Irresponsible Parents Try Out The Italian Medical System

I wanted an adventure. That’s what I was telling myself as I sat in a puddle of guilt and relief on a hospital cot at 2:00 in the morning while listening to my son breathing normally, finally. I wanted to experience the full gamut of real life in another country, complete with ups and downs. Well, sometimes you get what you ask for.

My boy Felix has a history of nut allergies starting at 18 months old when he got terrible hives from eating cashews. Until then I had thought nut allergies could only happen to families more organized than mine because it seemed like such a huge job being that diligent. But after a battery of blood and skin tests it was determined that yes, in spite of who he has looking out for him, my son was allergic to most nuts. So, we have been careful for the last 9 years. Not super careful, but pretty much careful. At our last visit to the allergist, about six months ago, we were thrilled to be told that of the nuts tested he was only allergic to three – peanuts, cashews and walnuts. This showed that he was growing out of the allergy and might someday not have to think about it at all.

Fast forward to Italy, and the homeland of pesto. Pesto, of which my kid has eaten heaps, but always nut-free. Pesto, which, here in this magical land, always contains pinoli, pine nuts. Pine nuts are not one of the nuts that they test in a regular allergy panel so we had no idea if he was allergic or not. I knew Felix had been exposed to small amounts of pesto here and there and hadn’t had a reaction so I was pretty sure we were safe. I figured that since he had never had an anaphylactic reaction before, he was growing out of the nut allergy, and pine nuts are from a different family from the other nuts he is allergic to, we were most likely safe. I kept thinking we should test him on pine nuts, just to make sure, so that pesto would be an option in restaurants and friend’s houses. And I said so as we sat down to dinner on Monday night. Robert and I had pine nuts on our salad and Robert was like, “Yeah, sure, how about now? Eat this.” We gave him three. Three measly little seeds. As you have already gathered from the title of this post, we did not make a good choice. We are not responsible parents. Things did not go well.

I have always pictured anaphylactic shock happening immediately. This did not. It started with a bunch of whining and complaining. This kid has two modes when it comes to how he is feeling – either he is great or he is carrying on like the world is about to end. So I take all reactions with a grain of salt. I thought he was talking himself into feeling bad. I thought he was fine and just being dramatic because that would be normal for him. I got him a Benadryl, just in case he was having a little reaction, and suggested he watch a show while it kicked in. He did, still whining, and I went back to my dinner. I looked over a few minutes later and noticed his upper lip was all swollen up and his eyes looked a little strange. So I got another Benadryl and had him take it. I was thinking, ‘damn, well, I guess he is allergic to pine nuts’. Soon after that he stood up and puked on the rug. We got him to the bathroom where he then puked up about 1/4 of his body weight. After that things got bad.

As soon as the vomiting was over we could hear him wheezing with each breath. His voice got low and gravely and he was crying and breaking out in hives everywhere. I was still, stupidly, thinking we could control things with Benadryl and I gave him more since he had just thrown up the first dose. Within ten minutes it was clear that things were only getting worse. But what to do? Foreign country and all. We came to terms with the fact that we needed to get medical help but calling the Italian version of 911 (112 for those who want to know) seemed daunting. We knew that the Croce Rossa, the Red Cross, was just behind our house and they are the EMTs here. I figured that if we could get him there they would be able to help us. But the breathing problem was getting worse, and Google smacked us upside the head with the reality of the situation. He needed epinephrine, and he needed it, like, 15 minutes ago.

The gods were smiling on me when I packed up my house in the US and decided to bring two almost expired Epipens. We have never once had to use one and I remember thinking it was dumb to bring them but I did it anyway. So I had an Epipen, but I also had a kid who is terrified of needles, and I had never administered one before. It’s not a simple shot. You have to swing the device, hit with a certain amount of pressure and then hold the needle in for three seconds. I did not want to do that. Not one bit. But, then again, as a parent you have to save your kid’s life from time to time. He was screaming and fighting us, while hardly able to breathe, but we got him to stop thrashing and look the other way and I did the thing. Immediately he could breathe better and we headed out the door to the Croce Rossa.

The poor guy who was in the Croce Rossa office all alone was given a big task when we stumbled in, me asking in panicky broken Italian if he could help and trying to explain what happened. He said we had to call 112 right away. So Robert sat with Felix while I called and talked to the emergency dispatcher and our poor lone savior somehow conjured some other Croce Rossa dudes to come and help. My phone call was a bit challenging, as many things are for me these days. The dispatcher told me an ambulance was on the way but at the same time we were being loaded in an ambulance by the Croce Rossa guys. We took off for the hospital with Robert following behind us in the car. There are good roads between us and the hospital but they are twisty and very much not a freeway. The speed limit is between 50 and 90 km/hr. Robert was driving 148 km/hr at one point trying to keep up with the ambulance. That is over 90 mph for those of you in the US who don’t know.

