Obtaining medical referral while on board

[janmcn]

We have HAL Platinum and GeoBlue insurance while on this long cruise. I’ve been unsuccessfully treated for a middle ear infection for several weeks with both ears still plugged. The doctor on board said I need to see and ENT doctor. The only large city soon is Reykjavík and after that it will be Portland, Maine after which I’m due to fly home from Boston, which I can’t do with plugged ears.

Who helps facilitate a physician appointment? My GeoBlue doesn’t indicate they have any referral in Iceland. Not sure about HAL Platinum.

Anyone with experience doing this? Walking into an ER won’t be any different from the medical center on board (which has been excellent!.)

[ExpatBride]

The European healthcare system is complicated and specialists are usually referral-based and can have long wait times. Additionally in Reykjavik, you'll be dealing with a language issue (I assume).

 

If the onboard doctor and the insurance companies can't help facilitate an appointment in Reykjavik, I suggest researching now and calling ENTs in Portland, explaining your situation and hoping they can fit you in upon your return. GeoBlue sounds like it would be your best bet for getting assistance. Have you called them?

 

What an inconvenient situation! I hope you can find some help.

Edited July 1, 2023 by ExpatBride

[Cruising Is Bliss]

 

Sympathies from someone with recurring middle ears from h*ll.

 

This is from the  US Embasy website. Hope you can get some help.

 

https://is.usembassy.gov/u-s-citizen-services/doctors/

 

If you are in Reykjavik and have an urgent medical problem, you may also go straight to the emergency room at Landspitali University Hospital located in Fossvogur.  It is open 24 hours a day.  Telephone +354-525-1700 or 543-1000.

After Hours Care

For urgent after-hours primary care, call 1770.  After-hours care is provided through a central primary care clinic located at Laeknavaktinn, staffed on a rotating basis by physicians from local clinics.  House calls can sometimes be arranged.  A nurse will answer, gather some information, and either:

• Offer advice on how to handle the problem.

• Suggest the patient come to the clinic to be seen.

• Send a physician to make a house call.

• Refer you to a hospital emergency room

You can visit the central primary care clinic without an appointment from 17:00 23:30 on weekdays and 9:00 to 23:30 on weekends. From 23:30 to 8:00 you should call 1770 as described above.

Edited July 1, 2023 by Cruising Is Bliss

[Cruising Is Bliss]

Also I think you're going to be pleasantly surprised by the Icelandic medical system.  Science fiction writer Mary Robinette Kowal was living in Iceland working on a TV production when she found a lump in her breast. She had no idea what to expect and what she got was, no appointment needed, just go to the cancer center without an appointment.

 

In 45 minutes she was in and out, all done. The nurse she first saw was very apologetic that since she was not an Icelandic citizen the appointment would cost her the equivalent of US$3. In those 45 minutes she saw a nurse, a doctor, had a mammogram, had an ultrasound, and got a diagnosis of a cyst that was nothing to worry about.

[ExpatBride]

2 hours ago, Cruising Is Bliss said:

Also I think you're going to be pleasantly surprised by the Icelandic medical system.  Science fiction writer Mary Robinette Kowal was living in Iceland working on a TV production when she found a lump in her breast. She had no idea what to expect and what she got was, no appointment needed, just go to the cancer center without an appointment.

 

In 45 minutes she was in and out, all done. The nurse she first saw was very apologetic that since she was not an Icelandic citizen the appointment would cost her the equivalent of US$3. In those 45 minutes she saw a nurse, a doctor, had a mammogram, had an ultrasound, and got a diagnosis of a cyst that was nothing to worry about.

I've had a similar experience in Denmark regarding a lump in my breast. They take cancer very seriously and have an amazingly efficient infrastructure in that regard.

 

However, when I've needed to see a specialist for something less serious I've waited between 3 and 5 months from the time my GP referred me until my appointment. From a system perspective, there's huge a difference between how they address possible cancer and how they address a non-life-threatening condition that a GP can't handle.

 

Just to set expectations...

Edited July 1, 2023 by ExpatBride

[Reagan0712]

I do not think you will have any problems in Iceland, especially as the ship will be overnighting.

