“Ah, quelle belle cicatrice!” (Oh, what a beautiful scar/incision!). Every time a nurse came to change the bandage, it was the same remark, both at the hospital in Marseille (2 ½ hours away) where I had total knee replacement surgery on May 14, then later at the rehabilitation hospital where I spent 2 ½ weeks.
Are they crazy, I wondered? Nothing beautiful about this long (8 inches) red and puffy line on my hugely swollen knee. When it was first uncovered, I was horrified. It seemed enormous. Then they showed me an x-ray of my new knee – more panic. It, too, seemed gargantuan. How would I ever walk with those chunks of metal (titanium) inserted in my leg? A plastic substance (the knee cap) is between the two pieces of titanium.
It did not take long to realize I could walk. The day after surgery, a therapist had me on my feet walking (limping) up and down the hall on crutches. He, too, admired the “beautiful” incision.
It was the work of Dr. Jean-Pierre Franceschi, Marseille’s famous orthopedic surgeon who is the team doctor for the city’s soccer team. One nurse referred to him as “a star.” Tall, dark and handsome, he looks as if he belongs in Hollywood, not bent over an operating table inserting new knees and hips in France’s second city.
When I finally made the decision to proceed with this drastic operation, I wanted the best doctor, a surgeon whose proficiency would get me back on the ski slopes. It had to be the celebrated Franceschi. The surgery report I received after the operation stated that the duration of the procedure was a mere 35 minutes. Amazing, but I hope the renowned doctor did not rush.
Franceschi’s skills are in demand, so it takes months to get on his surgery schedule. I made the May appointment in early January, and fretted off and on from then until the operation. What if I ended up worse instead of better?
It’s been a month since surgery, and, according to medical personnel, I am doing very well. I can bend the new knee leg to an angle of 120 degrees. A therapist at the rehab hospital told me 130 degrees is what they aim for. I am almost there.
I’ve also been fortunate as I have had very little serious knee pain. Discomfort, yes, but that’s to be expected. The dreadful part for me has been headaches and insomnia, said to be nasty effects from the anesthesia, but that’s another story.
Fabulous French health insurance
I feel very fortunate to live in France and be covered by the French national health insurance. My husband and I also have a supplemental insurance since the national insurance does not cover everything 100%. For both, we pay €4,520 (about $5,650) per year.
The benefits may make some Americans cry. My 11-day stay in the Marseille orthopedic hospital, the surgeon’s and anesthetist’s basic fees, a transfer by ambulance to the rehabilitation hospital in Forcalquier (about 1 ½ hours from Marseille), 2 ½ weeks at the live-in rehabilitation hospital, all medications, plus 20 follow up sessions of physical therapy now that I am home – all completely covered.
Not covered: Dr. Franceschi’s additional fee (you pay for his fame) €500 (about $625), and the extra charge for a private room at the hospital in Marseille, €75 per day or $94. Some of this may be reimbursed by the supplemental insurance.
In France, the standard fee paid by the national insurance to the surgeon for knee replacement is between €400 and €500 ($500 – $625). According to the July 2012 issue of Consumer Reports, a knee replacement in the U.S. costs between $17,800 and $42,750. These figures also include the anesthetist’s fee and hospitalization, nonetheless they indicate that medical costs in the states are clearly over the top. An American friend who lives in Aix en Provence recently paid €140 (about $175) for an MRI of his back. Consumer Reports states than an MRI in the U.S. costs between $504 and $2,520. Yet many Americans still vehemently oppose mandatory national health insurance?
Care at the Marseille hospital was fine. The food was not great, but perhaps a bit better than standard hospital fare. Lots of healthy fish and spinach. One fish dish with a tomato/caper sauce was excellent , and I plan to try and duplicate it.
The French are fanatics about pre-surgery disinfection. Both the night before the surgery, and again the morning of the operation, you have to take a shower washing with a special red disinfectant. There are even instructions in the shower as to how to proceed to disinfect the entire body – including hair. Husband Bob (dubbed Mr. Clean by one of his daughter’s previous boyfriends as he is obsessed with order and cleanliness) was horrified when he saw that the tiles on the lower part of the shower were black with mold. How sanitary can that be?
