Tuesday, June 26, 2012

My Spinal Surgery: Health Care in Asia

 

At the tail end of my six months of misadventures in India, I lived in Goa for seven weeks. Turning a blind eye to the packs of wild dogs which would attack the lone late night wanderer on the beach and reduce him to a pile of bones, the hordes of hustlers who were always trying to sell overpriced and mostly worthless souvenirs or clean non-existent earwax from my ears, the pot-bellied police who were constantly looking for whatever bribe they could extract from the tourists, and the generally dour and completely mercenary locals who actually populated the place, I have to say I had a truly wonderful time.

To keep fit, I swam over a kilometer every day, making my way through the herds of cows who were nice enough to let me share the seashore with them. I learned the art of stepping over and around copious amounts of cow poop, a skill which here in ultra-sanitary Japan is unfortunately atrophying.

Toward the end of the seven weeks, I noticed a knot in my back between the middle part of my spine and my shoulder blade. I assumed it was just tension, the result of having to go through major negotiations every time I wanted to buy something.

I returned to Japan. This was February 2010.

The "knot" kept getting worse. By late March I was experiencing numbness and increasingly severe pain in my left arm. I became convinced that I had some sort of growth, perhaps a tumor, that was pressing on a nerve. I sought medical attention here in the rural part of Japan where I live. After X-rays and an MRI, one local physician told me I was just falling apart and he doubted anything could be done. Surgery was an option but it was very risky.

Those of you who know me have rarely heard me say anything negative about Japan, even with the tons of radioactive pollutants now pouring into the seas as a result of the horrible mess in Fukushima.  I will say, however, that this doctor's advice was less than helpful and certainly very discouraging. Plus it turned out very wrong.

On the plus side of the Japan equation, I did get substantial aid in my distressed state from a sports doctor here (who shot electricity through my aching arm) and a chiropractic clinic who used massage and a neck stretching and alignment device to try to relieve my agony. By now, believe me, I was in severe agony.

Unfortunately, none of this was helping. But let me just point out something amazing.

Japan has universal health care, meaning there is in place national health insurance. The individual pays a very modest co-pay, the system picks up the tab. Both the sports doctor and the chiropractic clinic, knowing full well I did not have national health insurance, only charged me the co-pay and let the rest of the fee slide. Think about that for just a minute.

Back to the drama.

Nothing was working. By the end of April, my condition was catastrophic. I literally could not be vertical for more than ten minutes. Something was pressing on a nerve in my back. Being vertical increased that pressure. The pain was excruciating. Now it wasn't just my arm that was numb, it was spreading down my left leg. I had trouble walking.

To make matters worse, I was coming up on the end of the 90 days on my visitors visa. That meant I had to leave Japan, then come back in to get a fresh stamp on my passport. This was not good. But I did what I had to do and booked a flight to Seoul. Flights to South Korea are frequent and inexpensive.

I should have had a great time in Seoul. For three days I stayed in a guest house next to a beautiful university, Hongik University which is famous for its Colleges of Design and Fine Arts. The area is a typical "college town" with fantastic restaurants, night clubs, shopping.

But I spent my time there on my back in bed, trying not to moan and disrupt the others in my dorm room.

 

Then I got the call. It was my best friend, lover, companion Masumi Nishida. She had been looking around on the internet to try to find some way to address my disintegration into a worthless cripple and discovered that a world-renowned spine specialist was on staff at a premier facility right there in Seoul called the Wooridul Spine Center. The facility was a huge, fully-staffed  state-of-the-art hospital next to Gimpo Airport, promoting what it called medical tourism. Medical tourism is a recent form of enterprise, encouraging people from around the world to visit and take full advantage of health services.

I wrote them an email, expecting to hear back from them sometime later in the decade.

I got an immediate response! They set up an appointment for me the next day.

It gets better. And I'm not making any of this up . . .

I reported early the next morning __ that itself was a harrowing, painful experience even if the subways in Seoul are among the best in the world __ and spent five hours as follows:

First I met with Dr. Zhang's foreign visitor assistant, a personable and competent young man named Charlie Shim. Then I met with Dr. Zhang himself. That was followed by an X-ray, CATSCAN, and an MRI. I met with Dr. Zhang again to go over the results. He was 90% sure he had identified the problem. Severe compression between the 7th and 8th vertebrae. They would perform a procedure which would confirm his suspicions and possibly temporarily relieve my symptoms.

I was dressed in a highly flattering hospital gown, then put in a surgical CATSCAN, one that allowed real time monitoring of the area of my spine they would be working on. The work consisted __ brace yourself __ inserting a 12" needle at the base of my throat and threading it through all of the nerves, muscles, bones and miscelleous sinew along the way, all the way down to the middle of my spine, and injecting a combination of cortisone and a local anesthetic between the targeted vertebrae.

