Two years ago, I took a walk and felt a very mild twinge…and chose to go straight to the local clinic to have it checked out. You don’t fool around with a family history of heart disease! As it turns out, I didn’t have a heart attack, but was at risk and did get some preventative cardiac work done.
Now compare this with Darksyde: he felt chest pains, found that they eased with antacids and prilosec, and figured it was just heartburn, and so skipped going in to the doctor. Wrong move! It turns out he actually had a heart attack (a fact that gives Christians and libertarians cause for glee, apparently).
Actually, it doesn’t mean I’m smarter than he is — you know he’s learned a lesson with this event. The real difference between us is that I have very good health insurance and can afford not to hesitate when symptoms strike…while he is less well insured and is more likely to be reluctant at the expense. And that difference can cost someone their life.
There are two lessons here. One is that it is a wasteful injustice that we don’t have reasonable universal health coverage. The other is that you shouldn’t try to second-guess chest pains and other symptoms, you middle-aged and older people!
I cannot stress that enough. Yes to all that. I feel terrible for Steve and know just what he must be feeling. As most of you know I had a heart attack at age 36 and I count my lucky stars I only waited 15 minutes from the onset of acute symptoms to call an ambulance. Still, I was shocked and horrified to be told that, yes, I *was* actually having a heart attack.
Don’t wait. Don’t second-guess it. Especially if it’s a type of pain or discomfort that you’re not used to (I have acid reflux, but I knew this wasn’t heartburn very quickly).
Oh, and another thing about unusual discomfort—looking back I realized I’d had about three episodes of acute angina the week prior to my heart attack. Unable to draw a full breath, burning sensation in the lungs. Not crippling, but v. noticeable. I rationalized it away as “Oh, the air outside is so cold and you just shoveled,” but deep down I think I knew something was wrong. Yet I did nothing until I had a complete blockage.
Please pay attention to your body.
And not always in such dramatic ways either. I put off dealing with a toothache because I was unemployed, uninsured and just couldn’t afford to do anything about it. I ended up in the ER with an infection that swelled up half my face. That could have easily killed me before it got to that point.
As a family member who rushed to the hospital not knowing what to expect, knowing that my father wouldn’t have acquiesced to calling the ambulance unless it was really really bad… Please get checked if you can. Don’t “just walk it off”. Don’t hide feeling something that was quite probably a mild heart attack from your family until your heart starts giving up and you have to be rushed to the hospital and to the operation table.
And really, I’ll try to shut and stop preaching, but also: do not ignore elevated cholesterol test results no matter how young you think you are. From my late 20s my doctor had been warning me my lipids were all kinds of fucked up and badly. Given family history it’s likely they’d been that way for years. Well, I paid a price for not paying attention.
You are not too young to have a heart attack if you’re in your 20s or 30s, though it’s less likely. Not everyone with high cholesterol will have heart disease. But do you want to take the chance?
We still come down to money, like the homeless guy that threatened the President and his family so the Feds would arrest him and he could get medical treatment after being thrown out of the hospital because he couldn’t pay.
Amen. I had an extremely similar experience to yours a few years ago. Mine wasn’t a heart attack, either, but as in your case, the event alerted me and my doctor to some things and got me to make some changes in food, meds, and exercise.
Like you, I didn’t hesitate TOO much to go to the emergency room because I have excellent insurance through my employer. I knew that the most I would be out of pocket would be a few hundred bucks, maybe as much as a thousand, (this is not a negligible amount to us, but it doesn’t threaten the mortgage or mean no food on the table), and that I couldn’t be dropped from my plan if I actually dared to use it (my employer buys insurance for a couple of thousand people, which gave it the clout to insist on that kind of thing before PPACA takes effect). The paperwork was a bit of chore, since I was “out of area” when it happened, but even that wasn’t too bad.
I remember thinking, many many times, how lucky I was, and wondered what I would have done if I hadn’t had the insurance. I kept wondering how many people literally die, or suffer preventible damage to their health because they’re afraid of what it would cost to go to the hospital, or even to go to a doctor for a checkup and some tests.
A cousin of mine had a catastrophic spinal injury (not quite in the Christopher Reeve category, but damn near). His health care costs over the 20 years he lived after went well into 7 figures. Like me, he had great insurance provided by his employer (a public utility). Our entire family is eternally grateful that he had the insurance. His life was short and hard enough as it was. Without insurance he would have died much younger, and his quality of life would have been even poorer. (Bizarrely enough, he was a very conservative Republican to his dying day. I never got him to see the irony there.)