Several years ago I had a bad reaction to the Icelandic version of Dramamine while on a whale watching tour. The boat radioed back to have the EMTs waiting at the dock when we returned. They came on board to check me out, which by then fortunately the stuff was wearing off. Anyhow,  they checked heart rate, BP, had me stand up and walk. Asked if I wanted to be taked to ER. When I said I felt good enough to go back to the hotel they told me to make sure to call an ambulance later if I felt I needed it.  They never asked for any ID or medical information. I think if you go to Landspitali as soon as you can once the ship docks you’ll be ok.

[erdufylla]

I have no advice to offer on the doctor referral / insurance issue, but as someone who has semi-frequent ear issues and suffers seasonal allergies with chronically stuffed ears, I will offer up this game-changing advice an ENT gave me several years ago.
 

If any of the medication you’ve been prescribed is in the form of a nasal spray, or if not, but you think an OTC allergy medicine like Flonase might help clear things up, this trick works to get the medicine up in your ear canal, where it might combat the congestion there better, rather than keeping it in your nasal sinus passage. Instead of just spraying the medicine into your nose and sniffing it up, bend over at your waist before spraying it, and then once you’ve done that, while still bent over, plug your nose and blow. This will force the medication into the ears, where it might be more effective in your case.

 

You’ll look ridiculous while doing it, and I was super skeptical when the emergency ENT I visited suggested it. But it works. Just by changing how I took my daily Flonase, it put a stop to my near-annual ear infections and ENT visits.

 

Regardless of what you end up doing, I hope you’re able to get things cleared up in time to fly home safely! Perforated eardrums are no fun.

[seaoma]

We have GeoBlue also and I looked to see what information was available. There are some Hospitals and Clinics where you might get treated.

 

They did say you could also call Customer Service at 1.855.481.6647. Perhaps they can help you with information that isn't on the website.

 

Also here's a paragraph that you may find useful and a link to the US Embassy in Iceland.

 

U.S. citizens who have a non-life-threatening, non-medical emergency and need to reach the U.S. Embassy during normal working hours, 0800-1700 Monday through Friday, excluding U.S. and Icelandic holidays, may send email to the U.S. Embassy Consular Section at reykjavikconsular@state.gov.

 

https://is.usembassy.gov/u-s-citizen-services/doctors/

 

Good luck and I hope you can get the help you need.

 

[janmcn]

Thank you all for the info, some of which I already had, but it looks like the best thing ( most reliable) is to make plans to stay a few days in Boston and if my ears aren’t cleared by then we’ll go to MassGen Eye and Ear hospital where I can know I’ll get treated by ENT docs. All the other options do sound “iffy” as far as time. REALLY appreciate all the quick responses! And, I’ll try the “bend over for nose drops” …never hurts to try!

[horseymike]

Good luck , hopefully all goes well.

[Hlitner]

We would expect HAL's medical staff to have information on shore physicians or contact the ship's Agent to arrange a medical appointment.  My goodness, that is not asking a lot of a cruise line.  Last Fall, while on a MSC cruise in the Caribbean, DW slipped on a wet deck and fractured her ankle.  At the time, we were docked in Cozumel.  The staff got a wheelchair and took her to the medical center where a quick X-ray confirmed the fracture.  The ship's physician immediately said she was going to arrange for DW to see an Orthopedic Surgeon at the local Amerimed Hospital.  A quickly call to the Agent and the appointment was arranged.  15 minutes later we were off the ship, in a taxi, and on our way to the hospital where the surgeon saw DW after a very short wait.  He took new X rays, put her in a cast, sent us back to the ship, and followed-up with a call to the ship's physician who was waiting for our return.

 

This is how it is supposed to work!  Cruise lines have local "Agents" in all ports and the onboard physicians have the ability to contact those agents (and sometimes local medical facilities').  I will add that a few years ago we had another medical situation while on a Princess cruise in Asia.  Again, the ship's physician recommended that DW see a specialist in Osaka and the medical center made the arrangements (and we were treated like royalty).

 

Shame on HAL for not helping the passenger get onshore treatment.   We wish the OP the best of health and hope the problem is soon resolved.

 

Hank

[Moonbug]

Try this.   Pinch your nose shut with your fingers.  While blowing out, swallow!   Not easy to do.  But swallowing while blowing is the trick to unplugging those ears. Good luck.

