Health Care priorities are misguided - my ER visit

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Skip the pain and effect summary and go the last paragraph for the punchline if you don't want to be bored by multi-paragraphs.

Just had to get this off my chest after experiencing a left hip shooting pain on Thursday afternoon after lifting and moving a 40 lb. box in the house. I still lift weights all the time up to 60 lbs. Been dealing with lower back flare ups for the past 18 years so I'm pretty good at trying to avoid them, RICE them over a couple weeks, and get back to my routine. Happens about once a year. The hip soreness (sciatic) has been coming and going for 3 years but flared up a touch 3 weeks ago. It had been improving up to Wed. with ice and reduced exercise. Surprisingly, the sharp jabbing pain from Thursday's hip pain completely went away with no after affects that evening (following ice and Ibuprofens). It was like it didn't happen. That would never happen if my lower back was tweaked. I'm on no routine meds for back/hip pain, I haven't needed them.

Friday was different though. Did my usual chores for the first 30 min after getting out of bed without any additional discomfort, popped 400 mg Ibuprofens just in case. It was a normal day so far. The next 30 min after that a tidal wave of pain started building from the foot, shin, hamstring and into the hip. It became unbearable until I found an awkward sideways, 45 deg slouched sitting position on my bed with my head leaning against the headboard. Any attempt to move a few inches or get flat on my side was met with a lot more pain. So I stayed crunched up there for 2 hours. I called a nurse hot line offered by our state's health care system. The RN didn't tell me anything I didn't know. She said give the Ibu's 48 hrs to do their job and I'd be ok. An ER visit wasn't probably needed. Huh? I was gonna sit slouched in that position on my bed for 2 days with portable urinal, bed pan to assist me...while waiting to see if the Ibu's kicked in?

Called my doctor to see if he could prescribe some anti-inflammatory to get me to where I could at least get up and walk. They had done this on my last serious back spasms a couple years earlier. This time they said it was against company policy and they wouldn't do it. Not even 1 or 2 Valium/Vicodin/Diazepams if my wife went in to pick them up at there office. They could help me if I could be driven to their offices and get an injection of muscle relaxant. I scheduled an appointment with them for 4 hrs in the future hoping the 1200 mg of Ibuprofens I took over the past 4 hours would kick in. It didn't help at all. The longer I sat and stressed over the pain, the muscles/nerves only flamed up more. 2 hours later we called the ambulance. I had to grip on to and get assisted by a pair of 6-2 275 lb paramedics just to get me on the stretcher with tolerable pain. Still, I was crying in pain, sweating, and nauseous as they took me out of the house. Imagine my 5-2 wife with her own worse back pain issues trying to do that...lol.

Kudo's to the EMT's. Nothing but praise for them. I sat around my ER room for over an hour before they finally gave me a Valium pill (I don't think it was Vicodin). Within 20-30 min of being medicated they took me in for hip Xrays without the med having done much yet. That was pretty painful, they got me to tears again for those 15 min. At about the 60-90 min point my hip was no longer in pain. They couldn't have waited another 15 min on those Xrays? The ER techs did their job, I can't fault them. That one pill they gave me allowed me to walk to the car, and go home 3-1/2 hrs after arrival. No further spasms or over-the-top pain.

What I can fault is why couldn't I get a single muscle relaxing/spasm killing pill from my doctor? In years past I'd hoarded leftover meds for events just like this. But my "stash" of percocets, diazepam, etc. was gone. I never thought about "restocking" for the next event. My doctor cost the health care system a needless $1,000+ ambulance trip plus whatever the 4hr ER visit is going to bill ($1,000). I just don't get it. They've got my former prescriptions on record. They know I'm medicine-phobic and do everything I can to avoid any pills, not even aspirin (I use garlic instead). It's now 2 days since my hip/leg went into spasm. I've taken 4 of the prescribed pairs of 10 pills, and probably could have gotten by without them as the pain was tolerable. My plan is to leave at least 3-5 of them for the "next time." When I visit my doctor for my annual physical I'm going to express my displeasure....and request several more pills for the "next event." One lousy muscle relaxant would have gotten me to his office to be examined. After the fact, one of my neighbors told me they had some similar "pills" and they would have offered a couple to get me by. Maybe next time I'm out I'll call around first...lol. Is this what our health care system is coming down to....Community Assistance Health care? Am I screwed up here? I try to minimize seeing the doctors for things I know I can handle and do my best to keep health care costs down for everyone. My policy has an extremely low deductable. These costs are going to be paid by the providers and in turn continue to help raise everyone else's cost. All I needed was a $3-$10 pill from my Primary Care Physician. Should I vent to my provider? Will they even care? Or is this how they really want it? I fully understand legal risks where they can all be sued for dispensing pharmaceuticals. But a single pill, and one I've routinely taken for back spasms in the past? Just for a final kicker....my wife's back pain with a tingling foot was misdiagnosed back in 2006 as strained muscles. 5 months later she blew out a disk and was in the hospital for nearly a week. That event must have cost the insurance $10K-$20K...all from a misdiagnosis. 10 years later, she is fairly limited in what she can do. Before she could have spent all day cleaning house....now 30-60 minutes is all she can tolerate at one time.
 
