Thursday, February 23, 2017

Q&A: Do the French Drink All of the Time?

There are still random amusing things that happen during day-to-day life here, even when I'm mostly stuck at home with an injury.  For example, it took PB four weeks of me not driving before it occurred to him to ask how I was managing to keep food in my pantry.  Fortunately, he's not the main person in France who I turn to for help anymore or I *might* have starved.😂

I really have great co-workers in general though.  L’américaine provided work transportation most days, took me to pick up groceries and out to a few social activities.  PB provided the rest of my work transportation, plus took me for groceries & to the pharmacy; YV drove me to the doctor; SB called the doctor and nurses several times because the secretaries often don't speak English (even if the doctors or nurses do) and CB would have taken me to work every day this week, but my knee was finally healed enough to drive short distances!

And Alexis remains a great (and reliable) friend - I'm lucky to have met him.

Q&A on French Drinking
Since life with a knee injury hasn't been very exciting, I thought I'd post another Q&A.  I've been asked by several people if the French drink "all of the time" or a lot more than Americans.

The best I can say about total consumption is that I read something somewhere (really precise, right?) that said the French drink about the same amount as Americans, but spread out through the whole week, whereas Americans tend to drink their full consumption as "binge drinking" on Friday and Saturday night.
And again, when there aren't particular photos, you get examples of great French food.  Note: there technically *is* wine in the upper right corner.

From personal experience, here are the main differences that I've noticed:
  • It is not a big deal to drink during lunch on a workday.  Most tables seem to have a bottle to share (4+ people) or a glass each.  My company seems to be a little more conservative, so the managers who eat out for lunch typically only drink on Fridays.  L’américaine and I have adopted this habit and we have a pineau per week on "fancy lunch" Fridays.
  • It is nearly impossible to discipline or fire somebody for drinking, unless they are injured on the job or there is some other major incident that can be attributed to their drinking.  You can (and possibly will) have at least one co-worker who smells like they bathed in a bottle of booze, but if they're a functional alcoholic, nothing can be done about it.
  • Most of the French I know do not drink every day.  If they do, it is a glass of wine with lunch or dinner.  The only time I've seen them have multiple drinks in one sitting is at a nice dinner out (pre-dinner cocktail, wine with the starter and wine with the meal usually) or a nice dinner at home with friends (same 2-3 drinks).
  • Beer seems to be consumed only on rare occasions and not often with a meal, usually it's a pre-dinner drink or completely separate from eating.
  • Hard liquor is also consumed much less than in the US.  Most of the stronger alcohol is consumed as a pre- or post-dinner drink, one small serving only and not as a mixed drink.  It is something like a pineau (local specialty), cognac or a good whiskey.  I don't recall seeing a French person have a mixed drink the entire time that I've been here (this is not to say that they don't drink them, just that it is uncommon in my experience).
  • The French seem to be very conscientious about drinking and driving.  Too many people joke about it in the US and don't seem to take it seriously (unless they get caught).  Here, my French friends and colleagues very clearly drink less when they are the driver than if they are at home or not driving.

