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Old 10-07-2006, 08:46 AM   #1 (permalink)
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Location: Moscow on the Ohio
Stroke and medical costs

Four days ago I had a stroke. I was pushing the lawnmower cutting the grass when suddenly a buzzing sensation started on the right side of my face and traveled down the right side of my body through my arm and leg. Within seconds my right arm and leg went completely limp and I could not move them. I knew I was in big trouble and managed to maintain my balance on one leg for about 30 seconds until eventually some feeling returned and I was able to limp to the house.

It took a bit longer for the feeling in my arm to return and I was able to move it but not very well. My arm and leg felt like they were being controlled by someone else like a puppet on a string. My wife drove me to the nearest emergency room which was about an hour away.

After about 4 or 5 hours and a series of tests showed nothing (blood workup, EKG, Catscan) the doctor told me it might be a TIA (mild stoke) and I should take some aspirin to thin my blood and if things were not back to normal in 24 hours then I should see my doctor or come back there. He recommended that I stay in the hospital for observation but they were not going to do anything until the next day. I decided to just go home.

The next morning I got up and immediately fell on my face when my right leg wouldn't move. My leg and arm seemed to be wired differently and I had to concentrate to move them. After much effort I was able to get them to move but not very well. I practiced walking etc.. for several hours and eventually could move them but could not do simple things like pick up a glass, or write, use a mouse, type, etc... Any fine movements were uncontrollable.

I called the doctor who was referred to me by the ER and explained that things were worse. He wanted me to take an ambulance to the ER and check in to the hospital for observation and he would schedule more tests. There was no treatment to be done just observation in case I had a heart attack or something. He said the tests (MRI, ultrasound,etc..) could not be scheduled until the following day. I told him to schedule the tests and I would have my wife drive me there.

In the meantime I kept exercising my arm and leg and gradually things were getting back to normal. I am almost back to normal except for a small limp and I cannot do fine things with my arm and hand like write or hold objects real steady. But I am so relieved that things have improved so much in a few days and am convinced that I will be back to normal in a few weeks.

So now I had to decide if I should go forward with these tests so I called the doctor to discuss it. He said that there was only a very small chance that the tests will show the cause of the problem and most likely we will never know but he would be remiss if he didn't recommend them. Other than blood thinners like Plavex and/or aspirin there was no treatment other than physical therapy for this.

So I decided to try and find out how expensive these tests are in order to make the decision whether to have them done. The doctor said he did not know the cost but was sure they were not cheap and to call the hospital. The hospital was not sure about the ultrasound but the MRI would be anywhere from $800 to $4000 excluding any personel and doctor costs and the average was a few thousand. I asked her how a person is supposed to make a decision if they don't know the costs and she said as long as she worked there that I was the only one who ever asked.

I decided to take my chances and cancelled all the tests. I am amazed at how little we know about what things cost in the medical field. People seem to be bothered and somewhat offended when you ask them. If things don't improve dramatically or get worse perhaps I'll get the tests if I can figure out how to shop for them.
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Old 10-07-2006, 09:31 AM   #2 (permalink)
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Scary. If I may ask, how old are you? One of the things about strokes and heart attacks is, we think they only happen to old people. Totally untrue.

You have insurance, right?
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Old 10-07-2006, 09:53 AM   #3 (permalink)
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Location: Moscow on the Ohio
Quote:
Originally Posted by ratbastid
Scary. If I may ask, how old are you? One of the things about strokes and heart attacks is, we think they only happen to old people. Totally untrue.

You have insurance, right?
I'm 57. Yes I have insurance plus an HSA account. Most of these expenses will come out of my pocket up to a high deductible so it makes a difference to me if they charge $5,000 or $500,000.

It should be a concern to all of us if we want to ever control the expensive cost of medical care. The system does not seem to be geared up for one to shop for these services, just pay whatever they charge and claim it on your insurance.
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Old 10-07-2006, 11:34 AM   #4 (permalink)
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Go get the tests done! my mom had a mild stroke a couple years ago and she had alot of tests done and they found out she had a genetic defect in her blood that causes her to be at a high risk for clots and heart problems and all that. Shes been on medication now for it that is basicly a blood thinner. but because she found out what was causing it she can now change things in her diet to keep it from happening again along with the medication she should be fine. Turns out stuff like green veggies have alot of vitamin K in them that causes her blood to change and increase the chance of a stroke.

Go get the tests done find out whats going on. If you dont and it happens again and you have a worse stroke you will be wondering what the hell you were worried about money for when its your life at risk. So far you have been lucky dont push your luck. If you have another one and your still alive if its any worse you wont be able to work or cut your grass or bathe yourself or anything. A live in nurse for the rest of your life is alot more expensive then a few tests. Go get the tests done. Find a speicalist make sure its done right not just by some random quack. Your life isnt the place to cut corners to save money.

btw after my mom got tested and figured out what was going on with her we found out thats why my grandfather died so early and his mom died even earlier then he did. Turns out my sister and me both have the same problem only not as severe. We are both supposed to take 80mg of asprin a day. Nothin like being in my 20s and being at high risk of a stroke. If you have kids do it for there sake if not your own. you never know what they might find.

