Staying alive is expensive
with modern medicine. Post Japan Disaster Charity ride in April11, my friend
Francis called to tell me he is treating the major sponsors to dinner. He
already donated 50 grand. What more do I deserve? When asked why, he said:
"so that it may make future charity events a little easier on you".
So 12 of us were treated to a sumptuous dinner of Thai food.
Post charity ride, I was lethargic.
A mild, lingering fever and a
little soreness on my right ear bothered me for a few days.
With the impending long
week end of Labour Day, I took no chances, paid a visit to my company's doctor.
There was no fever and he concluded I may have a slight ear infection. So I was
put on erythromycin, a standard antibiotic, and paracetamol for suspected ear
infection. This is medicine 101 type prescription.
Despite medication, I felt
lousy, slept a lot with a lingering roller-coaster fever. Come 2May11, the wife
cooked a sumptuous abalone wanton mee for my son's 21st. We celebrated
together with his twin sister in UK, via Skype. By 4pm, I threw up everything;
prescribed antibiotic acted up.
The following day, I
consulted a doc friend. He did base line checks, drew blood, to rule out dengue
or any parasitic disease. Nothing showed and that was good. Two days on, I
still felt at sea and again visited the company doc, a different person.
Another type of antibiotic was prescribed. While my fever was kept at bay, I was
still not my usual self. My doc friend subsequently fast tracked me to an ENT specialist
in private practice.
Latter took a close examination,
said it's an inner ear viral infection (nothing changed) and immediately put me
on acyclovir, a powerful antiviral drug. In the next 2 weeks, I felt my ear
eaten up by creepy-crawly insects; crusted skin, flaking and then finally drying
up. My hearing was impaired and my balance compromised.
My dizziness persisted. At
each visit, the specialist would nudge me, ever so gently, to consider
undergoing an MRI on the ear to rule out any remote chance of a tumour. I finally
yielded. An MRI experience is most daunting. I rather draw blood a 100 times.
Visualise your head strapped still, push into a washing machine (without
water), no movement allowed, and clicking sounds torment you all over in this claustrophobic
capsule. A few millions gray cells must have died.
The results, according to my
radiologist, look normal except for a one liner observation. When I asked the
ENT specialist on that remark, he promptly suggested consulting a neurologist. Though
not my money, I said no.
While recuperating at home,
vertigo kicked in, the world went into a tail spin just a day before my driving
holiday up to Penang. It was so bad I eventually checked into hospital; slept
through 2 days on drip. The specialist suggested staying another day which I
turn down flatly; not over my dead body. A foreign talent nurse inflicted some
much unnecessary pain when changing drips (that's another story).
I waddled out of hospital with
vestibular (the inner ear organ responsible for balance and spatial perception)
imbalance from nerve damage. My lingering fever was gone, so was the pain in my
right ear but spatial disorientation took over. I would knock off objects. My
judgement of depth and distance was poor. I tried driving and it was hopeless. Eye,
brain, movement coordination suffered a lag and judging speed was difficult. So,
I hang up my number plate, took the MRT and bus to and from work for one month.
It was all good before Christmas arrived early for SMRT with 2 massive break
downs.
To put myself at ease over
MRI observation, my public service network recommended a neurologist. I eventually
consulted the head of neurology in a large public hospital. I showed him my written
summary and MRI result. He asked a couple of questions, viewed some images,
examined my ear and then pronounced: “you just recovered from shingles” (you
must google in case it hits you!). It’s unfortunate some nerves in the ear were
damaged, causing hearing impairment and imbalance. Lucky you, he said. If shingles
hit your eye socket, going blind is conceivable. So I guess I am better off hearing
less, seeing more!
He went on to comment that
the negative one liner is not even something he would document or discussed,
given my age. The profile of my brain is
no cause for alarm. He stopped short of criticizing
the MRI procedure as unnecessary. To him, it is game's over, nerve damaged and
hearing belongs to another discipline. So, he referred me to the ENT specialist,
a few doors away.
From hearing test, it was
confirmed by the ENT specialist that there was a slight damage. There is
nothing more to add, good luck. So I ask the doc if acupuncture is useful. He
was non committal. What about my imbalance I ask the doc? Oh, it will go away
through time. Damn it, it's far from going away, I mumbled to myself. Is there
anything I can do to take away the dizziness (this term vestibular was not even
in my vocabulary then)? Instead, he gave an open appointment to see him anytime
I feel something is amiss.
With each passing day, I
felt a little better. I force myself back to cycling, crashed into pedestrian
barrier once but persisted. On the suggestion of Cecilia who works for KTPH, I
visited the geriatric rehabilitation centre, ahead of schedule! It was good education to learn that imbalance
is a common problem with the not so young.
In rehabilitation, the
promise is: no practice, no gain. I was taught a regime of exercises, if you
like, to retrain the eye-brain and skeletal coordination. My physiotherapist
was horrified to learn I cycle despite my condition. As it turns out, she is an
avid cyclist. So she added gently: “cycle with care and please do more!”.
Apparently, cycling (because one needs to balance) is excellent exercise for imbalance.
If you can tolerate roller-coaster rides, better still.
According to my therapist,
old people are more prone to be inflicted with vertigo or other forms of vestibular
imbalance. Most adopt a sedentary lifestyle, lapse into depression, never to
recover.
Here is a pool of medical knowledge
with no medication, no cuts, no removal, nothing glamorous; only sheer
discipline to practice, practice and then practice to recover. Rehabilitation
centre is managed by physiotherapists, not doctors. There is barely any skin in
this game; a 45 min therapy cost under $40.
So as is often the case
with the elderly, especially hypochondriac, it is “lokun bo yao, bay ho”!
(roughly translated from Hokkien ‘doctor, without medicine, how to recover?’).
Are you then surprised to
learn that private sector healthcare cost 2 to 2.5 times of public healthcare
cost for similar procedures including up-selling? As medicine gets more
sub-specialised, every square inch of our body is potentially attended to by a
different specialist. Combined that with a more enlighten and litigious society,
it’s gun powder in kegs in the years to come.
To maintain healthcare cost,
medicine has to get back to basics, take a holistic view by having well-rounded
GPs as family physicians. I was unfortunate to have 2 different GPs diagnose my
condition. If it had been the same GP doctor, I stood a better chance of an
accurate diagnosis.
When it came to the ENT
specialist, my condition was already full-blown shingles and reflecting back,
the MRI procedure, I guess, is part of the circus of modern medicine. An
experienced family GP would have detected my early stage shingles, prescribed
acyclovir and spared me the agony of a long and debilitating post recovery. Now
my kids are screaming: "dad, why is the TV so loud!"
Think about this:
“With every additional
medical procedure or test ordered, there lies a fresh possibility of error” so
said the associate chief of neurosurgery at Grady Memorial Hospital Sanjay
Gupta.