On a more philosophical level, how many people never open that restaurant, or that website design business, or move to New York to play the violin or write novels, or go to LA to be an actor, or go back to school to change careers, because they’re afraid to give up health insurance for themselves and/or their families? They might be perfectly willing to live in a tiny apartment and eat ramen while they see if they’ve got it takes, but what if they have a health issue? Or they might be willing to take a chance on themselves, but not their children.
How much of that vaunted “entrepreneurial spirit” that conservatives pretend to like so much gets crushed by those considerations? My friends in Europe are much more comfortable taking risks like that because they know that, however tough things might get, their health care isn’t in jeopardy because of their employment status. Having our health care held hostage to the good will and financial ability of our employers is insane.
/joins Josh on the pupit
Also, high blood pressure.
It’s really nice that even though you always had 200/130, even when you were a strapping young lad, you could walk over two hills to the other town, uphill both ways. But you’re not a strapping young lad anymore and having high blood pressure should be worrying you.
That’s a general “you” in my #8.
If it sounds like I’m a bit ragey about my father’s (currently less) dismissive attitude ,that’s just a coincidence.
Here’s the story on that guy I mentioned. Florida of course.
http://www.sun-sentinel.com/news/palm-beach/fl-obama-threat-sentence-20130118,0,2372037.story
The fact is some folks are privileged to have access to health care and many of us are not. What it comes down to in real life is you die if you get a serious illness, plain and simple and frankly, nobody really gives a crap in spite of high sounding talk. Talk is cheap.
Amen. We’re dealing with that here at Casa La Pelirroja.
A few years ago, Rush Limbaugh had an event while vacationing in Hawaii. He raved about the quality of our health-care system. He mentioned that it wasn’t that expensive – it was only about half the cost of an SUV. Another case of the rich not comprehending their advantages.
It never made sense to me why “dental” is often considered different than other health insurances. Seems to me that what goes on in your mouth is somewhat important to what goes on in the rest of your body. The plan I have currently will pay for cleanings and exams, but if there’s anything else, well, you’re on your own. So, you can tell me what’s wrong with me, but you won’t pay to FIX me.
Great! Because cavities don’t cause any problems ever…
It’s easy to say “get checked”, but sadly many people have to decide if it’s serious enough to spend a couple hundred getting checked, assuming you can even afford to do that. It’s probably nothing, and a couple hundred buys food. That’s the insiduous part of the American pay-or-die health system.
I’ve seen a Canadian friend drive home from Floriday one week after a heart attack because of the 100k plus it would have cost for treatment in Florida. And he received full and effective treatment at home without any cost.
I’ve seen a young family carrying a limp child, clearly overdue for treatment, scraping together a bit of cash and a bit from a couple of credit cards to get some basic treatment. It could have been something quite serious, and the outcome made worse, because they had to choose between a health care and clearly scarce money.
And somehow this is called “freedom”. How many people are trapped in a bad job because someone in the family now has something that would be pre-existingand therefore uninsurable if they moved? Or unemployed and now unemployable?
And I’ll second what tbp1 said. I started my own business here in Canada, but I never would have done so if I thought a heart attack or even a bad broken leg would bankrupt us.
I have no where near the talent PZ has with words, so I’ll just say it blunt: do not fuck around. I am sorta what is considered buff, I lift weights religiously, I can run ten miles and did so just a few days before this happened.
BZZZ! Doesn’t always matter, because like PZ said, family history is a GIANT factor. I could have died of an easily preventable, relatively super mild cardiac event just for being an ignoramus. Don’t look to me as a mentor on this one folks. Do exactly PZ did, he’s the teacher after all :)
Argh, garblefuck.
I think I’ve lost count of the many stories of of serious health outcomes that were caused not by people stupidly pretending that it’s not a problem, but by people pretending it’s not a problem because they can’t afford to fix it anyway.
In socialist commie Germany my GP is putting me through a bazillion of exams every three months just to make sure.
And then there is trying to get decent medical care while being a woman.
At best, we’re ignored. At worst, we’re told that “it’s all in your head” and we’re prescribed psychiatric drugs or given a psychiatric referral – gah!
Does the US have ads funded by the Government to inform the public of the symptoms of things like heart attack or stroke, and telling people to go to the hospital immediately if they have any of the symptoms ?
