Sunday, January 18, 2015

What to Expect in Korean Hospitals

When you check into the Korean hospital you'll need all of your basic information. You'll need your ID card as well as your insurance card, National Health Insurance is tied to your ID card so you don't need to bring it in. Also, unless you are at a very large international hospital you will probably need someone who can speak Korean and help you translate.

There are three options for hospital rooms in this country. You can book a single, which at a big hospital will run you close to $500/night, a semi-private with two beds, and that was about $200/night even with insurance, and the dorm style that has 6 beds, which cost me about $12/night. You also have options for meals. You can choose the Korean style food, where it is $3/meal and you can choose juk or rice, or you can choose western style food, which costs over $36/meal. I suggest the cheaper Korean food because it's not bad and the western style food wasn't very good.

Now, there are some major differences between hospitals here and the ones back home. Since Korea is such a family oriented place, it is expected that your family will be there to take care of you. The nursing staff is only there to push pills and take vitals. It's your family's job to help with the food trays, adjust the beds, help go to the bathroom, help shower, change your scrubs and sheets, and basically do everything for you. There is always a cot provided for a member of your family to sleep on. In Korea there are no visiting hours, so there will always be a ton of people in your room at all times. The Koreans were very helpful to my mom and offered her a lot of fruit and snacks. But, they were also very curious and loved to come and stare at me. If you are alone in the hospital and had surgery, I would recommend convincing a friend of yours to be there at all times to help you. However, if you're not so ill and can do things for yourself then it's not really necessary.

Now, it's not uncommon to see Koreans wheel in a small suitcase while they're staying in the hospital for a while. I recommend you do the same. What you really need are the following:
  • NEED:
    • ID
    • Insurance card
    • Slippers
    • Toiletries
    • Towel
    • Something to do (dorms don't have TV)
    • Water bottle
    • Tissues
  • SUGGESTED:
    • Some mat or blanket to put on your bed because they're hard as rocks.
    • Pillow and blanket for the person staying with you.
    • Snacks and drinks
    • More things to do!
    • Food from the outside world
    • A neck pillow
You won't need extra blankets for yourself, since my room was kept at a balmy 90 degrees. I had to roll up my scrub pants and roll up my shirt sleeves just to prevent myself from sweating through the bed. Also, don't be scared to tell the nurse to use hand sanitizer or double check what they're doing. My nurses never washed their hands and made so many mistakes. They even tried to give me an IV they had just taken out of another patient. Be vigilant and aware of what's happening. Also, ask tons of questions. 

No one likes to stay in the hospital but in Korea it's fairly normal to stay in. That's because insurance covers more if they're an in-patient and their work will excuse them. So, some of them don't mind spending time there. That means, if you feel that you are well enough to go home then ask your doctor if you can be released. This worked for me. It never hurts to try.

Surgery Away from Home

WARNING!
Korean Hospital Stays are Horrendous!

I guess my story started out on a hot summer day. I was completely stressed out after teaching my students, who are 5 years old, all day. I just happened to lean back and rub the front of my neck and that's when I felt a weird lump. I thought I was being a hypochondriac since my cousin had just been diagnosed with papillary thyroid cancer (PTC) earlier this year and he's the same age as me. So, being the worry-wort that I am, I had my friend feel my neck to see if they could feel the same thing as me......and she did. (sigh) Off to the doctor I went.

Clinic

I went to the doctor that same day, because in Korea you don't need to make an appointment to go to the clinic to see a doctor. Also, in order to go to an actual hospital you need a letter from the clinic recommending you to the larger hospital. But anyways, I walked across the street and basically right into the exam room. He didn't speak much English but he could feel the lump and we decided to get an ultrasound to check it out.

We found that I had a large nodule on the left lobe of my thyroid that should be looked at further. The doctor there wrote a sort of recommendation letter that allowed me to go to a large hospital and be covered by insurance for further testing.

Asan Medical Center

Asan Medical Center
I went to Asan Medical Center, which is located in the Jamsil area of Seoul, South Korea. My doctor's name was Dr. Nam and he could speak fluent English. Since this is one of the biggest hospitals they have a wide variety of English speaking doctors and and International Center that helps people like me, who don't speak Korean. 

