This section contains all of the information you will need to arrange for treatment with Professor Corradino Campisi in Genoa and is designed for the international patient, who will need to know which arrangements to make before they leave home, what can be arranged once you are in Genoa, and how to deal with all of the miscellaneous difficulties one encounters when in an unfamiliar country.
Prior to Leaving Your Home Country:
· Contacting Professor Campisi: To discuss your case and determine whether you are a suitable candidate for treatment at his clinic, you can contact the Professor by email. or phone. It is important to provide Professor Campisi with enough information for him to be able to evaluate your case:
- Give a good description of your symptoms; when they started, is the swelling permanent or does it reduce with rest and elevation? Do you know what stage (e.g., stage IIa) your lymphedema is classed as? What treatments have you had so far and have they been successful? Provide him with photos of your affected and unaffected limbs if you can.
- If possible, also provide him with copies of investigations you may have had, such as ultrasounds and lymphoscintigraphy
- Some people prefer to have their vascular surgeon contact the Professor; however he will reply to personal correspondence (and we found him to be very prompt in responding) and answer any questions that you may have.
- The Professor’s contact details are on his web page: www.chirurgiadeilinfatici.it/en/contacts
· General Time Course of the Treatment:
o Pre-surgery treatment: one to two weeks of daily pre-treatment in the clinic. During this time you will also have pre-surgery checks (ECG, blood tests, ultra sounds) to determine if you are healthy enough for surgery.
o Surgery: Surgery takes between 3 to 5 hours under general anaesthetic. You enter the private hospital (Casa di Cura Villa Montallegro) the night before the surgery. You will be confined to your bed for 3-4 days following the surgery, as it is very important that the limb remain still to give the best chance of healing, and expect to be in the hospital for 5-7 days.
o Post-treatment: treatment in the clinic will resume after your return from the hospital for one to two weeks. Treatment takes between two to four hours each evening. For some of this time, you will not be allowed to walk around much. Be prepared for having a lot of spare time!
- Cost: (Are available on request to Prof Campisi at www.lymphaticsurgery.org):
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| Casa di Cura Villa Montallegro |
· Arrangements to be made before leaving home: Now that you have decided to go to Genoa for treatment, there are a few arrangements that need to be done in your home country:
- Payment:
- The private hospital requires that international patients pay their fees in full prior to entering the hospital. They do not accept direct payments from overseas insurance companies either, and require either a bank cheque or money transfer. Daniela Campisi (the Professor’s secretary) will provide you with their bank account details and an estimate of the costs. Remember that international money transfers take 3-8 working days to clear.
- Similarly, Daniela will provide you with the Professor’s bank details for his payment.
- If you are planning to use insurance to cover these costs (and the Professor gives assurance that this is regularly covered by insurance companies), then the Professor will provide you with a certificate outlining your diagnosis, need for microsurgery, and a fee schedule. You pay up front, send them this information, and then claim the money back, as with any other insurance claim.
- Travel Insurance: as with any other overseas trip, you will want to acquire travel insurance to cover you while you are away. However, many insurance companies, especially those associated with airline package deals, do not cover people for travelling overseas to obtain medical treatment. Additionally, sometimes pre-existing medical conditions are not covered by travel insurance policies. It is possible to get insurance but it often requires some time and additional medical certificates to get lymphedema covered. Remember to allow yourself enough time to get this sorted. Alternatively, you can choose to get a policy where pre-existing conditions are not covered but you still get cover for lost baggage, other injury, accidental death etc.
- Accommodation: Patients have access to a B&B located in the building where the treatment clinic is. The advantage of staying there is that you are close by for treatment; a necessity in the early days after surgery when you are not allowed to walk far. You are also in the company of other patients and can share resources, food, and have a willing ear for those troubling times. Breakfast is included in the price and there is a communal kitchen for cooking other meals. Each room has access to a private bathroom. Daniela can arrange for you to stay at this B&B. Of course, you are free to stay wherever you like; Genoa has many fine hotels and B&Bs in close proximity to the clinic. These may cheaper; however, you will need to factor in the cost of daily transport to and from the clinic, six days a week.
- Money: Genoa, like all European countries, now uses the Euro as their currency. Travellers cheques are used infrequently these day but the B&B will accept these as payment if you wish. Visa and American Express are accepted at most retailers but you often require passport identification to get these approved. There are many ATMs available to get cash out but remember that there are overseas fees and limits on how much funds you can withdraw each day (depending on your home country bank). There is also an unwritten rule in Genoa that small shops and taxi drivers prefer small denominations (under 20 Euros) but they will give change for larger notes, albeit unwillingly.
- Electronic Gadgets: Just a quick note because it is almost impossible to find plug adaptors once you are in Italy. Make sure that you bring adaptors with you. You are looking for the two-prong Other European adaptor.