Stephen,
Take care of yourself. I hope finances will make that possible for you.
sometimes it’s not just lack of healthcare, but stubbornness.
while I was home in Germany for christmas, my mom experienced an episode of severe pain in the stomach/ribcage area, nausea, and dizziness. She actually fainted for a moment (that’s how i found her: unconscious, pale, covered in sweat). I immediately told her to get to the ER because she might just have had a heart attack, but she absolutely refused. And I only managed to convince her to go for a checkup the next morning after reminding her of how my grandfather also refused to get checked when he had his first heart attack, and then threatened to call my grandmother (my mom’s mom).
luckily, it turned out to be not a hart attack but some stomach bug, but ugh, that could have ended so very badly. >.<
Matt: ads about stroke signs are fairly common. Heart attack not so much.
it does, sometimes. it also has campaigns begging people not to go to work when having a cold/flu/mono, but those are just as ineffectual. Yay, free market solutions!
when one of my female sociology profs had a heart attack, the ER insisted that she must be pregnant instead. How that was supposed to be possible, given that she had had a hysterectomy some years before, remains a complete mystery to me.
Jadehawk:
That certainly seems to the be case in the UK. Cost is not an issue when accessing healthcare, but still people do not go to their GP when they having symptoms that do not resolve themselves, or to A%E when they have have acute symptoms. Part of it is education, in that people are not always aware of the symptoms to watch out for, but part of is also not wanting to trouble your GP or waste the time of the A&E staff. Which is why there have been a succession of ads informing people of symptoms of hearth attack, stroke, cancer and telling them to seek appropriate help.
Because, as you know, it’s almost universal among employers to shit on workers and accuse them of “abusing” sick time, to insist they return to work before they’re fully healed, and to dock them pay so stringently that very sick people limp to work.
It’s disgusting.
I’m one of those people who cannot afford health insurance. I have to save and make sure I have enough money to pay the doctor before I can go. I go to a doc-in-the-box because it’s tough to get a doctor to take you as a patient if you don’t have insurance. And since I rarely have a couple of thousands of dollars lying around, I’ve never had cholesterol checks done or things like that despite heart disease being the major killer in my family. It’s just not possible to pay for it unless I want to go bankrupt. The ironic thing is I make too much money to be eligible for help, but not enough to pay for this kind of service.
It’s just one of the facts of living in this country.
To expand on my comment @17 –
I lost a sister-in-law to a misdiagnosed heart attack at the age of 42.
She saw her PCP and was prescribed medication for gastric reflux.
BIL took her to the (military hosp.) ER when she kept getting worse.
She was prescribed stronger gastric upset meds and sent home.
By the next morning, BIL found her cold and dead in the bed.
She had had a massive heart attack.
Doctors simply do not take women seriously.
ugh, I’m so sorry.
And now I’m going to worry about my mom again, given that they’ve diagnosed her fainting spell as a stomach bug :-(
Sure, but I guess it’s much easier to pretend that it will get better if the worst you face isn’t just an annoyed GP and an afternoon waste of time but a few thousand bucks worth of money.
Damn, I wouldn’t have gone to my GP with that torn neck muscle if I had had to cover it on the table. My dad in law would never have told us to call the ambulance when he didn’t feel well before christmas if he would have had to pay for it on the spot.
Stubbornness is another issue.
Women need to insist loudly on being given an EKG when such things happen. Women’s heart attack symptoms are often milder than men’s and manifest as symptoms that look like other things. The medical literature is well aware of this, but a lot of docs haven’t caught up.
Don’t take no for an answer.
Magistramarla
I’m really sorry to hear
Jadehawk
I think that things are slightly better in Germany.
Did they run an EKG?
I remember that when I fainted in the bookstore* the paramedics wouldn’t let me go and insisted on taking me to the hospital and the hospital wouldn’t let me go before they did one and checked that my heart was all OK despite me assuring that it was caused by me being stupid (donating plasma and forgetting to eat all day). Which it was.
*Despite what some novels might want to tell you, fainting into the arms of a strong man isn’t romantic. It’s scary
First thing to remember is these doctors a part of corporate clinics for the most part. They pay attention to what they want to pay attention to, which is the billing and “premiums” the get paid from the drug companies. The patient is the last consideration in the chain.
magistramarla,
I’m so sorry.
