Hello,

I managed to fracture my shoulder recently - I slipped on some ice, twisted as I fell and rammed the arm straight up into the socket and cracked the inside of the socket part of the ball and socket. Whoops.

I only realized two days later when the pain was getting worse and I went to an emergency clinic in geneva, by which point all I could do was shuffle along with every step more painful than the last. I am not sure how it's possible to shuffle along a corridor while still maintaining the foetal position, but I was doing a pretty good impression.

They were great, saw me quickly, took x-rays and a CT scan, gave me some nice painkillers and referred me onto the hospital the next day for a full assessment. I was told the x-ray initially indicated a glenoid fracture, which happens less than 1% of the time.

It was from this point onwards, when i arrived at the hospital on 1st feb, that I started to lose my faith in swiss private healthcare. Eventually saw a doctor and he briskly confirmed a fracture and said an operation might be necessary, but he would confer with his boss and call me that evening. He never did. I called the hospital at 10pm and they claimed not to find my records, and suggested I call again the next day and they could ask around the duty staff.

So, I called the next day and they indeed confirmed I had been there the previous day. The guy I was speaking with apparently spoke to the doctor and he said they would send me an outpatient appointment confirmation to see another doctor H, I would receive the letter in a few days. This was 2nd Feb.

I waited. And waited. And dosed myself up on painkillers. And slept . And waited some more and 9 days later I hadn't received anything. I also had not received any advice on what i could physically do, not do, whether i needed to exercise the wrist, the elbow or anything. The only consistent advice I had received from everyone I had spoken to up to then was, if I lost feeling in the arm, I should go back immediately.

I started to call the hospital, several times, and they again could not find my records. I enlisted help from a more francophone friend who tracked down an e-mail address of the doctor H i was being referred to which was hidden within the HUG website. We had tried searches for his name as Doc, Dr, Doctor, Monsieur, M, Medecin, Chiriguien Ortho etc but only by typing "DR." did anything come up under their search engine.

We both tried calling his secretary, no answer. She mailed the doc and the secretary, as did I. I received an out of office saying she would be back in August 2011, no answer from him. I called another 5 or 6 times and eventually lost it with the replacement secretary who said she couldn't find my records either and she didn't have access to the doctors agenda and couldn't give me his direct number. I mailed the doctor H again.

I decided to go down there after hearing nothing up until the 10th feb. 5 minutes before I am due to leave, the doctor calls and gives me some information, which was useful, but caught me a bit on the hoof and I still have some questions. He told me to keep the arm immobilized, another doctor would contact me for an appointment that i would take in 6 weeks and then it would be decided if an operation was needed. In the meantime, exercise the elbow and wrist and reduce the meds.

All in all, I feel very let down by Hopital uni de Geneve. The first few days were a frightening and painful few days and their losing my records and failing to follow up is really unprofessional. At least Dr. H followed up - but it should be the support and admin staff who do that.

After researching on the internet, I think the first few weeks are key to helping my body heal and avoid an operation 6 weeks away. I am taking calcium supplements, cod liver oil, glucosamine sulphate, multi vitamins and berocca mineral supplements. I am going to try and get a new shoulder sling + swathe ( the thing that stops it moving from side to side and wraps around the upper chest ) since this one keeps coming undone and I think it should be tighter.

I am also trying to obtain copies of my x-rays so i can go to the UK and get a second opinion from a specialist. Ok, so it's now been 3 days since i mailed doctor H to ask how i get copies of them, and i leave in 5. I have no idea whether i should be traveling on a plane, going for walks, jogging, resting in bed totally or what - so i feel a trip is necessary to get this issue looked and, and obviously totally begs the question of WHAT i am paying my healthcare insurance for over here.

I know i'm having a bit of a rant - but i just sneezed and i feel like i've been kicked in the side by a horse.

My main concern is to get timely advice and do the best for my shoulder - there is a very good chance of permanent movement impairment - but, again, that's only what i read on the internet and that's a very selective form of self-dianosis. I want a sit down session with an anglophone doctor who seemingly doesn't have just one eye on my wallet ...

