Wednesday, October 13, 2010

National Health Care!

As some of my readers know, I have a jaw disorder called TMJ (Tempromandibular Joint disorder). I was diagnosed when I was in the fifth grade after a mysterious and excruciating pain arose in my jaw that made it difficult to chew food as soft as the noodles found in my chicken soup. After a few weeks of the pain persisting, I went to a specialist who figured it out. I underwent some physical therapy in the form of intensive full body massage followed by hot packs (rough, I know), and it got better. Since then I've stayed away from gum and taffy, and it's mostly been ok. I'm a lucky one--some people have TMJ so bad, it causes intense migraines and chronic pain every day.

So, that was when I was 10 years old. My TMJ has been pretty dormant for most of the past 15 years with a few slight exceptions. However, strangely enough, a few weeks back it flared up, full force. I really don't know why, nothing in my jaw behavior has changed. I haven't started chewing gum--something I haven't done regularly since I was 10. As a rule I stay away from taffy and caramel, and if I'm feeling a headache coming on, I'll avoid anything even mildly difficult to chew. Nuts, salad, sweet-tarts. Contrary to what you might imagine, I'm not entering any yodeling contests either. But who knows? Moving to Korea and starting a new job amid a populous who don't speak my language or understand my culture--this is a major life change. Maybe it's related to that and the resultant stress? It's possible. At any rate, I realized after a week of Tylenol and no real change in the pain that I needed to do something more about it.

Quite conveniently, there is a Korean traditional medical clinic on the bottom floor of the building that Moon Kkang is housed in. Since arriving here, I had been wanting to check them out and see about getting acupuncture treatments just as a practice for general health and well being. With the return of my TMJ pain, I had an even more pressing reason to go. Two Mondays ago, I decided to give it a try. Joe accompanied me to help with the language barrier. We stepped into the waiting room, removed our shoes, and gave the receptionist my national health card. Less than five minutes after entering, unscheduled, I had filled out paperwork, and the doctor called us into his office to talk to me.

He wore a pale blue lab coat and a tie, and gestured to two comfy wings chair before taking a seat at his mahogany desk. We sat, and I looked around at certificates on the wall, a few photos on his desk, and felt the plush blue carpet under my sock-feet. I explained my pain and my history. Joe helped with the finer points. In broken English, but with only minimal help from Joe, the doctor said what my specialist said all those years ago. TMJ is a difficult problem to treat, and many doctors are unsure of what the best treatment is. He tacked on that this is true weather you chose to treat the disorder with eastern or western medicine, or a fusion of both. Then he had me hop up on the patient table which was discreetly tucked against one wall of his office. He felt my jaw, my neck, and my back, applying pressure gently. He asked me to open my mouth and say "ahh." He had me lay down and took what I recognized from previous acupuncture treatments in the states as what could be described as my "Qi pulse" (though this is probably really bad terminology, of my own mixed creation). Basically, he took both my wrists in his hands for a few moments, rested on my abdomen, in a different grasp than a western doctor or nurse would use to check the pulse of the blood. He then gestured that I sit back down in the chair.

He asked about any shoulder, neck or back pain, all of which I confirmed. I must admit, that's kind of the status quo, I have probably neglected it from being used to it. He said that though this is a difficult problem, he would like to try his best to help me. He said he wanted to see me 3 times a week, and that he would focus on the TMJ, but also attempt to treat the pain along my spinal column as well, as it is all connected. He explained that he thought acupuncture would be a good method to try. He seemed to be checking in with me about this, with an inquisitive, uncertain facial expression. I smiled, nodded, and said it sounded good to me--I had entered his office expecting to find treatment with acupuncture. The doctor stood up and opened a door that we had not entered through, at the other side of the office. At this point I looked at Joe, who had been helping bridge the language gap all along, because I was confused about what was next. I thought now was the time to make an appointment. My mistake! Now was the time for treatment!

