Nickel

The only thing I can add which may be of help is that back in the 90s I did consider working in France and was offered a post in a hospital, at a grade somewhere between SHO and clinical assistant I would imagine. If there is a speciality that particularly interests you then you may find you could get initial employment that way and during that attachment learn how the french medical system works and of course become 100% fluent ( OK 99%) in the language. and no I didn't take the post - the pay was rubbish!! so stayed in the dear NHS.

I don't want to achieve immortality through my work - I want to achieve immortality through not dying. Woody Allen  

Current NICE guidlines do say that beta blockers are no longer preferred as a routine initial therapy for hypertension. But may be considered in younger patients and those with an increased sympathetic drive or intolerance / contraindication to ACE inhibitors and Angiotensin II receptor antagonists. Patients under 55 should start on an ACE inhibitor. Patients over 55 or of African, caribbean descent (any age) on  calcium channel blockers or thiazide diuretics. These may be combined - beta blockers may then be added. As I said earlier and I agree with Sprogster - in view of side effects you should discuss these concerns with your doctor and maybe find alternative therapy.     

Puzzled Temerit (Nebivolol ) is a beta blocker - a very selective and effective antihypertensive medication which causes a fall in heart rate and blood pressure. It is usually well tolerated though of course there may be side effects notably dizziness and tiredness. Amlodipine which WB's B takes is a calcium channel blocker - both these drugs are effective in hypertension and may sometimes be used together but they act in totally different ways. Neither should be stopped abruptly There are many antihypertensive regimes and you are right to discuss your concerns with your GP who will no doubt consider alternative therapy It is good that his BP is now being well controlled and hopefully this can be maintained.  

Anything from M and S food departments !! always gratefully received here.

Maladie de Parkinson Classed as ALD 16           (Affection de longue durée.) However exemption appears only to be granted to rapidly developing Parkinson's with increasing incapacity. Assessed using "Unified Parkinsons Disease Rating Scale"  UPDRS ( also called  this in France! )    

Poor prescribing is widespread throughout Europe - over prescribing, under prescribing, inappropriate prescribing. Changes to the undergraduate medical education  has reduced the input of clinical pharmacology and in a survey of undergraduates  a majority expressed their concerns of achieving the required competence once qualified. In France I believe students receive on average 68 hours of clinical pharmacology  as opposed to a recommended 120 hours. Whilst agreeing that France has a history of overprescribing I think it may be incorrect to state that Sweet 17's GP : "Is obviously making a good living on the side from overprescribing" unless of course  a) you know this GP and his/her prescribing methods b) you know Sweet 17 and her medical history c) you were present at the consultation/examination??    

But ...... as Coops says you still need a comprehensive health insurance policy. Will the fact that you have hypothyroidism make that difficult to obtain, whether you can pay for the medication or not? On a more positive note it is easily and cheaply controlled so a nice friendly insurance company (????) may cover. 

Many thanks .......hope there isn't too much rain!!!

I have to pick someone up from Carcassonne airport tomorrow evening - 5.00pm so may have left this a bit late - I shall be driving from Toulouse direction just wanted any advice re access to airport and parking?? Thanks

A few more specific diseases that can be added to ALD 31 ( all very rare) Ostéogénèse Imparfait -                             Osteogenesis Imperfecta - genetic disorder of bone/collagen synthesis Cushing's Syndrome                                   Endocrine disorder - due to high levels of cortisol - several causes Turner's Syndrome                                     Chromosomal disorder affecting females * Rendu-Osler (Osler-Weber-Rendu )          Hereditary Haemorrhagic Telangiectasis Ehlers-Danlos Syndrome                            Genetic - defect of collagen synthesis Marfan's Syndrome                                    Genetic - defect of connective tissue synthesis   *Haute Autorité Santé    at present,  has only  issued  guidelines for Turners syndrome. I assume the remainder will follow in due course.      

This is an excellent site for anyone with any worries/concerns about the prostate and its pathology. http://www.prostateuk.org/  

Severe partial complex seizures - Crises partielles complexes. The "severity" for ALD exemption is ascertained by         the number/:frequency/ severity of the seizures medical treatment required to "control" the seizures (mono or poly therapy) social consequences  - ability for working/driving/sports etc  "grave" just translates as "severity" as you know some forms of epilepsy are more severe than others. Exemption is gained for "epilepsie grave" under ALD 9. It seems likely that  your daughter would be in this category I hope that is of some help.        

Hello Coops ALD 9 Forme grave d'une affection neuromusculaire It does specify "severe" epilepsy - as far as I can gather they (HAS) are in the process ( may have completed) of issuing guidlines to doctors I'll try and find out more. Could you add it to the ALD list on your Health Issue site?just as another heading under ALD 9- I am sure more will be added over time.  