The pill fear is so rampant from others abuse that a guy in need cant get the meds. Insanity.

I had 6 simple lumps cut out under my skin. $4000 each. Tiny pea sized lumps on my arms in a plain jane room with simple stitches. $24,000. And i paid a $6000 deductible for that one days events.
 
Third World healthcare is on the way. The Brits, often touted for their "free" "National Healthcare" also have a thriving population of "private" doctors for those who can afford NOT to use the "National Health". In this country the "leaders" who brought us this system will ALSO have a private network to rely upon. Did you actually think it would be any other way?
 
Sorry for your pain.

The drugs you want are classified as Schedule 2 drugs. Such high potential for miss use that prescriptions must be made in person and must be written, not electronically sent. Law changed in the past 12 months which is why the last time your were able to call it in. The law was changed, not your doctor or insurance company policy. The went into effect October 6th, 2015. Federal law at that.
 
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I can sympathize with the problems, as I have a back injury too (L4L5). Your symptoms are all too familiar.

In this case, it's all about liability. The physician just can't prescribe certain things without seeing the patient, no matter what your history. Their insurance company would panic, if it's one pill or 30. I have a stash of flexeril that I keep for exactly this situation.

At this point, you can just prepare for future problems. You might be able to find a doctor that makes house calls or keep your preferred muscle relaxant on hand.
 
It's funny that my other PCP who is on the verge of retirement and spending limited office hours these days, wasn't in on Friday. He might have prescribed a few pills over the phone as he's done if before. I can understand a newer doctor not wanting to risk their "career" for anyone who might abuse such a "single pill." But based on your inputs above, I guess he couldn't have done it. I'd have loved to be able to drag myself to the car on Friday and get to him. But I don't think I could have tolerated the pain, which was around 7 out of 10. When my wife blew out her disk she was at a 10 level and screaming even though she wasn't moving. I didn't want to risk jumping to the 10 level. I had never heard screams like that before in my life.

I must have been seen by a total of a dozen different nurses, helpers, and doctor's assistants (PA) while in the ER. Never did see a doctor. A PA could have driven to my home and back for a diagnosis and pill. It would have been a lot cheaper than $2,000. I did ask the EMT's how business was on the way down. They might only get a call each day on average. And on Friday they weren't busy. So I fit in perfectly. The ER didn't look all that busy either. So no doubt I was a plus that day to help fill things out. There were enough total people running around on Friday that someone had to be available to get a pill authorized for me. Why not a roving PA or Doctor to make a house visit. I guess I need to find a doctor who will make a house visit...I know my current PCP wouldn't do that.

Fwiw, this site has shown me the ways of having a stash at all times. I will never allow my PILL stash to ever drop down to below critical level. If it occurs again I will be in my doctor's office that seem week asking for a mini-refill. If they refuse, I'll find another PCP. Or better yet, I'll fake a back pain incident and limp into my doctor's office asking for pills. Or just wait until my next moderate back spasm and go in while I can to get refills. Is this what we want?

Thanks for the helpful inputs guys. I never saw the memo on the healthcare prescription law changes. They should have sent us all a letter to start building a "stash" of meds. Funny thing, I got some respiratory side-effects from this event too. Been off the asthma meds for 7 years thanks to diet and weight loss. I ended up taking a couple inhaler doses from a 2009 prescription. When I kicked all my blood pressure pressure meds in 2009 as well I had a multi-month stash remaining. I needed to used those in 2013 when my BP started wandering. When I saw my doctor for the annual physical months later I asked my Dr. for a new Benazepril prescription. He asked me what I had been doing for the past few months? Using 5 year old meds doc, what else would I do?
 
