I applied for a Teach in Taiwan program through the Arkansas State Department of Education. I was accepted and have been teaching in Taiwan since August 2010. It is quite the experience so far. There are many things to see and do here. For the most part, the people are really nice. Some are really curious! They like to stare, touch, or talk to you in Chinese even if you don't speak their language. Taiwan is a beautiful island. If you would like to know more about what I have been doing here, then take a look at my "Timeout in Taiwan" blog. I'm sure you will enjoy the pictures.
Before I came to Taiwan, my legs were my main concern. I wasn't sure how they would hold up after a +18 hour flight. My compression hoses really didn't help, but created indentions throughout my leg. When I arrived here in August, it was very hot and very humid. If you have been reading, then you know that I was as big as a house. To get around this lovely city, you have to walk, ride a bike, take the metro, or take a bus. Being that I am a foreigner, I have to walk to a lot of places. I just told myself that it was no big deal and that walking was good exercise. Well, before I came, I researched lymph edema clinics or trials. I found one and immediately contacted the guy. He responded through email and said that there was only one doctor in the area that had knowledge of lymph edema in the lower extremities. He gave me his name and email address and wished me luck.
I contacted Dr. David Hsu through email and explained my condition.The following day he asked me to give him a call. I called and he asked me several questions about my past medical history. He went on to say that he had an idea of what I had and needed me to come in to confirm his thoughts. I agreed to come out and thanked him for his time.
After the phone call, I just sat there in amazement. I was ready to cry because I had so many mixed emotions flowing through my body. At one point, I felt a smile come across my face because their was a possible treatment for my condition if it was what he thought. Then I felt anger because after 13 years it took me coming to another country to find something new to research. Later on that night, I just cried. The tears were a mixture of emotions from things in my past that were not health related to health and relationships. I just remember crying for a long period of time. My pillow was drenched in tears. I had to ask myself when was the last time that I had cried. Had I been trying to be tough for so long that I forgot how to cry? I believe that was the case because with this new found possibility EVERYTHING made me emotional. I could watch a movie and shed some tears. I could watch a popular TV series and a lump would form in my throat. Before I knew it, a few tears had dropped. The moments could be sad or happy. Whatever it was, I had a tear coming. I'm still having a hard time dealing with these new emotions. Anyway, let's get back to the doctor visit.
Like any other time, I expected to be asked the same questions and received the same tests. I was partly right. The questions were the same, but he only ran one test. He took a blood pressure reading in my legs. Let me rephrase that. He TRIED to get a blood pressure reading in my legs. They took giant blood pressure cuffs built for the legs and tried to get a reading. They performed the test twice and he came back to tell me that the blood wasn't circulating and that he believed that I had MTS. I was like "What is MTS?" After all these years, it was a new diagnosis that I had never heard of. MTS stands for May Thurner Syndrome. Basically, the iliac vein is either compressed, partially compressed, or in some cases blocked due to blood clots. He wouldn't know the specifics until he could do a venography. Of course, I freaked out because I thought he meant venogram like the one I did in the past. When I questioned him about it and calmly assured me that it was similar but not outdated like the one I before. That gave me some relief because I wasn't sure if I could go through that again. He explained to me that normally they would admit the patient on a Wednesday, do a vein study on Thursday (venogram), perform a stent placement on a Friday if it was MTS, get the patient up and walking around on Saturday, and discharge on a Sunday. That scared me because here I am in a foreign land and I have never had to stay in a hospital for over a day. Not to mention the language barrier. I agreed to and waited for the dates to be confirmed. As time grew closer, I learned that I would have to pay all of the money during the visit (at least $100,000 NTD). They have good health care here, but they do not have payment plans.If you are wondering how much $100,000 NTD is in American money, then I will tell you that it is around $3, 388. I hope you caught the "at least" part. That amount is for the stents only and not for the hospital stay, chemicals needed, or medicines. Each stent is worth $50,000 NTD. Because I could not afford it, I asked if he could do the test to confirm the diagnosis and he agreed.
VENOGRAPHY
Here is what I went through to get my diagnosis.
I was admitted on a Wednesday afternoon. I was taken to get blood drawn and I got an EKG done. Wow is all I can say when I want to compare the technological differences between the States and here. The EKG had suction cups in the shape of those suction devices for babies noses. They left hickies on my chest as well.