Last edited by Plaid13; 10-07-2006 at 11:40 AM..
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Old 10-07-2006, 12:12 PM   #5 (permalink)
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I agree. Whatever the cost, you have to decide if your life is worth the trade-off. One you can get past and the other is pretty much final.
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Old 10-07-2006, 01:31 PM   #6 (permalink)
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It surprises me how much people are willing to pay for the other things in their life: expensive clothes, fancy cars, computers, games, cell phones, tvs, etc; but are hesitant when it comes to their own health. I had a similar cost vs benefit issue recently. Then I realized, "holy crap!" this is my health, I should make that a number one priority. Dude, do what it takes, get whatever treatment, tests you need. It's your health. I don't have insurance, I use my savings like everyone should. SO instead of buying a LCD tv like I wanted too, I spent the money on fixing my knee and ankle. Now I won't limp for the rest of my life and I can start saving again for that tv.

Another thing you can try is negotiating with the doctor to get a cheaper rate especially if you tell them you don't have insurance. Tons of people go to the ER without insurance, people who aren't even citizens and don't have to pay. I dont see why you couldn't do the same.

Strokes are serious, I wish you all the best for a speedy recovery. Don't forget to look into physical therapy too, it will make all the difference.
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Old 10-12-2006, 09:03 AM   #7 (permalink)
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Location: Moscow on the Ohio
It has been about 10 days now and I have recovered about 95% of my motor skills. It is amazing how the body manages to heal itself. I thought for a while there I was a goner. We are hopeful that I will be 100% in a few weeks/months. For a few days there I couldn’t even type or use a mouse.

They tell me that the brain rewires itself and makes new connections to control those areas damaged by the stroke. From what they tell me this must have been a mild one and I am very lucky. The only thing to do now is take blood thinners like Plavex and Aspirin to prevent a future occurrence.

The point I was trying to make in the OP was that somehow there should be some kind of competitive control on medical costs. As long as us patients do not care what they charge then they will charge exorbitant fees only controlled by the insurance companies (for those who have insurance).

I understand that one's health should be a priority but it should make a difference to us what these procedures cost if for no other reason then to keep insurance premiums from going through the roof. Doctors are going to protect themselves from lawsuits by ordering every test they can think of regardless of the obscure chance they may have of finding anything. In my opinion it is up to us to make the hard decisions since they cannot.
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Old 10-12-2006, 10:07 AM   #8 (permalink)
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My chiropractor charges $40 if you don't have insurance, and $175 if you do. That's part of the problem right there--doctors treat insurance companies like the ATM.
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Old 10-12-2006, 03:31 PM   #9 (permalink)
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flstf, I did not see this topic earlier and I am relieved that you situation is improving. There have been a number of medical issues within my family that appears to support what your experience has been. No one asks how much it will cost as a rule, because it is our nature to follow "doctor's orders." As RB pointed out, the "cost" can't be answered directly without first knowing whether there is insurance coverage.

Further, I think much of the testing recommended, as well as unnecessary overnight stays in a hospital, are profit driven rather than directed by the actual medical needs of the patient. How could it now be, when we have a for profit medical system?

I wish you a full recovery and good health...
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Old 10-12-2006, 05:12 PM   #10 (permalink)
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Location: Moscow on the Ohio
Quote:
Originally Posted by ratbastid
My chiropractor charges $40 if you don't have insurance, and $175 if you do. That's part of the problem right there--doctors treat insurance companies like the ATM.
There was a thread a while back and several expose' type news reports where just the opposite was occuring. Hospitals were charging the uninsured much more for the same care in order to make up for the low payments they negotiated with the insurance companies in order to be in their preferred provider plans.

I haven't followed the story but there were some congresspersons advocating legislation to prevent this. I guess the only people who would have to be concerned are the uninsured with assets to go after.
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Old 10-12-2006, 11:27 PM   #11 (permalink)
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fistf, glad to hear you're doing better. Give yourself some credit. Recovery is _you_ and your body. I've known people to sit and wait for magic and they end up potatoes. A good friend had a stroke in his early 30's and had to work like crazy to re-gain control and function. It's certainly taught him to monitor his fitness.

It's good you already know to take charge of your healthcare. There are gems in the business but treat them like bonuses. Handing your care over to the system and its average result is inviting a result you do not want.

