Best place to live

[Doghouse]

Before I was diagnosed with WG in 2012 my husband and I was looking to move to France or Italy. That was put on hold while I was so poorly however I'm now doing ok and my condition as improved loads however my bloods are a bit haywire at the moment so we are adjusting my medication to correct this . However when that's settled we are looking to move any ideas the best place to go and what the health system is like? If we don't go abroad we was thinking of going south somewhere a bit warmer , I live in Cheshire now .

[PMRpro]

I live in northern Italy, in the mountains about 2 hours from Lake Garda in a region called South Tirol (in Italian Alto Adige). Here is cold in the winter but that was why we came here, once you go down into the valleys the climate is very mild.However - our health service here is excellent, I have no desire to return to the UK despite our entire family working in the NHS and we also worked in the NHS for years. It is not free at point of receipt: except for GP visits there is a co-pay for almost everything. For example, you pay for all blood tests unless you have an exemption for a specific chronic illness - I don't pay for cholesterol or INR tests. A full blood panel costs about 50 euros maybe. Things are done differently - and mostly that is positive: I have had treatments here that simply aren't available in the UK. And at present you don't wait long for an appointment for most things, Never for something urgent.

Beware though - wherever you move abroad you will need to get a good grip of the language if you need regular healthcare. Here is bilingual, German (mainly where I live) and Italian. All staff are meant to be equally proficient in both. They aren't. And very few speak good English - we are used to one or two consultants in our local hospital taking delight in practising their English with us but they are the exceptions. It isn't a problem for us, we are fluent German speakers, that's why we came here, but sometimes we meet an Italian who only speaks Italian. And when they do speak any English it isn't very good! I have never been asked if I need an interpreter - that isn't expected like in the UK.

We never regret coming here and don't want to come back - but we had lived abroad before and knew what we would meet. If you have any questions - just ask.

[John_Mills Volunteer]

We do have experience of the care available in France. Some of the best knowledge and experience can be found in France, but just like the UK it depends where you live, which hospital you go to and the care you receive.

We know there are places in the UK where you just would not want to be diagnosed and treated for Vasculitis. But we are working on these areas!!

There is a large support group for Vasculitis in France, but as PMRpro has stated having a working knowledge of the language is important.

We often go to France, sometimes for long periods, on one occasion we were visiting a very small village in South West rural France, when I had to visit the local GP (doctor), when I told him I suffered with Wegener's Granulomatosis (GPA) he knew more about WG than my own local GP back home!! he also spoke a little English, so along with my mediocre French we got on extremely well.

[ipswichlady in reply to John_Mills]

Hello John, Very interested to read your comments today and wonder which part of rural SW France you visit? We go to Charente Martime and visit a small hamlet called St. George-Antignac, nearest town (10 mins away) is Jonzac. Because I have Tak I do worry when we are there. I know the doctors are so advanced, but I am wobbly with my language skills, and my memory is not so good since being on steroids!! Your comments have given me encouragement as you can feel "rurally isolated" if you start to feel very unwell. Thank you John.

[Nadine99]

My husband has WG and we were living in France when his symptoms first presented themselves. We always had excellent medical care in France but our GP didn't speak much English so we struggled with a diagnosis. It was only when we changed GP to one with excellent English that he was referred to the hospital at Poitiers. The Specialists there knew about Vasculitis and he was given every help. We then decided that even tho they spoke relatively good English, it still didn't beat doing it in real English, so we decided to move back to the UK and our beloved NHS.

In France, if you do not receive your Government State Pension, you now have to pay an insurance pollicy to cover 100% costs unless you are working & pay into the system in which case you get approx 70% of your costs but can chose to take out insurance for the other 30%. Costs can be expensive, just depends on your circumstances. Check out a website called AngloInfo for good info on expats in France.

We also found the French climate too hot in the summer for my husband to cope with and we were between Poitiers & Angouleme. France lovely to visit but wouldn't ever live abroad again and we have good memories.

Good luck

[Ayla Volunteer]

Hi! We have lived in both Italy (2003-2006) and France (2006-2009) and, as I was diagnosed with MPA just before we moved to Italy, I can understand your concern! I can only give you my experience and hope it will help you with your decision.

In 2003-4 was treated in the North of Italy, at Varese hospital by a very knowledgable and capable female consultant rheumatologist called Elena Baratelli. She was excellent. We then moved south, to Le Marche and the lack of knowledge and appropriate treatment was very scary indeed! The local GP was completely ignorant of my condition, as were the recommended rheumatologists, and I was left with regular blood tests and no appropriate treatment, despite regular flares during which I felt very ill indeed. I would advise, if you decide to go to Italy, that you stay in the north of the country where care is more likely to be appropriate for your condition. Would also advise you learn Italian to a reasonable level, otherwise you could be dismissed with a smile and a shrug or even condemned for moving to their country without the necessary language skills! Also - consider paying for a private health care scheme. Well worth it, I believe, and it would certainly cut down on very long waiting times for blood tests, etc!

France was a different experience altogether. Knowledgable GP (though it turned out she didn't recognise a flare!) and the hospital system was excellent. Unfortunately, I had kidney involvement for the first time while living in France and it was not recognised as being linked with my vasculitis and it was not treated. This was dangerous and I would say that the medical systems in the UK for dealing with vasculitis, in my experience, are far superior (as long as you get to a consultant with knowledge!) to those in Italy or in France.

Having said all this, which must sound somewhat condemning, I would live abroad again, but I would make sure I found the appropriate medical care first and pick a place to live that would give me access to this care. I would also make sure I could explain all my vasculitis symptoms in the language of the country I was living in. I suppose this is common sense?

I wish you all the luck in the world.

[Doghouse]

Thank you all so much for sharing your experiences there is a lot to be considered . I have two wonderful rheumy consultants who have offered too help me find a consultant wherever we go .

[Suzym2u Moderator Vasculitis UK in reply to Doghouse]

sorry, John has not answered again Doghouse, but it is the VUK AGM tomorrow... and he has been so busy.. but he will be in touch again after tomorrow. Everyone seems to have given you lots of good advice