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Yesterday my wife started having great swelling in her private area.  She had been to Fort Lauderdale beach with friends for the day and we thought she might have been stung by a stingray or man-o-war even though she didn't recall feeling it.  Last night I took her to an urgent care clinic and because she is about 6 weeks pregnant they were reluctant to proceed with treatment because most treatments were risky for our unborn baby so they gave her something for pain and a mild cortisone shot and told her to come back in the morning after they got her blood work analyzed.  $275 bucks.

In May by company dropped health insurance for employees.  Even though I have been in my industry for over 15 years and have made over $100,000 a year for over 10 years, in an effort to cut costs for the company they dropped health insurance for all employees.  I was shocked they could do this, particularly because I am a consultant and am just paid an hourly wage and I paid for the health plan our of my wages, so I couldn't see where they were really saving any money by dropping it.  But for some reason they felt it was cost effective and after checking with the Florida insurance board and the US Department of Labor I found out it was legal as long as they dropped it for all employees, and didn't do it only for some employees.  This left me with a bit of a dilemma because the one good thing about the health insurance through work was that it was a group plan with no qualifying based on health.  I have a somewhat serious health condition that while not life threatening, excludes me for qualifying for private health insurance.  And because my wife arrived in the states in March, no major health carrier would give her health insurance in her name until she had been in the US six months (if I could have qualified she could have been on a plan with me, but not on her own plan).  So we were left with no health insurance.  I am a veteran and can get emergency services through the VA if necessary, but my wife was left with no health coverage.

Well today her swelling was about the size of half a grapefruit.  We returned to the clinic and they said she must immediately go to the hospital because necrosis and infection had set in. In wasn’t a sting but rather a cyst of some kind that somehow was spreading very quickly.  They called an ambulance because she had become so weak that she couldn't even stand anymore.  So she gets to the hospital and after a couple hour wait in a lot of pain, we see the doctor and he says that she has to have surgery immediately as the infection was spreading rapidly though her body.  I am pretty much in shock that my wife who was apparently perfectly healthy 36 hours ago is now facing the risk of death if she didn't have surgery.  And because without health insurance I was sort of doing the math and speculating what this all was going to cost.

Well she had the surgery a couple hours ago and the swelling and infection is pretty much gone.   She will have to be hospitalized for a couple days and it will be tomorrow before they can better judge if they have successfully treated all of the problem.  I talked to the hospital accounting person and though all the bills have not been entered yet she speculated that the cost would be somewhere between 10 and 11 thousand dollars.  They will give me a 30% discount if I pay it all at once.  I don’t have that kind of cash anymore as I spent all of my savings on meeting and marrying my wife last fall, but I have access to a line of credit, so I will just pay it off and deal with the line of credit later.

I am rather stunned by these events.  I had hoped to have my wife have our baby in Bogotá next year in part to keep the cost of the baby down.  But now in one short day I have spent more than I had thought in my worst case scenario for the baby.

I guess we will muddle our way through this.  The important thing is that my wife should be fine.  

Man this sure wasn’t in my plan when I thought about marrying a Latin woman.

... in response to My wife is ill, posted by lswote on Jun 21, 2003

Looks like the infection has spread and she has to have another surgery.  Man this sucks!

... in response to Another surgery, posted by lswote on Jun 23, 2003

Keep the faith Bruce, we're all pulling for you.

- Jeff

... in response to Another surgery, posted by lswote on Jun 23, 2003

You and yours are in our prayers.  Stay strong -TNC

... in response to Another surgery, posted by lswote on Jun 23, 2003

Praying your wife is well soon.

... in response to Another surgery, posted by lswote on Jun 23, 2003

I feel sorry for the both of you especially your wife she must be really scared right now. Try to keep her calm about this worrying may make it worse and try to stay positive around her, will make her feel more comfortable. Don't worry about the money in front of her this will make her feel bad and she doesn't need extra pressure. Hopefully this is taken care of soon.

... in response to My wife is ill, posted by lswote on Jun 21, 2003

I want to thank you for the outpouring of support.  I have only met or talked on the phone with a few of you guys and have even locked horns with a couple, but I consider you all friends and I hope I can return the favor someday.

