Day surgery in Spain – what to expect
Our author is a graduate working in Spain, and experienced an embarrassing health issue which required surgery - here's her advice about navigating the Spanish healthcare system as a Day Surgery patient.
1. Register at your local Centro de Salud upon arrival in Spain
No-one moves abroad expecting to need surgery or to get ill, but doing this as soon as you arrive in Spain will make your life easier should you need treatment. The process for this varies by region, but generally you just need to take your EHIC and passport or NIE to the Centro de Salud determined by your address.
2. Be aware of unforeseen costs - get insurance!
If I'd had to stay in overnight, my travel insurance would have paid me £30. They also told me that if I'd had to pay anything, they would pay anything over £100, but the only costs I had were the prescriptions and private nurse appointments when I went back to work. Spain only offers appointments in the mornings through the public system and a dressing change at a private clinic (sanitas) in the afternoon cost €10 each time.
3. Seek treatment as soon as you notice a problem.
This was probably my biggest mistake*. If the problem is affecting an embarrassing part of the body, don’t just wait two weeks and see if it goes away on its own… I can tell you now that it could get a LOT worse. Seeing the doctor straight away could mean that you avoid an infection and even surgery itself.
4. Follow your instincts.
After seeing the doctor, I was prescribed a general antibiotic and no painkillers, even though I could barely sit down*. I was given a slip of paper to give to urgencias in the hospital and told to wait a day or two to see if the problem would resolve itself. If it takes you 20 minutes to walk/waddle the usual 5 minutes to the doctor, and your housemates are telling you that you NEED to go to the hospital today, you should definitely go, or risk waking up the next day almost unable to move.
5. Don’t go anywhere alone.
This is especially important if you’re a weak Spanish speaker, but it’s unpleasant to be alone in hospital at any time. Explain your situation to a friend or work colleague and see if they would be willing to help you out. Also, following day surgery, you won’t be allowed to leave the hospital alone.
6. Make sure you go to the correct hospital.
The form for urgencias from the doctor should specify a hospital, however, mistakes can be made and sometimes the wrong hospital is written on the form. Make sure you double check the information you’ve been given. I initially went to the nearest hospital, only to be told that they didn’t have the correct specialists and I had to make my way to another one which offered all types of care. They did, however, inject me with very strong painkillers – Warning: this injection goes into your bum, which came as a surprise to me!
7. Consider all your options carefully.
After being seen by a specialist I was told that I definitely needed surgery to drain the abscess that had formed along with another small procedure. I was given the option to wait for a slot that afternoon and stay overnight, or to come back the next morning and go home the same day. Don’t let the strong painkillers fool you into thinking that it’s a good idea to wait like I did – they will wear off. If you were in unbearable pain, keep that in mind when making a decision like this.
8. Don’t have breakfast and be prepared to wait.
Shortly after arriving, you will be allocated a bed. There are no more than 2 patients per room and you will most likely be in your own room. Although you may have been given a morning slot, you could be waiting until 2 or 3pm as the operating theatre obviously prioritises emergencies. Don’t worry, they won’t forget about you! The don't have breakfast part is because you have to have anaesthetic on an empty stomach. They tell you to come 'en ayunas' if that's the case.
9. Read the consent form and ask questions.
You will be given a consent form to bring to the hospital on the day of the surgery, however it may not contain all the details. I was informed just minutes before surgery that I would have a general anaesthetic and was asked to sign another form.
10. Ask questions when you are discharged to avoid nasty surprises.
You will be given a discharge letter detailing the medicines to buy from the pharmacy and any curas that you may need. In my case, the doctor didn’t come and explain anything to me, and the form just said I needed curas (like a dressing change) once a day and 3 different tablets. I was under the impression that I would be able to do this at home, but when I saw the nurse, I learnt that the wound had been packed with 55cm of gauze which needed changing daily by a professional. As you can imagine, this was a shock and very painful as it was removed and replaced. You can avoid this being an unpleasant surprise by being persistent and asking questions at the hospital.
11. Ensure you are aware if you have stitches which need to be removed.
It didn’t say on my discharge letter that I had stitches and even my nurse didn’t realise I had them. Upon completing around a week of curas, I noticed two long black strings. Obviously I returned to the nurse as I didn’t know what they were, and was then informed that they would need removing, but not for another 2 to 3 weeks. They did eventually fall out on their own, but always check this as it’s definitely not good to be walking around for more than a month with stitches hanging out and they may not fall out on their own.
12. Be grateful for Spain’s relatively speedy healthcare system.
Although there can be a serious lack of communication – probably because hospitals are very busy – medical professionals will give you answers if you’re persistent and ask questions. Probably the most important are: What do the curas entail? Do I have stitches and will they dissolve? Is there anything I should avoid doing? What can I expect following the surgery (e.g. bleeding, soreness etc.)? Should I take time off work?
Generally, Spain has a great healthcare system, and everything is very clean, just make sure you’re informed about your situation. They will also try to speak to you in English/Spanglish to make you feel more comfortable, but do say if you can’t understand them!
* The author's surgery was for a bartholin gland abscess which can affect any woman and has no cause. It's a gland which can get blocked and infected. You could need day surgery for anything similar to, or the same as that. She says, "Mine was 4cm so required surgery and daily wound packing. I know people who've had other kinds of cyst and also needed a small surgery.
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