Tuesday, April 08, 2014

"Let's let the healing begin!"

Today's visit to the Kim Tae Yeong Orthopedic Center, like the center itself, could be divided into two principal parts: first, there was the exam; second, there was the beginning of therapy. The exam and consultation rooms were all on the first floor, as it turned out; physical therapy was up on the third floor.

I had been told simply to walk in, and was later told that that was generally how the center ran, i.e., without appointments. While I did have to wait for service at some points, at no time did I wait more than a few minutes. I filled out a basic form when I arrived: name, address, phone number, foreigner's ID number. I indicated where my pain was and was told to wait. I was eventually led to see a man who, I presume, was Dr. Kim himself, the owner of this practice. He spoke to me in Korean almost the entire time, only switching temporarily to English when it was obvious that I wasn't catching some of the medical terminology.

After Dr. Kim put me on a table and probed my range of motion, it was time for X-rays. I gamely went to a different room, emptied my pockets, and was asked to assume a variety of supine and near-fetal postures (plus one vaguely pornographic pose in which I had to spread my knees wide), all so that the technician could get clear shots of my lower back and my hip joints. After the pictures were taken, I was told to go back to the lobby to wait a bit more.

I was brought back into the X-ray room for one more set of pictures; the tech said he had seen something "strange" on one image; I joked that it was the alien inside me. With those pics done, I was sent back to the lobby again, but was almost immediately called into Dr. Kim's office for the next part of the journey: the consultation.

Dr. Kim took me through the X-rays image by image. The main thing he noted was that everything seemed in order: all the bones were symmetrical, there was no sharp-edged calcification, nor was there any over-smooth wear and tear. Everything lined up; everything matched. The X-rays revealed nothing but my apparently awesome bone structure. So Dr. Kim sat me down and shared his theories. Like any good doctor, he gave them to me in terms of percentages: there was an 80% probability, he said, that we were looking at a fairly typical case of joint inflammation. My own sense of the pain concurs with this. There was a 10% chance that the pain could be disc/nerve-related—possibly some sort of spinal pressure on a nerve somewhere, maybe in a location that the X-ray images didn't quite catch. Finally, Dr. Kim noted there was a 1% chance that my problem was tissue necrosis. I dismissed that almost immediately based on my view of the X-rays. I had stared at enough such images—X-ray, CAT scan, MRI—during Mom's cancer to know a little something about the difference between healthy versus unhealthy tissue. I'd have recognized necrosis in my joints, but I saw none. So: 1% chance, indeed.

Two other things: first, Dr. Kim shot down my speculation that my femur had been dislocated. "You can't dislocate your own femur on your own," he said. "That's impossible." I guess the femur is moored too tightly to the ball-and-socket joint; Mr. Kim strongly hinted that partial or slight dislocations are also impossible. Second, Dr. Kim told me that I should sit Korean-style on the floor: for now, it would be better to use beds and well-padded chairs.

The next step: where to go from here. Dr. Kim's recommendation was a two-week program of therapy: I would come to his center every day to receive physical therapy while also being put on a regimen of drugs, mostly of the anti-inflammatory type (i.e., not so different from aspirin). If, after two weeks, things weren't working out, then we'd have to move into MRIs. I asked how expensive this would be, and Dr. Kim couldn't say, mainly because it depended on the hospital as well as the person's insurance coverage. I have a feeling that I won't be getting any MRIs.

Therapy was scheduled to start today. I was given two sheets of paper: one was the prescription for my cocktail of meds; the other was the order for my physical-therapy (PT) regimen. I was told to go and do the therapy first, then to pick up the meds at any local pharmacy on my way home. Therapy was up on the third floor, so I took the elevator up, glad that I wouldn't have to heave myself up the stairs.

Beyond the heavy glass door that served as its entrance, the PT room was almost library-quiet, with one or two white-garbed techs placidly patrolling the area. The space had been divided into a long, wide walkway that occupied much of the interior, and a long row of private booths whose openings were screened off by curtains that drooped to a little below waist level. I was led to Booth 5, and was startled to see that each space, already snug, was actually a two-bed area. I had a boothmate. He was, luckily, uncommunicative, more occupied with his cell phone than with anything else. I was asked where my pain was; I indicated my left hip. The tech told me to empty my left-hand pants pocket, which I did. He then strapped on a heater that wrapped snugly around my hip. "If it gets too warm, tell me," he said. Then he left. I had begun live-tweeting my clinic adventure while I'd been downstairs; now, with nothing to do but absorb heat, I tweeted yet more.

The heating pad on my hip is comfortable; at least it's not hot enough to roast my left testicle.

Heat from my heating pad is so gentle that I suspect I'm being slow-cooked to perfection. Wouldn't surprise me if my leg simply fell off.

I could have stayed like that all day, but little did I know that my humiliation was up next. The tech came back in and pulled off the reassuring heat pads. He asked me more specifically where my pain was, told me to pull my pants down partway, and began applying these suckers—I don't know what else to call them—to my body, all of them clustering around my hip bone. He then started dialing up the suckers, which simultaneously sucked gently at my skin and released a tingle of steadily flowing electricity into me. Once again, the tech left me to percolate and prickle.

This stage of the therapy didn't feel particularly therapeutic; it felt more like a waste of time. I had been through the tingle-session before, years ago, when I went with my buddy Tom to visit Tom's chiropractor, a burly Korean guy whom Tom swears by. That chiro session, too, included a warm blanket with tingling electricity. The idea had something to do with micro-stimulation of the muscles just under the skin: the super-rapid clenching and releasing was somehow supposed to be beneficial—relaxing, maybe.

Even worse than the tingle attack was what came next. The electro-suckers were removed, at which point the tech smeared some sort of gel into the fold of my hip and began massaging my hip joint. I suppose I should be thankful that the tech was a guy and not a hot lady. Despite all the digital manipulation, no issues arose between us, praise Jesus. Soon enough, the rubbing was over, and I could stop staring into a nearby corner of the room. I was allowed to pull my pants back up, and that was that. I thanked the techs, headed for the door, then made for the elevator, intent on hitting a pharmacy.

Nothing had really changed regarding my pain levels. Today's therapy didn't do much for me. It certainly wasn't the therapy I'd been expecting to get: I'd been expecting a session of leg-flexing to improve range of motion, and what I got was heat pads and light massage. I pondered this as I limped outside, back into the world, and made my way down the street to one of the pharmacies close to where I live. The ladies running that pharmacy were an interesting pair: one was a forty-something ajumma who looked every inch the veteran pharmacist; her assistant was an old woman wearing some sort of cloth cap who didn't seem sure of what she was doing there. I was struck by this old woman, by the childlike way she seemed to apprehend the world, almost as if through a haze of brain damage. The way she handled paperwork, as if it contained alien script, and the simple, facile questions she asked all echoed in me. Her behavior was a forcible reminder of Mom, and I had to try hard not to lose it right there in the store, to burst into tears and grab the old woman in a desperate bear hug. Instead, I concentrated on striking up some humorous banter with the forty-something pharmacist, who carefully explained what the pills were that I would be taking, and when I should be taking them all. Internal crisis averted.

With that, meds in hand (all for less than $3), I limped on home. I'll start taking my meds tomorrow, and I suppose I'll have to show up for therapy sometime tomorrow, too. If this doesn't work, I won't be able to afford the MRI, but I might just take my supervisor's suggestion and try the hospital that he'd recommended.


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