So a fine flare-up of a chronic bellyache sends me to the Mayo’s ER with chest pains. Six hours of idling around that place in some discomfort yields the discovery that I have not ever had and am not now having a heart attack. The ER doc diagnoses GERD and a probable ulcer, and urges me to make an appointment with a regular doctor.
Now, the problem is, the part of the Mayo that houses its doctors’ offices is halfway to Payson from my house: twenty miles one-way, an hour’s drive through thick traffic.
Anyway, concerned about the possibility of an ulcer, I present myself to yet another new-to-me doctor (you never see the same doctor twice out there). She decides that I need an endoscopy with biopsies for H. pylori and cancer. This unpleasant test entails knocking you out, stuffing a tube down your throat, and cutting a sample out of your stomach lining. Obviously, since they drug you into oblivion, you can’t drive home.
So I start searching for someone to drive me out there. La Maya is in full crisis mode just now. KJG lives halfway to Yuma on the other side of the valley; asking her to drive to the Mayo would be like asking her to drive to Albuquerque. My son has a difficult time getting off work; besides, I’d just as soon he doesn’t find out about this until I learn what the hell we’re talking about. I call the church and at first am rebuffed, but then reach the head of the health-care ministry, who launches into a full-bore search for someone to make the 40-mile drive with me.
Time passes. Eventually, I calm down enough to think this through.
Item: The Mayo does not take Medicare assignment. This means that Medicare and Medigap will only reimburse—me, not the clinic—for the amounts they unilaterally decide services and procedures are worth. The Mayo will send the bills to Medicare but will not accept reimbursement. This means you have to pay the up front and then collect whatever Medicare and a Medigap insurer will disburse, which comes in little dribs and drabs of $30 or $40 over a period of several weeks, always long after the bill is due.
I figure an endoscopy and two biopsies are going to be bloody expensive. I also despair of finding someone to drive me out there, and I sure as hell can’t afford a taxi, which at best, with the senior citizen discount, would run over $80. A Mayo phone lady seriously suggests I rent a room at the Marriott next to the hospital, for a mere $100 a night, two-night minimum.
So it now occurs to me that really, if I need this procedure, there’s no reason to have it done at the Mayo. Why not find a provider who will accept Medicare assignment and then just have them send the results over to my doctors? Besides, wouldn’t it be better to have a doctor close to hand who can see me for routine issues, rather than having to drive all the way out to Taliesin West for every sniffle and bellyache?
At Angie’s List I find one, count it one, medical practice that’s universally lauded and is not in Scottsdale or way over on the far west side. Make an appointment. Get in forthwith to see a brand-new young doctor. He’s a DO, not an MD, but the old guys who do have MDs aren’t taking new patients, and since he’s the new kid in the practice I figure he’s probably consulting with the bosses, at least until they’re sure he’s not going to kill anyone.
Young Dr. Kildare, as it develops, is an absolute charmer about my son’s age. We discuss my various complaints.
He expresses surprise that the Mayo doc even brought up the prospect of cancer with me, much less went into detail about staging, surgery, and chemotherapy. Gastric cancer, he says, manifests several other symptoms that I don’t have, such as swollen lymph nodes, bleeding, and weight loss. He says he’s certain that it’s GERD, about which he knows quite a lot because he suffers with it, too. It is possible, he thinks, that an ulcer is forming and suggests doubling up on the omeprazole, which he says needs to be used for three or four months to get the situation fully under control. At this time, he says, an endoscopy is unnecessary. Instead, he thinks it would be better to continue the drug treatment for a few weeks, especially since the ailment is starting to settle down. If, however, break-through symptoms persist, he will want to do an upper GI series or an endoscopy. But not now. Come back in six weeks.
Meanwhile, he suggests I stay off the sauce, refrain from eating large meals, never eat late in the evening, lose weight, and get some exercise.
Huh. Whaddaya make of that?
Sure sounds like I was about to be subjected to some serious medical overkill, doesn’t it? Anyway, the tests are off until we find out whether the omeprazole (which is generic Prilosec) kicks in and and gets this thing under control. There may yet be a tube down the throat in the future, but at least now I should be able to keep the cost of it under control.
And so to the pool, for some of the prescribed exercise…