For my ranting, which I hope you can forgive me for - I DO recognize that I am lucky - for such a random fall, i could have cracked any number of bones, be in an uncomfortable cast, broken something really serious or hit my head ... and i have a pretty friend who is a physiotherapist who has offered her excellent services, plus the fact that - even if my experiences with HUG have been negative, at least I didn't break my shoulder in Africa or somewhere remote or less developed...

Does anyone have any advice, can recommend a good sling, experienced a shoulder fracture before, suggest if i should complain to hug, what i should be doing or not doing - it's now day 11.

Thanks for reading,
Matthew

My only thought is 'where is your general doctor' in this process ?

Normally, my Hausartz (General Practitioner) is my first point of call for all medical problems, and is responsible for making referrals, keeping the records and dealing with the insurance if necessary.

Since it's a fall, you should have been covered by accident insurance, which by now should be breathing down your neck for an accident report, references from doctors, treatment arrangements...

The hospital doesn't really 'coordinate' your care - ultimately, the follow up and case management should be with your GP, I think...

Sorry, I cannot offer you any help or advice at all but you have my deepest sympathy.

Quite apart from the lack of an appointment caused by 'losing the notes' , it is awful when you don't know whether you should be doing something - what? or nothing - how? Should you move your shoulder? or not? - of course you should move it or the joint will seize up/of course you shouldn't move it or it cannot be expected to heal. Take your pick.

Should you go screaming to the hospital? should you just wait and do nothing (and then be chastised for waiting when it was 'obviously' a 'minor slip up' at the hospital and you should have been in touch immediately).

Not been there, not done that - fortunately. And the T-shirt won't fit me either.

Again, no help but I'm crossing my fingers that things look brighter soon.
(Rants are permitted at the weekend as it is too cold and slippery to go outside and risk falling over anyway).

I'm sorry to hear of your injury, Matthew, and that you've had such a frustrating time getting treated.

This exactly.

My comments are based on my experience in SZ; the situation in GE could be quite different, so please take what I say with a grain or three of salt:

First, the doctors at the hospitals I have been to do not speak to patients, they only go through your GP. Whether an ER situation or a specialist referral, you go in for the procedure only, the hospital doc does not speak with a patient beforehand (although an assistant might), nor does he/she follow through with you afterwards. The doc sends a report of findings to your GP, who then discusses treatment with you. If you have questions, you again go through the GP who speaks to the hospital. (The downside is that you pay twice..)

Hospital docs and specialists are generally too busy to deal directly with patients other than to do the procedure immediately at hand. The 'soft' side of patient care is left to the GP. And mind, this is with a traditional insurance plan, not managed care of any kind.

So - not knowing how it works in GE, if you are getting no where on your own I would suggest that you go to your GP, discuss what has happened, and ask him/her to organize treatment, including referrals as needed.

I hope you get the treatment you need, and start to feel better soon.

This is a situation where your GP needs to step in (like Meloncollie said)

If you don't have a GP or your GP isn't being proactive enough, I cannot reccomend highly enough these people, they're awesome:

Centre Médico-Chirurgical des Acacias SA
Service d'urgence et consultations sur rendez-vous Médecine Chirurgie Radiologie, échographie Laboratoire Physiothérapie
rue des Epinettes 19
1227 Les Acacias

Téléphone: * 022 342 54 55

I broke my ankle in Geneva a few years ago and my GP was in Lausanne and I needed physical therapy in Geneva closer to my workplace, so I went to these people who sorted me out, got me drugs and got me a lot of physical therapy. Sorted it out with my insurance, I never even saw the bill. Great doctor, great physical therapist. The offices look ghetto but don't let that fool you.

I needed several months of physical therapy and follow up on my ankle (I walked with a cane for almost two years) and I cannot praise them highly enough.

The head at the time was an old Lebanese dude, if you go there tell him hi

Get better soon and LOTS OF REST. With injuries like that all you can do is rest. Take time off of work and get as comfortable as possible.

Sounds really painful, feel for you when you are in pain you people to help not wait. Hope you get some answers soon and start your road to recovery.

While it is true that somebody should be coordinating your care, remember that YOU are in charge of your health.

