Prescriptions in Korea

Two days ago I had surgery to remove an ingrown toenail, and the doctor prescribed a cocktail of drugs to help me recover.

If you've ever had a prescription filled in Korea, you are aware that pharmacies never give you (or even show you) the bottle, labels, or any printouts for the drugs that they dole out. Instead, they arrange all of your pills in convenient single-dose packets that you can tear open and take all at once.

Korean drug cocktail (example - not actually mine)

The obvious drawback is the lack of information about the drugs. Coming from America, where the corporate medical machine's rewarding of over-medication requires a healthy suspicion of doctors and prescriptions, this practice can be quite off-putting. In general, though, Koreans trust their doctors and follow their advice.

Yesterday, during my day-after follow-up visit to the surgeon, he informed me that I could stop taking the painkillers. The only pain I experienced from the surgery had subsided about 8 hours after the surgery, so I didn't need it anymore. Since I didn't know which drug was which in my string of plastic baggies, I pulled it out for the doctor to identify.

He looked at the group of multi-colored pills and poked them for a second before turning to the attending nurse. He said something to her in Korean and she pointed to a white pill marked "LOX". He turned back to me. "You can take this one out. And this small one, too, you can stop taking. It is a digestive." I wondered why I needed a digestive, but I didn't ask. After all, he told me to stop taking it. I didn't care much about what he told me NOT to take.

So yesterday I took the two pills out of each packet, and saved the painkillers in case I needed them later. As I did so, though, I wondered what kind of painkillers they actually were. Then I started to wonder what exactly was in the OTHER pills I was still taking. This morning I pulled out the receipt that the pharmacy printed out for me, and used the Korean prescription names to discover their English equivalents.

To my surprise, I discovered that the drug that he told me to take out (LOX) was actually loxoprofen, a non-steroidal anti-inflammatory. It struck me that, two days after surgery, this one might still be important to take.

The small one, that he claimed was a digestive, was actually misoprostol, often used to prevent the gastric ulcers that non-steroidal anti-inflammatories have been known to create. (Also, incidentally, sometimes used in the US to induce labor in pregnant women...)

The digestive was actually the large green pill (marked BEARSE), which I was still taking (and which I suspect is the cause of the digestive trouble I had this morning).

I was also still taking another antacid pill, which I suspect was thrown in for good measure, in case the misoprostol failed in its duty.

Luckily, I was still taking the antibiotic (cefalexin).

As it turned out, there was NO painkiller in the packet at all!

Maybe I should be more pissed off about this. It seems like an honest mistake, though - the doctor wasn't trying to hurt me. Maybe he actually was trying to tell me to stop taking the anti-inflammatory, and I misunderstood. I'll ask him when I see him tomorrow.

The real danger, in my opinion, is the practice of giving drugs out in little unmarked baggies. If you're visiting the doctor in Korea anytime soon, make sure to have the doctor spell out everything he prescribes you, and ask the pharmacy for a printout of the prescription information. I don't know if they can even do that, but, as in almost every life situation, it never hurts to ask.

Five Minutes in a Korean Hospital

My toenail fell off about six months ago. On Monday morning I went to the hospital because the new nail was growing into the side of my toe. The doctor recommended surgery, which would be quick and the ingrowth was "almost guaranteed" not to return. He said I shouldn't worry; it would be cheap.

We scheduled the surgery for the Tuesday morning, and I went to get a shot of antibiotics and an X-Ray to make sure the infection hadn't spread to the bone. I was given a ticket and told to pay on my way out; the bill, including the surgery, antibiotics, X-Ray, and doctor visit, totaled 25,000 won (about 22USD).

This morning I went back to the hospital for my surgery. After a 5 minute wait I was called through the surgery doors and a nurse handed me some floral print pants and shirt. He led me into the operating room, where a team of 5 nurses scrubbed my foot with iodine. The doctor injected several shots of local anaesthetic into my toe, and the heavy numbness crept in and overtook it.

I didn't watch, but I heard the sound of toenail cracking, and after 5 minutes of what sounded like bone being chiseled and pried and filed, I heard him say "Finito. We are finished." He wrapped my toe in gauze. "You will have to pay some extra money for this," he told me quite seriously.

I got another shot of antibiotic and stopped by the payment desk on my way out. The gauze wrap cost me 2,040 won (2USD), bringing the grand total of consultation, injections, X-Rays, and surgery, to 27,040 won (24USD).

Not only was my hospital visit incredibly cheap, it was also extremely efficient. All hospital records are computerized, so my information was sent ahead of me to each office I visited. When I arrived at the Injection Room, for example, the nurse looked at the name on my ticket and pulled up the injection order immediately. I walked around the corner to the X-Ray office and the nurses called my name and told me what they would be doing. At the pharmacy the English-speaking receptionist had my prescriptions printed out and waiting for me.

And although I did have to wait 2+ hours on my initial walk-in visit to see the foot doctor, a computer monitor on the reception desk displayed all of the patient names in the room in the order in which they would be seen. I could easily see where I stood on the list so I could estimate my wait time. When I saw that I was number 7 on the list, I went outside to get some coffee and walk around in the meantime, without worrying that my name would be called in my absence.

Though this is the most serious procedure I've had done, I've received health care in Korea twice before (for an eye infection and a sore neck). In every instance the doctors and attending nurses have been attentive and courteous, the process has been quick and efficient, and the actual service has been world-class.