My wife even called around on Friday to try and find "none-emergency" transportation to the ER without triggering a full-fledged 9-1-1 ambulance call...and save the insurance company some money. Lo and behold, the local EMT's showed up in under 10 minutes. They said there's a new law that says you can't circumvent a call to an official ambulance company (ie Hunters) if you are seeking ER transport. You might as well dial 911 because that's gonna happen any ways. They are obliged to get the ambulance to you immediately...even though I told them my life wasn't threatened and I could hold out for a couple hours waiting for a "cheaper" form of transport. Even two burly cab drivers could have done it....lol.
 
Pain meds should be available over the counter. Our silly drug phobia costs up billions of $$ a year. Not just the war on drugs but the med seekers who will sit in the hospital for a week just to get meds on the taxpayers dime. A good deal of people my wife sees are just there to get IV dilaudid, etc.

Doctors are scared to write prescriptions for pain narcotics. Some will not do it at all and instead refer you to a pain clinic. All the pill seekers made it hard for people who legitimately need meds to get them. Make them over the counter. If you kill yourself, you made your choice.

You are right to build up a stash so as not have to go through this nonsense again.
 
Originally Posted By: Bandito440
I can sympathize with the problems, as I have a back injury too (L4L5). Your symptoms are all too familiar.

In this case, it's all about liability. The physician just can't prescribe certain things without seeing the patient, no matter what your history. Their insurance company would panic, if it's one pill or 30. I have a stash of flexeril that I keep for exactly this situation.

At this point, you can just prepare for future problems. You might be able to find a doctor that makes house calls or keep your preferred muscle relaxant on hand.

This

Originally Posted By: Pop_Rivit
Note to self-this is why I've taken care of myself all these years.

Kudos. And at the age of 70 I am the poster child for this. But sciatica is something that is indepen dent of taking care of one's self. Thinner folks frequently get this,
 
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Outrageously expensive medical bills for people with health insurance pays for all those without insurance.

It also pays for hospital administration big salaries.
 
Originally Posted By: Mr Nice
Outrageously expensive medical bills for people with health insurance pays for all those without insurance.
It also pays for hospital administration big salaries. and cost of law suits

Fixed
 
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I think you can see this one article (Nov 14 2014) without subscribing:
http://www.economist.com/news/united-sta...merican-relapse

"In some states the number of opioid prescriptions written each year now exceeds the number of people."

The pain medication prescription policy has changed. For more than a decade (1990's) the policy was prescribe what the patient needed. Now, it's prescribe the minimum.
 
Yep. I work in healthcare and now you go to ER and the doctor orders a CT scan to cover his butt.

We charge $15K per month service contract on that CT. Healthcare is a business and needs revenue.... just like any other business.
 
Originally Posted By: Mr Nice
Yep. I work in healthcare and now you go to ER and the doctor orders a CT scan to cover his butt.

We charge $15K per month service contract on that CT. Healthcare is a business and needs revenue.... just like any other business.


Thank the lawyers for that. Too much defensive medicine.
 
This is why it's nearly impossible to get a doctor to treat chronic pain...not worth the risk. But the doctor couldn't even prescribe a MUSCLE RELAXER over the phone?!
 
Originally Posted By: Pop_Rivit
Note to self-this is why I've taken care of myself all these years.



For some, that's not enough. Some are unlucky enough to have been injured in auto accidents or by other outside influences. Also the O/P never stated what the root cause was for his back pain, so I think you should reserve judgment.
 
Originally Posted By: SumpChump
The pill fear is so rampant from others abuse that a guy in need cant get the meds. Insanity.

I had 6 simple lumps cut out under my skin. $4000 each. Tiny pea sized lumps on my arms in a plain jane room with simple stitches. $24,000. And i paid a $6000 deductible for that one days events.


Had two cysts cut out of my body last year. One in my neck one in my back. Dermatologist did it in 20 minutes with a few stitches with one assistant.

$14,000 was the bill. Insurance paid all but $2800. I work for a government agency also, and we have "good" insurance.

I keep reading about retirees going to latin america or south america to retire like kings on their Social Security money. Maybe they aren't wrong. I probably could had this done for $100 out the door in Ecuador, with the same quality of care.
 
I was in ER last October for 3 hours. Got dizzy while grilling outside and nearly passed out. I was pretty out of it for 20 minutes. I'm 63 and my wife was worried I was having a heart attack. She drove me to the ER. $17k for my 3 hour visit. They did an EKG and took an X-ray. No trouble found.

But, jeez, $17k for 3 hours....?

Scott
 
Slo-town,

What about the hospital collecting $0 from an illegal with no insurance and they have infected appendix needing surgery and 3 day hospital stay ?

Beckers Hospital Review.com has lots of info on the way hospitals are run. There is a good reason a bandage costs $300
 
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