Still waiting for my denture/Carlos Pueblo

 Still waiting for my denture/Carlos Pueblo

More than one and half months before, I have started my installation of my new denture in order to replace my old sets. Almost every other week, I must go to the dentist's office to do some preparations such as the extraction of loose teeth, making molds and re-adjustments, and  mostly the waiting for the mail in and out to a laboratory in California. I suspect that the demand is not high enough in Houston to have a local laboratory to meet the market demand. At the same time, I am still managing to use my old sets to do the daily intake of foods.

I try to imagine how my dentist to structure my new sets. He uses fake teeth to fill holes on my teeth beds two of them up and down. My old sets are more like the construction of bridges with the metal as the skeleton and support of the frame to hold every one tooth lost. There are holes made to hold on to my healthy teeth between that make very much sense of the structure engineering. I have checked a model every time I check out of the dentist's office, yet I still can't imagine how my new sets will do the job. New sets are all plastic not metal frame.

I select the denture instead of the in plant because of the cost difference and also that I do have knowledge about the fake teeth installation. My cousin, Dr. Chen of Taipei, Taiwan, has installed my first sets of fake teeth in Taipei in 2013 and are still very strong and sound except I have had additional teeth fallen. His father is my mother's elder brother. While I was staying at their home between 1963-1966, I saw his technician working on the denture hardware on the ground behind his dental clinic. He could come back and forth to check with his technician to adjust the crown, bridge, and the denture, etc. Last time, my visit to his son's clinic was much easier and smoother than now I am in Houston. They are three generation of dentists in their family.

Nurses in the dentist clinic in Houston have measure my blood pressure and found out my new issue with it. My blood pressure is high now at the brink of high blood pressure, the second high of my body other than the diabetes, blood sugar. I am so disappointed and frustrated. Health issues are coming on me as along as I am getting old and I have also need to worry my son's health issue. I am suffering on aging like the current Buddha describes.

等候假牙／莊峻華

 等候假牙／莊峻華

牙醫診所有電話來曰，包裹已達，要我今午後三時門診，我道是假牙已達，結果不是，仍舊是草稿，再量一次，複送到加州實驗室，比我想像中多一步驟，就是多一趟加州來回，兩個半星期，製作和郵寄。

我的牙齒脫落，已經到無法容忍的地步，又是武漢肺炎，台灣回不得，所以只有當地解決困難，美國假牙選擇，顯然沒有台北市普遍，可能是美國人從小保護牙齒，注意牙齒健康，另外是植牙，但植牙僅能植一兩棵，多者一般人負擔不起，我甚納悶，何以大休士頓區，六百萬人口，無法擁有一假牙製作實驗室？

幸運者為我之等候假牙，完全在家裏，無需投宿台北旅店，也省去旅途奔波，無需落地禁閉三週，等候假牙，不算辛苦，也是解決老年病患之一大宗也。

牙診護士量體溫血壓，發現我血壓偏高，現在我已經邁入二高，血糖高和血壓高，從今日起，我要恢護素食，甚至減少食蛋牛奶量，再會牛排。

The function of the health insurance/Carlos Pueblo

 The function of the health insurance/Carlos Pueblo

The function of the health insurance can be noted the most while we must see a doctor in the emergency such as in the case of my son Arthur's retinal detachment. We couldn't see his regular eye doctor because he was booked for the entire week. His company booked Arthur to his colleague to take a look. Arthur didn't have the correct year's health identification card; therefore, we were stocked at the front desk for two hours to get the correct copy updated. Once we saw the physician and referred to another specialist by this physician's office, it is like a breeze on and on to see another specialist out of the network and another out of network hospital. We can't argue to the cost of the co-payment in such life and death case. I am very appreciated that Arthur has a job with health insurance coverage which comes to be very handy for our family.

He has had a birth defect called the Stickler's syndrome. My job's health insurance covered most of his life and death procedures such as removals of his tracheotomy three times, the plastic surgery of his  cleft palate, and many other medical needs before his age of six. After 2001, I lost my job and couldn't keep two jobs with the benefit of the health insurance. He was naked without coverage until his graduation from the college. I was not sure if I asked him to carry the basic coverage from the school, anyway, I was lucky that he was alright.

I don't believe that the $300 a week additional unemployment benefit is an issue and I don't believe the government has very much burden of it. That amount is only symbolizing a kind care from the government and can't go very far. I don't believe the Obamacare  can help too much for a person with asset either. Only when we work and only when we have had a valid health insurance especially a group health insurance to satisfy the Obamacare.

I am taking my requirement minimum distribution out now to pay Arthur's co-payment for this emergency surgery. I save regularly and I am prepared for such circumstances. His health insurance has done the most already.

