Lost in translation

[Stripesagain]

My father in law has COPD and it had been gradually getting worse for a while but over the past three weeks he has rapidly gone down hill. The trouble is my in laws love in Spain and they do not have the same level of support for COPD like they do here.

On top of that he is currently in hospital, pretty poorly and we have no clue what’s going on. We have an interpreter joining my husband (who flew out yesterday) on Monday when the consultant comes round again. I’m trying to find out what sort of things are the most important to ask whilst we have the interpreter there.

Just for context he has had four episodes in the past two weeks where he has been struggling to breath and has had to be hospitalised. They do oxygen therapy for a night and then send him home. He does not have oxygen at home and the earliest they can give him an appointment to arrange it is November. They have kept him in this time as he has fluid on the lungs. Other then oxygen and paracetamol he is not having any other treatment despite being in so much pain.

The staff speak little English and my husband speaks even less Spanish but has been using a translator app to get by. The nurses have no answers though and just keep saying he has to wait till Monday.

If you’re still with me, thank you for reading this far and any advice is appreciated 🙏🏻🙏🏻🙏🏻

[Thepainterswife]

Hi Stripesagain, this must be so distressing for you , presumably they will be monitoring and possibly doing tests over weekend in order to get a better idea of your father in laws condition and the treatment plan going forward . The only comfort I can give you is that my brother has lived in the Canary Islands for 30 years and tells me the Spanish hospitals are as good as and in some instances better than in the uk His wife underwent cancer treatment about 5 years ago and her treatment was excellent. Of course he and his family speak fluent Spanish which obviously made things a lot easier . The fact that they sent your father in law home with very little treatment may indicate that they felt he was not in a serious condition at that point , not being able to breathe is very scary for people in the early stages of copd but not necessarily life threatening. My husband was diagnosed with Copd 16 years ago , he deteriorated about 4 years ago and was given oxygen at home etc then. It does take time to assess exactly what treatment is needed and I know waiting is just awful but I’m sure he will be taken care of , my nephews wife is Spanish and a nurse and I can assure you their training is every bit as rigorous as it is in the uk Keep us updated please and try not to worry too much , hopefully your father in law will be fine once he’s on the right medication 😊 xx

[Stripesagain in reply to Thepainterswife]

Thank you for the reply. The language barrier certainly seems to be the biggest issue. My in laws speak a little Spanish and it’s enough to order food/drinks or ask directions ect, but having a complex medical conversation is certainly beyond their skills. My husband can order a coffee at best 🤦🏻‍♀️I think he is more of a later stage COPD although I’m certainly no expert. We know he has fluid on the lungs and a heart problem, along with swelling feet. Visually he looks very different all of a sudden and he has become pretty low (although I would too with all that going on).

My in laws have always praised the health care in Spain, it’s only now things haven’t been a little lacking and I think the pandemic impact is certainly not helping. They normally have interpreters at the hospital but as the number of holiday makers is so low and the hospital is trying to keep as many people out as possible, to help curb the spread of covid, it’s left them a little lost.

My husband said they did come and do observations but only because he went and explained his dad was in a lot of pain. He’s been using a translate app to converse with the nursing staff

[Thepainterswife in reply to Stripesagain]

Oh yes I hadn’t thought about COVID , I wondered why there was no one to translate . We haven’t had any experience of fluid on the lungs (yet🙄) but we had to call the Gp a couple of weeks ago due to hubby’s lower legs and ankles being very swollen , ( which Im told is due to the kidneys not functioning properly ) they prescribed water tablets but I can’t say they’ve made a massive difference . They don’t even like to prescribe those because they can react with the other meds 🙈 this is what we’re up against when various organs are affected and various meds are prescribed but I do hope they’ve given your father in law something for the pain 🙏 x

[sassy59]

Wishing your father-in-law all the very best and hoping he gets the treatment he deserves. It is an anxious time for you but I’m sure the doctors and nurses will do their very best for him. Xxxx

[Caspiana]

This must be such a worry Stripesagain as everyone says the hospitals in Spain seem to be top class, but of course the language barrier is a problem😐 .

