Wednesday, July 21, 2010

Breadwinner Down

Yuni had what we thought was a problem with kidney stones. He had had it in Taiwan; some mornings he would wake up with excruciating pain in his kidneys. He would roll around in agony, but then he would get up and walk downstairs, go to work, and by evening when he went to a clinic, the pain would be gone. He had scores of x-rays taken, but the doctors found nothing. They told him that he had probably formed and passed a kidney stone.

He had a few attacks after we arrived in the US, but they occurred on work days, and he didn’t feel that we could afford it if he missed the opportunity to make money. Fortunately, he was working in a union shop, and after three months, we had very good health insurance. It included free check-ups and immunizations for the girls, and we only had a $500 deductible. On Memorial Day weekend, Yuni had another attack. It was a Sunday morning, so he did not need to go to work. He just lay in bed screaming. Finally, I called some church friends to see if they would take the kids to Sunday school while I took Yuni to the emergency room. The hospital closest to our home was a teaching hospital called Harborview. As we lived in the poorer section of town, it was full to the bursting with sick babies on a Sunday morning. After Yuni got up and walked a little, his pain subsided. We waited and waited with him lying on a bed, and finally we were seen by a student doctor. At first, he was going to discharge us quickly because the x-ray again showed nothing, but while he was waiting for the supervising instructor to come sign the discharge form, Yuni went into an attack again. The instructor berated the student for wanting to charge a patient in so much pain and ordered Yuni to take an ultrasound.

The line for the ultrasound was not very long, and within a short time, the entire class of ultrasound technologists were crowded around the screen showing Yuni’s kidneys. They could not tell me what they were looking at, but they did say it might be serious. I was freaking out. Back in the emergency room, the supervising teacher saw the film and told me that Yuni’s left kidney was blown up like a balloon. He asked a number of pointed questions as to how long the pains had been occurring. After finding out that this was a ten-year ailment, he said that the left kidney might not have any function left at all. He actually called in the head of the urology department to consult as to whether or not Yuni needed to be hospitalized immediately. The answer was no, but we needed to see the urology team on Tuesday and have some more tests done all that next week.

I was able to find friends to take the girls, but it was a very nerve-wracking time. Tuesday came around, and the urologist with his band of students told us that Yuni would definitely need surgery. He might even need his kidney replaced. We went home to look at the bank account because we did not know what we were going to do. Yuni was not working, so there was no income. I needed to accompany him to the hospital to translate because Mandarin translators were not as common then as they are now. We had fulfilled our deductible, but we still had to reach a threshold of $3000 before we had 100% coverage, and we did not have enough savings to live on AND to pay the medical bills. Yuni called his parents and told them what was going on. They arrived the next week with some money and to take care of the kids.

We did get some good news. The kidney still had 90% of its function, so the urologists said things were hopeful. They thought Yuni had a congenitally small tube that made it difficult for the kidney to drain. They were planning to go in and put in a stint. So plans were made; we called Yuni’s work. They would keep his job, but since he had only been there for 8 months, he did not have enough sick days or paid vacation to cover all the time off he would need to take. Pa and Ma brought a lot of money for them, but they had no idea of the relative costs of living. It was enough to support the family including them for the month Yuni would be off work, but it was not going to be enough to cover the medical bills. Yuni did not want to ask my family because he thought it would be a huge loss of face for him and Pa. I was saying lots of fervent prayers.

The surgery took much longer than the surgeons had expected. Ma and Pa and the kids and I were all sitting in the waiting room outside the operating rooms. Finally, the head of the urology department came out to tell us what had happened. When they got Yuni opened up, they discovered that the problem was not a narrow ureter; instead, Yuni had an extra branch off his aorta that pushed the opening in the kidney shut when he lay in certain positions. When he got up and moved around, things would shift a little, and the kidney would drain. This was why he had so much kidney function left, and it was also why the doctors had never found any traces of crystal when they thought he had kidney stones. If the surgeons had even nicked the branches of the aorta going into his kidney, he could have bled out, so they had taken the time to proceed slowly and carefully. That condition is congenital, and it only occurs in one out of every one hundred thousand patients. Of course, the surgery was too exciting to miss, and all surgical students had been called in to observe the condition that most doctors only get to read about. The surgeon himself had never performed the procedure, so he had taken extra care to do it right in front of all the surgical students. This was a good thing for the medical school, the students, and Yuni, but they forgot to tell us it was going to take an extra hour or so. Ma and I were almost crazy with worry.