The article from Cancer Reasearch UK gives a clear explanation of PSA testing and its value - it is a somewhat controversial testing procedure -and further trials are being undertaken to more fully assess the efficacy. http://www.cancerhelp.org.uk/help/default.asp?page=2719        

Is it best to turn the orange  livebox off when you are away for a few days?? ( I did try a search as this has probably been discussed but nothing came up )

Fibromyalgia is "une maladie exceptionelle qui n'est pas sur la liste de 30 maladies reconnues par la sécu."In effect "hors liste" - However,  the "ALD -31" exists for conditions such as this. So exemption (100% cover) can be granted depending obviously on your personal circumstances. As Tony says you need to see your médecin traitant   - and good luck!!  

I hope there are not too many  errors - please let me know if you find any so they can be edited for future use. I have tried to be concise and by being so will have left out so much important information, but I trust it gives a slightly better understanding of the chronic conditions. As for the exemptions and methods of exemption, well that probably requires another thread entirely!! There seems to be a lot of revision (political,financial and medical) at the moment with the entire list subject to constant updating and revision. There are plenty of guidelines for patients and doctors which are also under review. (see Haute Authorité de Santé - with many articles in English). Apparently 8 million patients are included in the ALD system and the care accounts for over half of the total expenses reimbursed by the Assurance Maladie.  

30) Tumeur maligne, affection maligne du tissue lymphatique ou hématopoietique. Malignant cancer and cancer of the lymph or blood system. Malignant cancer occurs when certain cells start to grow and invade the surrounding tissues and may spread to other parts of the body. An enormous number of different cancers can occur depending on the originating cell type. Diagnosis is made on clinical, radiological imaging,and definitive diagnosis on histological examination of a biopsy . Advances are continually being made in the understanding of causes and treatment of cancers, ( too many to warrant inclusion here) which may involve surgery, chemotherapy, radiotherapy. Exemption depends on the specific cancer,staging,prognosis, treatment etc etc. ALD 31) and ALD32) Exemption may also be granted for : ALD 31 a serious disease not in the above categories where continuous care is anticipated to last for a minimum of 6 months - examples stated  are - Macular degeneration ( commonest cause of blindness in people over 50)  Xeroderma Pigmentosum. ALD 32 where several diseases may be present, again where continuous care is anticipated to last for a minimum of 6 months an example given is of an elderly blind person who suffers a hip fracture. a so-called Polypathology.  

And now I discover there is an ALD 31 and ALD 32 !!

29) Tuberculose active Active Tuberculosis. A common and serious infectious disease,caused by a Mycobacterium.  Usually affects lungs but can involve other organs. Although a common infection throughout the world most people who are infected have a "latent" asymptomatic form. This may however progress to active disease (10%) and this is a serious condition requiring long-term medication ( up to a year) of 2 or more drugs Diagnosis is by isolating the organism or microscopic study of the lesions, however, treatment may begin on clinical diagnosis before confirmed diagnosis. Seen more often now in people with a compromised immunology ( due to immuno-suppressive medication or disease e.g AIDS) and due to widespread travel to regions where Tuberculosis is common Treatment effective so exemption is granted but  reviewed on 6 month /yearly basis - when "cured" subsequent radiological follow-up may not be exempt.    

steady on Ernie, still 2 to go !!!!

28) Suites de transplantation d'organe Organ transplants - Post- operative care Organ transplants include kidney, heart, liver, pancreas, lung, intestines and by extension bone marrow. All exempt because of continuing follow-ups including  immuno-suppressive medication, assessment of transplant and  monitoring of any complications ( rejection, infection etc) Corneal transplants are not exempt unless systemic immuno-suppressive medication required - when exemption is for 1 year and is renewable

27) Spondylarthrite Ankylosante Grave Ankylosing Spondylitis.  Chronic degenerative inflammatory disease of Spine. Onset insidious - repeated back ache in young age group. Diagnosis by clinical, radiology and some specific blood tests.  May be mild but tends to progress and bones of the spinal column fuse together ( ankylosis) causing severe handicap.It is a systemic disease so other organs - eyes, heart,kidneys may be affected. May be secondary to other disease processes e.g Reiter disease / Crohn's/ Ulcerative Colitis Treatment - No cure - anti-inflammatory - immuno-suppressive medication - Physical therapy (swimming,yoga ,tai-chi etc) and surgery.  *Exemption as are some of the primary causes e.g Crohn's 

[quote user="Chris"]What a fascinating and valuable list - can I ask a question, or should I wait until the end to avoid interrupting the flow of information?[/quote] Sorry just seen your post - 4 more to go - so a couple of days left ! if your question is about the translation please feel free to ask .