Ever buy something without knowing the price?

In August, some kind unknown soul decided to give me a little nudge to make me literally fly off the handle (of my bicycle) and my hand was broken.

After the cast ritual and eventual cast removal, was asked to go to physiotherapy by the hospital.

All we got was a piece of paper with 11 clinics which were supposedly on the same insurance umbrella!

So we selected 2/11 based on proximity, called the insurance company, confirmed that they were both good for our coverage and chose one because they mentioned rates that were slightly lower than the other place.

Now, no actual exact $ commitment was made by either place because they said "we don't know what we will charge you till we evaluate you, etc. etc."

Based on what they actually did, which was a finite time spent, (looking at the others in the room with hand problems)and there was no real variety to the treatment. Just a rotation of toys to play with for all hand folks.

They did do a great job and did all the wax stuff and eventually got my hand to a point where I decided that no more physio sessions were required. So, not faulting the actual physio doctors.

Never paid anything for the visits, because it was supposed to be covered for 30 visits post surgery and went only for 12 or so between October end to December.

Life goes on and the whole thing is forgotten and bang, we got a bill for ~ 600 bucks mid march!

We are still wading through phone calls trying to explain and get explanations from people. San is doing a much better job of getting answers than me simply because I am deflated by this whole episode. My faith in humanity (or the insuring fraction of it) is shaken to the core!

It was not easy to :

a. get the insurance guys to tell me what would be covered before the physio started

b. get the physio folks to tell me what the cost would be

c. find out what I would end up having to pay before starting the sessions (using all my years of mathematics training this would imply the answer to be b-a where both b and a are quoted in US dollars)

That is as crazy as it gets. Imagine walking into a barber shop, sitting down on the chair and you say "haircut", he "nods" and he starts cutting your hair. Then you walk to the counter and he charges you $128.97 when you expect it to be 10 bucks! Heck, he could charge you anything he wants!

Now the insurance company lady is telling me on the phone "Sir, you are responsible for your payment! It is your responsibility to know what you have to pay from your pocket !"

I wanted to strangle her on the phone. How? How does one find out if we keep running in circles between the doctors and the insurance folks with a chicken and egg argument?

Doctor : we don't know what we will charge you till way after we have treated you

Insurance : we wont know what part of the doctors bill will be covered by our insurance till we see the bill

doctor and insurance to patient : You are responsible for covering the balance of what we do not cover on a bill that we cannot determine at the time of treatment!

The best part is the bill we got for 600+ bucks after the original surgery from the anesthesiologist. This dude apparently does not work at the hospital and he came from another hospital in the middle of the night to knock me out.

Really nice of the old chap, except he is not under my umbrella, and it is supposed to be a big umbrella in California!

Now how is a person who is under extreme pain and is hardly conscious expected to ask an anesthesiologist "by the way, are you in my plan? I am at this hospital because this whole building is under the Holy Blue Cross! but are you a Blueman Crossalic?"

Seriously, it would be great as a "responsible person" to know what I am getting into. If an educated person like me who can ask questions and possibly cover this bill over a few months, can be stumped like this, imagine the plight of a lot of people in this country!

Scary!

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Needless needles?

The story starts with a Vaastu expert in Chennai advising the family that the bedrooms should be above the rest of the house and the bathrooms should be below the rest of the house. Hmm, so what is the big deal?

In the USA, you will never get a final permit for any house constuction if a tile is more than 1/8th of an inch higher than another tile. The idea of two different rooms being above or below automatically implies a "brain step" of 8 inches. But these kind of Vastu alterations seem to be a free for all in India. So the guy who was retiling the floor decided to use thicker tiles to meet this "vastu" requirement (which could be part of the official approval process for all I know).

It is 3:50 AM and my brother is driving me to the house after I have just landed in Chennai. Word is that dad is still awake waiting to see me.