My wife is doing better but is still not out of the woods yet.  The swelling is very minimal now and I can't even figure out where they cut her.  But her blood pressure is low (85/59), she is having a little difficulty breathing and some chest pains.  I can't see her coming home for at least a couple more days.

On the upside, (if there can be one in a situation like this) she got to see the baby when they did a sonargram today and she was all excited about seeing the baby's heartbeat.

... in response to Re: My wife is ill, posted by lswote on Jun 22, 2003

Please know that you are in our prayers and thoughts.  

... in response to Re: My wife is ill, posted by lswote on Jun 22, 2003

Bruce, good news about the baby's heartbeat. You and your wife are in my prayers.
Rob

... in response to Re: My wife is ill, posted by lswote on Jun 22, 2003

.

... in response to Re: My wife is ill, posted by lswote on Jun 22, 2003


Bruce:

I am in Bogota, read all the emails.  May God bless your wife, the baby and you. Dominguin

... in response to Re: My wife is ill, posted by lswote on Jun 22, 2003

Glad she's doing better. I KNOW that seeing the baby's heartbeat and knowing that he (or she) is still alive must have raised her spirits emensly.

... in response to My wife is ill, posted by lswote on Jun 21, 2003

Bruce,
Its scarry your wife could get so sick so fast from such a simple thing.I hope she is OK with no ill effects on the pregnancy.
I have never gotten health insurance for my wife and step son.I have excellent coverage through my civil service retirement but they won't let me add them.So far I have paid out of pocket,which has been cheaper than insurance but there is the risk of a big $$ item.She is getting a new job with benefits it looks like.I have been waiting for that to be the solution.
One of my wifes friends hauled her down to planned parenthood.They told them she was single.She has gotten an incredible amount of free medical attention and medicine from them.All female issue related but not really reproductive related stuff.

Pete

... in response to My wife is ill, posted by lswote on Jun 21, 2003

Bruce,

I'd just like to echo the sentiments of the rest of the guys here. You both have my prayers and best wishes to your wife for a speedy recovery.

JR

... in response to My wife is ill, posted by lswote on Jun 21, 2003

Sorry about your misfortune and hope she recovers quickly.
Greg

... in response to My wife is ill, posted by lswote on Jun 21, 2003

Good luck to you and your wife.  My wife and I are pulling for you both.  I have a feeling you will turn a bad situation around to something positive for both of you.  Maybe this will bring you closer together since all she has in this country is her husband to take care of her.

Take care.

... in response to My wife is ill, posted by lswote on Jun 21, 2003

I am happy for you that your wife eventually received the treatment she needed and is on the road to full recovery.  I wish you and your wife the best of good fortune with regards to your pregnancy.

Incidentally, I scuba dive and once met a doctor who also dived.  He said that it is very common for women swimming in the ocean or in lakes to develop infections especially if they hang around afterwards in their wet bathing suits.  There are bacteria and one-celled protozoa that make their way into body orifices or small skin openings such as those that might result from shaving or hair plucking.  He always recommends that women change into dry clothing immediately after getting out of the water.  What amazed after speaking with this doctor is that I noticed that EVERY female dive master at the diving outfits I went to, were doing EXACTLY that!

... in response to My wife is ill, posted by lswote on Jun 21, 2003

You can probably negotiate for 50 to 60 cents on the dollar.

Beattledog

... in response to My wife is ill, posted by lswote on Jun 21, 2003

n/t

... in response to My wife is ill, posted by lswote on Jun 21, 2003

Iswote, I hope everything is all right.  See if you can negotiate down further the bill from the hospital.  If you pay immediately, ask the billing department if you can have a PPO rate. That may cut the original bill by 60%. As to actually paying for this, can you get a home equity line of credit or borrow against a self-funded retirement plan?

... in response to Financial Options, posted by burbuja2 on Jun 22, 2003

I understands how you feel about legal action but at least get your money back from the urgent care center and tell them you'll call it even.

... in response to My wife is ill, posted by lswote on Jun 21, 2003

[This message has been edited by eddiemd]

Iswote,

I hope that your wife is doing better.
From what you wrote about the chain of events I would guess that your wife had an aggressive infection known as necrotizing fasciitis. This is considered a medical emergency and requires antibiotics and surgical debridement immediately. The infection is caused by different types of bacteria...staph, strep, gram-negatives. The treatment of choice is penicillin usually combined with a second broad spectrum antibiotic.
I will advise you to seek an attorney. It appears to me that the urgent care clinic was negligent in not recognizing and/or not appropriately treating the infection. Without knowing all the details it appears to me that they deferred treatment because she was pregnant. There is no excuse for this and in fact, this should have made them more aggressive in treating or sending her emergently to an emergency room for further evaluation and treatment.
It appears to me that this is a case of negligence.
If you need any further information leave a message on this board and I will respond.