To fix the problem, the doctors had to carefully detach the tube from the kidney and reattach it at a lower point away from both branches of his aorta. Then they had to be sure that everything was stitched up tightly so that nothing would leak in his body. They also had to cut around to approach it from behind, so he wound up with a huge 9 inch scar across his mid-section. He remained in the hospital for a whole week while the doctors made sure that everything was healing properly.

Every day that week, I would make breakfast and then leave the kids with Ma and Pa. I drove the car to the hospital and rushed in to get there before the morning rounds. Yuni did not speak enough English to answer the doctors’ questions. Every day, he had the largest contingent of doctors looking at him. He was quite the celebrity. The hospital was a mile and a half from our house, so Ma and Pa would walk the kids down for visiting hours at 4 pm. They would stay and watch Yuni eat his dinner at 5, and then I would drive everyone home about 6:30 or 7 when visiting hours were over. When we got home, I made dinner and went to bed pretty early. That week went by very swiftly.

Yuni was not allowed to work for three weeks. He stayed home resting and chatting with Ma and Pa for about ten days before he was totally bored out of his skull. We did have lots of visitors from church, and even though I had not spoken with them about our need, their generosity was an answer to all my prayers. We were short $2000 for the medical bills plus the expenses we would have for the two weeks after Yuni went back to work and before he got his first check. People from church kept giving us gift cards with cash inside. One person gave us an envelope with $2000, just enough to pay off all the outstanding medical bills. The rest of the money added up to enough for our living and enough to take Pa and Ma on a weekend trip to the Olympic Peninsula and rain forest.

As I watch the news these days, I sometimes wonder what some of our lawmakers are thinking when they accuse the unemployed of laziness or when people get so upset about unions. I am so thankful Yuni had the union job with the union health insurance. We still didn’t have enough money by ourselves, but it was much easier to come up with just a few thousand dollars for medical expenses and groceries and rent than it would have been to have come up with the $100,000 that the surgery alone had cost, much less the tests. We were not extravagant; we were working class poor. We still needed help from the food bank most weeks, and with that help we were able to save a few hundred dollars here and there, but we had not had time to build up much savings. I was very disappointed this year when the health care bill was passed without a public option for low-income people. We were so lucky to have had that health insurance because later in the calendar year of Yuni’s surgery, Truth stepped on a wasp and her foot swelled up to the size of a football. Then Peace got an intestinal flu and needed to go to the emergency room three times for IVs to prevent dehydration. Because we had good health insurance, our family was able to get through those small emergencies without any problem. The union used economies of scale to negotiate directly with the insurance company to get good coverage that was great for its members and cheaper for the employers. A public option could do the same thing on a national level.


murat11 said...

Having once survived a kidney "stone" that debilitated me and proved to be a mere "stone" the size of a pepper flake, I am amazed at all the stories I hear of folks going on with their lives while battling the pain. Of course, I was insured at the time, and as one of the uninsured now, I have seen where the "cost" of being sick often mitigates the symptoms.

Loved the musings of your last paragraph.

Teresa said...

When Yuni quit that job to start his own business a few years later, we bought our own insurance. The only policy we have been able to afford for over a decade covers emergency room visits and surgery. With Yuni on a construction site, we didn't feel we could do without insurance entirely, but after paying self-employment tax (double Social Security), we had to economize on the health insurance. Medium and small-businesses create the most jobs in an economy, and yet the small business legislation before Congress has been gutted by compromise like the health care bill was. The portions freeing up low-cost financing has been shot down as another "bail-out." And yet, people are still insisting on tax cuts for the top 1%. Small business owners are not eligible for unemployment benefits usually because that is one of the first places you economize when times get tough. The small business legislation is another measure like extending unemployment benefits to help keep families in the middle class. It helps stabilize society, and it was policies like these that propelled the US into its position of world superpower. Ironically, China is working to decrease income disparity as it chugs ahead into top economic form globally, and we are moving to make our society more and more like a third world country.

murat11 said...

Hear, hear!

Cloudia said...

you are so right...glad your prince is OK :)

i love zoos toos.....

Aloha from Waikiki

Comfort Spiral

Cloudia said...

Teresa for senate!

Teresa said...

Hi Cloudia,

Thanks for visiting.

I worked in the Senate for two years when I was at Georgetown. That cured me of any desire to follow in my grandfather and father's footsteps to be a politician. I am much too idealistic to be good at making necessary compromises.

Cloudia said...

Chris is back and well!

Oh joy-

Teresa said...

Chris is back and actively posting!!