Now we have a familiar house with new tiles, except there are these subtle height differences between the rooms which yours truly is not aware of. So, off I go, wheeling the suitcases to a corner and towards the room where my dad is and just as I enter the room, there is a blinding pain in my foot as it strikes tile. My dad thought that the tears running down my eyes were happy tears on seeing him before realizing that stuff like that happens only in Sivaji movies.

The next seven days went on with a lot of Ibuprofen, limited walking, no removing shoes even during a temple festival and only one visit to the inside of the temple on barefoot (which made it much worse) and a trek from terminal 70 to terminal 2 in the Hong Kong airport with carry on luggage, which is like a walk from Mylapore to Adyar!

The foot got so sore and the pain was unbearable. The wife who was already alerted to the situation that hubby might go straight from Airport to Urgent care was not (is not, and will continue not to be for another 3-4 years) thrilled.

After spending close to 200 bucks on co-pays, x-rays, special shoes, inserts, metatarsal pads, etc. etc. the podiatrist said

"look, what you have done is to take a hammer to the softest part of your foot. the nerve endings are contussed. you have to rest that leg for the next ten days and give mother nature a chance to heal this. you can also take these extra strength painkillers"

When this was mentioned to the employer and family, no one was pleased. Some suggested wheelchairs, some crutches, others a trip back to India to spend those ten days in the company of Vastu experts. Let us say that all options seemed to be divorce petitions for mother nature.

While being wheelchaired back to the parking lot in the hospital, the nurse and another kind lady patient in the elevator (who was a friend of the nurse, which implied she visited that department regularly) suggested Acupuncture. Nerve issues get faster resolution, she said, and as added incentive mentioned "it might even be covered by your insurance".

There were many who were trying to scare me from going for Acupuncture saying it is only a placebo, fake, numbs nerves, has side effects etc. etc. but many who also said it really helps.

So took a chance and went to the local Acupuncture clinic.

The expert (who is a Ph.D, MD) put six needles, wires to put a voltage through the needles, a hot lamp around the feet and 40 minutes later the pain was gone! GONE! Just a little soreness around the needle points.

(grainy photo courtesy of cell phone)

There were two more sessions, one two days later and four days later which were for shorter durations with one of the pins moving locations. The pain and soreness were nowhere. I had stopped taking the painkillers as well. As an added bonus, the visits were covered by insurance!

Now that I am walking again, tried to run a little today and it does not hurt.

So much for dismissing a technique just because Western medicine cannot grasp it!

In a way this is weird. We have Vastu (Feng Shui) which is an eastern concept of energy flow which is being abused to create the problem and Accupuncture, which again deals with energy flow bails you out!

If only we can acupuncture the brains of Vastu experts, we might avoid the problem in the first place, no?

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The only thing worse than PMS, is AMS

After a recent enquiry by Jr. and the Little one along the lines of "Are you okay daddy? Are you still bleeding?" and the snide comments from the wife and MIL about how women have periods a days a month while daddy has periods almost every day!

Of course, they were alluding to the nose bleeds and the one thing that has gotten it this far is the AMS, my abbreviation for the American Medical System.

At the risk of boring the gentle junta that scrolls past this space, this has to be explained!

A typical conversation with the appointment nurse is:

Me: (nasal voice, coughing) I need to see a doctor. I have blah, blah, BlaH and blAH! I think I am dying!

Hospital person: Do you want to see your "Primary physician?"

Me : Yes. That would be fine!

HP : Who is your primary physician?

Me : I dont know. I have probably met him or her once. I usually go to Urgent care. (this is true because, I get to go to a hospital only after 5 or on weekends and the regular doctors work 9-5!)

HP : Let me look up your primary care physician. Ah, there it is.. it is Dr. Azer-Chen-maniam!

Me : Oh! Can I see him today?

HP : I am sorry. The earliest appointment I have for him is on July 32nd!

Me : But it is June 20th today and July 32nd is like ....

HP : yeah! He is very busy and is very heavily booked!