[janmcn]

On 7/3/2023 at 10:41 PM, Hlitner said:

We would expect HAL's medical staff to have information on shore physicians or contact the ship's Agent to arrange a medical appointment.  My goodness, that is not asking a lot of a cruise line.  Last Fall, while on a MSC cruise in the Caribbean, DW slipped on a wet deck and fractured her ankle.  At the time, we were docked in Cozumel.  The staff got a wheelchair and took her to the medical center where a quick X-ray confirmed the fracture.  The ship's physician immediately said she was going to arrange for DW to see an Orthopedic Surgeon at the local Amerimed Hospital.  A quickly call to the Agent and the appointment was arranged.  15 minutes later we were off the ship, in a taxi, and on our way to the hospital where the surgeon saw DW after a very short wait.  He took new X rays, put her in a cast, sent us back to the ship, and followed-up with a call to the ship's physician who was waiting for our return.

 

This is how it is supposed to work!  Cruise lines have local "Agents" in all ports and the onboard physicians have the ability to contact those agents (and sometimes local medical facilities').  I will add that a few years ago we had another medical situation while on a Princess cruise in Asia.  Again, the ship's physician recommended that DW see a specialist in Osaka and the medical center made the arrangements (and we were treated like royalty).

 

Shame on HAL for not helping the passenger get onshore treatment.   We wish the OP the best of health and hope the problem is soon resolved.

 

Hank

Hank…they’ve done an excellent job given the ports we are in and the medical facilities in them. ENT doctors are not as common in remote areas and might require longer treatment than a few hours, so it’s far better for this particular problem to wait to Boston. Easier for us to plan for. Yes, emergencies are well cared for but this is not classified as an emergency…just an inconvenience. Hoping it resolves with current treatments.

[ExpatBride]

16 minutes ago, janmcn said:

Hank…they’ve done an excellent job given the ports we are in and the medical facilities in them. ENT doctors are not as common in remote areas and might require longer treatment than a few hours, so it’s far better for this particular problem to wait to Boston. Easier for us to plan for. Yes, emergencies are well cared for but this is not classified as an emergency…just an inconvenience. Hoping it resolves with current treatments.

Specialists are in short demand in many European countries. I live in Denmark's second largest city, which has a world-renowned hospital. Still, we have 3 ENTs.

I've received excellent healthcare here, but it's very different to what I was used to in the US. Smaller populations and a mostly government-funded system puts an emphasis on GPs. You're keeping the right attitude about it. Pitching an American-style fit about it won't help.

Wishing you a quick recovery...

[piper1]

If you are in Boston,  Mass Eye and Ear Infirmary has its own emergency department ( it is next to Mass General Hospital ).

 

[janmcn]

Just now, piper1 said:

If you are in Boston,  Mass Eye and Ear Infirmary has its own emergency department ( it is next to Mass General Hospital ).

 

I know, that’s why we’re planning to go there. My husband is a retired doc so we figured it’ll be easy in and out. We love Boston so no problem extending our stay.

[WriterOnDeck]

Assuming by the itinerary you are on the Zuiderdam? I am, too. I fell on shore and fractured my kneecap in April (Canary Islands), and medical made all the arrangements for me to get an MRI the next day in Agadir, Morocco. They were prepared to send me to an orthopedic at the next port, Casablanca, but the MRI showed no ligament damage and after a telemedicine consult with U Texas Medical Branch, they put me in a cast, then a brace, and I just healed on board.

 

Another passenger on the world cruise earlier this year had an eye problem, and while the ship medical was working with the port agent to get an appointment with an opthamologist in Papeete, Tahiti, the passenger found their own that was open on Saturday morning. He corrected the problem, and medical arranged a followup a few weeks later in Sydney.

 

I didn't rely on my travel/medical insurance company (Travel Insured) for any help, but after I filed the necessary paperwork for the claim while still on board, they had the reimbursement money in my bank account in 2-3 weeks. Make sure you get all the paperwork from medical and any onshore medical facilities.

 

So I would be proactive on your own, but let medical and the port agent be your primary advocate. They took care of everything for me. It sounds like you have a good backup plan for Boston.

 

Good luck!