- Support Person: It is possible to do this trip and treatment alone but we think that it would be incredibly difficult due to your lack of mobility after the surgery:
- If you do travel alone: Use the pre-treatment week to stock up on all of the food and supplies (if you are staying in the B&B) you will need for after the surgery, while you are still able to move around the city. There is a Carrefour (supermarket) located next the Professor Campisi’s clinic and a fruit & vegetable shop across the road. Explore the city and take in some sights! Remember: There will be approx, one week after leaving the hospital where you will not be able to walk further than the bathroom or go outside. We cannot over-emphasise how incapacitated you will be!
- If you take a support person: Their job will be to help you home from the hospital when you will not have the energy to carry your bags, cook and clean for you in the first week post-surgery, run errands, wash clothes, and provide entertainment when you are tired of looking at the walls of your accommodation. At the end you will want to cover this person in kisses and/or jewels.
- As the support person: Be prepared for your patient to be tired, a bit smelly (showers are out of the question while wearing bandages), and probably a little whiny and bored. Please bring your sense of humour with you. Also be prepared for having long periods of time to yourself while the patient is having therapy in the afternoon and evening. Luckily for you, Genoa is a beautiful city with plenty of shops, museums, an aquarium, and old buildings to explore. Most things are in walking distance and the public transport (metro and autobus) are efficient and cheap.
o Italian: Preferably you would learn to speak this before you go. Of course, for most people this is impossible. Many people in Italy speak some English, including Professor Campisi and some of his staff. Buy an Italian phrase book and make sure that it has both Italian-English and English-Italian indices in the back. Try to learn enough simple phrases to get you by. We have found the following useful:
§ Greetings: buongiorno (good morning), buonasera (good evening), buonanotte (good night), ciao (hello and good-bye; informal), arrivederci (goodbye, formal), mi chiamo ____ (my name is…) come si chiama? (what is your name?), piacere (pleased to meet you, informal)
§ General Conversation: grazie (thank you), grazie mille (thank you very much), prego (you’re welcome), mi scusi (excuse me), mi dispiace (I’m sorry), si (yes), no (no), bene/buona (good), cattiva (bad), okay (okay), Come sta? (how are you?), io (I), noi (we) , per favore (please)
§ Useful Questions: Dove…(where is?), Quanto costa? (how much is), Parla inglese? (do you speak English?), Quanto? (how long?), Che ora sono? (what is the time?), Quando? (when?)
§ Miscellaneous useful words: freddo (cold), caldo (hot) fame (hungry), tired (stanca/o), gamba (leg), dolore (pain), male (sick), malato (ill), in buona salute (healthy, io mangio (I eat), carne (meat), su (up), sotto (below), sopra (above), grande (large), piccolo (small), oggi (today), domani (tomorrow), ieri (yesterday), forte (strong), sinistra (left), destra (right), vecchio (old), giovarne (young), molto (a lot), poco (a little), lento (slow), parlare (speak)
· Ladies: A section just for you (Warning: explicit information):
- Get a leg waxing before you leave home and seriously consider getting a brazilian if you have lymphedema of the leg. You will not be allowed to shower once the first lot of compression bandages are applied during the pre-treatment phase and those bandages for the legs go RIGHT up to the very top of the leg. Trust us you will be amazed at the length your leg hairs can grow in three weeks otherwise!
- Remember that you are in Italy for a month or more. If you take the contraceptive pill, seriously consider skipping your menstrual cycle during this month if possible. If you are au naturale, then be prepared for the medication and general disturbance to the body from surgery to disrupt your normal cycle. Bring menstrual pads with you. If menstruation occurs in hospital while you still have a catheter in place, you will not be allowed to use tampons. Buy big night-time pads, as you will be lying down with your legs raised the majority of the time, and gravity will not be your friend. Be prepared to leave all dignity at the door; don’t worry, the nursing staff are lovely and very professional.
Once in Genoa:
As noted above, your one or two weeks of pre-surgery treatment is the time when you will be the most mobile. We know that things will be a little strange, and you will have a lot of new experiences to contend with, but we encourage you to use this valuable time, as much as possible:
· Explore the city; see the sights, taste the food, go shopping! Go on, you’re in Italy!
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| The Carrefour outside the B&B |
· When shopping:
- Buy some comfortable clothing, such as yoga pants, trackpants, or loose skirts that will accommodate your bandaged limb- see: compression bandages
- Buy some comfortable shoes or slippers that you can easily slip in and out of – see: my only italian shoes so far
- Buy books/magazines/writing paper etc. anything that will keep you amused during treatment and at the hospital. There will be television in the hospital but 99% of it is in Italian. It is possible to get a dial-up internet connection in your hospital room, provided that you bring an older laptop with an inbuilt modem. Otherwise, your support person can use the computer in an office on the ground floor of the hospital
- Buy fresh fruit and cold drinks to take with you to the hospital. There is a small bar fridge in your room. The hospital food is quite good but it is nice to have some treats too!
- Buy earplugs. Although you will have a private room in the hospital, it is a busy bustling hospital ward 24hrs a day and the air-conditioning is noisy.
