Health Care Plan B

Only fools live in the Phils without considering what their health care Plan B is. Plan A is get your health care here.

The overall quality is not good. Manila and Cebu have the best hospitals and docs. The usual advice is to live close to one of those cities. There has been a steady drain of the best nurses (or at least the best ones who can pass an English proficienty test) out of the country. Some docs have left to get certified as an R.N., or so I hear.

One has to pick and choose what problems one wants treated in country. My pre-retirement rule of thumb was to take advantage of Bangkok’s medical tourism industry for anything that: 1) Was life threatening, 2) Required surgery that could not be done under local anesthesic, 3) Was rare or unusual, 4) My treatment was at odds with conventional wisdom, 5) Didn’t improve quickly under treatment. I didn’t think about quality of life issues.

One in 50 adults gets Frozen Shoulder (FS) at some time in their life. Those who have had it once have a 1 in 5 chance of getting it again. I now have it for the second time. Or the first time on my left shoulder is another way to look at it. It developed my last week in Thailand. I knew Cebu had a decent orthopedic clinic so I had my self diagnosis confirmed there.

My first case of FS in 2000 revealed a hooked achromion. That is the bone that forms the roof of the shoulder. Surgery was performed. No bone problems this time, thank goodness. I will need a lot of physical therapy.

The cause of FS is unknown. It goes away by itself, if one is willing to wait 2-3 painful years. Physical therapy speeds the condition’s progression. That’s a Very Good Thing. I’ll deal with the pain of therapy.

My limited research says that the docs here are required by the government to be stingy with pain meds here. Only 4% of the docs have a license to prescribe opioids. I also found this quote: “Among other reasons [for under prescribing pain meds] is that stoicism is highly valued and, for Catholic Filipinos, suffering is an opportunity to demonstrate virtue.” This could be a Very Bad Thing.

Yesterday was the first therapy session. I was quite pleased to see that I could put on my shirt almost normally afterwards. During the first case of FS the pre surgery physical therapy was done just to slow the progression. I often saw no improvement after the sessions. When there was improvement, it was tiny.

I am hopeful that I can avoid a medical tourism stay in Bangkok.

I wrote the following after recovering from my first case of FS and posted it to a hang gliding list. Nope, I didn’t save it, somebody liked it enough to copy it to the ‘Why I Fly’ section of their club’s website and Google did the rest.

Date: Thu, 29 Nov 2001 04:47:17 -0000
From:
Subject: An unremarkable flight

The details of my flight are inconsequential; it’s just another entry in my logbook. What made it special is the nine-month lapse between it and my last soaring flight. My passion for flight was my prime motivation for the enduring the physical therapy that followed my bout with frozen shoulder.

My therapist and I quickly fell into a routine: she would hurt me, I would request that she stop, then she would ask me if I were willing to go again. We’d repete that until she decided any more work would be counter productive or I couldn’t take it any more, despite the narcotic painkillers. My goal was for her to call it quits first, because that indicated maximum progress had been made for the session. While contemplating the pain vs. reward tradeoff of letting her have another go at me, I would focus on the belief that the sooner I finished with physical therapy the sooner I would be back in the sky.

What is it about hang gliding that makes it rival crack in its addictive qualities? I’ve called it a passion, a lifestyle, an obsession and addiction, but those are labels and do not explain why. As a child I knew someday I would fly and never questioned why: It was obvious.

When wuffos ask me about the appeal of flying I usually offer up two quotes. One is from some unnamed tandem passenger in a post-flight comment book: ‘Now I know why birds sing’. Just so the wuffo doesn’t think I’m some sort of sensitive new age guy, I follow up with a paraphrase of something Kevin Frost (I think) once posted here: ‘I ride invisible columns of air miles above the earth. What part of that don’t you understand?’

Wuffos simply can’t understand the core concept: I can fly. We get it, they don’t. There is no point in trying to explain it.

Great air

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