crazy for quite a while, until it became my only option and it was something that i could do. then i did it and...

i'd do it again in a heartbeat... i think that for people who are in such situations would benefit GREATLY from such a forum. (there is another forum that has such info - i got some info there but the list-maker had gone to Germany - so i had to dig up info allll over the web and from friends/family about Spain/BCN).

the whole prodisc vs overseas alternatives is another topic altogether! but as i think you have seen w/ my experience and others' - there are many of us for whom int'l surgery is really the only option (need for hybrid or multilevel ADR, metal allergies, device concerns). a bit early for me to say, but i think it saved my life!

I'm so happy we've "turned" a doctor! My brother in law is a doctor and he drilled me pretty well about my decision. Hopefully my experience will lend him some assistance if he has a patient in need.

I'm so happy to hear your outcome is so far, so good!

[nanfromsactown]

Congrats on your solid plan! A couple of my thoughts:
Yes, ATT was a pain. We spent the first three days trying to get things to work right, after we had purchased the global (24.99) package. Might be a good idea to just buy a temp use phone as suggested.
I flew home in regular seats, but I was 3 weeks post op when I did. I think that may have helped. Had a hybrid lumbar fusion and 1 ADR, so pretty remarkable that I was fine without the recline seats. I wouldn't have benefitted from them. No problem sitting as long as I got up (day time flight helped to).
I changed my credit card to a no fee for foreign transactions type(Chase). They just use the day's exchange rate. That is how I paid for surgery too. And yes, do tell them the dates you'll be gone and where you'll be.
We only had a little bit of cash, and used our card otherwise. Since we didn't carry a lot of cash, we didn't worry too much about where to exchange it for the best rate. I think we did it at the airport right away.
Take it easy if they offer hydrotherapy. That is the one thing I would change about my experience if I could. It felt easy and comfortable and wonderful at the time.... I suffered greatly from overdoing it all three sessions about 4 hours later. I had to quit doing it until restarting it today at home (4 weeks post op). I think I can tolerate it now.
Prunes, prunes, and more prunes! :)

Thanks for the info. I'm looking into the cell phones. I'll be taking my iPad and leaving the laptop home, much less weight to carry! Will also have my smart phone with me to receive texts which is what we did last time we were in Europe. AT&T allows you to receive texts for free, so I would turn it on once a day to see if there was any news from home. It worked out well.

I don't think I've ever actually exchanged money here before going overseas. Always just took some cash and my debit card and advised the bank. In case anyone ever goes to Russia for a vacation, they are very particular. If you want to exchange cash for rubles, your cash has to be in pristine condition and nothing bigger than a 20. The better thing there is to take rubles out of an ATM machine or just pay for things with a credit or debit card.

[laid up doc]

i used gosim.com, not telestial - but they are similar