Over the last two weeks I have been having an increasing backache, that was steadily getting worse. By wednesday the 30th of October the pain was getting aggravating and I had occasional spasms that shot down into my right leg. I still went to work, but in the afternoon I called an orthopedic surgeon who specializes in in the spine – Dr. Tan Chong Tien. He agreed to see me that afternoon and I took a taxi to his clinic, which was located in a large hospital not far from the Embassy.
He examined me thoroughly and diagnosed a herniated lumbar disk. At the time I could still move well enough to walk, and so the decision was made to place me on muscle relaxers, an anti-inflammatory drug, and a medication that helps with nerve irritation. I was also scheduled for physical therapy to start the following week. I did some research online and discovered this was the normal routine. On the 30th (Friday), I was at work, and not feeling any better. I had to stay seated to hand out candy to our staff’s children who came door to door within the Embassy for a mini Trick or Treat event. I felt like crap! When I went home that night I was in much more pain, so I took my meds and crawled off into bed.
Friday night was not fun. I couldn’t find a comfortable way to stop the pain, and by Saturday morning I was in severe pain and virtually unable to move without shooting pain down my right leg. I called Dr Tang and he wanted me to get to his clinic immediately. I called a taxi and when we got there the taxi driver went to get a wheel chair and help. A hospital orderly wheeled me up to Dr. Tan’s office were he quickly examined me. A shot of demerol for pain and I was rushed up to the ward to await an MRI.
Herniated Disk
About an hour later I was wheeled to radiology and an MRi was done. By then the demerol had reduced much of pain, but my right leg knee was numb. When I got back to the ward an IV was started and Dr. Tan came up with the news. My ruptured disk was now much worse, and a lot of disk material has squeezed up between two vertebrae and was pressing on the nerve that controls my right leg. He said I needed surgery, and with my permission he would schedule it for the next day. We talked for a bit and he described what he would do. He needed to cut a small window through the bone in my spine, and use micro instruments to remove the disk material that was causing the pain.
That evening I was started on an IV drip of morphine and I sleep quite well! The next day I the usual lab work and chest x-rays as I was going to go under general anesthesia. I have asthma, so the anesthesiologist ordered me a nebulizer treatment to reduce the risk of me having an bronchial-spasm (asthma attack) during the surgery. I was wheeled down to the operating room and when I saw my surgeon I begged him to please not screw up the nerves to my right leg as I wanted to ski again! With that, I saw the anesthesiologist push some drugs into my IV.
Suddenly I couldn’t breathe. I felt like my lungs had no air, and I I was very disoriented. I heard my anesthetist tell me to breath slowly and that I was going to be OK. I tried to sit up but but he held me down and told be that everything was ok, and that my oxygen saturation was 100%. I didn’t understand why I was having this reaction or feeling and then slowly I realized that the operation was over and I was feeling the effects of waking up, and having the endotracheal tube removed. That was a terrifying feeling, but I do remember that as soon as I heard that my O2 sats were normal I calmed down and even though I had a hard time breathing I trusted completely in the crew that were taking care of me. I worked for over 20 years in the medical field (sort of a cross between a nurse practitioner and a paramedic) when I was in the Air Force and learned to trust my colleagues completely. This helped me remain calm while they continued to work on my recovery. I was also amazed that I had no memory of going to sleep, and was surprised to learn the surgery lated 3 hours.
Dr Tan told me that the rupture was worse than he had thought, and the disk material had worked its way around the nerve root and quite a ways away from the original damage site. My back was stitched up and I was left with a 2″ scar. Within a few hours I was more awake and had absolutely no pain or notable soreness. I could move me legs easily, and wanted to get up, but was asked to remain in bed all day and night.
The nurses were first rate, and checked on me all night. All I wanted to do was go home, but Dr. tan insisted I stay in the hospital for two days so he could watch for bleeding and any other complications. I refused all my pain meds, as I didn’t need any. I felt zero pain, over the next two days became quite restless and wanted to go home so bad. I am not a good patient, probably the result of being on the other side of the bed for so many years.
When I checked out I got the bill. In Singapore, everyone has health insurance – and foreigners are also expected to pay. I signed the bill which came to about $15,000 in U.S. dollars. That covered the inpatient care on the ward for 2 days, ICU care for 1 day, the operating room suit, the surgeon, the anesthesiologist, the lab work, and the MRI. I have the Foreign Service benefits Plan health insurance, which is a U.S. Government sponsored health care system much like what our members of congress get but with additional features for Foreign Service members serving overseas. The Embassy picks up any costs that the insurance doesn’t which in this case was my deductible and co-pay. I paid absolutely nothing out of pocket, plus the Embassy agreed to pay for any care that I receive relating to this incident for the next 12 months. This is one of the benefits we get when we are admitted to a hospital overseas.
I took the rest of the week off, and had time to think about this whole situation. The medical care in Singapore is so good that the U.S. State Department sends its members here for care from posts all around the Pacific. I had called a leading orthopedic surgeon, a specialist in spinal care, without a referral and got in to see him that same day. When I needed an operation, I was admitted to a first rate hospital within hours of calling and had high-tech micro surgery done within 24 hours. Singapore healthcare is first rate – and is definitely Government sponsored. Yet I never saw or heard from a single bureaucrat during this whole incident. All my care was worked out between my doctor and I. There was no government and no insurance company people involved at any time.
I also felt pretty good that I worked for an organization that helped me when I was down, and gave me the time to recover. And not having to pay a medical bill is the best part of all! I hope someday all Americans can enjoy the same access to quality health care every other industrial democracy in the world has – with the sole exception of the United States. I think its hypercritical for our members of Government to deny our citizens the same access to healthcare they enjoy themselves.
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