... in response to Re: My wife is ill, posted by eddiemd on Jun 21, 2003

[This message has been edited by lswote]

Yep, those are exactly the words the doctor used today.  I didn't know women were so vulnerable to something so quickly.  Guess this is what my mother used to refer to as "female trouble".

I thought about trying to pursue some kind of action against the clinic, but number one, I don't like that kind of thing, I stress out big time (I almost felt I wasn't going to survive all the stress of getting the necessary documents for marriage and spousal visa a few months ago, it aggravated my physical problem by 3 or 4 times).  The other thing is that the doctor today said that the treatment my wife received today would have been the same thing last night.  So the cost would have been the same.  He said the only treatment for this condition is to cut it out, that it can't be treated with just antibiotics so she would have ended up with the same surgery either way. Until the necrosis presented itself today it was unclear to the urgent care clinic what was going on.  Perhaps they could have identified it sooner, but any kind of treatment put the fetus at risk, so they wanted to defer aggressive treatment until they were sure what was going on.  Today she was so bad they just said they had to go ahead and take the risk.  But they said there is a 35 percent chance she will miscarry now.

... in response to Re: Re: My wife is ill, posted by lswote on Jun 22, 2003

There's no stress Iswote.
Just get the info to a lawyer, and a settlement will be negotiated out, it'll never see court.

... in response to Re: Re: My wife is ill, posted by lswote on Jun 22, 2003

Say, Bruce, I made my post below before you made this one. I did not realize that the baby is still in danger......you have my prayers too, if you think they are worth anything.

... in response to Re: Re: My wife is ill, posted by lswote on Jun 22, 2003

[This message has been edited by eddiemd]

Iswote,

The urgent clinic delayed in treating an infection that could have killed your wife overnight. Have you ever heard of flesh eating bacteria? People become septic and die quickly, overnight, from this type of infection. The absolute WRONG treatment was a steroid shot. A cortisone shot suppresses the immune system thereby allowing the infection to spread more quickly. Unles she received IV antibiotics when you took her to the urgent care clinic and/or was prescribed antibiotics they were NEGLIGENT. And they are still negligent until proven otherwise. I would get the medical record from the urgent care clinic ASAP and/or have the attorney subpeona the records.
This has nothing to do with whether the cost or treatment would have been the same the night before or not. This is a matter of the fact that your wife could have been dead due to failure to diagnos and treat.
You need to get a medical malpractice attorney to review the case. That is my advice. This is a case of missed diagnosis, delay in treatment, and wrong treatment. It sounds like a slam-dunk case to me. You won't have to worry about the cost of anything.

... in response to Re: Re: Re: My wife is ill, posted by eddiemd on Jun 22, 2003

Well you got that exactly correct as well.  The doctor at the hospital also said that cortisone was a mistake as it surpressed the immune system.  I hadn't thought about the fact she could have died was because of the cortisone shot.  I think I will contact an attorney.  Thanks.

... in response to Re: Re: Re: Re: My wife is ill, posted by lswote on Jun 22, 2003

I talked to one legal firm today.  Not many offices open on Sunday even here in Florida where there are more than the usual amount of lawyers.  I will try to contact others during the week.  The firm that I talked to dealt strictly with medical malpractice.  The paralegal who does the pre-screening told me that the kind of claim I want to file is medical negligence, not medical malpractice and he gave me the number of a firm that specializes in negligence.  If that firm isn't able to help me I will talk to others.

eddiemd, I want to thank you for sharing your knowledge and the clarity you expressed it with.

... in response to Talked to first attorney today, posted by lswote on Jun 22, 2003

This guy said ER doctors are held to a lower level of accountability than regular doctors and I would have to be able to get another ER doctor to state that the doctor acted with reckless disregard with his diagnosis and treatment.  What do you think the chances of that are?

