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My PI CAncer Adventure – Lessons Learned

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Part 1

Part 2

Part 3

Part 4

Part 5

Part 6

Part 7

You can all breathe a sigh of relief. This will be my last posting in this epic tome. I’ve been home almost three weeks and my nose is returning to what will be its new normal. My oncologist has cleared me, I’ve seen my dermatologist (as I will every 6 months for the rest of my life) and I visited a cardiologist who said I was fine, with my heart just compensating for – you know, getting old. My energy is coming back. In short I expect to put this ordeal in the rear view mirror soon.

I hear expats all the time complain and worry about health care in the Philippines. So the following are my lessons learned and suggestions. Take them with a grain of salt of course. It’s your body and your money.

Get a Doctor(s): Many guys here just wait till they have a major problem or keel over and then are dragged to the ER where they get whatever doctor is on call. And then of course complain about the care or the costs. So get and visit a General Practitioner regularly. Get a check up and have your blood work done. You’ll not only feel more confident that you are not likely to keel over, you will have an entry point into the medical system who can recommend treatments, medications and other specialists when needed. Yes, you may have to visit a few GPs before you find one you like, but that would be true anywhere.

The same is equally true with specialists. As we age and our little bits and pieces age they need to be cared for. So, depending on what issues you have, find a dermatologist, cardiologist, optometrist, dentist, etc. Typically doctors visits here are cheap – so go to the specialists you need.

And BTW, if you are pasty white and older in the Philippines, you definitely need a dermatologist.

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Get PhilHealth: I am surprised at how many expats here do not have PhilHealth. Yes I understand that a few years ago they raised their rates for expats and guys were pissed off, but unless you have other medical insurance it is still a good deal. If I have done my math correctly, this year PhilHealth covered nearly 100k of my treatments.

While PhilHealth only covers in-patient hospital care, many procedures are considered in-patient. My surgery in Manila was in-patient, even though I never spent a night in a hospital. My radiation therapy in Cebu was the same.

In addition, while it is true that my PhilHealth premium increased it also covers Janet. So again, It’s a good deal you should strongly consider.

Do Your Research: It may be harder, but if you know that you need an upcoming procedure, do your research. Ask about doctors, hospitals and the best procedures available. Ask about costs although this may be harder to pin down since the typical answer will be “it depends on what the doctor orders.”

I find that Americans do a little better with this than those expats from countries with socialized health care systems. Those guys are used to “free” healthcare and are less used to a system where healthcare has different prices, just like other services. Americans are also used to being gouged by doctors and hospitals and so are often pleasantly surprised by prices here – that is if they do their research – if they don’t they can get gouged here also.

Know People and the System: The Philippines is a communal society. Everyone seems to know everyone. Most expats do not take advantage of this but you should. Here are two examples:

Last summer, after the pandemic was well underway, but before we knew what we now know (lol) I had a weird rash, unlike any I had ever had. I also was running a slight fever. After a couple of days I wondered, ‘should I get a swab test?’ But we were all still afraid of going to a hospital so I hesitated. Then I remembered that I have a guitar repair customer who is a front line doctor. Apologetically, I contacted him. We spoke on Messenger and I described my symptoms and showed him my rash. He confidently confirmed that it was not Covid and I did not need a test. An antihistamine would help, which it did. I thanked him and apologized again but he reminded me that telemedicine is the present and future.

Second story: Recently I got my 1st Covid jab. I was surprised by several expat friends who didn’t know that it was available here and complained that their local towns or barangays did not come to tell them. Remember, this is the Philippines – a communal society. Everyone knew the vaccine was available for seniors; except my few friends. So, get to know people and get to know the system. Do you know where your barangay is? Do you know your Barangay Captain? You should. Janet and I know ours and we have texted her several times over the years when we had issues and she always got back to us with answers. So know people and know the system.

Have cash and keep it separate: Moving to the Philippines without actual cash in the bank is a disaster waiting to happen and most of us know this. What I am talking about is having a medical or emergency fund separate from your monthly living expenses fund. We have such a fund in the US. In addition, I also keep some cash in a dollar account in my Philippines bank. I keep it separate from my Peso account, so we don’t end up spending it for monthly living expenses. Figure out something similar. It doesn’t have to be huge – just enough so that you can easily access it in an emergency. The same can be true with a credit card. Most (though not all) hospitals will take credit cards, so in a medical emergency having a credit card can help.

Anyway, I hope and pray that this is the end of my medical adventure here. That said, as we get older there is a reasonable chance that there will be other such adventures. I think I’ve learned a little about navigating such adventures. Hopefully, you the reader have also.

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Life, Illness and Death in the Philippines – Preferably the Former

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There are a couple of well known Philippines vloggers who have recently had heart issues and of course vlogged about it, because that’s what you do nowadays when you are having tests and open heart surgery. I wish them well, but their experiences have been thought-provoking and scary.

In addition, I am Facebook friends  with many of my classmates from high school. Since we graduated 46 years ago, this means that they are all old. You notice I didn’t say I am old; I am married to Janet so how can I be old. But the rest of my classmates are 🙂

Not to be too unkind but they often post about their ailments, their partners’ ailments, their dogs’ ailments, etc. Some are minor and some are quite major.  Again, I don’t want to be indelicate, but I wish they would all get better quickly – if only so that I don’t have to be reminded of what lies ahead.