The first visit he just looked inside my throat at my vocal chords, I guess having one side paralyzed is a sign of cancer, and felt my lump. He decided to give me antacids to help my vocal nodes, which were discovered that day, and some voice therapy, that I declined. He seemed more worried about my voice than my neck and that frustrated the heck out of me. But, he still scheduled me for a fine needle aspiration (FNA), which is a biopsy.

Biopsy

When I went in for the biopsy it was just a normal day and the International Center volunteer helped take me around the hospital, talked to the nurses for me, and translated the instructions. I went in for the biopsy and they did it by ultrasound visualization. They stabbed me with the needle three times from different angles and they all hurt but the third one made the tears run. He had to punch the needle through one of my muscles in my neck and I don't have the smallest muscles. He had to shove that needle really hard and then wiggle it around in the node. I know that some people say that it's not so bad, well it can hurt like all hell too!

It took a long time for me to get my results back and he didn't seem worried at all about it. He thought that I should just keep an eye on it and see what happens in the future. However, I went back later because it was pressing on my larynx and esophagus and was being a big pain in the neck! Hahahaha! Get it?! This is also where I threw a hissy-fit because the doctor still hadn't checked my thyroid hormone levels. So, I forced him to give me a blood test, where everything turned out fairly normal. 

Admission & Thyroidectomy

After talking with the doctor, we decided that I should get a hemithyroidectomy. That's where they remove half of your thyroid. We decided on this because the chances of cancer were low and if it wasn't cancer, I would have to be on hormones for the rest of my life if I got a complete thyroidectomy. This whole time he was confident that everything would turn out just fine. That day, even though the surgery was scheduled for months later, I did my EKG, blood work, urine tests, etc. for hospital check-in. Isn't that weird?!

Listening to the TV in my semi-private room.
Then it came time for my surgery. I had to be there a day ahead of time just to sit in the hospital and take up space. I had to check in at 1:00 and hope that there would be room in the 6 person room, because that's the room that insurance pays for. But of course, there was no room in the inn. So, I had to stay in a semi-private room, meaning I had to share with one other patient and her entire family. I just had to stick around all day and wait for the doctor to come to my room to tell me when the surgery would be the next day and to explain the surgery.

It wasn't until I was asleep and it was around midnight that the doctor came to my room to explain the surgery to me. I had to go and talk about the risks, get markings on my neck, and instructions for the morning. I was also taken in a room so he could look at my vocal chords one more time. The worst part was that he didn't have all the equipment necessary for this procedure. So, I went back to bed and was woken up later when he had found all the necessary items. Finally, I got to bed around 1 am. 

At 5 am I was woken by the nurse and told I couldn't wear any underwear, bras, or socks for the operation. I also washed all my makeup off and had to take my toenail polish off as well. Then I was given my IV, where they screwed it up and I passed out. At 7 am we were awoken so that my neighbor could have her breakfast while I just sat there starving because I wasn't allowed to eat or drink. I was also messaging my mom, who was back in my apartment, to hurry up and come so that she could see me off before surgery. Then at 8:20 I was wheeled out on the surgical bed to go down to surgery, and my mom still hadn't arrived. 

It was very nerve racking as I was being wheeled through the corridors going into surgery. It was just like one of those hospital movies where all you see are the lights passing you by tunnel style. I was brought into a room where I was prepped for surgery. They did the usual, they put a hat on my head, a blanket on my body, and gave me IV antibiotics. Then I was wheeled into the OR. 

I couldn't believe my eyes when I was going into the room, the nurses/doctors were all in there just sitting on there phones messaging/kakaoing people. I thought that it was supposed to be clean in there and that they should have had their hands washed and gloves on. That's where I started to feel uncomfortable. I had to change beds in there and my IV was almost ripped out by a nurse who was rushing and didn't give a damn. I was strapped and tied down on the table and asked if I had any last words, like I was being sentenced to death. If I was going to my death, my last words would have been "Don't screw it up!"

When I first came to, just for a moment, I was asked to say the sound ee. I guess that shows if any nerves had been damaged in the surgery. I was expecting to sound raspy and horse but my voice sounded clear and good. I was so surprised that I said, "Oh, my voice sounds GOOD!" and then I quickly passed out again. 

When in the recovery room, not one of the nurses came to check on me except the initial check to put the blood pressure cuff on me. After that, they stood around, checked their phones, and attended to the Korean patients. Racist much?!

