Yesterday, I took a sick day. Over the last three years, this was my 2nd sick day. Now this is not to say that I haven't been sick. I have. It's just that many of my sicknesses have been well timed.

I've been fighting off a recurrent infection for, oh, the last three months. Not fun. I've been to see the doctor three times. I've gotten three different antibiotics and each time nothing has worked. The infection has come back.

This week I lost my cool when I realized that the infection was starting again and that this time around I was also having kidney pain. Just for the record, that's un-awesome. I spent a large part of Wednesday wanting to cry and after talking to my friend A. on Wednesday night she convinced me that I had to get a second opinion. (Thanks, A.)

So Thursday morning after my classes I called Takuda hospital for an appointment with an Urologist but they couldn't get me in until Monday morning. Enter tears. This lead me back to M. the Deputy Director at school--a woman who had helped me earlier this year with the same problem. She was incredible and rallied the troops so to speak. She had our school doctor making class, there were calls into Takuda and after all of this a plan was hatched.

The hope was that I could go back to Greenberg (the clinic next to the school) at 8am and that with the previous day's phone calls and the presence of D. the school nurse a diagnosis and a solution to my problem could be reached. Only it couldn't. I openly cried at the reception desk of the clinic in front of a lot of Bulgarian onlookers when my first doctor told me there was nothing wrong with me passed me off to the gynecologist. The result of these tears was that my first doctor decided to take another urine sample and to draw blood.

Then I got to see the gynecologist. He determined that there was nothing gynecologicly wrong with me. He of course didn't speak English so after my exam he tells D. all of this.<em> Well, that's nice to know</em>. However, he then preceded to tell D. that I have very nice looking eggs and that getting pregnant would solve my problems and he finished this up with a joke about the fact it shouldn't be too hard to find a nice Bulgarian man because I am young, pretty and American.

D. was wise enough not to translate that part for me while in with the gynecologist. She told me later. I think because she thought that I would be happy to know the part about my reproductive system. Maybe I should have been. But the feminist me sat there seething--what antiquated advice: pregnancy will solve your problems. D. shrugged the whole thing off as a doctor joke.

After this I went back down the hall to see the results from my tests. The doctor declared me fine. The doctor declared me fine. My blood work was normal and there was no bacteria in my urine. I complained about my back pain and explained that I thought it was related to my kidneys and in no uncertain terms, she told me that it could not be related. She wrote a prescription for painkillers and sent me out. For good measure on my way out she told me to wear 100% cotton bikinis, to wash them separately from the rest of my laundry and that this must be an American disease not a European one. Her final parting comment was that she was sorry I was in such a bad mood today. Now if that doesn't make a sick girl feel better about things, I don't know what will.

After paying my bill (54 leva), D. and walked back to school. I still felt sick. I was still having the same complaints that sent me to the doctor's in the first place--a series of complaints that each previous time resulted in an infection that required a round of antibiotics. But the doctor was so sure that there was nothing wrong with me I began to wonder if I was crazy. Maybe the whole thing was in my head. Maybe I was worried about another infection and there wasn't one.

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. decided that I need to have my kidneys checked with ultrasound and that I would go to Pirogov not Takuda.

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 you 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.

This hallway was something else--half of it seemed to be newly remodeled and the other half had exposed brick and 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.

When we 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.

So 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 new urologist suggested that I go and see a urine flow specialist a Professor K. I paid my bill at Pirogov (74 leva) and we headed over to Professor K.'s private office.

After some more waiting, this seems to be a mandatory part of seeing any doctor, and running through a list of my ailments and the series of events that lead me here. Then there were a series of questions about how much I have to urinate each day. The doctor was very funny because as soon as he learned I was an American he kept asking me about my urination habits in America and now in Bulgaria. <em>What?!</em> I've lived in Bulgaria for four years. I don't know what my urination habits were in the States. All I can tell you is that before Christmas I never-ever had to pee as much as I do now. He seemed skeptical and a little grumpy but when I mentioned this to D. after the appointment she thought it was just his demeanor and not me.

So, I had another ultrasound, underwent the urine flow test, followed by a final ultrasound. For anyone counting that's five ultrasounds in one day. I've got some serious pictures of my internal organs--but I can't actually make anything out on them. Anyhow back to the story, it was determined that yes I have a problem and that yes the doctor thinks he can help me. He prescribed a new medicine and asked me to come back to his office for a check-up in a month. I paid my bill (50 leva) and D. and I headed home.

At 4:30pm I was in a taxi on my way home. Phew. What a long day--8.5 hours, 178 leva in medical bills, 18 leva in food, drinks and a taxi, and in medicine, I had a diagnosis, a prescription and what I now hope will be a speedy recovery.

Oh and I also, had the realization that sometimes you have to stand-up for yourself. I shouldn't have continued to go back to a doctor who so willing dismissed me out of hand not once but twice at Greenberg but I didn't feel like I had another option. The big problem is that when you're sick, you aren't always making the best choices and it's not as easy to say: hey, there's a problem here. I knew from my second trip to the doctor when she pushed me off onto a gynecologist the first time that I had a problem. The first gynecologist confirmed that my problem was not gynecological. The third time I went back with a UTI was sure that there was a problem because no one should get three UTIs in three months but I ignored it based on the fact that the doctor was so sure of herself. This, of course, was very silly of me so on my fourth visit when I got pushed off on a gynecologist for a second time, I started crying. <em>A lot</em>.

I'll end on this note: I feel very lucky to have colleagues and friends at school who were so willing to help me. It's scary being sick in a foreign country where you don't speak the language but it's a lot more bearable with familiar faces around, plenty kind words and the assurance that we'll figure out what's wrong.