healthcare

It’s amazing the damage a little critter can do

My left leg – 20th August 2025 © Ricky Yates

Between 02.00 and 11.00 on Saturday 16^th August 2025, I seriously vomited five or six times. During that Saturday, the lower part of my left leg, together with my ankle and foot, became swollen, red and painful. At the time, I didn’t associate the two events.

I assumed the vomiting was because of something I’d eaten. And my left calf and foot are always slightly bigger than their opposite numbers on my right leg, ever since August 2015, when a deep vein thrombosis (DVT) escaped from there and became a pulmonary embolism in my lung, as described in this post.

After a day of resting and not sleeping very well that night, on Sunday morning I was still feeling quite unwell and also not very mobile. So I made the reluctant decision that I couldn’t officiate and preach at the Frauenkirche that evening, the first time I’ve ever had to cancel a service since I took up my Dresden responsibilities almost ten years ago. Thankfully, my friend and colleague Andrew Allen, stepped into the breech.

After another uncomfortable night and no improvement during Monday 18^th, late that afternoon, I decided the time had come to go to my local hospital in Decín and seek medical help. Fortunately, I had a friend staying with me, my first guest in my renovated upstairs rooms. We were unable to get a taxi and so Libor, husband of Sona, the boss of Restaurace U Soni, kindly drove us to the hospital.

At the hospital, I was seen by a nurse and had some blood samples taken. Then I saw the duty doctor who told me that I needed to be admitted to hospital that evening, in order for the infection in my leg to be treated with antibiotics and pain killers, fed intravenously. The doctor fortunately, had some English and used Google translate on his phone when he became unstuck. My friend got back to my house by taxi and the following day came to the hospital by bus, bring me clothes, pyjamas, toiletries etc.

The ward whilst receiving antibiotics intravenously © Ricky Yates

I took this photo from my bed whilst receiving antibiotics intravenously. It gives you an idea of the four-bedded ward where I spent three nights. Every morning, the doctor came around to see each of the patients. He only spoke to me in Czech, most of which I didn’t understand. He didn’t seem to have a word of English. Fortunately, a couple of the nurses spoke fluent English, the one who got me to fill out my consent forms was particularly helpful. Czech hospital food was as unappetising as I remember it being ten years previously in Vojenská nemocnice in Prague 🙁

On the morning of Thursday 21^st August, the doctor told me that I was being discharged and could go home. That was one bit of his Czech that I did understand 😉 I was presented with four prescriptions, (two for further antibiotics, one for anti-inflammatory tablets and one for pain relief), and a two-page report about me and my time in hospital, obviously all in Czech. But from the report, I finally found out what I had been diagnosed with – Erysipelas.

Erysipelas, historically known as St Anthony’s Fire, is a bacterial infection of the skin and the lymphatic system. Its origin is the bacterium Streptococcus pyogenes, almost certainly caused by an insect bite. When I wrote this on Facebook, along with the photo of my leg at the beginning of this post, a friend commented that, ‘It’s amazing the damage a little critter can do’, a sentiment with which I completely agree and why I have chosen it as the title for this blog post. One of the symptoms of being infected with Streptococcus pyogenesis, is vomiting. The two events of the morning of Saturday 16^th August were connected.

Whilst I’ve now lived in Stará Oleška for over eight years, I’ve remained registered with the GP practice, Young & Co, in Prague. This is for a number of reasons. They have looked after me brilliantly since my pulmonary embolism in August 2015. All the doctors have to be able to speak English. And going on a train trip to Prague once every six weeks to have my INR,(the level of thinness of my blood), checked, makes for a nice day out.

But having to travel there with a badly swollen leg, has been a little more difficult. So far I’ve been for five follow up visits, the first on Monday 25^th August, the most recent on Thursday 25^th September. Both my regular GP, Dr Josef Stonawski, and the boss of the practice, Dr Adriana Youngová, have been very helpful and supportive. Whilst the infection has been dealt with and I no longer have pain or numbness in my left leg, it is still swollen. Dr Youngová told me that I will probably have to take the anti-inflammatory tablets for up to three months which means I have another five weeks to go.

The other problem that has caused me to make frequent visits is that the antibiotics have totally upset my INR – a well-known problem. My INR is meant to be between 2.0 and 3.0. On 25^th August it was 4.2. Having reduced my Warfarin intake, on 2^nd September it was 1.6. on my last visit it was 2.9, just within range, but still rather high. And this has caused me further problems.

On my last visit to my GP practice, on the morning of Thursday 25^th September, I had an appointment in the afternoon with my dermatologist, at Vojenská nemocnice. This was to investigate a scabby lump, near the bottom of my problematic left leg. Is it a Basel Cell Carcinoma to be treated with liquid nitrogen? Or is it a leg ulcer requiring different treatment? But to extract a small sample for testing would involve an incision in my leg and with my INR being 2.9, my dermatologist is afraid I will bleed too much.