About half way to the hospital we pulled over on the side of the road. I had no idea what was going on. It turns out that when the emergency dispatcher said that they were sending an ambulance, they meant they were sending a doctor from the hospital in an ambulance to meet us. Four people with lots of equipment were suddenly there with us. I was trying my best to answer questions about the timing of things and how many kilograms Felix weighs (Kilograms. I barely know what he weighs in pounds and dividing by 2.2 was more math than my stressed out brain could handle in that moment). They started getting ready to put in an IV. Which involves a needle. I was doing my best to keep Felix calm-ish. Having him jump off the gurney and run into traffic seemed like it wouldn’t be a great thing. They needed a tourniquet to find a vein but didn’t have one so the doctor took off his belt and wrapped it around Felix’s little arm. And then suddenly there was blood. Something got messed up when they inserted the IV and blood was everywhere. I was begging Felix to keep his eyes closed and catching his blood in my hand while it ran down my leg into my shoe and all over everything. I actually can’t believe it really happened that way when I think about it now, but it did.

After that drama was over and we were back on the road to the hospital, they gave Felix some cortisone because he had turned into one enormous hive and was scratching his skin right off. About five minutes later we arrived at the emergency room, which, like all emergency rooms was chaotic. It’s a small hospital, and the ER was kind of a hallway with a couple big rooms off of it. We were assigned to the hallway. I was called into an office to answer questions that I only partially understood. One of them being, do we have insurance? We have a catastrophic plan that we were required to buy to get our visas, but until all our paperwork is settled we can’t buy into the national healthcare system that will provide us with regular doctors. The policy we do have was buried somewhere in the bowels of my email and I couldn’t find it. The guy told me non preoccuparti, vai tranquila, (don’t worry, go calmly) but of course I was not feeling particularly tranquila about anything at that point.

Luckily Robert arrived soon after us and was able to stay with Felix while I failed to answer questions. Fe had turned a very strange color at that point, a dark brownish purple, and was itchy and twitchy and tired. I assume that is what epinephrine does to you. After about 20 minutes of waiting in the ER, we were told that he was being moved to a room, but only one parent could stay. Robert promised to return shortly with some fresh clothes and a phone charger and I went with Felix.

Felix and I were taken to the pediatric floor and his IV was cleaned up and fixed by two competent but not particularly friendly nurses. They were less than impressed by his fear of needles, they just took care of business and got his drip going. We were put in a room, given a sheet for the cot, and told to push the button if we needed something. And that was that. I can describe the room by saying it was dated and spartan, but adequate. No art, no mirror, no couch and to Felix’s great disappointment, no way to turn on the little tv. The furniture looked like it was probably from the 80’s and permeated with decades of parental anguish. But what the room did have was an incredible view of the rooftops of Imperia and the Ligurian sea. It was night so I didn’t notice when we got there but it was awfully nice to see the next morning.

By the time we were settled it was 12:30 at night. Felix’s breathing had pretty much normalized and, starting at his fingertips, he was changing from rotten plum to his normal color. He fell asleep and Robert delivered a bag for us. I put a sheet on my cot, plugged in my phone and started searching for our proof of insurance, which I couldn’t find. I gave up after an hour thinking I’d just have to have Robert bring my laptop when he came in the morning. I spent some time texting with my grown up daughter, letting her know what was going on. Her response was, “So, you poisoned your kid, stabbed him and then let strangers take him away in a van?” This made me tear up with pride for the irreverent humor I have instilled in her.

We were visited twice in the night, loudly, by nurses checking on the IV. Around 8:00 in the morning someone came in to ask if Felix wanted some breakfast and he said yes. Half an hour later four cookies and a cup of black tea were delivered to our room. This breakfast was fascinating and hilarious to me on many levels.

While Felix was eating his “breakfast” we were called into an office next door to meet with the head doctor. She was fantastic. She is an allergy specialist, and the first person we encountered in the whole experience who spoke English. I was relieved to go through specifics with her. She told me that because Felix is under 18 and has a heath issue, we can get him on the national healthcare plan even without all of our immigration documents in place. She wants to see him again to do testing and then send him to an allergy clinic in Genoa, one of two in the country, for advanced treatment. She wrote us a prescription for a new Epipen and some antihistamines and warned me that we would have to pay for them because we aren’t in the system yet. I asked if I could email my insurance information when I got home and said I could leave my credit card information in the meantime. She looked confused. Then she said that this was an emergency so of course there was no charge. Then I looked confused. She said, “You came here in an ambulance, that’s an emergency. In this country we don’t charge people for emergencies.” Mind blown.

Side note: I knew that healthcare is much less expensive here, even without being on the national system. For us to buy into the system will not be an insignificant amount of money, but way less than for insurance in the US. What I did not know was that emergency care is provided for free to anyone, regardless of status. To put that in perspective, last year I had an ambulance ride and emergency room visit for atrial fibrillation. I had some tests done, the conclusion was that I was fine, and was sent home after 4 hours. I had pretty decent insurance and it still cost me a total of $6000. That is criminal. Here, we paid for Felix’s new Epipen and antihistamines and that’s it. €70 and two different people apologized that we had to pay anything at all. I am not proud for the United States.

We were sent home at 8:30 in the morning. No paperwork, no bankruptcy, no nothing. Just a slip of paper telling us who to choose as a doctor when we get Felix’s account set up. Plus a few more gray hairs and a new adventure under our belts.