Saturday, August 22, 2009

After the surgery, and why we need a public option

I sort of begged on the evening of the second night to go home. I was feeling pretty chipper and didn't really see why I needed to stay. My throat didn't really hurt that much and hanging out in a hospital did not seem like a good time. When the doctor finally came around to visit me around four he at first said that I would need to stay until the next morning. Then he came back about twenty minutes later and said I could go home if I wanted to and said I could check out around 7 pm.

I managed to call home and squeak out enough communication to secure a ride home from the hospital that arrived in the form of a disheveled boy around seven. Between the two of us we managed to communicate that I was going home, and nurses came around with bags of medicine and other fun things. I was also informed that I would need to settle up the bill before I could leave.

This was totally expected and I was prepared to bite the bullet to pay for my tonsillectomy and my luxury room upgrade. I'd been told the cost was going to be somewhere between two and four million won, roughly 2,000 to 4,000 thousand dollars, which would still be a bargain deal compared to what I'd probably pay in the states for the same. Assuming of course I could even find someone to take me without having to go to an emergency room. Since I don't have health insurance in the U.S. it would be more, and trying to get insurance after being told that a tonsillectomy was at this point a life-saving necessary procedure I'd be dead. I wasn't going to complain about a couple of grand and frankly I could afford to spend it so I would never have to deal with my tonsils again.

The nurse asked if I knew where to go, and I had no idea. So with the help of the Boy we walked up and down and outside the hospital, over to the older wing of the hospital. I was feeling fairly winded and dizzy what with the first movement I'd had in days, but I followed along as we went to several doors hoping to find the one where a payment could be made.

At one of the big checkout type counters the nurse asked for directions and eventually we were shuffled down the hall to the emergency room admittance area, which was apparently the only place we could pay up. The young Korean gentleman on call there had no idea what was going on. The Korean nurse explained and finally he picked up a pen and paper and us in Korea that I'd have to pay 300,000 won (300 dollars) to leave the hospital that night.

I handed over my credit card and he just looked at me in shock, then realized he couldn't run the card at that time of night and just asked me to come back the next day to pay, which was fine with me. I waited at the car while the nurse ran the boy back to the previous hospital to grab the bags of medicine and we took off to home. My neck was sore with every bump and turn but I was happy to be going towards my own place finally.

When I got back I was greeted happily by two dogs and in less then an hour made my way to bed to sleep for what seemed like the first time in ages. I woke up roughly ever two hours on the dot but it was still better sleep than I'd felt I'd had in ages. And it was nice to wake up Friday at home. The throat didn't seem so bad and I made a tonsillectomy cozy for ice so I could keep my throat cold when it started to hurt to much.

As the day wore on I asked the Boy to go and deal with the hospital bill since A) I couldn't talk, and B) I wasn't up to driving all over town again. He agreed and I hung out with the mammals and watched TV while he disappeared. When he returned a few hours later with my bank books and handed them over I used my computer to ask just how bad the damage was.

He just laughed at me and handed me the bill.

For the surgery, three days stay in the hospital, the constant care, two rides in an ambulance, major surgery,  the insulin, and all the work and care, I paid 285,000 won. That was after they calculated the expense for my extra swanky room.

Roughly 300 dollars for a tonsillectomy.

Korea is a country with a public option. Everyone employed pretty much buys into the public option. Even migrant workers, such as myself, have the option of buying in and getting coverage. And because of this I was able to have basically life-saving surgery for less than what I spend on booze in a given month. Korea also has lots of private insurance firms and many Koreans take the public plan and supplement with a private plan as well to cover the other costs, like the extra I paid for the room. But still, at the end of the day, three hundred dollars. Without insurance I would have paid eight hundred dollars, still a downright steal. Because the cost of medical care is kept down through government regulation, sponsored medical school, and lots of freaking options.

In the U.S. the out-of-pocket cost for a tonsillectomy is around $13,000 dollars. And the procedure is considered outpatient; you go in for the surgery in the morning and go home that night. Do a search on tonsillectomy recovery in the U.S. and you will read horror story after horror story about the pain. I can't help but to think that my speedy recovery and general ease through this thing is because I was monitored carefully before and after by people that would have been happy to have me stay at the hospital for up to ten days to take care of me. That's quality health care.