I am wondering where he has the most pain , is it in his chest? I guess the obvious question would be what has accelerated this decline. If he has water around the lungs what is the cause? This may be the source of his pain too. Potentially, pneumonia, pulmonary edema (has his heart been checked out?) , Pleurisy ( inflammation of the tissue between the lungs and ribcage, which can be excruciating ) There are so many variables. I am sure the doctor will have news for you on Monday .

I can't say don't worry, but I think they are looking after him well. Take care of yourself and I hope the news will be more positive on Monday.

Best wishes,

Cas xx 🙋

[Stripesagain in reply to Caspiana]

Thank you - it really is the not knowing what’s going on. We are all thinking the worse and that this could be it, when in fact we might be miles away from that scenario. Thank you for the suggestions on what to ask. This exactly the sort of thing I was hoping for - it seems so obvious and if we didn’t have the language issues we would probably know all of this. I guess it’s making sure we have all the answers we need whilst we have the interpreter on Monday. The past 3 hospital visits he’s been sent home, just to collapse and end up back in there. This being the 4th ambulance job in two weeks and we are none the wiser as to what’s happening. They do tests but he’s never known the results of any of them

[HungryHufflepuff]

What a worry for you all. I hope your father in law’s appointment on Monday goes well, especially with the interpreter, and he gets some information and explanations. Sending you all lots of good wishes.

[MoyB]

I think most of the questions I would ask have been mentioned here already.

Maybe, through the interpreter, you could also be asking about follow on care?

Are they going to refer him on?

Will he have contact numbers for support?

What can he do to help himself?

If it is a problem with his heart, will they be following it up?

It all seems obvious, I know, but when you're having to think on your feet in a different country and in a foreign language, it can be easy to miss what's right in front of you.

Fingers crossed for you to get some answers on Monday and hope he gets the best care he needs until then. xx Moy

[Stripesagain in reply to MoyB]

Thank you for your reply - it really does seem obvious doesn’t it but I just wanted to make sure we aren’t missing important information or questions when we get to speak to the consultant. It’s always the way that you think of things after and we won’t have that opportunity to go back to them very easily.

It’s just this horrible bit of not knowing, you’d like to think that as they’ve sent him home three times things aren’t as bad as we are fearing. However seeing him so poorly we are ready for the worst, with the hope that it’s no where near that bad. It’s the not knowing.

I really appreciate you and others taking the time to reply 🙏🏻🙏🏻

Thanks xx

[MoyB in reply to Stripesagain]

I completely understand what you're saying. Not knowing is just awful. At least if you can get some of your questions answered on Monday you might know what to expect and also, how to help him best. It must be so difficult for him and his wife and they are lucky that your husband is able to get there to support them.

I daresay others will come on soon with some helpful suggestions for you. You will be able to get everything into some sort of order and let you husband know what needs to be asked. Would he be able to let the interpreter have the questions ahead of the meeting in case he or she needs to look up any medical words? Just a thought.

Just on the subject of fluid on the lungs - my husband had an MRI scan for a prostate problem and it was discovered then that he had fluid on the lungs. He was referred to cardiology and they diagnosed severe aortic stenosis which means he will now be having a pacemaker fitted and then a valve replacement. Meanwhile, he is under the care of the Community Heart Failure Team and has received great support and advice from them He has been put on quite a number of medications and all seem to be keeping his condition stable. He was diagnosed last October and it looks now as though he will get his ops sometime in the next three months. I'm letting you know all this as it may help to know that even in the UK such a diagnosis doesn't lead to the obvious treatment straight away. My husband will have waited a year for his op by the time it happens and his condition has been monitored and well managed during that year so life has gone on much as normal.

Hopefully, if they find there is a similar heart problem, a management plan can be put in place for your loved one. Similarly, if it is all down to the COPD, they may be able to put in a plan of support to ensure he keeps living a good, full life for as long as he can.

