Navigating Portugal’s Healthcare System

While I feel healthier than I have in a long time due to less stress and all the walking we’re doing, I have been suffering from a few physical ailments over the past few months that I was attributing to constant travel and normal aging. 

I got knocked down with a nasty cold in Athens and some dizzy spells in Istanbul — but I figured those were a reaction to the massages we’d received. I’ve also had constant upper back and right shoulder pain, which makes total sense when you consider that I’m now working exclusively on a laptop (I do miss my mouse and my monitors) on kitchen tables and sometimes couches. And I’ve been a little concerned about some slight trembling in my right hand, which “could” be Parkinson’s (thanks WebMD) or, more likely, a continuation of the problems from my right shoulder. 

After a series of massages (including the best one I’ve ever had in my life) didn’t do the trick, I knew it was time to find a chiropractor. I reached out to our Lisbon Airbnb host, Monica, to ask for a referral and she suggested I visit an osteopath instead. For those of you, like me, who might not have known about osteopaths before, they’re licensed physicians who help your joints and muscles by focusing on their connection to the rest of your body. They manipulate your joints like a chiropractor, but they’re also paying attention to the connecting tissues and organs. 

Monica gave me the name of a nearby medical clinic and told me to ask for Filipa.

I called on Saturday and was able to make an appointment for Tuesday,
yes, just three days later as a new patient and non-resident. 

finding filipa

When we arrived at the clinic, Filipa was the one who very kindly greeted us at the entrance. In accented English she gestured for me to come back to her office, which was also the exam room. Though she said he could come with us, I left Clay in the waiting room so he could work while he waited for me. I asked if I should call her doctor and she said Filipa was just fine. 

Filipa asked me why I was there and I told her about how we’d been traveling for several months and been working on non-ergonomically correct dining room tables, which had led to some pretty severe upper back and shoulder pain. When I told her about the trembling in my hand, and asked if it could be Parkinson’s, she gave me a quizzical look with a slight smile that was incredibly reassuring. Then she asked if I had been struggling with any viral infections or dizziness lately. Since I couldn’t ask her if she was a witch for knowing that, I just told her yes. She nodded knowingly and invited me to lay down on the table. 

She started by massaging and pressing on different parts of my skull, asking what hurt as she did so, but seeming to know ahead of time which would be a little hurt or a big hurt. She moved down to my mouth and neck, continuing her exam while massaging and prodding and poking. 

When she got to my stomach, she told me it was going to be a big hurt and to be prepared. She was not wrong and I’m glad I was prepared. She massaged and explained as she went, but she got stuck on the English word for what she was pressing on. After some guesses, I landed on “liver.” And she said, “Yes, you have a problem with your liver. Right now it’s a small problem but it must be addressed.” 

She told me that most of the health issues I’d been dealing with the last few months could be traced back to my liver. Filipa said it would take 48 hours or so for the pain in my back to diminish from her procedure, but it had already started to work as we walked out the door. I’ll go back to her one more time before we leave Portugal, but I already wish I could just stay wherever she is, because she is magical. Though probably not a witch. 

Medical Care Without Insurance

When we were all done, she asked if I had an EHIC*. Since I didn’t know what that was, she took it as a no and told me the appointment would cost 50€ ($54.78) and that it would be 40€ ($43.82) for the follow-up visit. That’s it. No deductible, no premium, no bill showing up in the mail later once the insurance company decides what they’re going to pay. 

More importantly, she identified what had been bothering me for a couple of months by touching me. And everything she said made perfect sense. 

time to detox

Some Internet research let me know that the liver is incredibly resilient and capable of regenerating itself with some lifestyle changes, so I had to take a hard look at my lifestyle. Filipa told me to reduce (all the way if possible) my acetaminophen intake, which had become a pretty regular morning and evening ritual. I’m definitely consuming less alcohol here than I would be at home, since we’re not going to parties or mixers and my travel buddy doesn’t drink. I am, however, eating more red meat here, which seems to be more delicious than at home, but that also forces the liver to work harder than it should. I’ve also picked up mean Coke Zero habit, which has replaced much of the water I used to drink. With a little planning, these should both be pretty easy to give up completely. Baked goods and sugar less so, but we can absolutely cut back. We’re also adding even more fruits and vegetables to our diet, and water will go back to being my go-to in restaurants. 

I’ve always thought I leaned vegetarian because I like the food.
I didn’t realize it was a directive from my liver. 

I don’t think that doctors in Europe are better than doctors in the states, but I do think they have an advantage in not having to answer to insurance companies. Filipa was able to take her time with me and give her diagnosis without worrying about whether or not it would be covered. 

And as an osteopath, she looks at the entire body, rather than just the part I’m complaining about. I’m so glad I went to see her for my shoulder pain instead of a chiropractor, or I wouldn’t have known about the liver problems until it got more serious. And I would have continued on my meat and Coke Zero path. 

Bottom line? Good osteopaths are magical, as is navigating a healthcare system without insurance. And Airbnb hosts can be great resources. Thank you Monica! 

*I found out later that EHIC stands for European Health Insurance Card, that’s free for European and UK travelers to cover medically necessary, state-provided, healthcare expenses when they travel to other member states in the EU and the UK. If I had one, that visit would have been free.