急診用上健康保險／莊峻華

 急診用上健康保險／莊峻華

生活在美國，健康保險是一大負擔，尤其是個人健康保險，這次元兒眼疾，情況危急，用到急診，急診手術等，處處觸目驚心，讓我深深體會到保險之重要。首先，我們找不到平常眼醫掛號，因為他甚忙，一週門診已滿，還好其公司安排另位醫生，但在此醫生診所，因掛號對保險，耽誤一些時間，眼醫診所，十分忙碌，沒有健保，醫生不敢看病人，怕拿不到診斷治療費。

我們到專科眼醫處，診所更加忙碌，幾無空檔，診所有十位護士秘書，醫生也是團團轉，病戶都是重眼疾，然後安排另一位專科眼醫開刀，開刀房在大醫院之急診室開始，到開刀房，這醫院是世界級，不在元兒保險網內，因此我們需要多交多餘費用，因為事急，所以無暇思索，先開刀再講。

保險網內之自備費用，較為節省，網外就多百分之二十以上，美國醫藥費用昂貴，因為這是專業，而且我們是病人，有求於此醫藥專業，幸好元兒有健康保險，否則連醫生都看不上，美國有三千萬人口，沒有健康保險，美國一直無法有全民健保，我現在稍微了解為何緣故，美國保守派不主張，全民健保，不讓有限仁醫，為廣範大眾病戶纏身，緊急病患無救。

我最近也有醫藥需求，是假牙，因為老人健保增加一些牙險，所以我去詢問裝置假牙價格，和回台灣安裝比價，現在回台機票昂貴，再加上武漢肺炎隔離費用，我只好在休市裝假牙，牙醫給我一些折扣，雖是稍貴於台灣，但加上機票雜費和時間，自費安置也合算。

Miracle hands of a surgeon/Carlos Pueblo

 Miracle hands of a surgeon/Carlos Pueblo

Just two days before, I have witness a successful procedure of an eye surgery for my son Arthur. I call the miracle hands of a surgeon who has prevent him from the blindness. I have learned a lot ever since he was born almost 37 years before. He came to the world with a severe Stickler's syndrome birth defect. He couldn't breath when he was born, no cry and his body was in dark color because his wind pipe collapsed when he breathed. A surgeon inserted a tube from his neck to his lungs called the tracheotomy. He also had a cleft palate inside his mouth; therefore, he couldn't take food either  and relied a NG tube to take the liquid fluid formula and milk. Both di-efficiency and others were corrected by surgeons before his age of six. He had had no major health issues or surgery requirement since then until two cataract procedures in the past three years. We suspect that early age cataract surgery is related to his syndrome.

The doctors at Texas Children Hospital identified his syndrome by his cleft palate and treated him as a baby with respiratory difficulty. First, there was an ENT surgeon had attempted twice to remove a small piece of rip to strengthen his wind pipe and twice he failed. We didn't dare let him do it again on the third time. Finally, we were lucky to receive a recommendation to Dr. Rubin Cotton at the Cincinnati Children. He made it and removed the tracheotomy and closed the hole on the neck in 1991, right at the short conflict of the first Gulf War with Iraq.

There was a dentist specialist in plastic surgery who was successfully corrected the palate and healed the crack; therefore, he could start to take solid food. He was at Bendwood School for disable kids. His class teacher was amazed how much progress that he made and asked us to referred another unfortunate girl at the class to that plastic surgeon for her outside cleft palate. I still remember vividly now how disappointed I was to hear that the surgeon told me that her case was so solution at that time of the medical technology.

The other day, he told me that he had a retinal detachment according to his research on the You Tube vlog, a one eye blind girl with a Stickler Syndrome. We rushed to have an appointment with his regular eye surgeon who did both his eyes cataract procedures. The doctor was booked for the entire week; therefore, the eyes associates referred him to another eye doctor. This physician couldn't find anything yet referred his to a retina specialist, Dr. Andrew Kopel who came in to rescue me from my left eye cataract procedure. He couldn't tell the detachment either on the first visit yet recommended to have another appointment in three weeks. Arthur couldn't wait that long, on the second week there was an emergency situation. The black spot was getting larger. After careful looking and taking photos, he referred us to his old classmate, Dr. Petros Carvounis at the medical center area for the emergency surgery on the next day, a Saturday. I am so appreciated that through his kindness and our luck, we got it done successfully on that day. 

