Learning from medical misadventures

 

Miss D.‘s and my medical misadventures continue as we try to get tested for COVID-19, and figure out how to treat ourselves at home.  Basically, we’ve been shunted from pillar to post and back again by local medical facilities, to my profound and (by now) vituperative irritation.  She’s booked a test at a local pharmacy for later this morning, while I’m going to try to get one at a local doc-in-a-box (if it’s open . . . its Web site keeps changing on that subject, probably due to weather conditions, which are still far from ideal).

However, I’ve also been looking at the wildly varying prices being quoted or offered for tests and related issues.  They’re all over the place, from “free” (provided you have insurance) to a minimum co-pay of $500 apiece.  Nobody will be specific about what’s covered and what’s not.  Furthermore, there’s no guarantee that you’ll be given a prescription for anything useful.  Remdesivir, the only approved COVID treatment, is available to hospital in-patients only, while hydroxychloroquine or ivermectin, both widely used and proven “unofficially”, are not guaranteed to be available even if your doctor will prescribe them.  It seems that pharmacists can exercise a right of veto over such prescriptions;  and if they don’t want to issue them, you’ll do without.  That makes me incandescent with anger, but the system is set up that way.  (I probably know more than most US doctors about those remedies, anyway.  Lawdog and I are both familiar with them from our years in Africa, where we both took them freely to deal with malaria, fungal conditions, etc.  Although they’re scheduled drugs, they’re so common over there that one can frequently buy them at roadside stalls.)

To make matters more interesting, the prices being charged for care appear to be outrageous – and not a little fraudulent.  Apparently a hospital can charge at least 20% more reimbursement from the federal government for a case of COVID-19 than it can for any other ailment;  so a whole lot of people are classified as COVID-positive, when in any other year they’d be called flu patients.  (Just look at the official CDC figures for flu cases over the past year, and compare them to previous years.  There’s no doubt whatsoever what’s going on.  Hospitals are making financial hay while the sun shines, by mis-classifying every flu symptom as COVID-19.)

This is on top of the vastly increased cost of health insurance, which buys us less and less care each year;  and also on the predatory pricing practices found in many emergency rooms, which bill anything and everything they can to those they think they can force to pay, while treating indigents and transients free of charge (largely thanks to EMTALA).  Go read those two links for yourselves.  They’re enough to make your blood boil.  The “compassionate” and “caring” health care industry is revealed to be nothing of the kind – it’s just another business to those running it.

Suffice it to say that I’m not a happy camper at present.  Miss D. and I are self-medicating as best we can on cold and flu treatments, taking vitamin and mineral supplements, and hoping for the best.  Please keep us in your prayers as the struggle continues.

Peter

26 comments

  1. A source for hydroxychloroquine that I've heard of but not contacted is: Dr. Robin Armstrong, AmericasFrontlineDoctors.com
    Hope this is helpful and you improve dramatically.

    Richard

  2. Keep the Vit D and C and zinc going…
    As for the treatment availability…
    Our family and extended family came down with the China Virus over Christmas…The prescription CHQ was unavailable and the non-prescription web based Ivermectin was available, but the wait times were several weeks to several months.
    Since we had tested positive I did the unthinkable…
    I ordered and used the livestock grade Inject able Ivermectin.
    Used as an oral medication based on weight (about 22cc per 250lb body weight).
    Of four people infected, the longest that modest symptoms lasted was four days with an individual with diabetes. The other three cleared completely withing one to two days.
    Not saying that I would recommend live stock medications,
    BUT, considering the options, it is something to consider while awaiting "approved" medications.

    Prayers for you and your family

    MSG Grumpy

    https://www.revivalanimal.com/product/generic-ivomec-1-injection?SKU=31231-637&a=PLA&msclkid=eb3ff5d92e6811637c7aaa39a4038dcd&utm_source=bing&utm_medium=cpc&utm_campaign=%5BShopping%5D%20All%20Products%20-%20All%20Devices&utm_term=4580290568680277&utm_content=Top%20Products

    1. I had a girlfriend tell me the Veterinarian gave her dog a prescription for Ibuprofen. It was $35 for 10 days. He warned her that this wasn't people Ibuprofen, that she would have to buy refills from him.

      I laughed and explained that there is only one kind of Ibuprofen, and that is Ibuprofen. The rest is just algebra for dosing. Turns out seven drops of pediatric Ibuprofen syrup was just the trick. At about $3 for a lifetime supply.

      Good luck.

