Health Care in India is Amazing

Wednesday, June 25, 2008: It has been exactly one week since I wrote the last entry. Much has happened! Right now it’s 10 pm, and we just got back from a traditional dance performance at the Indian Habitat Center (not quite sure what that means, but it’s a beautiful complex with sculpted open areas in the midst of a maze of building). There are offices and art galleries, places to eat, and an auditorium where the dance performance was. It was terrific. There were two young, female dancers doing the equivalent of recitals. Their master teachers were very significant to all there, and their names were printed on the posted signs along with the dancers’ names. We were able to catch snippets of each performance on ML’s video camera, and I’ll post those if possible. There were live musicians and singers who were crucial to the performance. The singers in particular seemed to have a very tough job. I’m curious what their written music looked like.

In the meantime, here are some photos of the dancers.

We were supposed to meet the El Salvadoran Ambassador there. ML was told to contact her through a mutual friend, and they’ve seen each other several times now (once at the El Salvador Embassy Grand Opening, and once at the Ambassador’s house where she was hosting a dinner for her staff). She’s a very nice lady and is really looking out for ML, letting her know about different events and such. Unfortunately, her mother took sick while they were getting ready and when we called them to check in a few minutes before the performance, they were at the hospital. It doesn’t sound too serious, but she clearly must have felt pretty awful to have gone there.

Hospital talk leads me to the other theme of this week. The last entry was about my having a sore neck, and going to the masseuse to try and work out the tightness. The summary of the week is that I stayed home from work Wed/Thu/Fri because of the pain, spending much of the time on my back. Thurs morning I went to a Physical Therapist at a local clinic that was a satellite center of a really good hospital. It is literally 4 blocks away from our apartment. I found him through researching health care in Delhi on the web.

The PT was great. He seemed knowledgeable and was happy to explain things. He ordered an x-ray, diagnosed me as having muscles in spasm and said my x-ray showed the curve is practically gone in my neck, likely due to posture. He recommended moist heat, ultrasound, electric stimulation, stretching, and lying on a rolled up towel for 45 minutes 3 times a day. Muscle relaxants (that somehow didn’t even make me tired) and IBU for the inflammation. The receptionist at the PT clinic got to know me after three days, and would say, “Go on ahead, Sarah” when I came in the door.

Here is a photo of the actual 'script for the x-ray and pills:

The cost of the treatment? $1.25 for the consultation, $5 for two x-rays, $7.50 for the heat/stim/ultrasound treatment from the Doctor. Amazing, eh? I went to him Thur, Fri, and Sat mornings. Saturday while he was stretching my neck there was a twinge and I experienced the worst pain yet and couldn’t find a comfortable position for about 2 minutes. After witnessing that, he said he wanted me to go get an MRI. So that was my Saturday adventure, and my first venture out of the apartment for more than a trip around the corner.

The MRI went smoothly, and thank goodness it wasn’t a fully-closed MRI. It did send you head first into a tube, but there was light coming from the other end so it didn’t feel as closterphobic as I feared. The cost? $100. The results? The individual reading the MRI images wrote: a "small right paramedian posterior disc protrusion compressing the thecal sac at C5-6 level." Back on Google, then WebMD. My best understanding was that it means the disc is bulging slightly, and pressing into the ‘sac’ that holds the spinal cord and spinal fluid. Treatment is ice/heat, anti-inflammatory meds, and rest, and it should go away in 6 weeks. With that knowledge, I went to the PT the next morning (Sunday – he came into work because he didn’t want me to have to wait until Monday – amazing, eh?)

His read? “This is great!” Excuse me?! He said the MRI was basically normal and that there is nothing else to be done aside from what we were doing. Should I ice it? Nope. Just heat. Should I keep taking anti-inflammatory medication/muscle relaxants? Nope. Go ahead and stop that as well.
I began to feel the need for a second opinion, partly b/c the MRI diagnosis showed a ‘protrusion’ and because the severity of the pain just didn’t seem normal. I was getting side to side movement back, but it was EXCRUCIATING to tip my head backwards. So back onto Google, and a call to the US Embassy to get a recommendation for a good orthopedist. They didn’t know if the people on their list specialized in the spine versus hand versus knee, so the next call was to the Indian Spine Injury Center which is two blocks from where I live! The coincidences have been remarkable.

Off to a neck specialist Tuesday, 10:45. The Dr. asked more questions, checked reflexes and a number of additional things, and came to the same conclusion. The MRI shows the protrusions but is essentially normal. He projected 3-4 more days of pain, and then it should be almost better and I’d be ready to start some stretches and strengthening. He wanted me back on the muscle relaxants/ IBU to stop the process of pain and spasm, and stopping PT for a week. The straight neck was evident in the MRI as well, and he said that is what needs to be addressed to prevent this in the future. The cost? For a specialist, no insurance? $8.50.

Hearing the same conclusion from him made me finally feel better. I stopped worrying that the wrong movement was going to cause irreparable damage, or that the severity of pain meant severity of problem. It’s been two days since seeing him. The pain is still there, I have to say, and I’ve pretty much learned how not to aggravate it, so I’m not sure if it’s really better. If I try to tip my head back it still pinches terribly, but I try to do that as little as possible so as not to keep it ‘injured.’ So the jury is still out to some degree, but I do feel it’s on the mend.

I had a few cultural observations at the spinal center that I wanted to share. I walked in and said I had an appointment. Did I know the name of the Dr? No. (I wasn’t able to understand it on the phone, despite asking 3 times). I did know it was 10:45. They looked at a hand-written book. Ms. Sarah? Yes, that’s me. He sent me around the corner to the Cash Counter. Could he please write down the name of the Doctor for me? Yes.

There were three people at the cash counter, standing shoulder to shoulder right up against the counter, possible there together. I stood a foot or so behind. A gentleman came up and stepped in front of me, right up against them and between their shoulders. The moment she was done with them, he placed his paper right in front of her nose. She helped him, and two more men came up and worked their way in front of me, too. She stayed focused on the first guy, and I inched forward, not sure if I was going to commit a major cultural no-no if I worked my way in, too. I did it anyway, as subtly as I could, and God bless this lady, she looked me in the eye and took me next.

I noticed the whole time there that the men spoke for the women, even if the women were the patients. Most people were there as couples (or two women, two men). The lady didn’t ask me for my last name. Ms. Sarah was good enough for creating hospital records.

Phew. Long entry again. I will try to write more frequently, or perhaps just more succinctly. I'd been trying to keep my computer use down, but now I'm getting back up to normal usage!

Miss you all!
Sarah B.