Thursday, September 30, 2010

PC, Update #2: Medical Kit

Soooo, today I finally got back to Zurich after more than four weeks of traveling. It was a fantastic trip, educational on many different levels. You learn just as much about yourself as you do other people/places/cultures when you travel.

Waiting for me on my bed when I walked in the door was my Peace Corps medical kit, which contains all the forms I'm going to have to get filled out and some guides about how to do everything most efficiently. Basically it breaks down into three parts:

  • Medical: This includes getting a physical (clinical exam); getting a laboratory evaluation (blood and w/ reports checking for TB, HIV, CBC, Hep B (surface antibody, surface antigen, core antibody), Hep C antibody, G6PD titer, and urinalysis); getting any missing immunizations (Td or Tdap Booster, Polio Booster, MMR #1, MMR #2 booster, Varicella #1, Varicella #2); and providing documentation for all immunizations I've ever had. In addition, and very annoyingly, I have to write a personal statement about any psychological/psychiatric treatment I've received. This is additional stuff, and the only reason it's included is because on the initial Health Status Review, I said I had been to see a psychologist before, like when I was 11. That was just a couple times after my parents divorced, because my dad wanted to make sure everything was all right. And I also have to get my shoulder checked out and diagnosed, since I reported that it has sometimes been dislocated. That might mean X-rays. which would be lame. All t's must be crossed, all i's must be dotted, all documentation must be copied and saved, all lab reports included, and absolutely nothing may be left blank.

  • Dental: I need to get a general dental evaluation, a periodontal evaluation, and have the dentist check for a specific list of abnormalities. I must also include either a full mouth series of x-rays or a Panorex with bitewing X-rays.

  • Optometric: I have to have my eyes examined to confirm a prescription, and I have to fill out a form for specific measurements of replacement frames in the event that the glasses I bring with me break or are lost.

That's the long and short of it. The medical part will obviously be the most complicated. My situation is also complicated with insurance. My insurance in Switzerland should cover the physical exam. But I'm not sure if it would cover blood analysis and urinalysis. On top of that, the Peace Corps put an addendum in my packet warning me of the perils of getting lab work done in foreign countries, which often do not have the same standards that the US has, and so are often not acceptable. I called my Peace Corps medical review assistant, and he said my best bet, if I'm set on doing it in Switzerland, would be to call the US embassy and see if their medical office has a list of approved laboratories whose results are acceptable by American standards. It's a very pompous position. I mean, this is Switzerland, not Swaziland. But this is their game, so I have to play by their rules.

For the dental, I know that I'm for sure not covered with my insurance here. Luckily, I have learned that there are dentists across the US (members of the International College of Dentists, USA Section Fellows) who volunteer to do the exams and X-rays for Peace Corps Volunteers free of charge. Not only that, but there are half a dozen of them who work within an hour of my home in South Florida. So I think I could get that taken care of without much issue, especially considering I have a healthy mouth and no history of cavities, no fillings, no problems with wisdom teeth, no gum disease. Hopefully that'll be one of those in-and-out procedures.

As for the eye exam, that should also be covered by my insurance in Switzerland, and shouldn't be more than a single-appointment deal.

I have also learned that at VA facilities in the US, some doctors will perform the medical stuff, including the blood analysis and urinalysis, free of charge, as a courtesy from one government organization to another. It's done on a space-available basis, so it's not the same guarantee as going to a private provider. But it's free, and you get the feeling that a publicly funded hospital is going to be less willing to point out (or invent) insignificant abnormalities than a private facility, which profits from your return business. That could also be an option. I'll be looking into that presently.

Writing this out is helpful for me to keep it all straight in my head. When I look at all the information like this, I see that it may be more sensible to go back to the US and take advantage of the free options. I also wouldn't have to deal with the hassle of these different standards in blood tests. Blood tests are the most expensive thing here, and if I have to get multiple tests, it's going to cost big.

So that's what I've got for now. More as the situation develops.

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