Guess I'm saying to keep it up. Break a (doctor's) leg and all that.
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Old 10-21-2006, 03:10 PM   #12 (permalink)
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I'm glad to hear that your stroke wasn't fatal and didn't seem to cause much permanent damage, flstf.
Being Canadian, I can't tell you much about the medical costs associated with a stroke aside from one very large figure.
Two years ago my younger brother (he was 21 at the time) had a near-fatal brain aneurysm. An appointment with a specialist in Phoenix was set up a few months later, and just after a successful 18 hour operation to rewire his brain to bypass the aneurysm, he suffered three severe strokes within the span of an hour. Somehow he survived, but still has extremely limited use of the right side of his body, his recovery is slow, frustrating and painful, but steady. From what our family has been told by both Canadian and American doctors, the cost of his treatment, medication and therapy so far would have cost us between $750,000 and $1,000,000, had the Canadian government not covered our medical costs.
In the waiting room of the hospital, my Mom and I spoke to an older couple who had lost everything trying to pay for their son's medical costs after his second stroke.
It seems to me that $4,000 is an extraordinarily low price to pay to have at least a little insight into what caused your stroke and maybe, possibly prevent you from having another one.
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Old 11-03-2006, 09:08 PM   #13 (permalink)
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Sure as hell is worth it.

Like everyone has said in this thread, it's always best to take that money you're saving for a fancy car or whatever and save your life. Can you really put a price on your life??
To get a little more personal (see my journal for the whole story) my father just recently passed away because of a combination of heart attacks and strokes in succession over a very short period of time. But there wasn't much they could do in his case, as he was already on blood thinners due to his cancer, but had to take him off of them because he had one severe stroke that damaged one entire side of his brain, and to put him on blood thinners would have just killed him faster than give him a chance. But this is a unique story, as there were so many problems with his body to begin with. It was incredibly painful to leave the hospital at midnight and come back around 8am or so and see that your loved one has gotten worse from a stroke.
So please, I'm begging everyone in the TFP: learn the signs and symptoms of a stroke like the back of your hand. Any symptom is a sign of stroke, don't expect them all, and take care of that person ASAP, as strokes are ongoing, and unpredictable.
Here's some links to beef up on the signs and how to react:
American Heart Organization
Heart & Stroke Foundation
How to care for a Stroke
Stroke Association
I'll say it just one last time, know the signs of a stroke and heart attack, as both are serious problems where time is vital to saving one's life, react fast, but with knowledge, not in a panic. Trust me, if you don't learn to recognize the signs of these two common health risks, it might happen when you least expect it, and you could regret it for the rest of your life, when the signs were right in front of your face.
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Old 11-03-2006, 10:45 PM   #14 (permalink)
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To put it bluntly, you can't spend money once you're dead.

Get the damn tests done!!!!!! You cannot put a price on life.
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Old 11-11-2006, 04:01 PM   #15 (permalink)
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Location: n hollywood, ca
Quote:
Originally Posted by rockzilla
I'm glad to hear that your stroke wasn't fatal .
most strokes aren't fatal. most people who have a stroke are at risk for:
another stroke
a heart attack
succumbing to the problems attribituted to the stroke (for example, a stroke leaving a person with half of their body paralyzed, thus lying in bed, developing pressure ulcers, developing infections in those ulcers, going from a local infection in said ulcers to systemic infection...).

with all of that said, if you had seen me in the emergency room, i would have admitted you to the hospital in the first place. for the most part, the conventional wisdom on tia (transient ischemic attack) and strokes is changing, in the sense that if the symptoms are less than an hour, it's a tia and anything over an hour is a stroke. however, some people (those not up on the latest literature), still feel that symptoms for less than 24 hours are tias, and those for longer than 24 hours are a stroke.

the reason the time window is so crucial, is because if you get to the hospital under 3 hours from onset of symptoms, you can potentially receive a medicine called tpa (tissue plasminogen activator) that instantly breaks up clots and thins blood. there are some contraindications, and every situation is different, and of course the biggest caveat is that the hospital has to have it available.

with all of that said, you've had your stroke and you sound like you're doing ok. however, the cause of your stroke is unknown:
is it it a genetic defect in the blood (as mentioned by a previous member)? this would be important not only to you, but also to your offspring
was it caused by a heart arrhythmia (atrial fibrillation), leading to a blood clot in the heart, that then traveled to the brain?
is there an aneurysm in the blood vessels of the brain?

medications after a stroke, i.e. secondary prevention of a stroke, include much more than aspirin and plavix (clopidogrel). in fact, plavix doesn't provide any more benefit than aspirin alone in the secondary prevention of stroke. the only medication shown to be superior to asprin in the prevention of a 2nd stroke is aggrenox, which is a combination of dipyramidole and aspirin.

other medications that may benefit you would be ace (angiotensin converting enzyme) inhibitors such as lisinopril or captopril, and statins (such as atorvastatin or lovostatin).

provided my stroke patient's liver enzymes are ok, they will go home wth a statin. and if there creatinine is ok (a measure of renal/kidney function) they will also go home with a low dose ace inhibitor regardless of blood pressure (i.e. they get it even if not a hypertensive/person with high blood pressure). aspirin or aggrenox (if they have insurance, aggrenox, if not aspirin; as aggrenox is very very expensive) is a must.

the other piece is the knowledge that they are at risk for another stroke or a heart attack.

cliff notes: get the tests done, as they effect your future, as well as your family's.
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