I was immediately led through the back door of the office and into the treatment area, which resembled an ER. Exceptions being that it had low lighting, and a pleasant aroma of light incense. There were several beds, all in a row, separated by curtains. The nurse gestured to me to lay down and then brought a heat pack to drape over my abdomen. She turned on a heat lamp. I rested there for maybe 5 minutes, quietly chatting with Joe, before the doctor returned, and began the treatment. He wiped my temples and spots on my arms and hands with alcohol swabs, and inserted several needles. Perhaps 15? I'm not sure. He spoke to the nurse in Korean, who then attached electrodes to two of the needles. The doctor smiled softly and said "This, electricity. Do not afraid, normal treatment." I smiled and said, "It's ok," thinking of how I had sat with my grandmother a few times while she received the same treatment for her shoulder bursitis from our family acupuncturist back home.

I lay there for about twenty minutes, resting my eyes and trying to focus on my breathing. It felt good. Calming. Eventually, the nurse returned, removed the electrodes and needles, and told me I could go. I went to the counter to pay. It amounted to a total of 5,500 won, about the equivalent of $4.95. Hurrah for national health coverage.

Within 40 minutes of walking into this Korean medical clinic, I had filled out paper work, talked to the doctor, received treatment, and headed back out the door, early for my work day. I felt sort of heady, to be honest. Like I had just experienced some kind of miracle. I have a medical problem, and I am getting treatment. Immediately. At a cost I can afford. What is more, I have been back what, 6 times now? EVERY time I go there, without an appointment, I walk in and I am immediately taken to the treatment room where I lay down, I am given a heat pack, the doctor arrives and treats me, and I leave, within 40 minutes. Every time. Now, I know they are expecting me, but it is not the same as an appointment. They simply ask that I come on Monday, Wednesday, and Friday. They don't care what time. I haven't missed one yet, but I imagine if I did, that would be alright, no penalties. No cancellation fee. And each time I go, I pay about $5.

Prior to this experience, I had some medical issues I was dealing with back home, and the actual medical problem aside, it was less than pleasant. Each time I went to see my doctor, though I had appointments, I always had to wait for a good 20-30 minutes. Of course, by now I have accepted that as standard with any doctor appointment back home. That's almost always been the case, no matter where I've gone for treatment. Each time I went, I had to pay a $25 co-pay, even if all I did was talk to the doctor for 10 minutes (after waiting for twenty) and then have a prescription written. And of course, the prescription would then cost another $15-$30. Maybe more, if the prescription was not available in generic form. In this recent debacle, I had to have some lab work done, which amounted to much more than I ever would have dreamed of (thanks to my naivete). If I had better insurance, more would have been covered, but my low income demanded that my health care coverage be affordable (which means VERY basic with an inordinately high deductible). I'm still paying off the bill. I know my story pales in comparison to that of many more Americans frustrated and bankrupted by the same problem.

I did not intend for this to become a rant on the American health care and medical system, but it seems inevitable at this point. I've been bold enough to hope our country could work to create a better system, more so since I've been old enough to fully grasp what that means, but I'm beginning to become pretty disillusioned and frustrated. And I don't even have real medical concerns. In the 1960s, Korea had a GDP about equal to that of Ghana in West Africa. In the short time from the 1960s until now, Korea has grown to be have a market economy that ranks 15th in the world. One of the "Asian Tigers," Korea is included in the list of G-20 major economies and is included in the "Next Eleven" countries, which means it has high potential of becoming one of world's largest economies in the 21st century. How long now has the U.S. been an economic superpower and the world's wealthiest nation, and completely incapable of providing all of its citizens with adequate health care. Even minimal health care. Ugh.

It is such a wonderful feeling to know that if anything should happen to me while I am here, I don't have to worry about how much it will cost to see a doctor. This is something that used to cause me a lot of anxiety, and has probably delayed me from seeking treatment at times. I recently met someone who is also teaching here, who broke his arm last year. He was immediately taken to the hospital in an ambulance, saw a doctor within 5 minutes of arriving at the ER, and left with the bone set and a cast on his arm inside of half an hour. The cost of everything, the ambulance ride, the emergency room, the set and cast? About $5.

I will say that I sincerely hope that our country is capable of real and lasting health care reform. I know the problem is very complex and driven largely by capitalism and the almighty dollar. It is not so easy to change, as it is connected to every other part of our economy. But one can hope. However, I am deeply grateful to have this opportunity to utilize the gift of national health care while I am in Korea in a meaningful way. I am grateful to be able to see first hand how the system can work--it is not just a fantasy.

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