What are we paying for? Take 3

Since about a week after my return from Oz in January I've had issues with digestion. Sometimes intermittent, sometimes consistent--but most always inferring with my sleep. I contacted our health insurance (BUPA--a company out of the UK) and was pre-approved for a "full health screening." This included a LONG list of things, most of which I did. I walked into Intermed hospital on a Friday afternoon to see if I could schedule a few things for the next day so that I wouldn't have to miss work. Shockingly I was scheduled for most everything on my list and was sent home with the prep for a colonoscopy (my first). 

On Saturday I had a gastroscopy AND a colonoscopy with sedation. I had labs taken--both urine and blood. I returned a week later for the well woman exam and to have a chest Xray. I'd already visited in January and had an ECG done (Normal!). All my tests came back normal. My scopes showed no ulcers or polyps, though the doctor did note some "mild erosions" in my stomach and diagnosed me with gastritis and prescribed three weeks of a medication twice a day. I'm wrapping that up today. 

All in all, I had the following procedures done: blood and urine tests to check liver and kidney functions; pap smear; chest X-ray; gastroscopy & colonoscopy w/sedation; and met with at least 3 different specialist doctors. I met with these doctors the day of my initial appointment, or the following week when test results were available. I did not have to schedule an appointment--rather I walked in on Saturday at 10 am and asked to see a doctor about my results and within 30 minutes I was sitting at his desk. I walked across the foyer and purchased my meds at the pharmacy located inside the hospital before departing. I had my chest X-ray as well as all test results in hard copy and in my possession. I was pleased with the doctors care and attention to my questions. 

I paid in tugrik for what totaled about $280. There were a couple items on the full health screening which I did not do (lung function test, and my last mammogram was less than a year ago) and I added the gastroscopy--it was not on the approved list but I felt it was important to do. I submitted my claim to BUPA and was reimbursed the $400 maximum benefit for a full health screening with that "service" checked off my benefits for this year. Now when does Insurance every seem to go in one's FAVOR? And without a fight of some sort? 

All that said, everything showed normal and I am still battling the same issue. I have deduced that it is either dietary or environmental toxin (OR BOTH) in nature. Tomorrow I will begin an 11 day detox to get my digestive system back to a healthy baseline and then I will begin to re-introduce foods to see if I can find the culprit(s). Unfortunately there is no way to escape most of my environmental toxins that surround me--from the air to the water. It is spring break and my spring cleaning begins tomorrow--April 1--for both my body and my home. I'm excited to see the transformation! 

I do also want to pause and thank my amazing sister, Fawn, for sharing her expertise and training in health & wellness to help me troubleshoot the issue at hand and for giving me the information and support to do what comes next. You can find her online via Facebook at Walking Naked Truth or on her Blog of the same name. She resides and works out of Boise, ID, so if you are in the area I hope you'll check out all of the incredible work she is doing around health and wellness in regards to ALL aspects of ourselves--Health, emotional, interpersonal, and so forth. Thanks, Sis! 

What are we paying for? Take 2

Sunrise at Secret History camp in mid February

Back at the end of 2016 I published a post titled "What are we paying for?" which discussed comparative health costs and care expectations between the U.S. and Mongolia. It has become my second most popular post of all time. I'd like to continue and expand that discussion here. In recent weeks I've had a few more experiences that I think are worth sharing and noting. 

First, I had lasik eye surgery done about 10 days ago. I went to THE revered eye clinic in town--Bolor Melmii. A fellow expat teacher during my first year at the elementary school had the surgery to great success. From then until now I had filed it away as something to look into. A good number of the Mongolians that work at my school have also been to this clinic for the surgery or have had a family member who has. My faith and belief in the place grew as I learned this. At the beginning of March I went and was tested to see if I was a good candidate for the surgery. After a battery of tests it was determined that I was. But as I'd only been wearing my glasses for a couple days (I'm a long time soft contact lens wearer) I had to continue wearing them and repeat the tests in two weeks. As I didn't want to be wearing glasses any longer than necessary, I pushed on another two weeks, returned, and yes, was qualified for the surgery to correct my near-sightedness. That always sounds confusing....as the surgery would make it so I could see distance without corrective lenses. They were very clear that I would need "readers" for reading and my computer screen as I was over 40 they reminded me. :)

About three years ago I graduated to bifocals. If I wasn't wearing my glasses, then with my contacts I had already been using readers so this was no big deal. 

The night before Zorig left for U.S.

So the surgery was done on March 15 and I've been seeing distance now, without corrective lenses, for 10 days. I still want to remove contacts at bedtime so I'm still adjusting and still certainly on the eye drop regime prescribed by my doctor. I believe she is the doc in the cover photo for the clinic. All the nurses and doctors I spoke with and worked with were Mongolian. The doctors speak English. Enji accompanied me on the day of the surgery to get me home as Zorig is currently in the U.S. pursuing business endeavors for the family cashmere company. 

It is extraordinary to wake up in the night or in the morning and be able to see across the room without first putting glasses on. Wow...what a gift!