This whole experience reminds me of, but stands out in stark contrast to, Glenn Beck's raving diatribe on the health care he received for hemorrhoids.

Acupuncture in Korea

I hurt my neck the other day doing yoga when I fell over during a headstand. Coincidentally, I had been looking for an excuse to visit the acupuncturist, and here Fate was kind enough to present me with one.

Some of my friends have had acupuncture done before, so I knew basically what to expect; I just wanted to know if it really worked, and how it felt. I also love Dr. Kim, the traditional Korean doctor down the street from my house. Lisa and I went to dinner with him and his wife earlier this week. They are extremely generous, loving people - their family spent four years in Uzbekistan while Dr. Kim gave free treatment to local villagers, and he has also spent time in Sri Lanka doing the same. He has a very calming demeanor, and I can't help but smile when I'm around him. He speaks English rather well, but he speaks it in such a way that he seems to be mulling over each individual word for maximum meaning and impact before speaking it, so he has a very slow, melodic manner of communicating that is entrancing and endearing.

Anyway, I visited his office at 9am Friday before school. My neck had been killing me all through the night; I slept terribly, and could barely lift my head from the pillow in the morning. I wasn't sure I'd be able to go to school that day. I only had two classes scheduled, so I wouldn't have felt terrible about it, but I wanted to see how I felt after Dr. Kim's treatment.

His office is very pleasant, with lots of natural light and a heavy (but not overpowering) smell of herbs. I waited for about 5 minutes and was called back to see him. I told him my story and that my neck was extremely sore. He held my wrist and felt my pulse for about a minute (though he didn't time it), after which he declared that my condition wasn't serious. He recommended that I do several acupuncture sessions, which I agreed to.

His desk is within the same room as the patients' quarters; small, well-apportioned cubicles with modest beds and a heat lamp. I took off my shirt and socks as instructed, and sat in a legless chair on the bed with my knees propped up over a pillow. He came in and, using a small metal tube that seemed to work much like a ball-point pen, inserted several small metal needles in my skin - three near my shoulder blades, one in the outside of my left food, and one in the outer flesh of my left hand, which I had balled into a fist. He left me in that position for about ten minutes, with a heat lamp directed toward my back.

After he removed the needles, I lay down on my stomach and he placed two large heating pads over my shoulders and neck, for another ten minutes.

The third treatment was fire cupping, in which Dr. Kim sprayed alcohol into four clay cups, lit them on fire, and placed them down onto my back. The fire went out immediately and created a suction effect, drawing skin into the cup and blood into the skin. Again he directed the heat lamp to my back and I lay there for another ten minutes. He applied a large herb patch over one of the cup marks, and gave me some herbal medicines to take three times a day. The cost? 6,400 won (6 USD). I made an appointment to come back and see him the following day.

bruise marks from cupping

Although my neck didn't feel 100% better, the pain had decreased significantly. Where before my neck was suffering from sharp, shooting pains whenever I moved my head, now the pain had dulled substantially and I had regained some of the range of motion in my neck. I felt elated, as if I had been dosed with anti-anxiety medication, and practically skipped my way to work.

Throughout the entire day, including the night, the pain in my neck never increased. I had expected the effects of the treatment to wear off, particularly overnight. But I slept soundly and when I woke up this morning for my second treatment, my neck felt quite spry.

I think I may have to start listing Dr. Kim as my "family doctor" from now on.

Acupuncture is extremely common in Korea - most of my co-teachers regularly visit their local traditional Korean doctor when they have aches, pains, or illness. It's almost always their first line of treatment.

For more on health care in Korea, see below:

Five Minutes in a Korean Hospital

A Penny for your...Eye Infection?

A penny for your...eye infection?

Apparently in Korean schools, few things cause more concern than contagious eye infections. A cold or respiratory infection will usually just prompt the wearing of a protective mask to avoid spreading the disease to others. But a child with an eye infection won't be allowed to come to school. Koreans are so touchy-feely that it would quickly spread throughout the entire student population. Because kids KNOW that it will get them out of school, they will often go out of their way to consciously contract an eye infection. If a boy with an incipient infection comes to school, other kids will wipe his eye and then their own, willing to trade their comfort for a few days of guaranteed vacation. 

So when I called my co-teacher Wednesday morning to tell her that my eyes were red, blurry, and crusty, she told me not to come into school. I went to see an eye doctor instead. 

None of the secretaries at the doctor's office spoke more than a few words of English - luckily, their limited vocab included the words "discharge" and "infection" and ten minutes and 4,000 won ($4) later I was walking out the door with a diagnosis (allergic conjunctivitis) and a prescription. The doctor was very nice and professional, and he spoke a surprising amount of English. Within 2 or 3 days, he said, it should clear up.

I stopped by the pharmacy on the ground floor of the building to pick up my prescription - 2 bottles of eye drops, another 4,000 won (that's 8k total, or about $6 for a doctor's visit and prescription).

Unfortunately, my particular brand of eye infection was not contagious (whoever heard of non-contagious conjunctivitis?), and I returned to school the next day. I say "unfortunately" not because I necessarily wanted to skip school, but because it could have made me some money. I've been told that some enterprising, eye-infected kids, realizing the street value of their illness, will use their "gift" for profit. They charge other students 500 won for the privilege of touching their eyes.