Knee surgery

Hey, I will not advise doing any surgery here in Bulgaria as the health system and hospitals are awful here. Most of the people here, visit Tukey for such operations due to conditions and prices are much much better there. I am not sure from which country you are however better to consider doing it there before moving to Bulgaria. 

Thx.

Thank you for your reply I'm just thinking that in Bulgaria  I would be able to afford private surgery or I may just require  a gell injection,  which isn't, to the best of my knowledge  available in the UK however my sister in Germany had a gell injection into her spine and stayed in hospital  for  two days afterwards and is fine now.

Just wait your turn back home.

If you are not really insisting to do such things in Bulgaria, better do it in the UK I am just telling you the situation here, as I never had a good experience with Bulgarian doctors and hospitals ( Even private ones ) and never heard someone around me saying even a single good thing also.

GB2BG, oh yes so I'll wait another two or three years, I'm not getting any younger and it really nags me off to know that if I had the money or was willing to get into debt, something I've never ever done, never had or intend to have a credit card, I could have this operation next week. Because of the recent situation  loads of people besides me are "waiting their turn" here and unfortunately  a lot of people are dying during the wait. While a significant  number of people are getting into debt to have the operation  done  privately  and if anything goes wrong ( as it did with Alex Ferguson  ex manager of Manchester United) end up being cared for in NHS hospitals  because unlike private  hospitals  the NHS has qualified  staff available 24hours a day.

I'm very surprised by such negative comments! I have spoken to a number of expats here who have had very good experiences with the Bulgarian health system. In particular, there is little or no waiting here if you want something done.

If you're resident, then it's pretty easy to contribute to the social security system here, and hence get free healthcare. I registered as unemployed and pay 13 euros per month (if you're proper retired you ask for an S1 from the UK and then it's free). And they gave me an EHIC for use in the rest of the EU. I think it's worthwhile to do this, just to keep your options open (and have no worries when travelling). I haven't even registered with a local GP, but that would be a sensible thing for you (and me) to do. There is an extra faff in trying to find an English-speaking one, which is harder in a tiny village than in a big city, but I'd say there are plenty around.

One very good aspect of the system is that private hospitals are fully integrated, and receive payment from the national health system. So you can go to a public hospital for free, or you can upgrade to a private hospital, and pay the difference between the state's payment and your VIP treatment.

I'm not sure I would do a major op at a public hospital here, but there are plenty of excellent private hospitals in Sofia, Plovdiv, Varna. I went up to Tokuda in Sofia (acibademcityclinic.bg/tokuda) for a consultation, and I was very impressed with the place.

Knee and hip and replacements are very common operations these days. Even if it hurts, you don't have to go direct to replacement, there are less invasive surgeries you can try first (various types of injections, or arthroscopic repairs/investigations). You can also try to defer by physiotherapy, low-impact activity (walking, pilates, etc.), supplements (chondroitin/glucosamine seem to have positive feedback), pain management (most effective is NSAID gels like Voltaren or Voltaren Max direct to the affected area), and mechanical aids (walking stick, or nordic walking poles).

Most of the private places can provide rehabilitation for a week or two afterwards, which might be a good idea. (It costs, of course.)

Turkey has a thriving medical tourism scene in Istanbul (and other cities) so it's definitely worth checking out. The cost is significantly less than a UK private hospital (and close by).  But I think it's hard (but not impossible) to get the UK (or BG) healthcare system to contribute.

I found a very well-regarded clinic in Lithuania (nordorthopaedics.com) which is a specialist in knees and hips. The cost is highly competitive, so worth a look.

Toduka is pretty local (90 minutes from me), and will get the BG state payment. I think they will do a better class of op/prosthesis than NHS standard, with a private room, with extra rehab. Maybe at an extra cost of 1,000-2,000 euros. And you can get the op pretty much when you want.

You're in a different situation as you're still in the UK. If you move here, then I definitely recommend getting yourself into the local healthcare system, as I described. If your knee is very bad (and an op is fairly urgent), it's probably very sensible to stay there and go through the usual NHS process. It's a bit slow, but they do a good job. And your local GP will look after you, if there are any post-op issues. If it's something you're thinking about doing in the next few years, then it would seem better to move here as planned, and be in the system so that when you do decide you need it, it won't be an issue.

