14 September, 2016

A Recent Medical Adventure

The United States should join every other major nation and recognize that
health care is a right of citizenship. A Medicare-for-all, single-payer system
would provide better care at less cost for more Americans. ~Bernie Sanders
After spending approximately four days inpatient, I was discharged from the hospital today. Last Saturday, I was taken (via ambulance, which probably isn't covered by my medical insurance) to the ER at Hartford Hospital and admitted there in a "code red" situation because I was having difficulty catching my breath due to my heart racing and perhaps some other medical problems I was experiencing.

As a (somewhat very new) volunteer for Hartford Capital City Pride, I was at HCCP's PrideFest, which was held outdoors (in the very hot, very humid weather) in Connecticut's Capital City of Hartford's Bushnell Park. It was a very hot, extremely muggy day—just the sort that my asthma-based COPD has serious issues with. Despite the fact I had been resting for half an hour in a chair, I was having some difficulties breathing, and reached for my inhaler.

As it turned out, I had the wrong inhaler in my bag. Because of my recent COPD diagnosis, my primary care provider (PCP) switched me from Flovent to Symbicort, and advised me to discontinue taking the Flovent. My pharmacist (at CVS) also advised me not to mix the two, as doing so could produce an "adverse effect." I wasn't paying attention to the inhaler (I was somewhat anxious and a bit more concerned that I couldn't catch my breath as my heart was racing and pounding in my head, so concentration was beyond difficult) and wound up taking two puffs of the Flovent, which I thought was my Albuterol inhaler, which is OK to take with the Symbicort.

Evidently, the effects of drug interaction between Symbicort and Flovent isn't something that's been explored very well. Either it's there's very little comprehensive information about the interactions or it's unavailable to the consumer. There is, however, a bunch of medical gobbledygook about possible interactions, the most notable of which is hypokalemia.

A few moments after taking the Flovent, my heart began racing, and blood was flowing through, and pounding in, my head at deafening levels—essentially muting the noises around me from the festive, fun, and friendly LGBTQ+ pride celebrations. Thankfully, another volunteer from the organizing committee popped into my view at that moment. I flagged him over. He realized that I was in duress and took immediate and decisive action, for which I'm most grateful and thankful (thank you so much, Dennis! #gratitude).

I was loaded into an ambulance (and the EMS workers who literally shoved the stretcher into the ambulance managed to bang the top of my head up against the ambulance's door frame quite hard—enough to produce a sizable lump on the top of my head) and whisked to Hartford Hospital's emergency room where approximately ten healthcare professionals began working me over. I was able to write out on some paper (as I couldn't really speak) what I believe had happened, and they began running all sorts of tests.

Approximately 12 hours later, I was admitted to hospital on an inpatient basis for acute kidney injury, with a secondary diagnosis of severe dehydration. Apparently, despite having drank about 10 bottles of water that day, I was perspiring so profusely that I became quite dehydrated. The fact that I'd had nothing to eat, and that water has no electrolytes (read: virtually zero) in it whatsoever, may have contributed to this dehydration or, at the very least, an upset in my water-electrolyte balance (especially as I most likely was losing electrolytes en masse through my heavy perspiration).

During the first two days that I was inpatient and being re-hydrated, I kept complaining about my head smarting quite a bit from having been banged into the ambulance's frame by the EMS workers (who, by the way, never even acknowledged injuring me, let alone apologized for doing so). My attending physician finally relented and ordered a CT scan to rule out any possible damage, to "allay any concerns [I] might have."

While the results of the CT scan showed no brain injury as a result of the mishandling by the EMS workers, it did, however, show an unidentifiable calcification in the fourth ventricle of my brain. Nearly simultaneously upon my return to my room from the CT scan, the attending physician called to inform me of this finding, and that she was ordering an MRI (folks, we're talking about a time span where the CT scan was completed and the MD was providing me the results literally less than ten minutes after the completion of the CT scan, in an inpatient hospital setting—read: exceptionally expedient & totally #amazeballs).

I waited more than 24 hours for them to perform the MRI. Finally, someone from radiology came to see me, and took some measurements. A few hours later, I was told that they wouldn't be able to perform the MRI in the hospital, and were "exploring their options."