妙手回春／莊峻華

 妙手回春／莊峻華

昨日帶元兒門診，這是緊急掛號，由我的專科眼醫安排，隔日週六到德州醫學中心，求助另一視網膜專科，準備緊急開刀，因為眼球水液，已經逼近黃斑體，元兒左眼即將失明，眼科曰視網膜脫離，若不緊張者，眼睛失明，都茫然無知，我已經許多年，未曾如此緊張過，我之左眼白內障手術失敗，眼醫立即送我到一專科眼醫，再度手術，渡過難關，所以新眼醫觀看我左眼均曰，有視網膜脫離，我因為及時更正，故未知其厲害，這次元兒病情，始令我稍了解眼疾始末，我的專科眼醫，和他的專科眼醫，都是中文裏曰妙手回春者也。

這是36年半前的往事矣，元兒不幸，出生窒息體弱，有德州首例史提格勒併發症，呼吸仰賴塑膠管，從喉嚨插入到肺部，當時有位台灣護士留學生曰，漢譯為人工造瘻術，眼耳鼻科醫生，想辦法從胸排肋骨，取出一小片，貼在支氣管上，以求強化䡗固這天生崩潰之支氣管，德州兒童醫院兩次手術失敗後，我們好運得到一位英國仁醫瓊斯大夫，推薦到辛辛那提兒童醫院之，盧賓卡頓醫生，他一舉將插管拔除，封上頸洞，使元兒能自然鼻肺呼吸，這是妙手回春一大例。

併發症病例之一，就是兎唇，這也是德兒醫生查出之病名，他們就跟據呼吸困難，來治療元兒，元兒另外一大困難是內兎唇，就是舌頭向上，阻擋上額之癒合，生下來就如此，因此無法吞食，每口進食，就從上額漏出鼻孔，因此需要插鼻管通胃餵食，德兒專門，有專門護士進住寒舍，愛美也接受訓練，她在台灣當過護士，後來終於遇到一位牙科整型大夫，將上額縫合，當時元兒在邊林學校，級任發現元兒進步，要求我們推薦這位仁醫，治療另一位班上外兎唇小女孩，我問醫生可否介入，他們都在醫學中心，處理疑難怪症，不知是已經是他的病人，他說他很清礎病例，與元兒不同，而且是當時無法挽救，我到現在仍舊清礎回憶，手術成功後，元兒開始能口食，當年岳母大人來幫忙，熬豬大骨麥片粥，讓元兒食用。

這是1991年，首次伊拉克戰爭後，我們照顧元兒，喘了一口氣，然後元兒順利完成學業，休大畢業後，在超市當收銀店員，一直健康愉快，直到這次三日驚嚇，還好遇見這位妙手回春之仁醫，此醫生是希臘裔美國人，第三代專科眼醫，劍橋醫預，牛津醫科，在貝勒專科與我的專科眼醫同學，除開業外，尚是貝勒之臨床教授，我提起併發症，引起群醫好奇，也因此替元兒解圍。

我邀請元兒，在我部落格寫作文，他已送出首篇，我這三十多年，出版很多回憶他的病情，在鄉訊和幾張台灣人報紙，有些有保存，均是美憶。

Arthur's surgical procedure of his retinal detachment/Carlos Pueblo

 Arthur's surgical procedure of his retinal detachment/Carlos Pueblo

For the last four days, we have been very busy to manage Arthur's surgical procedure of his retinal detachment. I have invited him to write about his ordeal on this blog and now I like to describe the same from my part as his parent. What I like to describe about are the help as parents in this case, the insurance prospects, and dealing with the medical field issues.

Arthur has been like a normal kid after his six years of age without any severe medical attention. About three years ago at his age 33, he had had his right eye cataract procedure, and his left eye procedure at age 35. Both procedures were successful without incident even though he was very young for such procedure. After 14 months from the later procedure, he has discovered that he has a retinal detachment on his left eye. We think that may be due to the result of a genetic default because that my left eye also had a detachment right after my left eye cataract procedure. I had to have another surgeon to  repeat the procedure. My eyes are doing great after the three procedures and I do have a detachment on the left eye. We keep him at home in order to take care for him and I know how much the medical attention will cost me. Luckily he works with a company which provides the health insurance for the employees.

He attempted to see his cataract procedure surgeon to take a look yet he was booked for the entire week. Then the provider's firm sent him to another physician to take a look. The new physician couldn't tell the problem yet referred to my eye surgeon, the one who came to rescue me last time. He couldn't identify Arthur's detachment either yet asked him to come back in three weeks. On the second week, Arthur's condition was getting worse and he managed to get the same specialist's attention to get an emergency appointment. After careful examination, he referred Arthur to his fellow retina specialist near the Texas Medical Center for an emergency surgery on the next day. He is lucky that he gets this eyes surgeon on Saturday and entered the Methodist Hospital on that day as an emergency case and got the procedure done all within three days.

I can't care too much about insurance net works or not. The final surgeon's office and the hospital both take him as a patient and I know that I have to prepare his part of the payment. I am alright with such payment. The money pain is like a breeze that his blindness in the future. Now, I am more appreciated of the current health insurance system in the U.S. I can tell the difference if this urgent need of medical attention occurred in Canada or in the United Kingdom, etc. I wonder if Arthur and we as his parents can get a peace of mind. He might not get the quick attention.