For those of you following along at home, this is an entry from an on-going multi-part series that I am writing about an infection I have and the lengths I've got to resolve my problems. <a href="http://www.karolinkabulgaria.com/2012/03/27/battling-bacteria/" target="_blank">Part one is an overview</a>. Part two is <a href="http://www.karolinkabulgaria.com/2012/03/28/greenberg-clinic-in-mladost/" target="_blank">my experience in a small private neighborhood clinic Greenberg</a>. Today picks up with me detailing a few hours that I spent at Pirogov.

In M.'s office after my first round at Greenberg, she decided that it was time for a second opinion and that I would be getting my second opinion that day. She had a heated discussion with our school doctor and Doctor L. and it was decided that I need to have my kidneys checked with ultrasound and that I would go to Pirogov not Takuda to have this done.

Now <a href="http://www.tokudabolnica.bg/" target="_blank">Takuda </a>is a private foreign hospital establish by some Japanese medical company but as such it's not cheap. This is the hospital that is recommended to all foreigners and because I have really excellent international health insurance I can afford to go anywhere I want. Pirogov is Sofia's Specialized Hospital for Emergency Medicine but even given fancy name no foreigner would recommend that another foreigner go there.

However, Doctor L. insisted that there were better specialists at Pirogov and that because D. used to work at Pirogov before coming to work at ACS that this hospital was a better choice for me than Takuda. These seemed like reasonable arguments and really, I was in no position to fight anyone about it. I just prepared myself for the worst and reminded myself not to touch my face, mouth or eyes with my hands after entering the hospital.

At Pirogov, I found myself surprised by the fact that things are fairly quite but chaotic. There were people everywhere in various states of illness, unhappiness, old age and plenty of broken bones, bandaged limbs and worried looks. After a brief check in where D. explained my illness and that I needed to see a urologist we were directed to a specific room number. We waited in the hallway with a number of other people.

I'd describe the hospital as shabby at best. The whole place feels like it could use another coat of white paint and a good scrub. Nothing seemed especially clean and the place smelled well, very un-hospital like. There's no sterile bleach clean smell at Pirogov. Instead it's part retirement home, part thrift store, part dirty bodies.

The hallway we found ourselves waiting in was something else--half of it seemed to be newly remodeled and the other half had exposed brick, hanging sheets of plastic and crumbling plaster. To top this off, bags of garbage were being collected in a small hallway near by. The most appalling part of this was that there were used syringes which had been carefully collected in a old Nestea bottle sitting next to the garbage and there were cleaning women moving garbage by hand from one bag of garbage to another even though the garbage bags were marked as bio-hazardous waste with big stickers. They appeared to be methodically consolidating bags of garbage in the hallway. This didn't seem like the best plan to me given the Nestea bottle of syringes but to each her own. I guess.

Apparently, waiting is a huge part of going to the hospital in Bulgaria. So as we waited I considered whether it would be appropriate for me to take pictures of the hospital for my blog. I ultimately decided against it. I didn't need to make a spectacle.

When we finally got into see the urologist, it turned out that he was young and spoke the best English of any doctor I met all day. He was basically fluent. <em>Amazing</em>. He listened to my complaints and agreed that this was not normal. He actually checked my kidneys, unlike the doctor at Greenberg, and decided that I, in fact, did need a ultrasound and that he wanted the Pirogov lab to check my urine again. I have no idea what this doctor's name was but I'd like to say to him thank-you, thank-you for taking my complaints seriously.

D. and I set out for a half an hour for me to drink some fluids so that I'd have a full bladder for the ultrasound. The ultrasound revealed two things. First that I did have a back-up of fluids in my left kidney and some inflammation of the bladder but the big thing it revealed was that post-urination not of the urine in my bladder was actually being expelled from my bladder. This is clearly the cause of my problems.

Now the ultrasound felt pretty straightforward. We go in the doctor tells me to hang up my coat and bag and to like down on the examining table. At this point, D. reached down to pull down the roll of paper that's covered the table so that I have a clean piece of paper. The doctor thanks her. I unbutton my pants so that the doctor can preform the ultrasounds of my kidneys and bladder. The thing is, upon standing up I realize that the room for the ultrasound looks right out to the front of the hospital and that the window is open. I can see a row of policemen leaning against a retaining wall smoking and they can see me. So can anyone who walks in the front door of the hospital. <em>Interesting</em>.

Then I go to the toilet. It's disgusting. There's no toilet seat on the toilet. Not that I would have used it anyway. There's standing water (I hope) on the floor. There's absolutely no toilet paper but after four years in Bulgaria I am used to that. I try my very best not to touch anything. Then I head back to the ultrasound doctor. She has me lie back down. This time no one changes the paper on the examination table and it's clear to me that she hasn't changed it before I entered the room because I can see footprints on the bottom of the paper. <em>Awesome</em>. I line down and proceed to convince myself that the worse thing that could happen from this would be that I get lice. All things considered that seems unlikely, or so I tell myself, and I try not to worry about it.

After this D. and I went back to the urologist to have him take a look at the results of the ultrasound and my urine sample. The sample revealed bacteria. Interestingly, only 4 hours early the sample at Greenberg revealed nothing and I'd been pronounced bacteria free. Anyhow, the young English speaking urologist's shift has ended so I get to see and talk to a new urologist. Well really D. gets to because this new urologist only speaks Bulgarian. He suggests that I go and see a urine flow specialist a Professor K.

So, I paid my bill at Pirogov (74 leva) and we headed over to Professor K.'s private office.