The hospital wasn't able to perform the MRI that the attending physician ordered because, while they did not have an issue with my weight (at least in terms of the machine being able to accommodate me), the machine was unable to accommodate my physical dimensions (apparently, my shoulders are too wide and my chest is too deep -- areas of my body that are somewhat less-affected by my weight issues than others). As such, I was discharged from the hospital earlier this afternoon, into the care of my PCP.

(As an aside, the food at Hartford Hospital is some of the best I've had in an inpatient hospital setting; I don't really see why people complain so much about hospital food these days...especially as, despite my numerous hospitalizations over the years for various issues, I have yet to have what historically has been described as "hospital food.")

So now the plan is to have my PCP order the MRI on an outpatient basis, which means having to make an appointment to see my PCP, which takes about 1-2 weeks (it's set for next Wednesday afternoon), and then having him write the order. The order then has to be submitted to my insurance company (Medicare) for approval before they will even schedule an MRI in an outpatient facility that has an "open MRI," which apparently is the only type of MRI machine capable of accommodating my body's physical dimensions. Once that approval comes through, they'll call me to schedule the MRI, and heaven only knows how long that will take.

Having read the discharge papers, it looks like my attending physician in hospital ordered the MRI to either rule out or confirm the presence of an aneurysm, which essentially tells me that they believe I do have an aneurysm in the fourth ventricle of my brain. It now might take up to a month or longer in order to confirm the presence of the aneurysm, and then they'd have to figure out what to do with it. I'm told that aneurysms in the brain usually are "dealt with" due to the high risk of death from stoke if they rupture—and aneurysms can rupture literally at any time and under almost any circumstance.

Given my previous interactions with Medicare (where I had to have a genetic test done to determine whether or not I have the breast cancer gene—or am BRCA1-positive—and they refused to pay for it unless I actually had a diagnosis of cancer, even though knowing that I might be BRCA1-positive would determine the scheduling of certain screening tests of which early screening could substantially reduce my risks and increase my chances for survival, thus prolonging my life but, because apparently the medical and insurance industries don't want disabled and elderly people to live long, which is apparent from their complete lack of coverage for dental and vision care, which means that they really don't care if we can see or eat but, I digress...), while they probably will pay for the MRI to confirm the doctors' suspicions based on the CT scan they performed on my head on Monday that I have an aneurysm, it might not be until the suspected aneurysm actually ruptures -- at which point there's a high probability that I'll die from such a rupture, especially given the location of this particular aneurysm in my brain.

In either case, I'll still have to come up with the 20% co-insurance payment, which is the amount I'll be responsible for paying. Given that the average cost of an MRI is US $2,611, that will leave me with a bill of about US $522—and that's only for the test, itself. That doesn't cover the other costs associated with the MRI: the technician, who will perform the actual test, the radiologist, who will interpret the results of the test, or my personal MD, whom I will have to see in order to obtain the results of the test and then plan a course of action to deal with whatever those results might reveal.

In light of this recent medical episode, I might just have to set up a GoFundMe campaign to pay for all of the costs associated with the unexpected medical services I received over the course of the past week, as well as the related and unexpected medical costs that I will undoubtedly incur over the coming weeks. Medical care in the USA is completely absurd, and I should not have to worry about whether I should pay my (medical and other) bills or purchase some unhealthy food (we all know that it's more expensive to eat healthy foods than it is for so-called "junk foods," which is another contributing factor to the poor health of so many in the lower-income and poor communities in our nation and why many who, like me, must struggle between purchasing food—often opting for a less-healthy diet but one that fills our tummies—and paying bills but, again, I digress...).

The only positive news to report about this entire escapade in medical "un-care" is that I just got off the phone with my PCP's office and he's waiting for the CT scan results to be sent to him so he can attempt to order an MRI for me without actually having to have me physically come into his office to examine me first, before ordering the MRI.

Hopefully, what this means is that he'll be able to order the MRI now, which will cut down some of this waiting around nonsense, and there's a sliver of hope that I just might be able to have the MRI performed before his first available appointment, which is set for next Wednesday afternoon.

Of course, if we had a single-payer healthcare system where healthcare were viewed as a right and not an opportunity to profit off of individuals who are ill, then I probably wouldn't be going through this entire rigmarole but again (and for the last time in this article), I digress... #justsayin