An ER visit (I’m OK!) — and lessons for women

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By Caitlin Kelly

 

I awoke this morning at 4:40 a.m, feeling like my chest was being crushed.

I sat up in bed, trying to focus on whether this was a heart attack, knowing that symptoms are very different for women than men, and because of that often overlooked or ignored.

I had never had one, but knew to pay close attention to my body’s signals.

 

These include:

 

shortness of breath

nausea

dizziness

pain in chest, jaw, back, shoulder and arm

cold sweat

light headedness

 

I felt light headed and, although there is no history of heart disease in my family, I’ve been taking a low dose of cholesterol medication daily for a few years.

We have health insurance and a very good regional hospital that I know far too well from multiple orthopedic surgeries since the year 2000, only a 10 minute drive from home.

The roads were empty at 5:00 a.m. so my husband got me there fast and the  emergency room luckily, had only one other patient in their 30 rooms.

I was quickly given an EKG, X-ray and had four vials of blood taken. The nurse put in an IV line in case (as I did need) they would need to take more blood later.

The pain subsided and within a few hours, thankfully, I was pain-free, if exhausted.

I learned a lot.

If it had been (thank heaven it was not!) a heart attack, specific proteins like troponin-1 are released into the bloodstream as heart cells die. The first blood test showed I was probably fine, but the second one needed to be taken six hours after my symptoms — i.e. I arrived at the hospital by 5:00 a.m. but had to wait there til 11:00 for the second set of blood samples to be taken and results read and shared with me.

I also learned that if it had been a heart attack, I would have been sent to another larger hospital for the insertion of a stent.

I also learned that many people present at the ER thinking, like I did, they were having a heart attack but it was — as we think it was for me — a very bad case of acid reflux, an esophageal spasm. (Very unusually, I had eaten a very small snack at 11:15 the night before. Normally, I know better, and don’t eat anything later than 8:00 p.m. now.)

 

We are very lucky:

— we have good health insurance, so few fear of surprise huge bills for this treatment; we’ll see

— it’s a very good hospital, created by the Rockefellers who live a 10-minute drive east

— we didn’t need the cost of an ambulance (which, we hope, would have been covered); our town has a volunteer ambulance squad as well.

— my treatment was quick, respectful and detailed.

— the hospital was recently renovated so the ER, which we knew too well from a few broken fingers and my husband’s biking concussion, was very different from a few years ago. Now it’s attractive and very comfortable; I was a bit stunned to have a TV screen in the room with me. Each room had an internal privacy curtain and a sliding glass door and an overhead light that didn’t glare into my eyes.

It was so American — each room had a glass plaque by the door with the name(s) of the donors who gave the funds for it.

But I’m grateful as hell for their generosity.

 

If you’re female, please memorize these symptoms — and make sure your partner/spouse and/or family know them as well.

 

They’re easy to ignore or dismiss.

 

 

Why getting sick in America is a really bad idea

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May_30_Health_Care_Rally_NP (641) (Photo credit: seiuhealthcare775nw)

One element of living in the United States sickens me to my core — the persistent inequality of access to affordable quality health care, something citizens of virtually every other developed nation take for granted.

Today the U.S. Supreme Court will hand down its decision on the constitutionality of what’s been called Obamacare, a mandate requiring all Americans to purchase health insurance. A CNN/ORC International poll released this month showed 43% of Americans favor the law, 37% think it too liberal, and 13% oppose it because it is not liberal enough.

I grew up in Canada, where health care, paid for through taxes, is offered cradle-to-grave by the government. Yes, it has some deficits, but everyone can see a doctor and go to the hospital without fear of medical bankruptcy, common here.

From this week’s New York Times:

When Wendy Parris shattered her ankle, the emergency room put it in an air cast and sent her on her way. Because she had no insurance, doctors did not operate to fix it. A mother of six, Ms. Parris hobbled around for four years, pained by the foot, becoming less mobile and gaining weight.

But in 2008, Oregon opened its Medicaid rolls to some working-age adults living in poverty, like Ms. Parris. Lacking the money to cover everyone, the state established a lottery, and Ms. Parris was one of the 89,824 residents who entered in the hope of winning insurance.

And this, on how confusing and frightening it can be to receive a fistful of enormous medical bills:

With so little pricing information available, expecting people to shop around for quality care at the lowest cost — something that’s not always possible in emergency situations — is also asking a lot of consumers. “I have always found a bit cruel the much-mouthed suggestion that patients should have ‘more skin in the game’ and ‘shop around for cost-effective health care’ in the health care market,” said Uwe E. Reinhardt, a health policy expert and professor at Princeton University, “when patients have so little information easily available on prices and quality to those things.”

President Obama’s Affordable Care Act, the health care overhaul law passed in 2010, tries to make some improvements (though the Supreme Court is expected to rule whether all or some of the law is constitutional this month). But while the law’s changes help you shop around for insurance policies — specifically through its new HealthCare.gov Web site, a one-stop shop that lists all of your insurance options in one place — it’s still unclear how effective the law will be for anyone comparing medical services.

On February 6, 2012, I had my arthritic left hip replaced. Thanks to my husband’s job, we have excellent insurance coverage, but I knew enough to do plenty of questioning, and negotiating, long before that gurney wheeled me into the OR to avoid nasty and costly surprises later. For example, I needed to make sure the surgeon would accept whatever fee my insurance company offered — decisions and prices I have no control over — but which would come bite me on the ass if I didn’t plan ahead.

I also had to make multiple calls to find out:

1) what the anesthesiologist would charge (about $3,800);

2) what my insurance would pay (about $1,000);

3) who would be on the hook for the difference. Me. (I told the billing manager I’d send my tax return to prove my income; $2,800 is a very big number for me.)

Jose, my husband, offered to look at the medical bills as they arrived, as they would only freak me out, not helpful post-surgery. The hospital — for a three-day stay, with no complications, charged $90,000. No, that’s not a typo.

Did they collect it? Probably not, but they routinely try for whatever they can get.

Then my surgeon billed $25,000. (Our insurance covered it all. Thank God.)

But…what if, like millions of Americans, I had no insurance?

Like my friend R, who is young, broke and lives without it. He recently slipped and fell on a wet sidewalk, needed an ambulance and needs physical therapy then surgery. Worst case, he’ll be paying off a huge bill for years, maybe a decade.

In my 24 years in the U.S. I’ve never lived one minute without health insurance; my mother has survived four kinds of cancer and I live an active and athletic life that also puts me at greater risk of injury. How ironic that being active, (fighting the great American scourge of obesity), can put you at risk of losing your shirt financially…

The cost of buying my own insurance, as a freelancer, left me with few additional funds for fun stuff like travel or nice clothes or shoes or replacing things in my home — air conditioner, dishwasher, computer — I needed and relied on. By 2003, it cost me $700 a month.

Health care is a right, not a privilege. We will all get sick or fall down or suffer a complicated labor or discover a tumor or suffer a heart attack. None of us is immune.

Many Americans cannot even purchase health insurance because they have — in that exquisite euphemism — a “pre-existing condition.” If you’re already sick, tough shit!

Seriously?

Life is a pre-existing condition. Americans, and their elected officials, must deal with this reality more effectively.