Friday, December 18, 2009

Ear Ache Overkill

I just practiced being a responsible health care user. Here’s the short back story. Two weeks ago I woke up in the middle of the night with a pretty acute ear ache. I first applied traditional home remedies. I put a hot washcloth over my ear. I put in some homeopathic drops. I took some ibuprofen. 

In the morning the ache was a little diminished but I now also had terrible tinnitus and could hear my own voice echoing in my head. I lived with it for a while but when it didn’t seem to be getting better I figured I needed to take further action. 

 Two days later I tried the low cost option of seeing the nurse practitioner at Walgreens figuring she could prescribe some antibiotics. I assumed it would be a quick trip in, look in my ear, see the inflammation and walk out with some pills. Sure they might ask some medical questions to make sure I had no medication allergies or other symptoms that might mean something other than a simple ear ache. But honestly, other than the deafness and dull ache I had no other symptoms. It seems however that the Walgreens corporate philosophy is that people who don’t have regular health care providers will use them as their main source of health care. That seems the only explanation I can come up with why the nurse also had to listen to my heart, take my blood pressure and palpate my abdomen, for an EAR ACHE. Then there was the computer guided medical history she was required to take that asked, in addition to the health of all my blood relatives, how many people lived at my home, what their ages were and if I had any pets. It was beyond thorough. It was invasive and unnecessary for an EAR ACHE. 

I could not help imagining all this personal data being collected by the newly formed medical panels in DC to create a database about my health. With that in mind, I was not exactly honest in my answers because you don’t need a medical degree to know that your grandmother’s heart disease has no bearing on your ear. So by my answers it would appear that, not only are all my relatives healthy, but in fact none of them have died, ever. We are still waiting to see what kills us. 

Unfortunately for me, 5 days of antibiotics only brought relief from the ache. The deafness and sense that something was plugging up my ear were still ever present. I could no longer locate the source of sounds. I could not hear my clock radio going off in the morning. A simple rubbing of my fingers infront of my left ear and then right ear proved that I was not hearing well on my right side. I had used enough ear wax cleaner at this point to be fairly certain I did not have a giant plug of wax blocking things. I had also taken enough Sudafed to dry up every mucosal lining in my body so I figured there was something else going on and it was time to bring in a real doc. Off to the ENT. 

He looked in both ears and said they looked fine. He listened to my complaint and then sent me to an assistant who did a very thorough hearing test which confirmed I had some loss on the right of the high pitches, but that overall my hearing was good and I did not have any fluid behind my ear drum. Somewhat disappointed that there was not an obvious cause of my symptoms I met again with the doc who concluded my problem was viral and prescribed antiviral meds and steroids to bring down any inflammation I had. He also prescribed an MRI “just to be sure.” Here is where I started becoming suspicious. 

His staff had me scheduled for one in 36 hours and a follow up appointment for another hearing test in a month before I even left the office. By the time I went for the MRI the meds had done their job and I could hear again. I had misgivings about going for the MRI but, not really understanding what was involved in it, I still went to the appointment. Once there I had the usual paperwork which included all the necessary warnings about the procedure. They would inject dye that could cause kidney failure, or could remain in your system and cause “permanent hardening of the tissue”. There also was some increased risk for cancer from the exposure. While the techs answered my questions, they were not bubbling forth with information about what would happen even though I told them I had never had this done before. 

I got as far as laying on the machine and being slid into tunnel when all my misgivings hit me. They said this would be a 45 minute test, not a quick snapshot of what was going on. They would be injecting potentially harmful substances into me. They would have a picture not only of my ear but of my whole brain (again the vision of the DC database came to mind) and all of this could cost more than $1500 for an EAR ACHE that was 95% better! I made them take me out and I walked out of the center. Despite what I mumbled at the time, they thought I left because of claustrophobia from being inside the machine and said I could come back after taking an Adavan if I wanted. I did not tell them that I was suffering more from cost-rophobia and Adavan would not solve that. 

All the way home I kept questioning why a doctor would order such an expensive and potentially risky procedure BEFORE finding out if the medication alone would resolve the problem. I had gone along like a health care sheep with the whole process as I’m sure most people do. I wonder if most people would have had the MRI thinking the doctor knows best. I believe it is this kind of medical practice that leads to such high health care costs and a sense from people that they need all this expensive “health care” treatment. In the end it is entirely possible that if I had been a bit more patient with my aging body that it would have eventually overcome the inflammation that was the source of my problem and I would not have had to spend anything except may $2.98 on a bottle of Advil. I am grateful to have health care that will pay for the nurse and the ENT, but I will be a cost conscious consumer in the future.

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