Josh
You know, that isn’t as easy as you might think it to be when you’re feeling like shit and somebody with power over you is talking in medical above your head
Heh, I remember what I would have said when I was conservative/libertarian: “What’s the point of me trying to start or run a business if my profits are just going to get taxed away to fund welfare programs that I wouldn’t need I you just let me make as much money as I want? I won’t have to worry about cancer or heart disease if you damn tax-and-spend liberals will let me keep enough money to buy my own insurance. Besides, the greater the risk, the greater the reward!”
It would take ten years of making less than $26,000 a year punctuated with a few bouts of long-term unemployment to cure me of my love for capitalism.
Yes. My sister. High blood pressure. Didn’t do anything about it because expensive. (Husband a lawyer, in his own firm.) Well that was a mistake.
(a fact that gives Christians and libertarians cause for glee, apparently).
Hmm, Darksyde didn’t say anything about libertarians (not everyone who writes mis-spelled polemics against socialized medicine, nor do all libertarians write mis-spelled polemics against socialized medicine). Pretty cheap, but I imagine it will play well with the commentariat.
NHS
Is there any more to say?
This is the sort of public service advertisement you get in a country with a sensible health system.
http://www.youtube.com/watch?feature=player_embedded&v=hk-NgtjzHZg
Even then, a lot of people won’t call because of the ambulance cost. There’s a big issue with cardiologists and neurologists wanting to make ambulance services free (most of us have ambulance cover, if we have private health insurance they reimburse the premiums but won’t pay the costs directly if you’re not covered) to avoid the problem of people not wanting to call.
I was going to say: what kind of stomach bug makes people faint? But I guess if she simply overestimated herself and stood up too quickly while being all weakened…
Anyway, I’m with comments 30 and 34.
As an Australian, it’s really disturbing to me that Stephen deferred a visit to the ER partially because of financial concerns. In Oz, bowling up at the ER is effectively cost-free, which I’ve done a couple of times with my children over the years. The thought that I MIGHT have delayed some of those visits because of health insurance issues I just find… wrong. Survival in such cases is chancy enough without your inner idiot saying “Oh, I’m sure it’s nothing. Why spend money on something that’s probably nothing…”
ravenred, unless you don’t have the money in the first place. In the US that’s going to get you blown off and you might as well stay home for all the care you’ll get. It’s entirely about profit here in the States.
I just got hauled to the hospital at 2:30 in the morning a couple days ago with chest pain. It’s been 1 and a half years since I had to do this so I guess I wasn’t too disappointed that my ticker was running almost like a swiss watch. I do have a bundle branch block but it’s mild and has gotten any worse since 2005 so I get let go from the ER with a scrip for NorCo in case I have pain again and an order to follow up with my NP. It is troubling to not be able to track down pain in your chest even when you aren’t fibrulating. My dad has had a double bypass, my mom an oblasion and a pacemaker and I feel like I have a target on my back.
ravenred @ 41
Welcome to America! Our unofficial motto: “Fuck you peasants, I’ve got mine!”
In a cardiovascular research lab (mostly focused on channels and channelopothies) you hear about the many times the heart can just stop with no warning, often if you have a genetic presdisposition. It’s a bit scary to think about.
My best friend had his first heart attack at the ripe-old age of 38–just a couple of weeks away from his wedding. Cardiac trouble has always been in his family’s gene pool and the nigh-obligatory junk food diet that comes with the D&D gamer lifestyle didn’t help either. Fortunately he was smart enough to recognize the warning signs and got himself to a hospital before their was any damage. They popped in a stint and he was back on his feet in a day and dancing like a fool at his reception. Fortunately he had insurance, but the final costs were still huge. It didn’t help that he lost his job a few months later and was unemployed for several years. That was five years ago and I’m not sure if they have them paid off yet.
He finally got another job just this spring. One morning, a week into his new position, he starts having chest pains. Another trip to the emergency room, another stint. More bills. Luckily he’s still employed, but he has a four-year-old daughter now as well as student loan payments to worry about on top of the medical bills.
Please, I’d like to have some asshole on the right-wing explain to me why it is “moral” for society to do nothing on the behalf of my hard -working friend who is a good father and husband (and GMs a mean “Star Frontiers” campaign). Don’t give any shit about “personal responsibility” about how it’s the “achievers vs. moochers.” He and his wife are working themselves ragged to make ends meet and they are still living in the basement of their parent’s house.
