Money Talks – Mine Says Goodbye

“We’re going to have you stay overnight,” might be fun if it’s an invitation from a friend, but it’s not something you want to hear in the hospital.  My first thought was, “Whoo-wee!  This is going to be expensive!”

On my second day as an inpatient, I quit being concerned about the enormous cost.  I realized that I’d owe 100% of the charges until my annual deductible was met, and after that I’d owe 20% of the charges until my out-of-pocket maximum was reached.  Add those amounts together, and that’s what I would owe regardless of how many extra tests were ordered or how many days I stayed.

It’s hard to check my EOBs and start seeing the numbers:  ER $1082, radiologist $375,  hospital $42,000, radiologist $29, GI consult $354, rheum consult $303, EGD $375, radiologist $237, GI E&M $80/day, PCP E&M $140/day, operating room $30,000…    What a relief to realize that there’s a limit to how much I’ll owe!

My husband, it turns out, hadn’t reached that conclusion.  He hasn’t been sleeping well.  When he does manage to sleep, he grinds his teeth.  Not only is he concerned about my health, but he’s also concerned about our coming medical bills.  We have to pay those bills, and he’s been worried about how high they’ll be.

I, on the other hand, am not concerned about paying those bills.  We have clear division of labor in our house, and paying bills isn’t my department.  My department is insurance.  My husband leaves those details in my capable hands and doesn’t keep track of the details of our policy.  He doesn’t worry about, or even think about, our medical coverage.  It’s never been an issue for him because it’s always been something I’ve taken care of.

This led to an interesting situation.  I’m not worried about what we’re going to owe because it’s going to max out our out-of-pocket expenses for the year and there’s not a thing I can do about it.  My husband, however, has been losing sleep because I didn’t think to cue him in on the pertinent details of our insurance policy. He’s been picturing all those charges and thinking that 20% of an enormous number is still an enormous number.

Thankfully we discussed the subject, and he’s sleeping much better.  I am soooooo thankful for insurance when those catastrophes hit.

Thank you, Alexander Graham Bell

I’m calling to make an appointment to call you.

You just did call me.

Yes. I called to make an appointment to get some information from you.  When would be a good time?

I’m available right now.

Oh, no.  I need to make an appointment to call you tomorrow.  We need to get a complete medical history from you for your upcoming procedure.

I gave that information to the surgeon yesterday.  He said he’d fax it to you.

Well, I can ask him to fax it to us, but I really need to make an appointment to get this information directly from you.

Let me get this straight.  You’re phoning me from the surgical center today to make an appointment to phone me tomorrow to get information from me that I gave to the surgeon yesterday?  Even though I’m available right now, you’re not allowed to ask me now; you must wait until tomorrow even though my schedule is already full?

Yes, ma’am.  That’s our protocol.

Your hospital’s protocol has certainly provided lots of blog fodder.

Methotrexate in the Hospital

The young woman who’d so cheerfully introduced herself as my nurse when I was admitted to the hospital returned to my room about ten minutes later.  Now looking afraid, she stopped hesitantly only a few steps into the room and explained that there would be a different nurse assigned to me since she was expecting a baby and I was taking methotrexate.

Methotrexate, unlike tons of other prescription medications, comes with a black box warning.  Patients are told to be careful to avoid infections because one could be deadly, and are given a host of other instructions.  There are apparently some things they never tell us about this medication, though.

More than once I heard people talking at my door stop as they were about to enter, then one would tell the other, “Uh-oh.  Someone else will have to take this room.”  Apparently people taking methotrexate are worse than lepers.

Later I discovered that my hospital room had this sign on the door:

Part of me thought, “This is ridiculous.  It’s not like I’m exuding the stuff through my skin.”  Another part of me wondered why they were so concerned about methotrexate, but not about Cimzia.

It turns out that although methotrexate doesn’t ooze out the pores, it can be found in bodily fluids for 72 hours after a dose is given.  Since medical people deal with blood, vomit, urine, and the like, they really do have to be careful when patients are taking methotrexate.

Had I known that, I might have been able to alert people from the very beginning:  “I’m taking mtx; please make sure my caregivers are people who aren’t trying to have a baby.”

Women expecting a baby try to do everything possible to have a healthy baby.  Seeing the look on that poor nurse’s face, I imagine she was beside herself.  She looked to be about eight months along, and spending the next month worrying what she might have done to her baby couldn’t be good for either of them.  It wasn’t until a few days later that I learned what the concern with mtx is, and I asked my nurse if she could track the other nurse down and let her know that my last injection was beyond the 72 hours, so she and her baby were in the clear.

That should never have happened.  Had I known that it was an issue, I would have told them from the start.  Wouldn’t we all do that?  Shouldn’t we all do that?

A stranger’s baby shouldn’t suffer birth defects due to the medicines I’m taking.

I’m adding a note to my cell phone (where I keep my meds list):  Cytotoxic agents.  If there’s ever a next time, that information will be among the first provided.