During my 2 hour mophine high.
After I got wheeled upstairs, I was greeted by my mom, who I could tell had been crying since she missed my send-off. Her and a nurse helped move me onto my new bed, which was in the 6 person dorm style room. They also had to change my shirt because there was iodine everywhere! It was even in my hair! Then I started to cry because the pain became too much to bear. Finally I was given some, what I am assuming to be, morphine and I felt good for a full two hours. I even got up to walk and talk to my mom. However, I soon slipped back into pain and the only other medicine I was given was like a liquid Tylenol. I had to wait 8 hours to get morphine again. 

For that whole first day, I was only able to lay in bed in pain and whisper to my mom. At the end of that day, a trainee doctor came around to check on my wound. Instead of gently feeling around the incision, he grabbed a fist full of my neck and squeezed. I though I was going to die! That's when the nurses rushed into my area and gave me some more morphine and I drifted off to sleep for two hours, the last sleep I would have for a while. I had to stay in the hospital for a total of 3 nights and I thought my ass was going to fall off from how hard those beds were! I forced myself out of bed just to walk around so I could feel my fanny!

While I was in the hospital I saw some of the worst practicing nurses of all time. There were no gloves, no religious washing of the hands, and none of them even used the hand sanatizer that was provided at the end of each patient's bed! I was also told that sheets were only changed every 3 days and so were the hospital scrubs. Not exactly the germ free environment that you want after surgery. I was also told I wasn't allowed to shower there either. However, the worst practice was by a nurse who gave my IV pain medicine to the lady directly across from me. When she realized this, she took  those pain meds out from her IV, put her pain meds in and then tried to give me the used and contaminated IV meds!!!! OMFG!

Discharge

The real nurse who actually worked.
Eventually, my drain was removed, my wound was redressed, after two days, and I was able to pay and leave. It was about $2700 for everything but we had to pay it all upfront. Then we had to go back upstairs to get my meds and pick up our stuff from my room. They wanted us out so badly that they had thrown some of our stuff away, including the flowers my mom had just bought me. But, I didn't care as long as I was able to get out of that 90 degree hell hole they call a hospital. 

I spent the next few days sleeping and doing nothing at home while my mom watched me sleep or cleaned my house. I was on meds and in too much pain to do much. Just walking outside for a short period of time tired me out. But, I had to return to work just 5 days after the surgery.

Going back to work was HELL!! I was so tired and I still didn't have a strong voice. Try controlling 12 5year olds with no voice while you're not able to bend down or move your neck. Luckily, I was able to leave work early that entire week. And then my mom went home.

Follow-up

The next Tuesday, about 13 days after my surgery, I had to go in for my follow-up and to get my pathology results. When I went into the room the doctor wouldn't make eye contact with me and would just try calling on his phone or messaging. This went on for a long time. Eventually, I looked at the computer screen to my left of find out my results by myself. There it was, after all the reassurance I had gotten from the doctor that everything was going to be okay, after I had told my mom not to worry and to go back to the States, and after I had convinced myself that everything was fine, it was staring me in the face. I had cancer.

I couldn't believe my eyes. There I was by myself, just after my 30th birthday, finding out that I had cancer. I felt like I had been hit by a train. That means more surgery and more treatment. The doctor still didn't know what to say. It was that day that I had found out that I had follicular neoplasm going into the surgery and every doctor knows that you can't tell if it's benign or cancerous from a biopsy and that surgery is always recommended. This doctor had told me to wait and that it wasn't cancer. He reassured me countless times that "it was not cancer" not that the odds were low. So, needless to say, I was quite surprised. Then, being as freaked out as I was, I forgot to ask all my questions and just walked out to call my mom and tell her the news.

I cried and cried. What was I supposed to do? I hadn't re-signed my contract with my school because he was waiting for my results to come back. Would he hire me now that I have cancer? I can't go home because it would be too expensive in the States and no new school would hire me because I would fail my physical. My mind was spinning and spinning. 

Luckily, my boss has re-signed my contract so that I can be covered by National Health Insurance here in Korea. I also filled out paperwork for cancer patients and I will get additional insurance benefits because of this. But, I'm still waiting to see the doctor to see what my next step in treatment will be.

But, I guess if I had to get cancer, getting thyroid cancer is the best one!