26 April 2009

The Sad Saga of My Left Testicle

My love affair with the Korean medical system came to its full fruition this weekend as I had surgery to repair various vascular components of my left testicle. This medical episode has been ongoing throughout my first year here and has been described in various post that I haven't the energy right now to hyperlink. I spent the night before I got here in the emergency room with this problem and have been treated for it twice since and several times before. Basically, for those not already sick of hearing about it, the blood supply exiting the left testicle has to go through the kidney to get back into the stream and in something like 40% of all men this causes a problem, especially when the affected individual is physically exerting themselves. The problem is further aggravated when these activities occur during warm weather.

As I enjoy moderate physical exertion (climbing, biking, walking, quoits) whatever the weather, I have become rather frustrated with the situation. I have had swelling and pain pretty much all of the time for the last couple of years and five times it has become bad enough that I have sought medical assistance. This week I finally said enough is enough.

The surgery was technically described as the "excision of the varicele and hydrocele of the spermatic chord." The procedure itself was quick and painless. I passed out when they put in my IV beforehand, but the injection for the spinal block wasn't that bad and I was awake throughout the surgery and felt nothing but some pushing and pulling. I was in quite a bit of pain for the first few hours but then they gave me a shot in the ongdongi (butt) that put my whole pelvis to sleep.

I began to worry, however, because they had dropped about 2 liters of saline on me by that time and they kept asking me if I had peed yet. Between the lingering affects of the spinal block and the local I couldn't feel my pee mechanism and I knew that another wrong answer was probably going to result in the dreaded catheter so I did what anyone else smart enough to know the difference would do: I lied. I told them that I had pissed like a horse and felt great. The following morning, still having not peed in reality, I lied again and told them I didn't have any pain and refused the local butt shot. At this point I got feeling back and could consciously open my urethra.

Some interesting differences about the Korean hospital experience:

  1. "Do It Yourself." There is an amazing degree of self-help expected of patients at the Korean hospital. I was given silverware with my first meal and thereafter I was expected to clean it after each and keep it in a secure place for the next. If you want a bath: "There is the shower room! (Hope you brought a towel)." Thirsty? There is a water cooler in the patient's lounge down the hall. Need to use the internet: two coin operated terminals in said lounge (W100 [.07 USD] for 5 minutes). PJs come with the room but if you didn't bring slippers those will cost you W2000.
  2. "Help Yourself." If you press the "help" button every nurse on the floor sprints down the hall to your room figuring you must be dying. I only saw a light come on once in the 48 hours I was there. They never even told me where it was. There was an astounding amount of cooperation and assistance in our little room. Yujin and I helped the guy recovering from a major abdominal surgery and he reciprocated by letting me watch two innings of baseball (remote control control was apparently dictated by seniority).
  3. "If you can't 'Do It Yourself' bring your family." (Or your girlfriend) Every bed had a fold-out cot underneath and the majority of patients had at least one relative attending 24-hours a day. In some cases entire families were there. Yujin, godsbless'er, wanted to stay but I got her to go home on the pretense that the cat needed care. (Still, she once again saved the day with Snickers, snuggles, and smiles, even smuggling in a Big Mac when I had pegged out my kimchi-eat-ometer.) These family members did everything that in many cases would fall to CNAs in American hospitals and nursing homes. The nurses were there for medical assistance only.
  4. Needles. I would say that over 90% of the hospital patients were on IV drips. Into this went everything that wasn't intramuscular (that went in the bottom). I didn't get a pill to take, not one, until I was discharged. (I cheated and took three Advil I had in my hangover kit during "Operation Urethra.") The hospital I went to specializes in treating foreigners and the nurses were ready for my squeamishness. They told me that Koreans are used to shots and I believe them: when you go to a pharmacy for a prescription here they ask you if you want pills or an injection. They love the needle here.
  5. Speed. I walked in to the hospital and when they asked me what was wrong i pointed and was sitting in front of a urologist in three minutes (you take a number!) I entered the operating room at a trot and was there for thirty seconds when they maneuvered me into a fetal position and stuck a needle in my back. The last thing I felt down there was my pants being jerked down. I then heard an electric shaver and some sounds like someone sorting silverware. I asked a guy standing there (I think the anesthesiologist) when they were going to start the operation and he said they were finished.
  6. Money. I have remarked on this before but I am continually astounded by how much you get for your money here. It makes the American medical system seem like a huge hoax. Two days room and board, sonogram, x-rays (chest and ab), complete blood work, electrocardiogram, urologist, anesthesiologist, surgeon, operating room, and all meds: less than $500 USD. And I think my co-pay was over 50% because this was elective. In contrast, the one-hour visit to the ER the night before I left is over $2000 now and the bills are still coming in.
All in all it was a wonderful experience. I may go back soon and have them look at the other problem area(s). Stay tuned.

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