Basically I am hearing that if my wife fully recovers then my only damages were the additional medical costs and and that isn't a lawsuit worth pursuing.

... in response to Talked to third attorney, posted by lswote on Jun 23, 2003

but also remember the health of your wife and unborn baby are the primary issues. I'm sure you realize that.

So, also spend significant time for finding healthcare coverage because you never know if she or the baby may need it after birth.

One other detail is that I know being a private consultant has it's advantages, but there are also some draw backs with regards to healthcare benefits. Many companies don't want to pay these benefits unless the person is a full-time employee.

Maybe working a full-time position for a company that provides good healthcare benefits for you and your spouse would be the best thing now. You can do your consulting on the side to supplement your income if you want.  

Being a consultant is great, especially when a person is single, but there are allot of other issues that come along with it. I'm sure you're aware of them.

.02 cents.

Aaron

... in response to Talked to first attorney today, posted by lswote on Jun 22, 2003

This law firm did handle medical negligence but they said that the damages would have to be significant to go forward with a case.  As it stands (because my wife hasn't recovered and the full effects of the illness are not yet known), the only thing I am out is additional medical expenses and because of the costs involved in bringing a lawsuit, that is not enough to file a lawsuit.  The lawyer I spoke with told me I can file in small claims court or if the final prognosis for my wife's or the baby is bad to call them back.  Basically this attorney said my wife has to die or be disabled before there is enough damage to file a lawsuit.  The fact that there appears to be negligence and I am having to pay $5000 to $10000 additional medical costs isn't enough.

I have a couple calls into other attorneys and I will see what they say.  If it comes to it being me have to pursue it in small claims court, I will drop the matter, because as I said previously that would involve a lot of stress and I can't handle stress.

... in response to Talked to second attorney, posted by lswote on Jun 23, 2003

There are 2 issues,do you have a case and is it worth their while to get involved in it?Sounds like they want to work on cases with possible huge rewards.So unless the outcome becomes very bad,which it hopefully will not,they don't see big bucks.
I discovered this one time when my attorney strangly lost interest in my case.It flunked the $$ test.
I would keep trying other attorneys.Maybe there is a consumer advocacy group that is interested.Even if you just pay someone to file a lawsuit it might get them to cough up your medical expenses.

Pete

... in response to Sounds like they don't smell enough mone..., posted by Pete E on Jun 23, 2003

Med-mal cases are treated by most states differently than regular negligence cases.  The cases are expensive to try because of the reliance on out of state expert witnesses.  This is because it is necessary to show a deviation from a standard of care and that usually can only be established through the use of expert testimony.  For obvious reasons, physicians in one locality will rarely agree to terstify against other physicians in the same area.  Also, the procedures are often more restrictive than regular negligence cases and in some states, awards are capped. I'm not familiar with Florida.  If I was in Iswote's position in Louisiana and two specialists thought I had a dubious case, I would consult an attorney to see if I could get the urgent care center to pick up at least those medical expenses related to the delay caused the misdiagnosis and treatment.  He should then be able to negotiate down the balance.

Burbuja2, JD

... in response to The problem is..., posted by burbuja2 on Jun 23, 2003

Barburja,
I have a question concerning getting another doc to testify there was a compromised standard of care.  If the attorney specializes in this area of law, don't they have some sort of network of docs willing to do this?  (Not necessarily in the same area as the lawsuit is filed).  If they do, I believe this would really help Bruce.

... in response to Re: The problem is..., posted by HeyNow on Jun 24, 2003

Its my understanding that doctors are available but they would have to be from another area to get around the conspiracy of silence.  These doctors need to be paid expert witness fees.  Can you imagine their fees for a case which may demand days of their time?

... in response to Re: Re: The problem is..., posted by burbuja2 on Jun 24, 2003

That brings up the next questions.  Will an attorney take a case (like this) on contingency and absorb the expert witness fees?  If yes, how much would the attorney need to gain to take it?  If not, do you think an attorney could write a threatening letter so, Bruce can get his moeny back?

... in response to Re: Re: Re: The problem is..., posted by HeyNow on Jun 24, 2003

The attorney may advance costs but most contracts make the client ultimately responsible.  Apparently, the attorneys Iswote consulted uniformly thought that the financial risks and case complexity was not commensurate to the likely outcome. So to answer your question, the Florida attorneys would not take a case like this on contigency.  The threatening letter may work to the urgent care center, but an attorney is probably going to charge more than the center's bill.