Thursday, February 16, 2017

French vs. American Healthcare

Advantages of the French Medical System:
  • There doesn't seem to be any cost-benefit analysis done.  If there is a risk, even minor, that you could die of a blood clot, they will treat you.  Update: they also do not wait for you to have a life-threatening reaction before prescribing an EpiPen equivalent.  If you have a food allergy that causes respiratory issues, they prescribe it - as the doctor noted, the reactions are often progressive and you could easily die before medical services reached you.
  • Even uninsured medical costs are so low that I mistakenly thought they were my post-insurance rate.  Twice.  23 Euro for an uninsured doctor's visit?  88 Euro for DAILY injections at home by a nurse for two weeks?  Oh right - attending university is free here, so they don't need to pay college-educated people crazy high salaries just to afford their student loans . . . that's one way to keep the gap between "rich" and "poor" narrower for sure.  There is a premium paid for college-educated people (you still invest your time after all), but it isn't nearly as large as in the US.  This is also NOT a for-profit system, so every level of the medical industry doesn't need to carve out their profit at levels that satisfy shareholders.
  • While I pay A LOT of taxes, the overall percentage for somebody like me is not actually that much different from what I paid in the US, plus my health care premiums, plus the FSA to be certain I could always foot the 20% that my insurance didn't cover, plus the higher amount I needed to save for retirement because health care costs are one of the big spend categories for US retirees . . . basically, the difference in France is that many people pay a little more in taxes, but then everyone is also covered if the worst happens.  You aren't likely to lose your house here because you get sick or injured.
  • They prioritize your health.  I could have easily chosen to spend the last 3 weeks off work with nearly full pay.  Except, I didn't really feel it was necessary with my job and it would have hurt my plant to go through close and year-end adjustments without their only local finance person.
  • The doctors actually explain stuff to you.  They tell you not only that they've determined you injured a ligament, then later, probably tore the meniscus, but also that it was this particular test where they moved your leg in this or that way which told them what the problem was.  It inspires a certain level of confidence in the diagnosis when the doctor openly tells you how they drew that conclusion.
  • If you tell a French person that you're calling on Wednesday for an appointment the following Monday, they will be shocked because you're calling so EARLY.  Apparently, there must be a much better per-capita number of doctors here than the US if a few days notice gives you your choice of appointment times.
  • Doctors will make house calls, if necessary.
  • If you can't drive, there is an "ambulance" service that is made up of normal cars to provide medical transportation.  I will be using one of these for my trip to Poitiers for the IRM (MRI).  Or not - I decided to take the train and save a few Euro.

There are really no pictures that go with this post, so you get random French food.  This is a super tasty tartiflette
Disadvantages of the French Medical System:
  • Daily injections?  Really?  This isn't really a "con" of the system, but I loathe needles and this was a special kind of torture for me.
  • While I understand that there can be issues with people abusing painkillers, pain management is kind of important.  When somebody has torn a ligament, a week's worth of narcotics is not that big of an issue.  Especially when it eventually turns out to be a torn ligament and meniscus.
  • Even though most French people aren't paying for them, I'm not sure what the point is in prescribing a full box of medication instead of just the number prescribed.  I guess the upside is that I can tally up my prior leftovers before filling a prescription, just to be sure I actually need it!  It also saves time at the pharmacy - they just grab the boxes and send you on your way.
  • Again, probably because there is virtually no cost to the individual (and the gov pays either way), you are required to see a doctor if you miss even a single day of work.  Otherwise, you're taking vacation pay for it.  It comes across like your employer doesn't trust you, but actually the government won't reimburse their share without proof you were ill/injured.
  • Due to the house call issue, your doctor really needs to be in your town.  You can't just pick the person in a town 20 minutes away who your friend recommended.
  • There can be a little wait for certain non-emergency procedures.  Like, my MRI can't be done until February 28.  But, I've had to wait in the US for non-emergency MRIs also . . . and there is certainly a long wait for many specialists in the US.  It was over a month both for a dermatologist and a hand surgeon.
And . . . well, that's about it (other than dealing with CPAM initially).  Honestly, the disadvantages are more just nitpicky stuff and I can see why it is rated one of the best healthcare systems in the world.  Due to the low medical costs, I've still paid more in taxes than my medical treatment has cost, so it's still a net win for France, but I'm feeling pretty happy about the medical side of the experience.  There are certain specialties here with a wait due to too few doctors, but that's true in the US also (see above).

Update on my Knee:
For those who are interested, as mentioned above, it appears that I tore the meniscus.  I was allowed to try walking without the splint if I could tolerate the pain, but unfortunately it took less than two days of trying to walk around at work without it before my whole lower leg and foot swelled back up and every step was painful again . . . so I'm back in the splint until after the MRI and treatment is determined.

Of course, I had my own comedy routine on Monday and there really should have been video.  I had asked the doctor if I could drive with the splint off and she said, "if you can?"  I thought this was like the walking and referred to my pain level, so I was determined to tough it out and have my freedom back!  So, I tried to sit in the car and realized that I had to move the seat back.  I was quite proud of myself when I was in, foot on the gas pedal and ready to go . . . except I was so far back that I couldn't fully clutch.  "Ok, so I'll scoot the seat forward a bit. Yep, I can fully clutch now!"  Pushed the clutch in and went to press the brake to start the car.  And learned the doctor literally meant if I was actually physically CAPABLE of driving when I can only bend my knee unaided to the position shown below.
It's enough to sit my foot on the gas, but I tried, and failed, to bend my knee enough to actually raise it off the gas and onto the brake.  I yanked on my pant leg, moved my leg to the brake by hand and went to start the car before the less-stubborn, more-logical part of my brain suggested that perhaps it was not wise to drive, especially a manual, when I'd just had to use my HAND to transfer my foot from the gas to the brake.  This was proven quite true when an attempt to transfer my foot back over unaided resulted in my foot half on both peddles and a bit wedged between them.