As a result, tomorrow morning I am being admitted to Vojenská nemocnice for four or five days, whilst my INR is reduced and closely monitored and then appropriate treatment will follow. It will be a very early start to catch the 05.40 bus from the village, to then catch the 06.25 train from Decín to Prague, in order to reach the hospital by 09.00. So I’m off to bed as soon as I’ve successfully posted this text.

The Dermatology building at Vojenská nemocnice © Ricky Yates

Since my return from Switzerland……

Five weeks ago today, I returned to Prague after spending a wonderful two weeks accompanying Sybille on her pilgrimage from Prague to Santiago de Compostela, walking with her across Switzerland. Since returning, I have successfully written and posted seven blog posts about our journey together. A big ‘Thank you’ to the faithful few who have left kind and appreciative comments on these recent posts.

The evidence of how far we walked can be seen by state of the soles and heels of my much loved walking boots. In the last couple of days of walking, I did slip slightly in a few muddy places, because of the increasing lack of tread. I also discovered that the waterproof cover, integral to my rucksack, was unfortunately no longer waterproof 🙁 . I have now invested in a new pair of walking boots, though I’ve yet to test them out over any serious distance. And I will buy a new, separate waterproof cover for my rucksack as, despite being twelve years old, it is otherwise still in good order.

Two other major things have happened since returning to Prague. On Tuesday 2^nd September, I paid another visit to my dermatologist at Vojenské nemocnice, the Military Hospital. Unfortunately, one Basel Cell Carcinoma (BCC) on the right side of my forehead had, despite numerous treatments with liquid nitrogen, refused to disappear. So we mutually agreed that the only way forward was to have it cut out under local anaesthetic.

What then followed speaks volumes for the efficiency of the Czech Health Service. Armed with a brief report from my dermatologist, I went straight-away to the plastic surgery department in another nearby building. There, without an appointment, the surgeon quickly examined the BCC and promptly gave me an operation date of Wednesday 10^th September – just eight days later.

My head following surgery! © Ricky Yates

The operation on Wednesday 10^th September, despite being under local anaesthetic, was a bit more major than I was expecting. I was grateful that I’d accepted the kind offer of my friend Rev’d Dr Karen Moritz, to accompany me to the hospital. This is how I looked following the operation – Karen being responsible for taking the photograph! Fortunately, when I returned to the hospital the next day for a follow-up visit, the head bandage was replaced by a large sticky plaster which I was able to remove the next day.

The wound was pulled together by six stitches, the last two of which, were only removed on Monday of this week. But the good news is that the histology report, whilst confirming that what was removed was a BCC, also said that it was completely removed – it was clear around the edges. I now have a return visit to the dermatologist booked for the middle of October.

Then on Monday 22^nd September, the day I had the last of my stitches removed, came the news that my daughter Christa, had gone into labour with her first child. Later in the evening came word from my son-in-law Ian, that I had become a grandfather for the first time, following the birth of my grandson Finley.

Because of breathing and other difficulties, Finley was immediately taken to the Special Care Baby Unit of the hospital in Northampton. But as this picture below, taken yesterday, shows, Christa and Ian were finally able to hold their newborn son for a short while. The latest news is that they hope to be able to take Finley home this weekend. I’m hoping to meet my grandson for the first time at the end of October when I’m visiting the UK for a few days.

My grandson Finley and his proud parents © Ian Margieson

A visit to the dermatologist

The entrance to Vojenské nemocnice, the Military Hospital © Ricky Yates

On Wednesday 30th April, I paid my fifth visit in the last nine months, to see a Czech dermatologist at Vojenská Nemocnice, the Military Hospital here in Prague. It prompted me to think that I really ought to write a blog post all about my experience, along with a brief explanation as to how the Czech Healthcare System works. But first a bit of background about me.

Between July 1970 and February 1975, I lived and worked in Australia. During my time there, I got badly sunburnt on several occasions and have since suffered from the consequences of being a pale, white, north-European, who exposed himself to far too much Australian sun.

It took nearly twenty years before I first experienced the unwanted consequences of my unwise actions. It was in 1988, whilst I was training for ordained ministry at Wycliffe Hall, Oxford, that I eventually went to see my GP about a scab, located on the hairline of my forehead, that refused to heal up. The GP sent me to see a dermatologist, who promptly diagnosed it as a Basel Cell Carcinoma (BCC), the commonest, but fortunately least dangerous, form of skin cancer.

Unfortunately, by that stage, it had become too big to be cut out under local anaesthetic, with a couple of stitches to pull the resultant wound together. Instead, the BCC had to be removed under general anaesthetic, with a skin graft taken from my chest, put across the gaping hole on my forehead. The evidence of that operation is still visible today, all the more so because my hairline has receded much further in the subsequent twenty-six years.

