the costs of removing a pyogenic granuloma

so what the heck is a pyogenic granuloma? you may ask. and why does it need to be removed? –– a tale of how the united states health care system works, a personal example

it probably happened by laying on my ear in a funny way during night. but i don't know what exactly caused it. all i know is that i woke up with a pimple behind by right ear lobe. after admittedly squeezing it for a bit, to get rid of the zit, it grew. and grew.

it grew into a do-nothing bothersome bubble the size of one of these pale reddish erasers attached to the end of a pencil. i spare you more graphic details. it didn't hurt but was moist and messed up my pillow every night. after a few weeks with my new parasite pet, i went to ohio university's hudson health center.

as an international student i'm forced to be on the health insurance that ohio university provides. every quarter i pay $338, which usually covers three months, but for spring quarter the six months between march and august if you paid the rest of the year. what the insurance covers is pretty complicated, you can find out details when you click on 2008 police brochure at the bottom of this page.

what it does not cover for sure are teeth and eyes, like most other u.s. insurances.

since my ear was the trouble i was good to go. so hudson health center it was. people fear it and tales of the incompetence of the staff abound on campus. it's a bit like eating in the "Mensa" (the dining hall at german universities for voluntary use): everyone complains about it but everyone goes there, too.

i had, too, anyway. the process goes like that. after checking in with the computer which recognizes your ohio university identification number you get to choose the disease you have from a menu. you also confirm your address, birthday, etc.

you sit down in the waiting area.

a receptionist calls you. you confirm everything again and sign a green small slip of paper saying something legal i should know but i'm oblivious of right now.

you sit down in the waiting area again.

a nurse (is it a nurse? medical titles are different here than in germany and it's too complicated for now to go into right now) calls and asks what's wrong, she takes your temperature, your blood pressure, asks for allergies. i showed her my friend behind the ear lobe. she send me away.

you sit down in the waiting area again.

then another nurse called and wanted to see my friend also. i granted her a visit behind my ear. she seemed puzzled and referred me to holzer clinic, one of the two real hospitals we have in athens (the other one is called o'bleness, which people have dubbed sarcastically o' blessings). she scheduled an appointment with a real doctor.

the next day at holzer i checked in with a receptionist since the computer there refused to recognize my data.

i sat down in the waiting area.

my name was called, i talked to another nurse (?) who asked me everything again i had told to the two nurses (?) at hudson.

you sit and wait for the doctor. luckily a time magazine was in the room.

after a while the real doctor swooshed in, twisted my ear lob for thirty seconds while babbling in latin, said something about that i need to come back for cauterizing, and swooshed out.

i went back. twice.

once for cauterizing my bubble friend. for this i saw the real doctor for several minutes. enough time to ask him if he could write down the proper name of my otherwise nameless friend. he actually came back to hand me a copied sheet, probably from a medical textbook. there is was: pyogenic granuloma.

"pyogenic granuloma is a rapidly developing vascular lesion (=wound of blood vessel) usually following minor trauma (laying funny on my ear). this is a very common solitary eroded vascular nodule (=single bump) that bleeds spontaneously (hence the messed up pillow) or after minor trauma (possibly further squeezing the pimple)."

after two weeks i had to go back, the 30 second swooshing was repeated and i was properly taken care of.

about two months i got the bill for ending the brief relationship with my friend:
$879.

• $195 for the first 30 second swooshing in
• $286 for burning my little friend
• $71 for the second 30 second swooshing in
• $327 for examining my friend in a lab

i have to pay $95 (€67) of the total – and the 42 cent stamp to send the cheque.

germans: never complain about the €10 Praxisgebühr again.

u.s. readers: the Praxisgebühr is a fee paid for seeing the doctor for the first time of the quarter in germany. €10 is about $14 as of this writing. otherwise the insurance picks up the bill directly except for i think €5 as a base payment for certain medications (germans: please correct me if something has changed in that respect or if my memory fails me).

oh, and by the way. next week my dentist wants $78 for a check-up.