Immediately after the injection had taken place and they removed that incredibly ominous looking needle, the pain on the left side of my body was gone. I practically jumped up and started dancing.

But they cautioned me. I had to wait 15 minutes. If the pinching on the nerve was too severe, when the anesthetic wore off the pain would return. Unfortunately it did.

Now came my final meeting with Dr. Zhang. He explained where things stood.

Though I was still writhing in unbelievable pain, we had accomplished a lot. As the good doctor pointed out, we now knew exactly where the problem lay. A nerve which served the sensory apparatus in my left arm and had connections down the left side of my body was experiencing 100% compression as a result of the collapse of necessary padding between the two suspect vertebrae. The good news was that this could be corrected by surgery.

My five hours at the Wooridul Spine Center finally came to a close with my paying the bill. Total amount = $562.

Wait! Can this be right? Three meetings and an examination by a world-class and highly renowned spinal surgeon, an X-ray, an MRI, two CATSCANS, and a major procedure involving a needle the length of a car antenna and it came to $562?

Yes, folks. It's true.
Since you're already getting the gist of this posting, I'll make the rest of it as short and sweet as I can, my tendency for being an incurable motor-mouth notwithstanding.

I returned three weeks later for surgery with Dr. Zhang. Charlie Shim had summarized all that was involved. Five days in the hospital. Pre-care. Post-care. Anesthesia, medications, surgery, food, my semi-private room with two other patients. Total estimated at $14,800.

As part of the "pre-care", I was given every test, scan, monitoring known to modern man. Frankly, the facilities at Wooridul are probably as technologically advanced as any in the world. I am despite my advanced years a very healthy guy. With one small noted exception (one heart valve functioning at 68% efficiency), I passed with flying colors, a physiological wonder and testimony to the merits of the regimen of exercise and good diet over most of my life.

After 2 1/2 hours of surgery, they wheeled me back into my room. I emerged from the fog and euphoria of a general anesthetic __ very nice stuff! __ and saw that there were about ten people staring at me. Nurses, assistants, Charlie Shim and Dr. Zhang himself.

"How do you feel, Mr. Rachel?"

How did I feel? Besides groggy?

I felt great!

I started to sit up. They told me just to rest.

Dr. Zhang then told me that my operation went perfectly. He was 100% sure it was a complete success, and if I felt like sitting upright that would be fine.

A nurse helped me up. Not only did I sit up but I stood up. Then I did a little dance. Everyone seemed to think I was crazy but I got a small round of applause.

I spent the next day recovering. During that time I made a promotional video__ I think it is still posted on the Wooridul website __ telling my story and effusively commending everyone involved. I also helped correct some of the English for the promotional material on the facility, working along side Charlie, who was responsible for such things.

Since I was doing so well, I checked out two days early. They fitted me with a neck brace. My last official act there was paying my bill.

Total charges for all of the above: $10,450.

But...but...but...they said it would be $14,800 in their estimate.

Well, I didn't stay the entire five days, only three. But the simple truth was, as Charlie explained to me on my way out the door, they really appreciated my help with correcting their English and doing the promotional video, so they were just returning the favor. They effectively knocked over $2000 off my bill.

Just returning the favor.

Okay. I know I am a novelist. So you are all thinking, "This John Rachel really expects us to buy another one of his wacko fantasies. He's still in satire mode from writing "11-11-11" and "12-12-12". You've seen his promo videos. The guy's nuts!"

True as all that might be, in this rare instance I'm merely reporting the facts. This is what happened and how it happened.

Since my surgery __ that was two years ago __ yes, I can feel "something" in my back. Certainly no pain. But maybe a little tweak. I mean, they spent 2 1/2 hours threading all sorts of exotic robotic instruments down the length of my spine, grinding and chipping away at bone, inserting some sort of supportive splint. You'd expect to feel something.

But I ride my bike every day. I have worked out at four different gyms (three in Vietnam, one in Taiwan), lifting weights and doing heavy cardio-vascular work. I still do a rigorous floor routine to keep from turning into a pile of jelly while I spew out more nonsensical books and annoying political rants.

I'm not going to preach or spoon feed anyone on this. Look at health care in America and draw your own conclusions.

I will add this in closing . . .

People have said to me, "Did you ever consider getting your surgery in the U.S.? America has great doctors and surgeons too."

Right. This would have cost minimum $50,000-60,000 there. Then there's the risk that some underpaid nurse or administrative assistant would make the wrong entry on my chart and I'd end up with my leg amputated or with double-D breast implants.

Consider getting surgery in the U.S.?

Give me a break!


[ This originated at the author's personal website . . . http://jdrachel.com ]