Ever since that operation in September 1988, I have kept a very watchful eye on any scab or spot on my face that refuses to heal up and promptly sought medical advice. As a consequence, over the years I’ve had several more small BCCs cut out under local anaesthetic. During the latter years of my time living in the UK, my BCCs were usually ‘frozen off’, by being treated with liquid nitrogen which destroys the cancerous cells.

During my first few years in Prague, I was pleased that I could not see any visible signs of further BCCs on my head and face. However, in the Spring of 2013, a tell-tale non-healing scab appeared on my current hairline, on the right side of my face. I also observed several smaller spots, all of which looked ominous. So in early June last year, I finally took myself off to see my GP, Dr Adriana Youngová.

Dr Youngová is a fluent English-speaking Czech, helped no doubt by being married to an Englishman called Mr Young, hence her unusual surname. Interestingly, although she has taken the Czech genitive form of Youngová, she calls the medical practice she heads, ‘Young & Co‘, without the ‘ová’ 🙂 But I digress.

Dr Youngová immediately agreed that I almost certainly had a BCC and promptly wrote a letter of referral for me. She recommended that I see a dermatologist at the Military Hospital as she knew that many of the medical staff there, spoke English. However, unlike in the UK, where your GP sends your letter of referral to a hospital and the hospital then writes back, giving you an appointment, in the Czech Republic, the patient has to contact the hospital themselves and make their own appointment.

I therefore went in person to the Military Hospital in order to make my first appointment. I could just have telephoned, but realised that if language was going to be a difficulty, which it was, you cannot make hand signals over the phone 🙂 Surprisingly, the young female receptionist on the main hospital entrance, spoke better German than English, and successfully directed me ‘auf Deutsch‘, to the building where the dermatology department is situated. However, the receptionist in the dermatology department itself, only spoke Czech, so I was most glad that I had not tried to phone. Eventually, my limited Czech, combined with appropriate hand signals, got me my first appointment for 15th July 2013.

As is required under Czech law, as an employed person, I and the Church as my employer, make contributions each month, to VZP CR, who in turn provide me with full medical cover under the Czech public health insurance scheme. VZP CR in turn, issue me with a European Health Insurance Card (EHIC) which I show in order to receive, almost free medical care.

Pay CZK 30 & obtain your ticket © Ricky Yates

I say ‘almost free’ as, on each occasion you visit your GP or have a hospital appointment, you are required to pay CZK 30 (just under £1.00 or US$1.50). On entering the dermatology department, there is this machine in the entrance hall, into which you put your CZK 30 and obtain a printed ticket, showing you have paid up. This is then retrieved from you, when you see the dermatologist.

My appointment yesterday, like a couple of previous ones, was for 08.00. This is very Czech as there is quite a tendency here to begin work early in the day. I first went to the machine to obtain my CZK 30 ticket. There was a delay whilst an elderly Czech lady in front of me, slowly managed to recover her coins, having first pushed them into the slot where the ticket comes out! I felt a certain sense of satisfaction that I understood the instructions on the machine, better than did a native Czech!

Then it was on to reception, to confirm my arrival. This receptionist is a classic example of what I have previously described as how to dress Czech. She regularly wears tops that reveal a large amount of cleavage. As I’ve previously written, it is look that would be appropriate for a romantic dinner with her husband or boyfriend, but not what I really want to see at 08.00 in the morning, in advance of being attacked with liquid nitrogen. Fortunately, the top on Wednesday, was somewhat less revealing than a couple of the previous ones 🙂

Once my arrival had been confirmed & the receptionist had found my file, I had to wait in the adjacent waiting room, until summoned. For the first time yesterday, I was summoned by a nurse who could actually pronounce my surname. My surname of ‘Yates’, causes great problems most of the time, as no Czech surname begins with the letter ‘Y’!

I saw the same young female Czech dermatologist that I’ve seen on four of my five visits. She speaks fluent English and has a helpful and friendly manner. She agreed with me that the original large BCC on my hairline, has still not completely disappeared, despite four previous treatments with liquid nitrogen. However, she was convinced that it was now much smaller and that one further treatment might finally do the trick.

So it was out with what I would describe as a cotton bud on the end of a large stick, first placed into the flask of liquid nitrogen, and then dabbed firmly on the offending area, several times over. She also treated a new spot I had identified, alongside my ear on the other side of my face. After treatment, she dusted both with a white antibiotic powder which does leave me looking slightly ghostly.

Having received treatment, I was duly given my next appointment for two months time at the end of June, along with a written report about my treatment, all in Czech! Then it was back to the tram for my journey home.