Come on! I dare you!
The numbers, in this case, are clear and unequivocal:
Countries that have universal health care spend between 50%-60% per capita what the U.S. does but have better outcomes. These savings come about in a number of ways but mostly prevention.
Here are links to citations for my previous comment:
http://www.commonwealthfund.org/Publications/Fund-Reports/2007/May/Mirror–Mirror-on-the-Wall–An-International-Update-on-the-Comparative-Performance-of-American-Healt.aspx
and
http://ucatlas.ucsc.edu/spend.php
I did not pursue what I really wanted to do because it would have involved years more schooling after the magical age of 23, when my parents’ insurance would no longer cover me as a student dependent.
I have moderate-to-severe, sometimes treatment-resistent asthma, and knew there was no way to afford meds and treatment without insurance. The university’s student insurance would not have covered treatment for my asthma, and there was *NO* way I could have purchased insurance on my own.
It’s sad that after all this time, and after seeing all the benefits of universal coverage in other countries, the US still debates if it’s worth it and supporters still put up with it being labelled “socialist” by the reactionary right wing. If not being held hostage by my employer for health care is “socialist”, then sign me up.
Stent. Stent. Not Stint. There is no such thing as a “stint,” I’m sorry to inform you, Southern US speakers. Just like it’s a pen, not a pin, and Democrat, not Dimocrat.
Sorry, that drives me batshit. Ignore me.
Two years ago, summer, I was having extreme heart palpitations so I marched over to the clinic. As an insured ($132 a year) temporary resident of Saint Petersburg, I get free health care but I chose the pay clinic because they usually have some people who speak English and my Russian is pretty terrible, still. Plus, there are no lines.
They did many tests on me; EKG, bloodwork, other things I have no idea what they were. Everything was normal so why my palpitations? (I walked right in to the cardiologist’s office, by the way, there was no need for referral.) I was then sent to an allergy specialist (on another floor of the clinic). Turns out it was a severe allergic reaction to Russian mosquitoes. Common in foreigners and easily treatable. I immediately felt better.
My point is, I probably wouldn’t have gone to the doctor in America because it’s so cost prohibitive. And that’s awful. It’s our shame in America (well, one of them). My total cost for an entire day of medical care AND medications? $50. While I don’t think the Russian practice of paying doctors crap money is ideal, I do think there must be a happy middleground somewhere between.
I shouldn’t be shocked by the barbaric healthcare in the US, but it still gets to me. When your health is at stake, financial considerations shouldn’t even cross your mind. No country lacking universal healthcare free at the point of delivery deserves the label “civilised”.
The Swedish tax authorities made this ad for TV a few years ago:
http://www.youtube.com/watch?v=7sXKMglu-ok
The text at the end says “… or you could pay tax”.
Swedish Conservatives went crazy and managed to get it withdrawn as being too political for a government body, but I reckon it sort of sums things up.
Please keep in mind that symptoms for heart attack can, and often do, present in entirely different ways for women, so if you think you are having a heart attack please kick up a giant fuss untill it’s explicitely ruled out.
Some info here: http://www.ted.com/talks/noel_bairey_merz_the_single_biggest_health_threat_women_face.html
Not the best talk, some rhetoric may well have been done without, but the info is good.
I’ll repeat: Women, please make a fuss if (and when) a doctor dismisses concerns of heart attack without checking, and make sure anyone accompanying you will back you up; threats of a lawsuit for malpractice should work fine here.
I’m lucky to live in one of those european liberal hell holes where we have free(ish) medical care. Going to the ER costs me around USD 26, and that covers pretty much everything.
The bad thing is our current very right-wing government trying to end that.
They’re actually trying to sell us that the american model is better because it gives “service users” more choice. And with the “adjustment programme” stuck down our throats by the IMF/EC/ECB, they may actually succeed.
Yes, so very true. I can relate; before my forced retirement 18 months ago, I had quite good insurance for myself, wife and son, with only a $10 copay per office visit. Now, I’m resisting going to the good doc’s office for even routine exams due to the exorbitant $500 dollar/yr deductible, plus 10% co-pay plus 10% co-insurance . And adding insult to injury, an increase of another $70/month just got raised on top of the already exorbitant portion of the the premium I pay— and that’s after 80% is taken care of by my retirement package. ( That might be a good thing, if my retirement income was adequate, which it isn’t)
One middle-ager here that would agree with both statements.