The short story is that we arrived in Taiwan, saw a hernia surgery specialist the next day, and I had the hernia repaired surgically two days later, staying overnight and being released the next day. That was Sunday a week ago and since I've been on the healing journey, gradually becoming more mobile, less inflamed, and recovering from a few minor side effects. The whole process was covered by Taiwan's national health plan at an out-of-pocket expense of under $150 US. You can see the doctor's website at http://www.hernia.com.tw/, but if you don't read Chinese you'll need to use google translator or something like I did.
I didn't feel at first that this was very good material for an email update, because it is after all a bit medical (well, I was going to say "gross.") But someone who has lived in Taiwan longer than I have recently noted that it seemed unusual to him that I would choose to do surgery here when I could have done it in the US. After all, most of the savings ultimately goes to the TEAM health plan, not to me personally. This got me to reflecting on how the medical systems represent a very significant part of cross-cultural adaptation, and remembering that this was not an easy part of our own journey in coming to Taiwan. If you're interested, you can keep reading… (Otherwise, you can skip to the last two paragraphs now.)
In the early days most of our health crises were with our young children, who of course continued to get sick after we came to Taiwan. Not knowing any local MDs and finding the Taiwan systems of care bewildering, in the early days each sickness was an adjustment crisis. Sure, ordering a pizza over the phone can be a crisis, too, but somehow the stakes always seem higher when someone in the family is sick, especially during the part where they're getting worse, before they start getting better again, or when they seemed to be getting better, but then had a relapse.
One nightmare was Joey having asthma crises, which we didn't know how to manage until later. Another time I had intense vertigo with nausea, from which I only recovered much more slowly than I thought proper. It was even a crisis when Sarah got a loose tooth, which we thought was permanent, but turned out to be a baby tooth, which we then learned is called a "milk tooth" in Taiwan.
Each time we drew on whatever resources we could, including local MDs, friends in the US with a medical background, and "Dr. Bob," a pediatrician who lived 8 hours away across the mountains in Taiwan, but always was kind to take our calls and provide some advice at a distance. Once we even got his personal attention when Joey got wounded on the basketball court during a retreat and Dr. Bob accompanied us to the local hospital where he was stitched up. Sometimes we waited to get medical attention until we could return to the US, although that has its own frustrations.
As the years went by, though, we were beginning to understand and develop familiarity with the local systems. One friend went with me to the hospital and helped me work through the clinic system so I could be seen by a specialist. Another friend recommended a family practice doctor near my home that began to manage our ongoing medical care in a way that inspired confidence, including referrals when needed or talking us down when we didn't really need more care. And, between visiting others in the hospital, getting medicines from MDs and pharmacies, and navigating the various health challenges that came our way, we gradually came to understand and accept the medical system in Taiwan.
To be honest, there are now some things I like better about Taiwan (low cost and rapid care) and some I like better about the US (better discussions with the MDs, more thorough evaluations), but I have basically come to believe both systems work somewhat well most of the time. Also, knowing what to expect definitely helps in whatever system.
So when I came to Taiwan this time, I knew God would have to be gracious for us to find a surgeon while we were here, I knew it would help to have some personal referrals and I knew who might be able and willing to help, and I knew they wouldn't give me nearly as much pain medication as in the US, but that Laura would spend the night in the hospital room on a cot nearby. (And she knew she'd be more comfortable if she brought a backpacking foam pad and a sheet!)
God was gracious. The first day we visited the hernia specialist, and he had had a cancellation for surgery two days later so I was able to get on the schedule right away instead of in a month. I know in the US the surgeon probably wouldn't have given a 4pm Saturday surgery appointment, but this was Taiwan. We completed the afternoon by going by my family practice doctor, paying another $6 US copay, and getting his take: "At the hospitals, they give the interns and residents the hernia surgeries because they need to practice, so you're better off going with someone who has done 10,000 of these as his stitches and technique will be better."
Instead of having a complete set of hospital garb, I put on the gown over a t-shirt and boxers, and they gave me the muscle relaxant and installed an IV shunt downstairs before walking me up to the surgery floor. Once I was on the table, they strapped me to a cross, and shortly thereafter I fell asleep. I really don't know whether they stuck to just using local anesthesia or if they made an exception for the wimpy foreigner! In Taiwan they don't feel a need to tell you all these things.
A couple extra-strength Tylenol for the pain and the next morning I was "good to go," at least from the MDs perspective. When I was in too much pain to get on the examining table he just redressed the wound while I was standing up and sent me on my way. When I came back five days later to get the stitches out, he said, "You were in a lot of pain last time!" (Yes, I'm just another North American wimp at best, maybe not even that!)
I went in to my family doc again today (another $6 US copay), got some steroid cream for the rash from the heat and my allergic reaction to the tape, and I think I'm well on my way to a slow recovery. Yes, I'm even off the Tylenol (and the ipbuprofen I was sneaking in between for the first several days J).
What is my take away? First, that our trust needs to be in God, no matter who we call on for help in this world, and we do need help. Second, there really isn't a first, second, and third world anymore. There are a variety of models and standards of care, and people in any given country can receive both good and bad care on any given day. Third, costs vary for many reasons, and not all of them are relevant to us personally. As a global nomad, sometimes I pay more for things, and sometimes I pay less. And we all like a good deal, but none of us like it when things go wrong, which they can most anywhere.
I hope if you've read this far that you've enjoyed this journey in medical tourism, though perhaps it's more like going back home for a surgery given that I've actually lived longer in Taichung than I ever lived in any other one place. It looks like this medical journey is on its way home and Laura and I are shifting our attention to enjoying Taichung a bit, re-engaging dear friends and coworkers, and soaking up a little time with my sister and her family whom we left behind here when we moved back to Colorado. Unfortunately, she is biking alone as I am restricted to "biking in flat places only" until about the time we leave.
Regarding the hernia, we're both grateful to the US MD who noticed it and the Taiwan MD who stitched it. And may God give you grace in your own journeys of adjustment and adaptation, wherever they may take you!
Yours in the one who keeps us, Steve and Laura
TEAM, PO Box 969, Wheaton, IL 60187, 800 343-3144
<spinella@alumni.rice.edu> <lauraspinella@alumni.rice.edu>
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1 comment:
Interesting post.
"there really isn't a first, second, and third world anymore. There are a variety of models and standards of care, and people in any given country can receive both good and bad care on any given day."
That is a truly profound statement.
Like you, I am also intrigued by the good and bad I see in the US healthcare system versus what I experience here in Taiwan. I thought your description of both was spot on.
Thanks for sharing your story.
-Michael
www.Taiwaneers.com
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