Thursday, January 25, 2007

Super Happy Medical Fun Time

Well ladies and gentlemen, I can say this for 2007: thus far it hasn’t been boring. And even though I’ve spent a good part of the month traveling to one place or another for medical reasons, it’s managed to be somewhat fun too, at least most of the time.

After a large portion of one of my molars fell out in Boracay (the size of a baby tooth in its own right), I high-tailed it to Manila to see the local Peace Corps dentist. As I mentioned in my last entry, I fully expected that after 24 short years of wear and tear, my mouth would see its first crown. I wasn’t looking forward to it. However, this has not come to pass. Instead, after examining my mouth, the dentist decided that although it was a close call, a large filling would do.

Now, I am not fond of dentists. The feeling of dental work being performed in my mouth, even with Novocain, has always unnerved me. That in and of itself would be tolerable except for that which is even worse: the sound. As soon as I’ve managed to tune out all the poking and prodding being done inside my mouth, the other senses, formerly ignored, come pouring into the forefront of my mind. This brings on the inevitable thought: ‘Why, what is that sound of cracking, hammering, and drilling? Is there a coal mine nearby?’ It takes only a split second for the horrible realization to hit me. There is no coal mine! These mining operations are taking place inside my own body. That cracking and hammering and drilling is being done not to some foreign object nearby, but to my very own body. Consequently, those noises don’t sound particularly gentle, certainly not delicate -- very unlike the work of a doctors’ graceful hands or even those of a stage magician. It sounds like they’re smashing apart your mouth.

In any case, I’ve lived through that process easily enough in the past, and I survived yet again. At the very end of the filling process, tooth fully installed, the dentist slipped a piece of carbon paper in my mouth, and asked me to gently move my jaw back and forth. As I obeyed, the filling broke off and toppled out of my mouth.

So it was right back in the dentists chair again for another 45 minutes of tooth-mining. I bite down on the carbon paper a second time, and everything seems much better. So I returned home to the Peace Corps pension only to have that filling fall out again at dinner. It was a very sad event, for having a tooth detach from my mouth ruined what would have been a very nice meal for me. Good food, after all, is plentiful in Manila.

So the next day I returned to the dentist where I was absolutely certain they would give me a crown. After all, they said it was a difficult decision in the first place, and It seemed obvious, at least to me, that the filling was not working out. However, this was my assessment, and the professional disagreed with me, opting for the philosophy of the timeless motto “If at first you don’t succeed, try, try again!”

After the filling was installed for the third time, my jaw ached terribly. I’m not sure exactly what technique the dentist used, but I recall her pressing down into the filling area with all the strength her arm could muster, and I felt that for several days afterwards. As the dentist debriefed me afterwards, she told me to remember that the molar in question was weaker than all my other teeth, and that I ought not to chew on much, especially hard things.

“For how long?” I asked.

This was met by a brief, uncomfortable silence, followed by her words “Just be careful”. I pressed her on the matter, and she basically made it sound like I ought to follow this rule indefinitely. This concerned me a little bit, since in my 24 years of life chewing has actually been the most common use I’ve found for my teeth.

Then the woman at the desk went over some paperwork with me, and told me fairly directly that chances are more than likely that my filling will fall back out again, and when it does they will give me a crown.

I didn’t go back to my pension happy. Actually I returned very discontented. I have no urge to have a crown, but if I need one I see even less reason to delay the time consuming and uncomfortable operation. So I directly asked the Peace Corps medical officer that they remove my filling and install a crown, since it seemed inevitable anyway. The medical officer was very sympathetic, but told me that my dentist was convinced she had done the procedure right this time, and without the recommendation of my dentist, Peace Corps HQ would never approve a crown.

You gotta love insurance companies. They’ll just be spending more money when I return to Manila the next time my filling falls out. Such is life.

What I haven’t mentioned thus far is my migraines. In Manila I had my first migraine of the year. When I returned, half a week later, to Iloilo city I had a headache. This headache was to be the first of many successive headaches and migraines I would have over the next 10 days. For those 10 days, sometimes my headache was so minor I could barely feel it, sometimes it was an extreme migraine, but not a single day passed without the former. 7 days in, I contacted my medical officer with a medication question. When she learned how long my head had been plaguing me, she told me to see a neurologist in Iloilo, and so I did.

This neurologist sent me to another neurologist, working at the local hospital, and that one told me that she wanted to hold me at the hospital for the night and run several tests (including an EEG) the next day.

Staying the night in the hospital seemed almost laughable to me – I didn’t even have more than a minor headache at the time. But the doctor talked with my medical officer, and stay at the hospital I did. My Regional Manager from Peace Corps happened to be in town, and when she heard that the doctor had ordered me not to eat any processed foods, she went out and essentially purchased me an orchard’s worth of fruit. Grapes, bananas, mangoes, apples, pears, chico (a brown fruit that tastes oddly like brown sugar), I had them all in plentiful supply, and things were good.

The next day was my EEG. Fun times! They attached all sorts of electrodes to my head, told me to fall asleep if I could, then they flashed bright lights in my eyes. I think some part of me really expected I would somehow gain super powers from this, but if I have, they have yet to manifest.

In the afternoon the results of my EEG and neck x-rays came back – both perfectly normal. I didn’t have more than the slightest of headaches and above all else was going stir crazy in my room. Ross, who had been my kasama the previous night, went home mid-day when it was clear I would be fine. So I was more than a little shocked when the doctor told me that she would not release me until the following day. Despite the fact that I was feeling good, in perfect health, with no signs of serious ailment, she wanted to hold me for another night for testing.

This was not a good situation for me. Filipino hospitals were made with the assumption that any person staying there would have a kasama, someone to run needed errands for you. Soap, toilet paper, water, outside food, even medicine – you need a kasama to procure all these things for you. If the fact that ‘medicine’ is on that list surprises you, recall that this is a 3rd world country. They have 6 pharmacies around the block, but only a limited variety of medicine actually in the hospital itself. So after the doctor has proscribed you to take a medicine during your hospital stay, you still need someone else to go get that medicine for you.

So this was the problematic situation I found myself in. Ross had already gone home, and the notion that I might stay in the hospital without a companion really was unthinkable, both to myself and to the staff. Someone came to my rescue though.

A lovely Filipina, the one I had spent the good part of Christmas Eve with, had come to visit me late that day. I don’t name her, because I’m not sure she would want me to, but she was very kind. She agreed to be my kasama and stay the night with me in the hospital. So my evening wasn’t half bad, staying in an air-conditioned room, with cable tv, a refrigerator, plentiful fruit, cold water, and a beautiful young lady – I would have felt downright guilty if I wasn’t being held against my will.

I was released from the hospital Thursday afternoon, and had no intention of letting my traveling stop. I had long been planning to travel north for the weekend, to see the cultural festival known as Atiatihan. Taking place yearly in Kalibo, it is known as the largest and most elaborate yearly cultural festival, and draws Filipinos and tourists alike from all around.

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