Doctor's Visits and Expenses

When you have a chronic illness such as lupus, you make a lot of trips to the doctor's office. You have lots of blood work done, and you take lots of medications. At my quarterly visit today, my rheumatologist peered over his glasses as he flipped through my chart and pronounced, "Everything looks good."

The best words any patient would want to hear. Then followed the usual, "Keep doing what you're doing, stay out of the sun, and remember to take your meds." Then the inevitable pay-out at the nurse's station which adds a bit of crunch to the budget, but at least it's just an insurance co-pay and not the full amount.

For those who are unfortunate enough to not have any kind of health insurance, the road is rough. Not may persons can fork over $80.00 or more for a simple office visit, and the medications are costly, too.
So what does a person in that situation do?

I was asked that very question one day last week when a person called me as the facilitator for the local lupus support group; she was new in town and wanted the name of a doctor. Well, I had to tell her that if she had no health insurance, she might have to go to the County Hospital System. Words nobody wants to hear, but it's necessary.

I was a patient of the local County Health System for quite some time, when I was out of work and had no health insurance, and bless their hearts, they do a great job in seeing to the needs of packed waiting rooms every day, dispensing life-saving prescription medications at a fee even the poorest can afford. And if they can't afford the lowest payment, there are arrangements that can be made there, too.

Sure, you have to stand in line to register, to see the doctor, to pick up your medications. You soon learn the best time of day to go get your meds (definitely not Friday afternoon!) and when the doctors are less pressed for time (any day but Monday). Pretty soon you adjust to the routine and learn to settle in for a couple of hours, even when your appointment time was 8:00 AM and you broke your neck driving through rush hour traffic only to discover that you might actually get in to see the doctor around 3 PM.

The Emergency Room is even worse. An exercise in patience. I wouldn't advise anyone to use the county ER as their primary care physician for routine matters like checking blood pressure, which can wait until you have a regular appointment at the hospital/clinic. However, one day I had to go to the ER for a seemingly routine matter: I had pink eye.

And let me tell you, pink eye is painful and looks awful. I had rubbed my eye so hard by the time I got there that the triage nurse took one look at me and almost wrote "physical altercation" before I could blurt out the words, "I think I have pink eye." But they are trained observers, and it surely looked like I had gotten on the wrong end of a fight. I was finally called into the treatment room and emerged later, much later, with eye drops and a prescription for same.

Quite frankly, my own primary care physician's office is almost as crowded, and if you don't have an appointment, the "work in" situation is chancey at best.

So I shared all that with the woman who called and added that some of our best rheumatologists volunteer a day or two a month at the county hospital, so she would be getting good treatment for practically nothing.

Still, there is that stigma of having to go "on charity." Let me tell you....You can't pay the rent with your pride. You can't eat it, or drive it. Pride is the very last concern when you're faced with a choice, literally, between life and death. Ignoring your lupus symptoms and/or eliminating those life-sustaining meds will get you to the end of your life much quicker than if you swallowed your pride and accepted "charity." Remember, your goal is to live, and live well, even if you have lupus. It can be done.