      Ps, if you are being tested with nasal swabs, that is 95-97% false positive. Best way to reduce false positives is to Netti Pot yourself before testing. Plus it's good training for when the government water boards you.

  3. Of course they are a business. That's why our health care system is, in general, better than anyone else's in the world. If they don't treat you well, you go elsewhere. Try that in Canada or the UK. To the extent that there are problems, they are caused by government interference in that market. Notice that all your examples can be traced back to government.

    More reimbursement for COVID? Any rational health care provider will maximize the number of COVID patients.

    Free care for anyone required in the emergency room? Again, you have to make that money back because it isn't free for you, the provider. So you charge where you can.

    Outrageous charges for ordinary items? Who complains about those charges when they are all paid for by your insurance company? Why is most medical care through an employer and therefore an insurance company not beholden to the consumer? Government mandates and incentives.

    More money for less insurance coverage? Again, who decides what must be covered by an insurance company? My insurance covers prenatal care (I'm a 56 year old man), chiropractors (I go with the AMA in labeling them as "quacks"), acupuncture (I did this a few times and it only cost me $60 a pop. Since I didn't go to a doctor first and since I'm not sure how many doctors would even prescribe an acupuncturist, I paid out of pocket. Didn't break the budget. Also wasn't super helpful.) My point is that the government, at least in our state, has loaded on a list of things that the insurance company has to pay for. I don't have the choice of a bare bones plan that covers what I need. They even took away my ability to have a Health Savings Account unless I made all the contributions myself.

    So I don't blame the insurance companies. They are doing precisely what they were set up to do, but within the increasingly onerous mandates of the government.

    On other topics, I read one of Rockwell's books. It was disappointing. He came across as inarticulate and obsessive. A book supposedly about the basic tenets of libertarianism was instead an diatribe against the Bush presidency. And poorly written at that.

    Also, yes on hydroxychloroquine and zinc. Call your local GP and ask if he can prescribe them to you. That website does look interesting that was linked above, to Compass/America's Frontline Doctors. Don't have any idea how above board it is.

  4. Just go to the local feed and seed, or gasp, Amazon. Buy the Ivermectin only type, apple flavored. Better do it soon.
    The graduations on the syringe are adequate to dose #250.
    Protocols can be found on the web.

  5. Peter – see https://chiefio.wordpress.com/2020/12/15/ivermectin-works-vaccines-happening-now-vit-d-a-biggie/ and the other articles on Ivermectin there. I think that, where you are, the drench Ivermectin, used to treat cattle, sheep, and horses, should be available in someplace like Tractor Supply for less than $10 per bottle, sufficient for around a ton of livestock. Since you apply it to the skin, no problems with stomach upsets.

    There's also some personal experience with using that in one of the many comments on the subject there. It is of course up to you as to whether you'd want to use a veterinary medicine on yourself, but bear in mind that, when slapping it on an animal and rubbing it into the skin, the human doing the treatment will get dosed too and thus the product can't be dangerous for the stockman. Personally, I see this is a far lower risk than the virus anyway, since the veterinary product needs to also be human-safe.

    The longer that virus is allowed to multiply in your body, the more damage it can cause – replication of the virus in a cell ruptures the cell. There's a race between your body producing enough antibodies to kill the virus and how fast the virus can replicate and produce new viruses to infect other cells.

    If you don't want to do that, drinking tonic water (with real quinine) will at least have enough of an effect to help, though you may find drinking a litre or two per day too much of a good thing. You also may try bundling up warm and sweating it out, since viruses are more easily damaged by heat (why taking Tylenol/paracetamol to reduce the fever isn't the best thing to do, since it prolongs the infection).

    The medical system is what it is. Given that the official advice is to stay at home and take Tylenol until you can't breathe and need to go to hospital, and doctors will in general obey the official advice if they want to keep their jobs, I figure you'll need to fix this yourself. Travelling round trying to get a test only puts you in danger of catching another variant of the virus, so really going to either a doctor or hospital needs to be somewhat of a last resort.

    Judging from the reports from pr. Raoult here in France and Dr. Zelenko in NYC, HCQ is only really good up to around 5 days from onset of symptoms, and Ivermectin up to around 10 days from other studies. Basically, time is of the essence here. If you're still ill after 10 days of symptoms then you may well end up in hospital.

    Though we're all assuming you have Covid-19, maybe worth noting that Ivermectin also stops other coronaviruses replicating, too. I don't know if it works against noroviruses, which are largely responsible for 'flu. Still, it won't do any harm anyway.

    Best wishes for fast recovery for you and yours.

