Wednesday, January 28, 2015

Limping through Korean health care


The outset of my journey was a precarious one. As is any involving health care I suppose. Nearing midnight, I found myself lying on the filthy brick court just under the basket. Before I know it, faces appear before me and that numbness in my ankle starts to regain some feeling. That's when a string of three or four obscenities pour out before my impulses wane and I realize that screaming does nothing to ease the pain.

“It's probably just a sprain, there's no way it could be broken,” said my usual opponent James. We match up well height-wise. We each have different strengths, he with his shooting, me with my quickness. If he gets the ball, I can't defend his shot; so I play a tight defense in order to intercept any pass that comes his way.

“He's probably right,” I thought. “If it was broken it would hurt more.” Completely forgetting that time in eighth grade when I fractured my right foot playing basketball with my brothers in Denison Park. I limped home after some prodding to suck it up and keep playing. Here I was, 15 years later, limping off a court on the other side of the world, ending yet another basketball game. This group slightly more forgiving than my brothers were. With each step, a tingle shot from my ankle up through my leg. As pressure fell down on the injury a warmth surrounded the affected region before the pain abruptly took over.

“You probably won't be able to walk for a couple of days”, James continued. Apparently he had some experience with bad sprains. That's when I began worrying about work. How many days I’d have to take off, how serious is the injury? Those thoughts really began to run after the visit to the ER.

The pain and swelling just got worse and so Mihai and I took a midnight cab to the hospital for an X-ray. When I finally spotted my leg on the screen I naively remarked, “It doesn’t look so bad”. The male nurse giggled slightly and assured me I was wrong by pointing out a misplaced chunk of bone. They gave me meds and sent me home to return the next day to see the orthopedic surgeon.

Eagerly anticipating my real doctor’s visit, I mulled over how I was going to tell my boss. It had been a year and a half, more even, without taking sick a day. I’d need a doctor’s notice. How many days should I take off? How soon can I get back? By the end of my meeting with the doctor my questions were answered for the most part. In somewhat broken English I was informed that the bone is not broke and in two weeks we’ll find out if the ligament damage is severe enough to have surgery. “Come back in two weeks?” I thought, “Here we go again. Another one of these hospital routines where I just keep coming back just to be told to come back in two or three weeks.” I had no clue when it would be healed and, until then, I was stuck on crutches.

Finished by 10 with plenty of time to get to work.

Work had just gotten difficult. I’d taken on an extra hour and a half of teaching preschoolers. My schedule was the heaviest I’d had yet and I had this injury to top it off. Either way, things were going ok for me. I didn’t have to ask for any sick days. I just had to figure out how to manage this work schedule on crutches. The key, was insisting from the very beginning that the injury would not hamper my ability to teach.

Instead of carrying a basket up and down the stairs, my books were loaded into a backpack on my back, and I made good use of the elevators. Instead of taking my 10 minute breaks between classes upstairs in the office, they were taken in class, hanging with the kids or correcting papers. In this way, I may have managed to display greater effectiveness with more face time with the students.

I dreaded the idea of having to get a surgery, thinking of the costs, possible complications, misunderstandings with poor communication. Before that though, I had to fork over nearly 500 dollars to get an MRI done that wasn’t covered by the National Health Insurance. Wait another week for MRI results.

Finally, some good news. No surgery. I did however have a broken foot. Wait another two weeks for the swelling to go down so that a cast can be put on.

As the next couple weeks passed I really fell into the routine at work and it got quite easy. My small apartment made life easier, as I could easily roll around in my computer chair to get a drink or something to eat. Meanwhile, Mihai was the greatest help. Suddenly, all the shopping, bill paying, cleaning, taking out the trash, was loaded onto her shoulders. To top it off, our exciting weekends of exploring Korea were now confined to a small area around Yeonsu where I would easily tire with the crutches. She remained next to me, helping me the entire time despite obvious frustrations.

Next doctor’s visit and I get my first cast put on. I’d had a broken leg and a broken foot before this and had always somehow managed to avoid getting a cast. Wait another two weeks.

Life with the cast was harder. It was harder to fall asleep. The weight of my fiberglass foot made lying in bed awkward. The swelling went down even more within the cast which made for an awkward positioning within the hard-cover. Luckily, it only lasted two weeks. The creepiest part of wearing a cast was when they took an electric saw to my leg to remove it. Start physical and wait another two weeks.

Physical therapy was a relaxing routine of warm lights and suction cups. After of a short wait they called me in. After taking some time to get my leg wrappings off I layed down and relaxed as a white light was brought to my leg for 10 minutes or so. Next came 13 minutes of suction. This was usually the best part, with exception to those couple of times when the intensity was turned up a bit much and I periodically experienced the grinding of something hard against my bone. Finally, they brought over a red heat lamp for another 10 minutes. Physical therapy became a perfect time to review my GRE word cards or listen to my podcasts. This would happen three times a week until I could finally ditch the crutches.

Two months in, at a doctors visit, I was told that this may be my last visit regarding this injury. Over time, doc and I had gotten used to communicating with each other and it was no longer quite as hard for either of us. He prescribed me four more weeks of crutch-assisted walking. That would mean that I could finally ditch the crutches at the 3 month mark following the injury. Deja vu, the other ankle also had a three month crutch time. Finally, the end was in sight. Of course, he had to add another scary element. A fresh x-ray had shown a chunk of bone still floating around in there, as well as the fracture that was still healing. He assured me that it was all normal but I would have to “take it easy” for the next 6 months.

I left that last doctors visit with mixed feelings. I suppose I left all of them with mixed feelings. Finally, I could start using my foot, but 6 months of taking it easy? I don’t even know what that means. I suppose I can’t snowboard, but can I hike? Will I be able to run or jump? That “taking it easy” period will last through a long-awaited trip through Southeast Asia.

Those preschoolers were wide-eyed for about five minutes when I finally walked into class. For the three months they had known me I was always accompanied by my rickety metal friends helping me along. There amazement waned as we began the day’s lesson.

Costs:

I’m not sure how much my whole ordeal with my last ankle injury in the US amounted to but from what I’ve been told, health care in Korea is both efficient and cheap. I have national health insurance in Korea and I found some things to be covered and others not to be. My first x-ray and visit to the ER was not covered. This put me back about 90 dollars. The MRI was not covered, nearly 500 dollars. I only needed a week worth of pain med which only cost me about 7 dollars. Doctors visits were about 6 while physical therapy sessions were about 4. My final x-ray was about 40 dollars and the cast was 20, I think. Including the cab fare and it added up pretty quickly. I supposed I just should have invested in a good pair of basketball shoes.



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