I think like any country it depends where you go. We sat beside a disabled retired woman on our last flight to Varna, who has complicated ongoing health issues and spends half her time in Bg and half in the UK. She said she received far better specialist care and treatment for her chronic medical problems in Varna than in the UK. That was in a public hospital! 

Not the same as having surgery, but she'd been using the NHS and Bulgarian health systems side by side for a few years and far preferred the care she received in Bg.

Thank you for your positive reply gwynj I had heard very positive reports regarding knee ops in Bulgaria and unfortunately I was waiting over two years after my first x-ray and only had another one because my knee gave way and I fell over in February of this year. I haven't seen my GP in all that time just spoken over the telephone and was seen by a consultant last month, given a steroid injection which didn't do me any good, as it didn't take away the pain, my knee still " locked" leaving me unable to walk and still gave way now and then. They next thing I think they will " fob me off with"  will be an arthroscopy, day surgery. This is supposed to be day surgery but when I had this op on my other knee I was told not to walk on it for six weeks because they'd micro fractured my knee cap to promote growth of cartilage, something that has been proved not to work since. All these supposed treatments remind me of a saying " one of the main symptoms of madness is to repeat the same actions in the hope of a different result".

That is why I'd like to start my new life in Bulgaria, living off the produce of my garden, knitting and listening to Radio4.

Thank you Jane as well.

You must be a Bulgarian resident. Your personal ID number (usually 100xxxxxx) is for tax and social security.

You have to go to your local social security office (I think it's NAP). First step is "activate" your number. Then register as unemployed and pay some contributions. There is minimum to be covered, so maybe pay 6 months or a year up-front.

Then pay further contributions at same office, or pay via online system.

As well as unemployed, you could choose self-employed, or employed. If you are employee, your employer would usually take care of it. Cheapest is unemployed around 26 leva. I think self-employed minimum is 100 or so. Employed is fixed percentage of salary with an employer contribution.

The online system has a status check option, this is what folks use to see if you are in the system. If it says "THE PERSON HAS CONTINUOUS HEALTH INSURANCE RIGHTS" then you are good to go, and the hospitals and doctors will treat you.

When you are fully covered as above, you can get a BG EHIC at DSK bank (a bank?) after filling in the required form.

Non-EU residents can be excluded in some circumstances, so then they won't directly register you as unemployed. You can get round it by getting a job (no problem for employer to put you in the system), or getting accountant/attorney to set you up as self-employed (also not restricted). You can also open your own BG company and be an employee and sort it out that way. Once you're in the system, and have paid a few months, you can give up all the above and change status to unemployed. I am not 100% sure on Brits at this stage, but I suspect that they are a special case under the Withdrawal Agreement and so it won't be an issue.

Im hoping that I will be able to purchase rehabilitation care in or near to the Bulgarian hospital were I'd get my surgery, fingers crossed

Hoping it all works out mo matter which way you choose to take this, Kath!

Wall I should know tomorrow  late afternoon  because that's when I've my hospital  appointment.

Wall  met with the consultant  yesterday and in short although hes not inclined to d a knee replacement  and I remain inclined not to take painkillers we've agreed to the following , he,ll refer me to one a hs colleagues and I'll take one paracetamol  a day. He said that my appointment will take place a few weeks away from now as soon as I get a date I'll book a return flight to Bulgaria to continue work on my home.

The best pain management for knees and hips is not typically paracetamol, or aspirin or such over-the-counter medicines... and you are right to be wary of stronger ones (often highly-addictive, prescription-only morphine-based ones like Vicodin and Oxycontin). Usually, you're better off with NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). These are non-addictive and help with pain, but also (as per the name) reduce the inflammation in your joints. Ibuprofen is the most common, but there are stronger ones (e.g. dexoketoprofen, diclofenac). You can take as pills, but most agree that a topical gel (applied only to the troublesome joint) is more effective. If you haven't tried these yet, I think you'll be surprised how much Voltaren (or the stronger Voltaren Max) can help when applied to your knee. You shouldn't go crazy, but long-term (once or twice per day) use of these is perfectly feasible (and they are over-the-counter gels, so no prescription is needed).