It's up to you to raise hell and pound on the desk and demand results and threaten if necessary.

I hope you get the care you need sooner than later.

Good luck.

First, let me say I feel your pain. I had a particularly bad shoulder dislocation last year and was in pain for quite a long time - sneezing and coughing were my worst fears at the time.

I can understand wanting to consult with a doctor in the UK but unless you are planning on staying there, you really need to consult with a local gp here who can coordinate everything: with the hospital, insurance, physiotherapy etc. This is essential so that everything is covered and that you get the treatment you need.

My shoulder froze and I needed surgery to break it back open. Not fun. This doesn't happen to everyone, though, so I don't think you should be too worried about it. What is essential is having a gp coordinating your recovery so that you are referred to physio asap. The physio is a major factor in avoiding a frozen shoulder or permanent damage.

Something positive: it is a little more than a year since my surgery and my shoulder is great. So there is a light at the end of the very painful tunnel. Good luck!!

Just as an aside, I find that the telephone is not the most effective way to get things done here. Turning up in person, while inconvenient, means you can't be ignored. If I hadn't received a phone call after a few days, I'd head back down in person to track down what I needed. If you weren't mobile enough to do this, I'd do my best to find a friend who might pop in on my behalf.

No, it shouldn't be this way -- but it's easier to play the system than to try to change it.

So it seems to be important here, to be registered with a GP, just in case one is ever needed, as in suddenly have an accident? I had always thought that a waste of time as I have not needed to see one in literally years. I'm wrong, huh?

But the key point is that in Switzerland you need to be pounding on the right desk... and it is not always clear which desk that is. But pounding on the wrong one will just as often throw up barriers.

It's a frustrating, I know. Jumping through the bureaucratic hoops and parsing the unwritten rules is at the best of times difficult for someone used to a different system, and all the more so when one is in pain, or facing a serious illness.

I have my own concerns about the quality and delivery of health care here, to say the least - but as VI says, it's the system we have and in order to get any treatment at all we have to learn how to navigate it.

Wishing the OP a gute Besserung, and all the best.

I had let her know, but the office was closed when I decided to go to the emergency room, and they referred me direct to the hospital. She was kind enough to fax across a repeat prescription to the pharmacy near my house but you made me think of something else - perhaps she can help to get hold of a copy of my X-rays at the hospital without me needing to go thru the contact rigmarole again...

good point !

I think from reading everything that the best advice and next step is to now get to my GP and to have her get hold of the x-rays on my behalf - they might be much more likely to respond to her directly than me - a "mere" patient.

I would still like to get the second opinion in the UK, even though I will be paying twice, but the insurance will cover most of the Swiss bills, plus I am on chomage here so they should have better cover than I do privately.

just a matter of staying still, not getting too stressed, and eating well, but I do wonder what I'm going to do the next time I get an interview since I'll really have to wing it with the suit

Ok, so - on the To Do List - Monday morning, call GP ...

Very sorry to hear your crazy story. If you need one, I can recommend an awesome shoulder specialist in London - just pm me for the details

sent PM - thx

quick update - i called the radiographer direct this morning, on the chance they could just whizz me of a copy of the rays, and they can - all for 10 chf - AND they are putting them onto a cd for me, so that's about the best outcome i could have hoped for today !

Just a happy ending to this story

I went to the UK and had another x-ray with a private doctor - the fracture is healing nicely and he said I could start physio at week 4, so I am I going to see my GP on Monday to get a prescription to do just that, plus it's all covered on my insurance here so that's great. Even before the physio, I have regained about 30-40% movement in that arm and I have some quiet exercises to do in the meantime, plus the pain is mostly gone ( even though it's kind of frustrating to not be able to lift my arm higher than my chest, but considering where I was a few weeks ago, it's a really good progress )

Thanks everyone for their comments and suggestions and support - you guys rock

Thanks for coming back Matthew, not a lot of members do. Glad your shoulder is healing nicely. Are you claiming for your days off work? You need to supply your employer with an excused work doctor's certificate.

thanks! Im on chomage here so covered by the venerable state of GE, no need to bother employers about it, although i should wear my sling to an interview and maybe get a sympathy job ...