Too bad I can't get it in the greatest nation on earth.

Today it is Sunday, I managed an eight hour meeting yesterday and have a busy week coming up with lots of presentations. I feel at the top of my game today. And things are looking in general.

It's good to be back.



Thursday, August 20, 2009

Things To Do Once You Land in Korea

Having just gotten off a fourteen-hour flight, one-hour bus ride, and three-hour train trip to get home I started to wonder what I could do for fun now that I was back on the ROK.

Major surgery, I thought to myself, that's an interesting way to deal with jet lag. My schedule is generally insane, and the tonsils really were trying to kill me, so as much as I did not want to have to have surgery, once I knew they had to come out; it was more a matter of finding the time. The time I had was the roughly ten days I had between jobs upon landing back in Korea after my month-long class in Chicago.

I made arrangements for the surgery before I left, scheduling my pre-op day for the 10th. It was not until I landed in Chicago that I realized that was not going to work as I was going to be a flight back that would put me in Korea ahead a day, so I'd land on the 10th not the 9th as I was thinking when I made the original arrangements. One fine evening in Chicago I used my cell phone to phone Korea and talk to the doctor. He had a lot of trouble understanding me but somehow between the two of us and his nurse he managed to suggest that I move my surgery back one day (which is what I had been asking for all along) and I agreed to his arrangements. With that done it was really just a waiting game until August 10th rolled around.

And so at noon on August 10th I found myself walking into the second floor of the large Daegu Fist hospital. The nurse was happy to see me and we started to make arrangements. Being this was the pre-op day I expected to get the usual pre-op stuff and be made ready for a fast, etc, and return to the hospital the next day.

"No, no, you check in now," the nurse explained.

"No, the surgery is tomorrow, I can be here tomorrow morning."

"No, no, today, you must check in today. We have to monitor the fast." I was thinking what's to monitor? I don't eat; you're going to watch me not eat? Okay.

Finally I acquiesced, there was no way I was getting out of this. I had to be back to the hospital by four in the afternoon as I saw no good reason to check in around noon if I didn't need to. I phoned home and made arrangements to eat a last meal with the Boy before checking in. The nurse helped me make arrangements for the room and asked if I'd like to be in a larger room with five people or in one of the smaller rooms with two people. I also had the option for a private room.

"I think the two-person room is fine."

"Maybe many people recovering will make you feel better?" I thought about this. Me recovering with five other Korean women, who would be in the hospital with their husbands and their kids. Not a chance in hell did I want to be the waygook on display while I was recovering.

"No, I'll feel better with less people."

"Small room big cost."

I took the bigger cost, roughly seventy dollars a night for the smaller room with less of a crowd and went home to pack my bags. I packed some things to wear at the hospital as I knew the Korean clothes they where going to try to force me into would not fit. I brought my computer, a book, and my ereader, I figured with that I'd be set. I was checking in Tuesday night with the prospect of being freed on Friday morning.

The check-in went smoothly enough and they shuffled me off to my little room, which was surprising a small solo room. It was a single off a double compartment, which is what was meant by a double room? Beats me. What I did discover was that I was able to hack an internet connection. Happiness.
I watched a movie on the computer until the first cute Korean nurse came in  to give me the expected IV. For some readily apparent reason as she tied off my arm she turned it toward the thumb and started slapping a vein that went right over my knuckle joint.

I turned my arm around and offered a vein slightly further up my arm toward my elbow joint, but the nurse promptly turned my arm back around again and started going for the vein on my thumb. I figured that there was no way she really meant to stick a needle in there next to so much bone and was about to say so when the nurse jammed the needle into the vein right over the bones on my thumb. I sucked in my breath and started slapping my leg while the stars started spinning in my eyes.

"Apayo?" Does it hurt?

Fucking A it hurt. I just smiled and nodded and said a little. She smiled back, started the IV and walked out and I just sat there waiting for the throbbing to settle.