... in response to Talked to first attorney today, posted by lswote on Jun 22, 2003

Hope that I helped.

You should not have to pay any up front money to the attorney. They should know right away if the suit has any merit.
All your medical bills should be payed for by the urgent care clinic if all works out. And you will get a settlement on top of that.

... in response to Talked to first attorney today, posted by lswote on Jun 22, 2003

Shop around, don't pay them too much. Your wife has done all the physical suffering and was exposed to the danger, and you and she both experienced the mental anguish. The lawyers haven't suffered as much as a torn toenail, yet will want 30% or 40% of the 'take'...and they won't do anything to earn it except write a couple of boilerplate threating letters and make a couple of phone calls (to another lawyer they like as not play golf with anyway)....when the first one says 'we can get you X dollars, but we want 30%', figure they can actualy get 1/2 of that, and then shop that figure around and you should be able to find a hungry one willing to do it for 10%, 15% at most.

... in response to Re: Re: Re: My wife is ill, posted by eddiemd on Jun 22, 2003

Iswote,

I'm not an attorney or MD, but if you hire a lawyer, THEY do the dirty work, not you. It won't stress you out.

... in response to My wife is ill, posted by lswote on Jun 21, 2003

Bruce:

Sorry to hear about your wife... I pray that she and your baby will have a full recovery and no further complications... As others have noted, $11K in the overall scheme of things is a drop in the bucket... I know it doesn't seem that way now, but just be grateful that you caught it in time and that the prognosis is good...

I can empathise to a certain degree... I added my wife to my health insurance coverage as soon as we got her SSN, but she couldn't be added to the policy until July 1st... Well, she had been in the US for 4 days and developed a serious infection too... Similar to your wife's, but no cyst... She couldn't even stand up the pain was so bad... We rushed her to an Emergency Care Center... $400+ out of pocket later, she is on the mend... I am just thankful that is was treatable by antibiotics...

As far as your health insurance, yes, it is legal for your company to terminate health benefits, as long as they do it to everyone covered... By the same token, COBRA is designed for just this scenario... You can continue your existing coverage for up to 90 days via COBRA... During this time you can shop for new coverage... There are laws that prohibit insurance companies from declining coverage based on pre-existing conditions... If nothing else, you may be able to opt for coversage that procludes covering your pre-existing condition, but covers you and your family for everything else... I know this is a little to late at this point, but this may be a wake-up call to get your butt in gear and examine your options...

Best wishes...

Francy and I hope everything will be ok...

Mark

... in response to Re: My wife is ill, posted by wizard on Jun 21, 2003

I did check my options Mark and I didn't find one decent company that would cover my pre-existing conditions even with exclusions here in Florida.  I found a couple companies I had never heard of who would have covered my wife, but since I never heard of them I don't know what their claims departments are like.  I couldn't find any companies with PPOs or HMOs, only companies that you submit claim forms to.  Fairly hefty premiums, big deductibles, lots of things they don't cover and at least a years waiting period before pregnancy is covered.  And as I said I don't know how good they are at handling claims since I never heard of them.  Even some of the larger, well-known companies don't handle claims particularly well as I know from my experience with CIGNA this past year.

Please read my response to MikePastore concerning my COBRA options.

I didn't know what else to do so I just hoped things would be okay and I wouldn't need insurance in the near future.  I felt I had the baby thing covered since she can have the baby in Bogotá for 1/10th the cost of the US and since I am a consultant it is possible in a years time I will be working a different contract with a different company that offers group insurance again.  At least that was what I was hoping for because I didn't know what else to do.  Also in a years time the Veteran's Administration will let me cover my wife at the VA (not exactly excited about VA care, but it beats nothing).  But I have to be married a year for that option.  I have spent a lot of time and energy looking for insurance and so far have come up with zilch.

... in response to My wife is ill, posted by lswote on Jun 21, 2003

The IMPORTANT thing is that she and the baby are allright, thank goodness. NFI

... in response to My wife is ill, posted by lswote on Jun 21, 2003

I feel sorry for what happened, hopefully your wife is not in pain now and will recover. Insurance is going to be a major epidemic soon, already 40% of Americans don't have any not including many whose plans cover very little. I make about half what you do but since I belong to a trade union they can buy policies for thousands of workers so they get a good rate.