So, there will be no driving for me through Feb 28.  Hopefully, there will be good news then and I'll only need a few weeks of physical therapy!  If not, I'll be facing surgery in a foreign country.  The period of time since I injured my knee is the first extended period when I've wanted to return to the US - at home, I know how to take care of myself.  Here, the forms are in French, the instructions are in French, many of the people only speak French.  Naturally, I'm in France, but it adds a level of complication that is really unpleasant when you're already hurt.

Thursday, February 9, 2017

The Hunt for an Open Restaurant on a Monday Night in Rural France

Upon moving to rural France, you quickly become accustomed to the fact that you cannot count on things being open at all hours like in the US.  Most stores close by 7:30 PM each night and are closed all day on Sunday (or only open until 12:30 PM).  Same with the pharmacies, except there will be a sign indicating the rotating schedule for which pharmacy in the area has extended hours.

This also extends to restaurants.  While virtually every restaurant is open for weekday lunches, most of them are closed all day on Sunday.  Several restaurants will also close all day for one week day and, as I learned this week, very often that day is Monday.  Since Alexis has been helping me a lot, I offered to treat him to dinner (since I'm not really up to cooking).  This is sort of the American way, at least in my region - if somebody helps you move, assemble furniture, etc., you offer food and/or drink in return.  The last time he was over, he both assembled furniture AND provided the food, so it was certainly my turn to do something nice.  Of course, I offered to treat him to dinner on Monday . . . without a full realization of precisely what I had done.
Thus began the great search for an open restaurant.  As it turns out, the place that is reliably open for dinner is NOT open for dinner on Mondays (O'Napoli - picture above is a burger from there).  The other restaurant that I had in mind is only open for dinner Friday and Saturday (O City'ven - see picture below).  A quick search of the internet and a few phone calls established that virtually all restaurants in the area are closed for dinner on Mondays.  It also established that, during the winter, many of them are closed all day Sunday-Tuesday, many are open only for lunch during the week and many have random days they are closed.  One restaurant advertised a new take-out menu of 6 dishes "tout les jours" (all the days), but when I called, I was told that "all the days" apparently does not include Monday. 😒

This is not accounting for the fact that you either have to follow local places on Facebook, check their website (if they have one) or eat there weekly to learn when they will be closed for a week or two for their vacations, to completely revise the menu or to remodel.  In short, you become accustomed to the idea that you may want to make a reservation for lunch or dinner every time, just to be sure that the place will be open when you show up!
Finally, I checked one of my other favorite restaurants, Relais Pays de Civrasian.  I was in luck because their closing days are Wednesday night and all day Thursday!  I do think that I'm introducing Alexis to bad habits because the big social meal in France is normally lunch, but here I am dragging him out for dinners . . . and twice in one week at that!  You do realize why the restaurants aren't really open for dinner outside of the weekends though because they will be packed at lunch, but only two or three groups will come in for dinner - and both nights it was virtually all British people.

Once you're here for awhile, you also start to realize why they all have days they are closed and limited hours though - the people cooking and serving are usually the owners; several restaurants in the area are actually owned and operated by a married couple.  Due to some of France's laws, it can be cost-prohibitive or a regulatory nightmare to hire additional staff, so the owners have to limit the hours they are open, and have some days they are closed, simply to have a break!  Having said that, I think it is smart to be the only place in town open on a particular night . . . however, in my search for a restaurant open on Monday nights, I saw several Brits in my area with the same question, so it seems that the restaurant could have a lot more Monday night business if they got the word out that they are open!