Later in the evening an older nurse came in as I sat in the bed looking out the window of my room into the rain. "Is my brother." She handed me the phone.

"Yes hello, tomorrow you surgery?"

"Yes."

"The surgery is at 9:30 am."

"Yes, I know."

"You will have much pain. So much pain. Really awful. Okay, only cold things after surgery. You will be much pain so nothing food. Okay?"

"Uh-huh."

"Okay, much pain, don't worry, no problem." He asked to speak with his sister I handed the phone back over and wondered what the hell I had managed to get myself into.

I had several nurses coming around at intervals to check my blood pressure, which broke up the tedium a little. The hospital bed was something straight out of a Klingon battle cruiser, so I did not sleep very well that night. The Boy planned to meet me at the hospital before the surgery the next morning; lucky bastard got a full night's sleep, I tossed and turned, and woke up around four to check email, chat online and read until the surgery started.

They came in around 8 to give me my backless hospital gown; the Boy showed up and we talked and giggled until a gaggle of orderlies entered at 9 on the nose, all of them smiling and staring at me. Yee and ha. I climbed onto the stretcher they had wheeled in, they strapped me in, tossed a blanket over me and we were off.

I was wheeled through the hospital, into an elevator, and then out the door and into an ambulance which took me over to the main surgery area. I was asked to transfer to a second gurney, which I did, and I laid back while they strapped me in again. This time I was pretty sure we were going in for surgery and sure enough a few minutes later a nurse came by who strapped me down harder and rolled me into a room with bright lights.

There was some poking and prodding for only a second when a nurse strapped on another arm cuff for my BP, then adjusted the IV. A friendly old Korean doctor in a green suit leaned into the large bright light shining over my face and told me to breathe deep. I tried to. Most of me was scared out of my mind, worried I'd not wake up again, and then I felt like someone was crawling under my skin and I was gone.

The Korean nurse woke me up and asked me to move back to the stretcher, which I managed to do. I was having some trouble breathing, which I tried to convey, but found I couldn't really talk. Finally I wrote asthma on a piece of paper, which got some shocked reactions before I passed out on the stretcher and woke up back in my room with people asking me to move to my bed. I realized at that point that there had not been a catheter, so I removed the hospital pants I had on and with some help managed to change underthings and scoot into the bed as six surgeons burst into the room with a gigantic oxygen tank.

Okay, I thought. "Mmm, cough...mmmm...bebnnemmemme...memem..." I explained.

Finally I laid my arm flat and shook my head no, then tilted my arm to 90 degrees and shook my head yes. The nurse seemed to get it and she turned a crank to lift the bed and I crawled in happy to be able to breath around the mucus in my throat. It wasn't an asthma attack so much as whatever they had given to knock me out had caused a lot of draining and I was all sorts of full of phlegm. The doctors backed off, but left the oxygen tank handy. I asked for water (all right I mimed getting a cup and drinking), but the nurses said no, pointed to the clock and said I had to wait until 8 pm.

I shook my head and promptly crashed and passed out for a few solid hours. I woke up again around five feeling actually pretty good. I assessed. My throat was sore. But it wasn't pain, not the pain I had been expecting anyway, certainly no worse than any of the really severe sore throats I'd had over the last few months. Actually the throats where I had to get a puncture were definitely much higher on the pain scale. It was the worst when I had to cough but for the most part no problems.

The nurses kept me on the saline drip all day and finally at 8 a nice nurse walked in and said "Water, milk, ice cream. Okay." She smiled. I smiled back, I could tell she had been practicing this for hours. I asked if it was all right for me to go the bathroom as I know on occasion hospitals like to monitor these things, but she told me I'd be fine and so after some venting, I had the first sips of water and a little ice cream.

I slept fitfully again that night, waking up to make frequent trips to the bathroom and to refill the water cup, but overall I felt pretty fantastic considering I'd just had a couple of doctors cut out parts of my throat. The docs woke me up at some point and gave me a thumbs up saying "The surgery was a success." Which I could also tell was a nicely practiced phrase. I dreamt that night of knives, and Koreans, ice cream, water, all dancing about to the light throbbing in my neck that tempo-ed my dreams.