That said, I don't know if I could do it again knowing what it feels like. Of course there is not any real pain, your eyeballs are numbed! But it is downright freaky to have your eyeballs worked on because you are watching the entire time. I couldn't get the image of Mel Gibson in "Conspiracy Theory" out of my mind. After numerous drops in your eyes, you lie down on a table facing up. They do one eye and then the other. The whole thing takes less than 10 minutes total. They use a small device to hold your eyelids permanently open (hence the Mel Gibson vision). They place some sort of barrier over the space and then open for access to your eye. Using a blade they cut a flap in your cornea. This doesn't hurt and it's fast, but there is a sensation and you know what is happening. Then you are told to hold still and stare at the green light in the machine over you. The light was a mix of colors--red, orange, green, and blue. It's bright and you do as you're told. Then you feel very cool air blowing on your eyeball while the laser is turned on and someone counts from 1 to 5. It's turned off briefly and then engages again for another 5 second burst. I felt the cool air and could smell the laser burning my cornea. I would say it was burning flesh...but it wasn't exactly flesh, so I'll go with burning membrane. It's very disconcerting to say the least. Once the laser is finished the second round then the doctor replaces the cornea flap and you watch while some sort of paddle is used to smooth the flap out and get it placed just so. Then they irrigate your eye with some fluid before releasing your eyelids to close. The process is then completed for the second eye.

Once both eyes were completed I was led into the holding area where I joined my fellow patients. There were four of us that day and I was number three of four. I think we were there about 30-40 minutes during which time the shock hit me. My eyes had started to burn a bit and it did hurt, though on a scale of 1 to 10 I'd put it only around a 5 or so. My body does this funny thing when having procedures done that are somewhat traumatic--my blood sugar plummets and I faint or pass out. This happened a few years ago when I first had an IUD implanted. I literally blacked out that time. This time I could feel it coming on--I felt nauseous first and then that strange wavy feeling throughout my body that was a mix of feeling hot and numb. I thought, Oh No....I'm going to faint! I was in a room with three others that seemed to speak no English. The doctor was only one room away, but I wanted to try and manage it. I grabbed on to the seat of my chair and breathed deep breaths and the waves flowed throughout me but I managed to NOT pass out. Shortly thereafter my "wounds" were checked and I was sent home with instructions (which Enji translated) and lots of eye drops. You cry A LOT in those first few hours. Shortly after i got home I began to feel much better. The burning had subsided and it was obvious I could already see better. I rested and then returned the following morning.

Celebrating Tsagaan Sar with friends

My cornea flaps had curled under just a tad (sometimes a minor complication that is easy to fix) so the doctor numbed my eyeballs again, lifted up and then replaced the flap again. I got to watch again as the paddle smoothed my cornea flap out and then the eye was irrigated. Process was repeated on eye number 2. Then I rested with eyes closed for 30 minutes after which time the doctor checked the wounds, all was good, and I was sent home for the weekend with three different kinds of eye drops to use on various intervals. I returned on Monday afternoon and all was as it should be. I'll return in another week for my next check up. 

I opted to do this procedure while in Mongolia because of the reduced cost. I had considered doing it in the U.S. before I departed but ran out of time and money. The cost here, including the testing, procedure and follow-up care, as well as the various taxi rides to get to the clinic, was just under $1200. From what I know about the procedure in the U.S. this was about half price--or rather I got both eyes corrected for the cost of one eye correction in the States. I can certainly see why medical tourism is a thing! Obviously I'm not here as a tourist but I did opt to have a medical procedure done here and not in my home country.

I've spent so much time on the lasik event thatI will save the other comparison post for another day. It will discuss having a full health screening done! Hope this post finds you doing well and enjoying Spring! We broke above 60 degrees Fahrenheit today which feels a bit early--but I'll happily take it. My battle for the next couple weeks will be trying to keep the dust out of my healing eyes!

Brilliant Engineering

I can't say I ever spent much time thinking about light switches until I moved to a country/continent that placed the bathroom light switch on the OUTSIDE of the bathroom. Yes, here in Mongolia and it seems much of Asia that bathroom switches are on the wall outside of the room. This was true in hotels I visited in China. I mean, come on! I want to soak in a tub and relax by candlelight, but once the water is lukewarm I want to flip on the switch and shower off. That is not possible here unless you text your partner in the other room to offer an assist by hitting the switch. So frustrating. And then there's also the chance that someone forgets or doesn't know you are IN the bathroom and while walking by flips the light OFF in an attempt to save electricity. Again--not a problem to yelp out that "hey, I'm in here," but really, WHAT is the point of the switch on the outside?

I guess you could say this plight of misplaced lavatory light switches has increasingly made me sensitive to the placement of light switches in general. In the US they are usually inside the room, just around on the wall, generally within a foot or 18 inches of the door frame. For the most part these are fairly easy to locate. However, on occasion one can find themselves feeling up the wall in the dark in search of the switch. 

I can undoubtedly say that Aussies have this situation engineered EXACTLY right. The light switch is ON the door frame and just near where the door knob or latch is. It's brilliant! Pun intended. 

Additionally, I was impressed by all the outlets in the kitchen and bathrooms. These are the outlets that are often used for additional electrical appliances--blow dryer, deep fryer, electric skillet, crockpot, etc. Where you find these outlets you will find both a switch to make the outlet HOT and then the outlet to plug into. I also thought this was a nifty safety feature. I observed my friends plugging their appliance into the outlet, then turning the outlet on; once finished cooking/using the appliance, they would turn the switch off. Again, I don't know why the rest of the world doesn't have switches and outlets such as these. My friend Kendall and her mother can confirm just how much I marveled at these devices. I really couldn't get over them. So practical, safe, and useful. 

So yes, why doesn't the rest of the world have electrical engineering like this? Talk about intuitive design and comfort of ease and access! No feeling around in the dark, no guessing where it might be. Just open the door and bam, there it is!

Thanks for entertaining this random and short blog post. This is one of the joys of travel--learning how different countries or places address a commonplace need. Who knew!