... in response to My wife is ill, posted by lswote on Jun 21, 2003

Don't tell me that you ignored your COBRA election and let your health insurance lapse, there must have been some provision for some kind of continuation.

... in response to COBRA?, posted by MikePastore on Jun 21, 2003

Actually I was on COBRA.  As I said before I am a consultant so I work for different companies for varying lengths of time.  My latest employer didn't offer health insurance to me when I started (there seems to be a real trend in that recently), so I was on COBRA from my last job.  But that company dropped health care coverage for all its employees as well as its COBRA ex-employees.  That is why I called the Florida insurance board and the US Department of Labor.  It was very interesting and educating in an unpleasant manner.  Each agency I talked to said they felt it had to be illegal for the company to drop coverage, but that it wasn't actually in their jurisdiction to do anything about it and referred me to another agency.  When I finally worked my way to the Department of Labor they said it was under their jurisdiction and that it was legal for the company to drop the coverage for COBRA employees if they dropped the insurance for other employees as well.  What was even more of a surprise was that if I had been on COBRA for a full 18 months I would have been eligible to get a certificate that would allow me to get private insurance without the health pre-existing conditions qualifications.  But since the insurance ended before the 18 month period ended I am not eligible for the certificate which means I can't get private insurance.  And this was legal, can you believe it?

To answer Wayne11’s question to where the money went over the last 10 years, well hardly any of it went for fun.  When I was 32 I married a woman who had 3 small children and we were married for 13 years until they were raised without any child support from the father.  When we divorced about 4 years ago after the children were raised, I gave my wife all the major assets which amounted to a house and about $30,000 because she didn't have any skills which would earn very much and I didn't want her to be destitute.  I think it was the right choice because she found somebody in less than a year who was able to provide for her and I continued to earn a good salary and had bought another house for myself and amassed about $30,000 again.  Unfortunately I spent all but $5000 on my trips to Colombia (I went every 2 weeks from September to February) and the wedding and honeymoon.  When my wife got here I spent the last $5000 on a car for her.

Well I am rambling big time and seemed to have revealed about all my personal information for the last 20 years, but I am still kind of in shock of everything that unfolded so suddenly and I guess talking about it helps me feel better since my wife isn’t here to talk to.

... in response to My wife is ill, posted by lswote on Jun 21, 2003

Iswote,

I wish your wife a speedy recovery.

My wife has been ill off and on since we have been married.  It seems its something new all the time, from bladder infections to a sore leg or other issues.  Nothing like you are going through but we have spent our time at the Doctors.  When we were sailing down the coast from California she had partial temporary paralisys in both hands during a bout with sea sickness.  Scared the hell out of me that is for sure.

After you are done paying the Doctors, it maybe time for a financial planner.  100k a year for 10 years and little savings....  Sounds like you have been having way too much fun.

11,000 is nothing in the long run.  That is an American women's donut and pcychotherapy bill for 6 months.

Wayne

... in response to My wife is ill, posted by lswote on Jun 21, 2003

Bruce,

So sorry to hear about your wife's illness.  You did not say if the doctors thought it might affect your unborn baby.  Hopefully, she will make a full recovery and get out of the hospital soon.  Don't let the money issue get you down as it could have been much worse, possibly losing both of them if diagnosis and treatment weren't provided right away.  

About the insurance...I don't know about Florida but here in Oregon if you lose your job and health care coverage you can opt to pay it yourself for the next three months.

Keep us posted bro.

... in response to Re: My wife is ill, posted by pablo on Jun 21, 2003

Don't worry about the money now, just pray your wife is well.

... in response to Re: Re: My wife is ill, posted by Wasp on Jun 21, 2003

Bruce,
 Sorry to hear your wife is ill but, glad to hear she is improving.

... in response to Re: Re: Re: My wife is ill, posted by HeyNow on Jun 22, 2003

Glad your pretty wife is doing better.  i'm an agent in Atlanta & would check the yellow pages asap for those short term health policies covering you for 1-6 month periods and renewable for addl 1-6 month periods up to two times. Perfect to hold you over until your new employment situation and amazingly cheap vs regular health ins.  Expect an exclusion for pre-existing conditions.