So as we get older, how do we deal with this? For years I could avoid dealing with any of the aging process by saying “I am perfect, no issues, not a broken bone, not a stitch.” I was the guy who went to the doctor’s office and the nurse took my blood pressure and said, “Wow, I wish I had your BP.” A few years ago they stopped saying that. Not that my BP is high, just that the doctor says I should cut down on my salt. “So what would you suggest?” I asked. “Telling them not to put salt on my fries at McD’s?” Ok, it’s a start.

Last month I bought a blood pressure monitor because I figure they might not have those free monitors in super markets in the Philippines. My 20 year old son asked what it was. “The gizmo that’ll tell me what week I’m gonna die.” And of course like most people with BP monitors I have begun to obsess  over it and try to figure why yesterday I was 5 points lower than today; knowing that at this rate of increase I have maybe a month to live.

I have a couple other minor physical annoyances. I’m a woodworker and my fingers and thumbs are always stiff and sore. Everything else is sore too but the fingers are sort of important to me. I even bought a pair of cut-resistant gloves because when I was younger and cut myself, the bleeding would stop. Now it stops only after all the blood has completely run out.

But really I’ve been lucky. No major health crisis and nothing’s fallen off. According to our Optometrist I am 20-20 with better vision than Janet. Of course I have to wear reading glasses most of the day because my arms have shrunk.

I have an acupuncturist and every time I go to him he says I am in great shape with no major issues compared to his other patients, who apparently have stuff falling off. So I keep going to him because just like with the BP, I like hearing that I’m OK – until I’m not.

But all this health and aging stuff is an issue for those of us moving abroad. After all I live in a country with the best medical system in the world 🙂 OK, that was said sarcastically, since we all know the U.S. medical system is far from the best; it’s only the most expensive.

So how do I deal with the possibility of getting sick in the Philippines? The same as here – I’ve decided not to get sick. I mean there is no easy or pleasant way around it, is there? Wherever you are, whatever the medical system is like, no matter what the costs or the insurance coverage – no one wants to get sick. And yet someday most of us will. Personally I prefer dying in bed with Janet or getting hit by a jeepney, but what if I don’t?

From a strictly nuts and bolts standpoint there are a few things you should do in the Philippines. Phil Health, the Philippines health care insurance system is a deal that beats all deals in life. It’s about 2400 pesos a year, which is about $50/year. Yeah you heard that right, 50 bucks! And even if you are an expat not married to a Filipina, you are eligible. Now the coverage is modest. It covers hospitalization and depending on the hospital and what’s being done, Phil Health will typically pay between 15 – 40% of your bill. But did I mention it’s $50 a year!

Thanks to President Duterte there is a now a national 911 system in the Philippines. It’s an amazing achievement. However in most of the Philippines calling 911 because you are having a medical crisis has limited benefit because in most places there are no ambulances. So, make sure you or your wife or your trike driver knows how to get to the hospital.

Choose your hospital wisely: Last year we were in Cebu City and I cut myself (I hadn’t brought my cut resistant gloves) and we thought I would need stitches. We grabbed a taxi and Janet told the driver to take us to the emergency room closest to Ayala Mall. Janet is a smart multi-tasker.

With these facts, most men are turning into other alternatives such as taking cialis online natural supplements in fixing erectile dysfunction. The main reason for people wanting large penis always circulate around man’s ego, like how bigger penis can satisfy women better as compared to other levitra purchase . In this manner they have to take steps to improve your sexual life and satisfy your partner, then you definitely need to consult an ED treatment spe free prescription viagrat in Delhi, Dr. They are supposed to keep http://deeprootsmag.org/2017/03/14/my-beautiful-birds/ viagra pills your sexual performance and sex life intact and safe. Find a good doctor: This seems obvious to me but I know guys who live in the Philippines who have not signed up for Phil Health and don’t have a doctor. So we will do our research and try to find a doctor we can mesh with. This is not so easy even in the US, with our best medical system in the world 🙂 I have at times struggled to find a doctor here I like, even with nothing wrong with me. A few years ago I was advised by my then doctor to have a minor surgical procedure and referred to a surgeon. I went to the consultation and while the surgeon made it clear he’d be happy to cut me open, he indicated I didn’t really have to do it. So I didn’t. My primary care provider was pissed at me; perhaps he gets a kick back. I found another doctor.

So in the Philippines I will find a doctor I can work with, a dentist, and an acupuncturist to tell me I’m in great shape. I will tend to give them the benefit of the doubt because – they are dirt cheap. Oh, did I not mention that before? When I went to the ER last year for the stitches that I actually didn’t need, the doctor and nurse dressed my wound, and gave me a tetinis shot. ER cost? $9.

One of the vloggers I referenced at the beginning of this piece ended up needing quadruple bypass surgery. He used Phil Health Z, a special program for particularly major health issues. He posted that his quadruple bypass cost the equivalent of $5100. For that amount it’s almost worth having the blockages.

And BTW, in the US with our greatest medical system in the world 🙂 , you’re not going to see doctors jump for joy like in the Philippines (see picture above). So the Philippines has a big advantage in the jumping up and down for joy medical category.

I was talking to a friend recently who happens to be a health professional in this, the greatest medical system in the world 🙂 We agreed completely; quality vs. quantity is where it’s at. His other advise? That we should all tattoo “No CPR” on our chests.

So here for me, as I age and prepare to retire and move is the issue: do I want to park my keester near a hospital in the country with the greatest medical system in the world 🙂 or do I want to live out my life with joy and happiness, even if it’s farther from a hospital and there are no $600 ambulance rides to be had?

Now if only I can convince Filipino restaurants to cook with less salt I can have both quality and quantity.