In conclusion, I have to say that I have been most impressed by my experience of the Czech Healthcare System. It is effective and efficient and gives an excellent level of care. Even as a foreigner, once you get to know the basics as to how the system works, then you should not have any real problems or concerns. And because most well-educated Czechs, especially the younger ones, speak reasonable English, language is usually not a problem with many doctors or with some nurses.

The hospital block where the dermatology department is located © Ricky Yates

Two days after President Obama’s re-election

Prague American Election — Prague on the Vltava River © Ricky Yates

For better or worse, I am part of social media. I write this blog and I am on Facebook. Yesterday via Facebook, I received a barrage of posts from my American ‘friends’ regarding the outcome of their Presidential and Congressional elections held on Tuesday 6th November 2012. One person, (you know who you are 🙂 ), posted over fifty times between my going to bed late in the evening of Tuesday 6th November and logging on again mid-morning the next day!

The vast majority of these ‘friends’ were expressing a mixture of joy, relief or satisfaction at the election result – often a mixture of all three. But a small minority, mostly ‘friends’ of American ‘friends’ of mine now living here in Prague, were in utter despair at the result and were threatening to leave the USA and come and live here in Europe, in particular here in the Czech Republic. This unplanned blog post is specifically for them.

As I understand it, these right-wing Republicans are concerned about a number of issues. One these is what they believe to be ‘uncontrolled immigration’ into the USA by non-American citizens who they think have no right to live within their country. Yet these self-same people are now proposing to emigrate from the USA, to another country. Have they ever given any thought as to why another country might actually want to receive them as immigrants?

Whilst via this blog, I have been very supportive of American citizens who have come to the Czech Republic at the invitation of Czech companies and businesses and have then experienced visa and work permit problems, it does not mean that, just because you are an American, you have the right to live and work in this or someone else’s country.

In recent times, I have heard various complaints from Americans and other non-EU citizens, who have come to the Czech Republic on a three month Schengen tourist visa, started working here, and only then have begun to apply for a long-term visa and work permit. Their concern is that, by the time they have completed the paperwork for a long-term visa and work permit, travelled to Bratislava, Vienna or Berlin to lodge their application, their three-month tourist visas will have expired before Czech bureaucracy has successfully issued them with necessary paperwork.

Can any American citizen tell me what the attitude would be to a foreign national who arrived in the USA on a tourist visa, started working, and then applied for a ‘green card’? I think I know the answer to my question! Therefore, why should rules, similar to those that apply to immigrants to the USA, not also apply to American citizens seeking to live and work in another country?

Another major dislike of these self-same individuals is what his supporters would see as one of President Obama’s major achievements during the first four years of his presidency – the provision of health care for all, denounced by his opponents as ‘Obamacare’ or ‘socialised medicine’. I am well aware that the package eventually passed by Congress and upheld by the Supreme Court, is far from perfect. But it remains beyond the comprehension of most Europeans as to why the supposedly richest nation in the world has not until now, provided universal healthcare for all of its citizens and that a large vocal group actually object to such provision.

Therefore may I inform all those Americans thinking of leaving the USA and moving to Europe in order to escape ‘Obamacare’, that all twenty seven members of the European Union provide universal healthcare for all of their citizens. Yes it costs money – my Church Treasurer often points out that of all the money that leaves our Church bank account at the end of each month to pay me, only about half of it ends up in my bank account. Because from that sum is deducted employer and employee contributions to social security and health insurance as well as my income tax. But if I need to consult my GP or need a major operation in a hospital, all I have to do is pay 30 Kc (£1.00 or US$1.50) – all the rest is covered. As an online friend recently pointed out, if you are looking for a country that doesn’t have universal health care, why not try living in Eritrea!

One topic that didn’t arise in the campaigns of either of the Republican or Democratic candidates for the American Presidency is that of gun control. Neither candidate wanted to challenge the power and influence of the National Rifle Association (NRA). But if you want to come and live in Europe, don’t try and bring your weapons with you unless you think you can show very good reasons for having them. Just citing the second amendment to the US constitution will fall on deaf ears 🙂 By the way – the murder rate in Europe is about one quarter to one seventh of that in the USA. I wonder why?

I could go on by pointing out many other things that conservative Americans might find objectionable should they try to escape their own country and seek to move here. For example, in the Czech Republic, you will regularly see women openly breastfeeding in public. You cannot ask for them to be arrested as there is no law requiring women to go and hide in a public toilet in order to feed their babies in the manner that God intended. In case you hadn’t ever realised, unlike guns and violence, a woman’s nipple has never killed anyone.

This post is not meant to be anti-American but rather an attempt to challenge some of the frankly absurd comments I’ve seen and read this past 48 hours. To use two well known American expressions – ‘get real’ and ‘go figure’.