Actually, you've heard it here folks - if you are looking for a restaurant in the Civray/Ruffec area that is open on Monday for dinner, Relais Pays de Civrasian is your place!  They have a menu of the day that is available for dinner, not just lunch, plus other fixed price menus. And the owners (and staff) have always been very nice to us, even with our awful French!

Thursday, February 2, 2017

A Serious Injury in France - Part 2 and Great Friends

The differences in France and the US when it comes to healthcare are a little surprising.  I don't think that I've ever heard of somebody with an immobilized limb getting daily injections to prevent blood clots in the US, but PB has asked me multiple times about this and was acting like I was in grave danger of imminent "death by blood clot" because I went the whole first week without the injection (largely due to difficulty finding a nurse).  It's also weird that they just hand you these boxes of injections, so PB had a valid threat when he said if I didn't find a nurse, I would force him to inject them himself.

By the way, if I do die tragically from a blood clot - PB, you were right.  As always.  Postulate #1. 😁
Frankly, I would probably have went ahead and gotten the injections (why take an unnecessary risk, no matter how small?), except for two small problems.  The first is that I tried to register my social number and it wasn't valid - apparently, a "temporary number" is basically useless.  It wasn't until January 30th that I finally received a valid social number . . . which I registered and my information was promptly sent out.  To my old address.  Apparently, my HR folks forgot to update the address with CPAM (although the prefecture has my correct address).  Of course, governmental departments don't really share information in the US either, so this is no different.  Everything seems to be working smoothly now with my certificate of rights, even without the Carte Vitale.

The second problem is that, despite a large British ex-pat community in the area, I have had serious issues finding English-speaking medical care.  The doctor that I saw in the neighboring town won't drive to my town.  Unlike the US, you may not be able to call your doctor when they've, say, given you a prescription that you're allergic to - the doctor is too busy to return calls.  But they'll make a freaking house call . . . as long as you live in the same town basically.  So, no more doctor in the neighboring town (the nurse that was recommended in the same town also won't drive here for my injections).

So, I started the great quest to find more English-speaking medical people.  The next nurse I called also told me that their group is too far away and gave me the number of two groups that are closer.  I postponed calling the new places because I was a little concerned about daily nurse visits without confirmed insurance.  Once it was confirmed, the nurse's group in my area had inconsistent English ability, so PB gave them his number as my contact person.  He was thus able to arrange for my daily torture, which is probably good because I would have quit after the first two!  Check out the bruise from the first one - can you blame me for wanting to skip them!  The second one left a smaller bruise, about the size of a penny . . . and the third looks like it might be the best of all.  Which is good, because I was beginning to wonder how they'd possibly find room for 14 (let alone 21) of these.😱
I have to say that I'm happy I live in an area with a large British ex-pat community at the moment because they really came through on medical suggestions!  I now have the name of an English-speaking doctor and dentist, plus the nurses.  I'm only missing an eye doctor.  My new doctor is great, but sadly leaving the area in July.  She'll at least be able to get me through the rest of my knee treatment - at the one week mark, she determined I'd actually injured TWO ligaments and that the swelling was not down as much as it should have been.  I was lectured on being less active, but persuaded her that I could still work AND be less active.  PB persists in refusing to fetch my coffee though, which really undermines his assertion that he's become my highly-paid assistant.😂

In addition to PB looking after my medical care (and occasional transportation), l'américaine has been super helpful with driving me back and forth to work most days, taking me to get lunch and buying some of my groceries.  I'm super lucky that I picked a place that is close to work, so it's not SUPER inconvenient for people.  It is still a hassle though because they have to consider my schedule, such as me needing to eat in order to take my medication . . . so I have to be home by a certain time.  Another woman, YV, volunteered to drive me to my doctor's appointment, which was also really nice and a third co-worker has offered various forms of help too.  My team takes good care of me during the week, but I was a little concerned about the weekend.  It was pure luck that Alexis' knee had healed up and he'd arrived back in town the weekend before (I was actually getting him from Poitiers when I hurt myself), so he offered to come by on Saturday.  He ended up looking after me nearly the whole day and assembled my shelves, table and chairs for me (and cleaned up the packaging).  Plus, he took me to get groceries, helped unpack some of my stuff, hung my curtains, washed my dishes and cooked us dinner.  Yep, I've been very, very fortunate to meet some really great people in France!!!