Sunday, August 16, 2009

And Then There was One

So, unbeknownst to me my tonsils were launching an campaign for emancipation in the spring of 2009. I say unbeknownst as at the time I assumed it was merely a little strep infection, I'd go through my usual round of antibiotic treatment and days of social isolation and then I would move on.

But no; my tonsils had something entirely different in mind this year. They were done. They were leaving, and they were going to make no small bones about how exactly they got out.

I'd had issues with the tonsils since I was a kid. I had several strep infections as a child, and at least one that was severe enough I probably should have been more closely monitored and a tonsillectomy might have at some point been recommended. But no, the tonsils stayed and I got older.

I remember during my second year of school getting an infection to beat the band. Painful, owie let me tell you. Being an uninsured college student I treated myself with a gargling solution of salt and water and was extremely lucky that it actually did clear up in five days and not get worse. That was probably the luckiest I ever got with the tonsils, as an untreated strep infection can pretty much kill you. Through the years I've had tonsillitis or strep at least once a year for as long as I can remember. I had it in 2006 twice in the same month. That should have been the sign right there. My doctor was worried, but the second round of antibiotics cleared it up and I was on my merry way.

Enter round, who knows how many, of tonsil infection: Springfest 2009. At first when I got it in March I was pretty sure I knew the source (this is what you get for kissing girls). The second time I had it, not two weeks after it had just cleared up, I blamed the doctor for not giving me a longer run of antibiotics and I blamed the yellow dust.

Over the next five months, though, when the infections were coming on again as soon as three days after stopping the antibiotics I knew for a fact that my tonsils were preforming their version of Morse code. What they were saying was, apparently, that they were through. Maybe it was the tequila, maybe my oral habits, maybe my diet, or a necklace or collar they disagreed with. I don't know but what I did know was that after having close to ten infections in five months I was listening and they were definitely leaving.

The worst infection was probably the one that started the day I was flying to the States for the class I was taking in Chicago that summer. That one was bad enough that I was pretty sure my brain was going to fill with pus on the plane (I was given a fifty/fifty chance by my doctor). 10 hours and less brain pus later I made it to the city to start the class. I promptly had a nervous breakdown five days into the class when I came off the antibiotics and was sure that my tonsillitis was coming back that day. It didn't, it came back three days later, but it was still a little too close for comfort. I survived my class, and actually had one period of eight days in July where I did not have to take antibiotics before the tonsillitis kicked back in and I stayed on antibiotics until I took off and landed in Korea.

Upon arrival to Korea I slept. The next day I checked into a hospital for pre-op. The next morning I woke up in the hospital room to get the motherless organs out of my body for good.

I've been recovering from the tonsil experience the last couple of days. The hospital is a separate story and will be dealt with separately. There are also some things to write about from Chicago that got neglected. I realize a lot of my life got neglected over the last couple of months. I was so beaten down by being sick all the time that I just didn't want to do anything. Now I'm a little out of the habit. Out of the swing of not only caring, but of everything.

I'm so used to crawling into a ball to hide, feeling like the tonsils were some kind of gigantic gatekeeper between me and my true emotions. They boxed me in, cut me off from my creative avenues. This year I've barely spent any time writing, or sewing, or making art. I've just been obsessed with my illness. I have only minimally managed to keep up my gym life. And forget a social life. I stopped drinking pretty much anything but wine during the third round of tonsil infection. You see after the third infection I didn't get much pain in my throat. Instead I got migraines, chronic nausea and dizziness. Nothing says fun like going to the restaurant your friends own, having dinner, and then promptly throwing up in the bathroom not an hour later. It wasn't their food, it was totally my tonsils. The tonsils were taking the joy out of my life. I've missed the joy.

So I have a lot of making up to do. To myself and to anyone out there who might still be reading.

The tonsils have been freed. I don't know exactly what they will be off to do now that they have finally gotten their wish. Perhaps they are joining some sort of conservative Christian cult as a way to recover from the aforementioned lifestyle they were leading via being located in my mouth. I don't know. I do know that I'm happy to see them gone and looking forward to rediscovering myself and everything me during the next few months.