Wishing you - and him - all the best. xx Moy

[katieoxo60]

I am sure you are very concerned about the oxygen wait . I would be asking why can't he be assessed for oxygen while in hospital rather than waiting several months especially as he has been in hospital four times in the last two weeks. But as you say rules in Spain are different to UK. It could be plurisy too with all the pain hope you get things sorted once the translater is there. Usually in spain they have on site English speaking at the hospitals. But the Covid virus as changed many things . Every Best wish for help to be sorted. Trust he as been tested for the virus too.

[hillclimber1]

I live in Spain with my wife who has EPOC (spanish for COPD) The hospitals are good but operate in a different way. They would not prescribe oxygen assistance without a six minute test, but couldn't do test due to covid. Eventually we made enough of a nuisance of ourselves that we left with a large oxygen concentrator and a portable concentrator.

Our translator is amazing and understands how the medical system works and a little about COPD. Invaluable. It seems like referrals from pneumologists to cardiologists is not as joined up as in the UK. Often we have had to go back to the GP to start referral all over again.

Hope all goes well.

[Stripesagain in reply to hillclimber1]

I wish we could say the hospital have been amazing but actually it’s been beyond bad. I am getting the British consulate involved on Monday. My poor father in law is old school, put up and shut up. He rang the bell as need the loo last night and can barley stand up let alone walk. They didn’t come and after waiting for over an hour he was so desperate he decided to try going himself. He made it to the loo but then must have collapsed. He woke up in the floor but there is no emergency button/cord in the bathroom. He laid there till day light before being found.

I know it’s a different country so o can’t judge by our standards but the care he’s received so far has been truly shocking.

He’s in so much pain and discomfort - he is convinced he is dying and we can’t assure him he isn’t as we haven’t got a clue.

Sorry to rant. I am just feeling so helpless and wish they were here 😢😢😢

[Caspiana in reply to Stripesagain]

Hello 👋

Negligence is negligence. It has nothing to do with the country. I am very surprised to hear the hospital is so incompetent. 😡 Is there any chance of him going back to the U.K? It would be better for him to have his family who can advocate for him.

[Stripesagain in reply to Caspiana]

I would love to say that we can get him back here but we haven’t a clue what wrong or what the prognosis is. They are so staff limited and obviously I understand that given the pandemic but it’s horrendous as well. My mother in law is now staying there 24/7 as she’s said they just can’t be trusted. She’s so worried that he passes away during the night alone and left before they realise.

They have been there for over 15 years and have always praised the health care there, preferring it to the NHS but this has been a different ball game all together 😢😢😢 x

[Caspiana in reply to Stripesagain]

Is it possible to change hospitals? 😔 Your mother in law will get ill too if she is at the hospital all the time. It will take a toll. Can you facetime or WhatsApp with him? See how he looks etc. If he is very poorly I think it would warrant him coming home wouldn't it? I am assuming he didn't give up his British citizenship. Which part of Spain are they located? I unfortunately, have a good idea what you are going through. It is so stressful.

[Stripesagain in reply to Caspiana]

He would certainly not be deemed fit to fly at the moment. I know my mother in law being there isn’t the idea situation but her and my husband agreed on that solution until Monday when they are hoping to get a better idea of what’s going on. Personally I think he’s got multiple organ failure and despite being a Dr I am not a medical Dr so I’m hoping I am very wrong. He looks very different and every day seems to be worse.They are near Alicante

I am sorry you have been through similar - thanks for your reply and best wishes to you 🙏🏻

[Caspiana in reply to Stripesagain]

I didn't realize he was quite that seriously ill. I am so sorry. I hope you get more concrete answers on Monday that will lead you to a good solution. I wonder if you / your husband could fly there , this is after all an emergency situation. I feel for you both. I hope you will update us if you can. Sending a gentle hug. xx 🦋

[Stripesagain in reply to Caspiana]

Thankfully my husband is there - he flew out Thursday after his dad was taken ill again on Wednesday. Thank you and I will keep you posted xx