They didn't hurt, but they weren't comfortable. Next, I had to get a chest x-ray. After the chest x-ray, I was shown to my room. The semi-private rooms were all full so I had to stay the night in a community room. NOT FUN!! Four people to a room. 2 of my roomies were alright, but the last one drove me insane. I felt sorry for her. She kept yelling throughout the entire night. I don't know what she was yelling because it was in Chinese. The only time that she would stop was when a nurse or aide came in during their rounds. As soon as they walked out of the door, she was back on it. I did not get a lot of rest that night and the IV in my arm did not help.
Thursday morning, I was greeted by several nurses and doctors that were going to be looking at my tests and that were learning about my condition. Many spoke to me in Chinese. I would say to them (in Chinese) that I didn't understand. I guess to them that meant that I didn't understand what they were saying and that they needed to rephrase it in Chinese. I would laugh and then say "I don't know" (in Chinese). They would give me a strange look and then realize that I couldn't understand them. They would do some kind of motion to let me know what they were about to do, take care of the task, and then we would both laugh as they walked out of the door. That happened off and on until they took me downstairs at noon. Talk about an experience!
Downstairs they put me on a table that had some kind of machine above it and a monitor that swung out so that the IR (Interventional Radiologist) and I could watch the procedure. Yes, I did have a flashback and began to get nervous. Ok, next they applied iodine over the area where they were going to insert the catheter. The IR explained the procedure again and asked me if I had any questions. My main question was "Is it going to hurt?" Don't laugh! I had a valid reason for sounding like a kid at that point. I think I was traumatized by previous events. Anyway, he went on to say that he was about to give me a numbing anesthetic for the site. He brought out his needle and I flinched but made it through. I was able to breathe through the pain and relax a little. Now, the next part is kind of hazy and you will understand why in a second. The IR said and I quote "Alright, I'm about to puncture you." I wish I had a camera for the look on my face when he said that and the look on my face when he "punctured" me. OH MY GOODNESS!!! I didn't think I was supposed to feel it! He didn't understand why I was in so much pain. The tears came a-rolling. I remember the pain, gripping the table, trying to breath, and mentally praying for it all to be over. After about 3-5 minutes that felt like eternity, I was FINALLY able to calm down and look at the screen a little. I didn't see anything so I closed my eyes again. The aide kept coming over and wiping my tears away and saying nice things to make me calm down. She was really sweet. After I calmed down, they began to talk me through the procedure and asked if I wanted to hear music. Of course I wanted to hear music, but the thoughts in my head weren't allowing the sound to filter through. The went in through my right iliac vein because they felt the left would be too closed or blocked to proceed. I could feel the catheter creeping across my stomach. It was a weird and funny feeling. I remember them telling me that they were injecting the dye (did not hurt like before Thank God) and that I needed to hold my breath. The injecting the dye part was a weird feeling. It felt warm going through my veins and it felt like I was using the bathroom on myself even though I was reassured that I wasn't. I think we did that 2-3 times and then that part was over. I was instructed NOT to move! And I do mean not a muscle. There were about 6 people that came out of nowhere to get me off of the table, on to the bed, and on to a CT machine. Once in the machine, I was instructed NOT to move! I was following orders so well that I was afraid to blink. When that test was over, they helped me to the bed and told me that I had to rest for 2-3 hours before they would discharge me.
I'm not sure if the woman from the previous night was still in the room. I know I passed out from exhaustion. 3 hours later, my IV was almost finished and the doctor came up to talk with me about his findings.
DRUM ROLL PLEASE...........................................
"Just like I thought. You have a condition very common here in Taiwan. You have MTS anatomy." The lady that was with him wanted to correct him and say that I had MTS, but he said something to her and she shook her head in agreement. He went on to say that my left iliac vein is compressed in two areas. One up high and one down low. I was amazed! God has been taking care of me for some time now. No wonder why my left leg is 2-3 times bigger than my right leg. I was happy! I am still happy! I now have a diagnosis for a condition that has bothered me for 13 years. The only thing keeping me from treatment was money.
2 weeks later, I received an email from Dr. Hsu stating that a company wanted to offer me a free stent. He wanted to know if I wanted it and when I wanted to do the procedure. Of course, I want it! I'm not sure what I will have to do to get it, but I will do an interview, write a story, or talk to others if I have to. We are currently working on the dates. As of now, I am praying for sometime during the week of April 11th - April 17th. I will get the free stent here and then get another stent put in when I return to the States in July. You can see a picture of the 3D images that I received during the test. As soon as I can get the video to work on my computer, then I will upload it as well.
