Background
This is a continuation of my earlier post here, also just noticed I wrote about the US healthcare systems back in 2009: My Thoughts On US Healthcare Reform, My Thoughts On US Healthcare Reform: II, My Analogies On Healthcare Reform Protest, and Healthcare Reform: Some Good Things About US Hospitals.
Below was written over a few days. Personal story. Hopefully could be useful for people in the USA. As one of my previous colleagues said: the best is to avoid the hospital, but if we do go, it’s important to have the healthcare insurance 🙂
Today (7/01) I spent almost full day at the total access urgent care center (TAUC). I am not complaining but rather quite appreciative of how things came about. Yesterday (06/30/2023) we had a storm here and I did a dumb thing looking back: remember hindsight is always 20/20. I climbed up the ladder shortly after the storm with the intension of removing a few big tree branches on the roof. But things didn’t work as I hoped: I fell from the ladder, back down 1st and totally unexpected. Btw, here are some safety tips re: using ladders, and this one too. And I talked to my colleague about it later, who has medic and safety experience. Reflecting back the loose foundation (with mulches etc.) is also a contributing factor of the fall of ladder.
I didn’t feel too bad in the immediate aftermath, but things turned worse over the night as I found I had blood in my urine. It was about 9 or 10 pm and I didn’t think it’s a good idea to hang out at a hospital emergency room. So I tried to tough it out until 8 am this morning when the urgent care places opens. Note the main reason not going to the hospital emergency room (ER) is the ER usually tries to help the most in needed, those were seriously hurt etc., and I don’t think I am in that category.
But why I still spend almost a full day? I think the short answer is they have many patients that are in similar situation as me. Also my case is a bit more complicated because the doctor wants to do a CT scan on my neck as well as my abdomen with contrast. There is X-ray in the 1st TAUC place I went (Creve Coeur), but for CT scan I need to go to another TAUC place which is about 20 minutes drive (Chesterfield). Note this is my 2nd CT scan in the US. My first one was documented here. This time I got more scans than last time, I think I got both the regular scan as well as contrast scan. And I got the GE CT machine instead of the Siemens machine last time (year 2015).
I think TAUC started to pop up in last 10 years or so in the St. Louis area, with the booming of the urgent care in the US in general. They are not the 1st urgent care place in the area (Creve Coeur to be specific). That honor goes to St. Lukes. But St. Lukes has one disadvantages, they usually have two bills (one from the urgent care, another one from the provider). TAUC only has one consolidated bill. I think TAUC bill is also usually cheaper. For example, yesterday (7/01) I went to the Creve Coeur location 1st. I know from past experience, that I need to queue up online 1st. So I did. I waited at the Bread Co. at Old Olive road. At about 9 am, I saw I am at spot 3, and the restaurant is getting busy, so I went to the clinic.
Tests, lots of them
Typical treatment flow of urgent care goes like this: check in at front desk (may or may not fill out paperwork, or may need to make some payment from last visit, become more rare as more payments are done online nowadays). Go to the treatment room, and wait for the nurse. Nurse come in the take vitals. The provider (a doctor, nurse practitioner, or a physician assistant PD) will come in and ask questions. In my case I talked about what happened, and the aftermath. The doctor will order some tests. Actually I think my urine sample was taken before doctor even come in. And the doctor checked my back etc. and ordered both X-ray for back and legs, as well as CT Scan for the neck and the abdomen. While the X-ray technician started to work on my X-ray, I realized I have some minor pain on head too, so they (the doc and technician) did the head X-ray as well. After that they did some blood draw as well as the prep for IV for the contrast CT scan (basically leave a cap in my elbow area). I was ready to move on at about 12:15 pm at the Creve Coeur location. Thought about ordering McDonald’s but the text message came quickly asking me to go the the new TAUC location, and I realized I have something in my elbow too. So I started going there.
At the new location, I got the vitals again (before leave, the CC location did the vital for me again to make sure, and I realized the med tech/assistant is a Wash U student), and the IV which is just saline. I did the CT there, which is more complicated than last time, mainly because of the contrast scan. I closed my eyes during testing. I recall in my recent China (refer to my recent visit, this one and that one ) trip I realized they do way more CT than they are doing here, and some elders don’t like hold breath etc. and my mom didn’t like some of the tests either.
Waiting
After done the CT, as well as finishing up the IV (again saline). I was mostly in the waiting mode. I noticed in the new location, the TV is not on. I managed to plug in the power adapter for the receiver and was able to watch some TV. At one point I was restless, so I went to the car and get water as well as the portable battery to charge my iPhone, as the iPhone battery was low after I used it for a while. At about 3:30 pm or so, I got the call from the provider and he explained the things to me, and ready to let me go home. I got the call when I was in the restroom taking the call from my Apple Watch (I left the phone in the treatment room). I think I started to order McDonald’s via the app as well. The main thing at the time was to remove the cap on my elbow, and receive the discharge instructions. They did the vitals once again as well.
At about 4:15 pm, I was finally ready to go. And I went to the McDonald’s right away.
PS: on Saturday night when I 1st saw blood in my urine (which is probably the 1st time in my almost 52-year-old life), I was unsettled. Today (07-04-2023) I think about the life insurance I bought in the year 2012, which is a 15-year term life for $500,000 coverage. And today I realized 500k in the year 2012 is probably 250k in today’s dollars. Inflation is another tailwind for the insurance companies, in addition to the benefits of float (they didn’t have to pay out all the claims because people didn’t all die, or claimable accidents didn’t all happen at once). So basically they can invest the float (the income from premiums) money for a long time. Today I went to skating too, and I think I may not need to see a urologist that urgently for now.
PS 2: I found out my elbow has some residue pain from the IV, refer to this. It seems “Once the tube has been placed, the IV site shouldn’t hurt, sting, or burn. When the IV procedure is completed, some swelling and bruising at the site are common and not cause for concern. Most IV sites heal quickly in a few days.” I think I am starting to fear if I got this IV thing when I get older. And it seems to me the pain is there when I visited my mom recently in hospital in China. This seems like something comes with the modern medicine (note IV is used much more in China than there). Before my recent visit to urgent care, I recall I did this only once when I had fever (and maybe cough) a few years before pandemic. I recall the nurse put in some steroids to help me (make me more comfortable).
PS 3: regarding safety, I think we need to be careful and vigilant in many aspects: from driving (car incidents) to climbing ladder, or on the lake (reminds me one incident in which one of my old friends died). I understand sometimes things are not 100% under our control, such as this recent greyhound bus accident.
PS 4: 07-30-2023 I saw the insurance benefits explanation, it looks like I (only) need to pay $200. This seems a good deal to me 🙂