Shower mold aside, the room was spacious with an extra bed for a family member to spend the night with the patient if desired. Mr. Clean is a dedicated husband, but I dared not ask to him to spend nights in the hospital with me. However, my days were long and lonely as Marseille was too far for most friends to visit.
Every morning therapist Philippe, a jovial type who liked to kid, came to put my new knee leg on a contraption which bends the leg. Each day he increased the bend angle. I also walked the hall several times a day –and in the middle of the night when sleep escaped me.
I had a favorite nurse: Monika Kiss, an angel from Hungary who was extra kind and caring. She and her husband, a builder, are out to see the world. They have lived and worked in Russia, Austria, the Netherlands, England and now France. Monika speaks at least five languages, and is now studying Spanish as she hopes for a job in Spain next. Her favorite job was at the Cambridge University Hospital in England where she termed working conditions “the best.”
Vanessa, a perky nurse’s aide in training, loved to talk about the U.S. She’s never been, but dreams of visiting ”California, New York, Brooklyn.” She says most everyone in France thinks Americans are crazy, but her father reminds her, “If it weren’t for the Americans, we’d be Germany today.”
The ambulance ride (my first) to the rehab hospital was an amusing experience. A bossy, chatty, 51-year-old woman sat next to me (I was on a stretcher). Between shouting orders to the driver and talking on her cell phone, she told me her life story: born in Portugal, six children, divorced, lives with boyfriend. I heard about the problems with the ex, some of the children, her philosophy of life… I had mentioned that I was a journalist. “I’ve been looking for a journalist to write the story of my life. It’s very interesting.” I did not volunteer.
When I arrived at the Saint Michel rehabilitation hospital in Forcalquier, I thought I had entered paradise. The hospital is surrounded by green, with spectacular views of the chapel, Notre Dame de Provence (1875), atop a hill above the town. Spotlessly clean (no mold in bathroom), a large room which I shared with another patient, a huge window next to my bed offering a lovely view, and an adjoining balcony. Friend Lynne who visited several times called it “your hotel.”
There I had lunch and dinner in a dining room with other patients, an entertaining group with whom it was interesting to trade stories about surgeries, doctors, hospitals, etc. Gilles, a retired chef, brought his own jars of sauces and condiments to season the food. Jacques, a retired baker, was used to getting up in the wee hours and also had trouble sleeping. Fanny, a rail thin woman with a tan that would put Coppertone to shame, sported cute mini dresses and claimed she was born with skin this amazing color. Suzanne, who often dominated the table conversation, told us this surgery, hip replacement, was her 17th operation. Michelle, an artist, spent her days painting the surrounding scenery.
The food was much better than that in Marseille, including an excellent seafood paella and a tasty lamb tagine. In French fashion, each meal was several courses: entrée, main course, cheese and dessert. I had heard that wine was also served with dinner at this hospital, but unfortunately that practice had been discontinued. The nurse who admitted me explained that “too many patients were getting drunk.”
Therapy, both morning and afternoon sessions, was excellent. My first therapist, Carlos from Spain, liked to chat and joke with those in the therapy room. The lively conversation took my mind off the pain of bending the knee back and forth. Carlos went off to another job and was replaced by Sara, a gorgeous young woman, also from Spain. By my last week at the hospital, the “beautiful “ incision had healed and the stitches had dissolved. I could join others in the therapy pool for water exercise. Sara taught me numerous pool exercises which I am continuing in our pool.
The rehabilitation facility was better than I ever expected, but, after almost four weeks of hospitalization, it’s wonderful to be home.
My discharge papers from Forcalquier described the “beautiful” incision as “perfect.” I hope the new knee will be perfect, too.
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For a taste of Provence, try the recipe just added in column at right, Chevre Au Gratin (Baked Goat Cheese), a delicious and easy spread for bread or crackers.