Me : Are you telling me that people actually know when they are going to fall sick in advance and booked appointments in the future?

HP : (has probably been trained to answer this in front of a mirror without flinching a hundred times, as part of qualifying for the job). Sir, people usually schedule advance appointments with primary physicians for regular checkups, post checkup after they have gone to urgent care, etc.

Me : Is there any other doc. in the facility I can see today?

HP : Let me check.. Can I put you on hold?

Me : (about to open mouth and realizing that HP was asking a rhetorical question.. I was already listening to music that would put any elevator to shame!)

HP : Thanks for holding. Actually we have doctor David-Rama-Park with an opening at 10:00 AM day after tomorrow. Will that work?

Me : I dont think I can wait that long! (by now reminded of great grandmother and her saying things like "saavukku vaadanna paththukku varan" which literally means, we invite him for a funeral and he shows up for the 10th day ceremony)

HP : In that case I suggest you go to Urgent care again.

Me : Is there ANYWAY I can see a doctor, with an appointment, as soon as I am sick?

HP : Yes. There IS a way. You see, we have some appointments reserved every day with rotating doctors in the out patient department called "same day appointments". They are not movable to other times and are first come first served. So if you call in at 8:30-9:00 AM, you might get a same day appointment..

Me : thanks for letting me know that!

HP : Anytime. I hope you feel better!

Except for the last four lines, this has been the typical conversation for the last few years! Only this time I burst out and found out about the "same day" stuff. Not great, but still better than nothing.

Now, why is this dude complaining like this about the system? Why can't he learn to deal with it? you may ask!

The answer lies in a small name board on a single story building, that used to be on St. Mary's Road in R.A. Puram, Chennai, which simply read:

Dr. S. Jagadeesan
M.B.B.S

Just five houses away from ours, Dr. known in our family fondly as "Jaga", was a towering personality (probably because he seemed huge and most of my memories of him are from when I was a kid!). With his big face and even bigger cooling glass / spectacles and his booming voice he would make me cower either out of respect, fear or both.

He was in true sense our "family" doctor. Grandpa, grandma, parents, uncles, aunts, siblings, cousins, a total of 20+ people in our house alone, were all Dr. Jaga's patients. He knew everyone, their history(not just medical, but real history), hereditary problems within the family tree, family gossip, etc. etc. He was pretty much the only doc. we visited unless he recommended us to see some specialist guys like ENT's, Dentists etc.

He would take one look at me and go "Enna Sundararama? patta padaikkara veiyalla vilayadittu gold spot kudichchiya?" (did you play in the hot sun and drink a cold drink right away?) and I would be thinking "How the hell does he know that?" and he would read my mind and say "I just saw you yesterday drinking gold spot in the store across the street, as I walked out of the clinic and thought I would be seeing you here soon!".

I have so many memories of how he "cured" me of things, be it Jaundice, Madras-eye, chicken pox, etc. etc.. Let us just say it is a long list!

After I came to the USA, my parents called me one week out of the blue and told me "Jaga" passed away. I cried for two days just thinking about him every now and then. Just before my first flight to the US (which was also my first flight!), he spoke to me for half an hour and told me to carry a bunch of medicines with me, just in case. Then he gave me an MMR vaccine almost last minute, because people in the US are picky and insist on it. He said "unakku than ella vyadhiyum at least oru daravai vanduduththe.. you have built up good immunity by now!" (you have got all the major ailments at least once..) and continued "So I never gave you an MMR. Also it is not normal here, but I think they require it there. You will have a mild fever and feel sore for a day. Better here than just after you reach US!" So thoughtful....

It is possible that I keep complaining about the system here, because I miss Dr. Jaga! I was pampered by a doctor who knew how to fix me in a few minutes or within a few hours with the right threat, advice,and or medicine. The fact that he knew me was definitely as much a factor there as how much he knew his medicine!

That perhaps was the magic "Jaga" touch!

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