  6. Peter,

    Had it, got through it in 2 weeks. Doc said watch O2 sats, take vitamins, baby aspirin, tylenol & melotonin. Baby aspirin takes care of serious clotting risks. Tylenol helps w/ aches & fever – I used the big 650mg time release version they sell for arthritis relief – seemed to work well. Melatonin to help sleep – did not need help there 🙂 but doc said it has other benefits.

    If O2 gets <90, see doc/ER ASAP. If develop crackling/wheezing in lungs, same. If tylenol does not control fever, same.

    Good luck.

    RAS

  7. Dear Peter,
    ER nurse in Ohio here. I know people want a diagnosis to hang their hat on, but it makes virtually no difference in treatment. Just stay off the crappy roads, stay home and treat symptoms. Get to the ER if your O2 sats drop or you're short of breath. (pneumonia)
    Listen to Aesop.
    Vitamin C, D, zinc. ASA if you're prone to clots, as this seems to be causing a hypercoagulable state, and we're seeing a ton of pulmonary clots. If you're looking for abx, Fish antibiotics, online.
    Just stop racing around, and rest.

    BTW, I had it last winter, before the chinese announced they'd unleashed a problem. Blood test later showed that's what it was. Sickest I've been in 25 years. Doctor found I was self pay, and refused to do anything. Our healthcare system sucks; I work in it, and can't afford to use it. I've written whole papers on this.
    Jen

  8. Durvet Ivermectin is available for $4 in the Equine section of your local farm store. 2 doses, 2 days apart seems to do it for most people, but the sooner the better. One tube should supply 5-7 doses, so there's enough for your whole family there.

    A pistol won't stop a tank, but if you can bag the tank commander with it, it will certainly slow it down.

  9. I recently had to get tested prior to a medical procedure. Nose swab, so I figured this was just a way for the doc's practice to cover their backsides and soak an insurance company for some of their money.

    The real treat was reading the report. Good grief. There is more waffling and butt covering there than I would believe could be packed into such a small space. Basically, I tested negative, but it proves nothing, they have less than no responsibility if they're wrong and I ought to act like I have the Wuflu for the rest of my life.

    Good luck, listen to the advice above and take care of yourselves. I wish you a speedy recovery.

  10. Peter,

    I must disagree with your characterization of the classification of patients by hospitals and coders. I function in a role where I am reading 20 to 30 hospital charts daily, reviewing both the clinical content and the coding. I am a 30yr nurse, with 10+ years experience and education in coding.

    It is true there is a financial incentive to capture COVID. However, I can also say with certainty that the large majority of hospitals ARE NOT fraudulently reporting the codes for COVID infections.

    From reading the clinical notes, and contrasting with the coding, these generally match. There are clinical findings (not just test results) that support the diagnosis of COVID infection in 98% of the records I am reading. These patients are often extremely sick.
    (and when the clinical picture doesn't match whatever the documented diagnosis — not just covid — one of my roles is to send a direct question to the treating physician, summarize the clinical picture, and ask whether the patient has an active covid infection, a positive test recovering from a prior infection (especially if both covid and covid IGG are positive), a false positive test, or other explanation)

    In addition, the RISK of reporting for financial gain is much higher than the gain might be. The sources of payment all have active audit programs with penalties attached … and they extrapolate from the sample to the entire patient set … believe me, NO ONE wants to go there.

    I can not offer an explanation of the CDC flu cases abnormality. It is NOT because of false covid reporting on the part of physicians or hospitals.

    All of the above being said … I do have concerns with how far the reporting and data has been pushed. Things like:
    *the number of test cycles performed (which should raise the false positive rates; raise the total # of patients, but conversely decrease the mortalilty rate),
    *how thoroughly test results are screened to exclude multiple tests on a single person,
    *how well the data collection is able to differentiate mortality with coincidental covid + vs covid being a contributing factor along with other acute and chronic conditions
    *etc…..

    BTW, your blog, and the comments, are a daily read for me. THANK YOU for your outstanding work (same for your books).

    Sincerely,
    Don_RN

  11. My sincere apologies … should have started with the most important:

    My best wishes and prayers for the rapid and complete recovery of you and your wonderful wife.

  12. "Apparently a hospital can charge at least 20% more reimbursement from the federal government for a case of COVID-19 than it can for any other ailment; so a whole lot of people are classified as COVID-positive, when in any other year they'd be called flu patients. (Just look at the official CDC figures for flu cases over the past year, and compare them to previous years. There's no doubt whatsoever what's going on. Hospitals are making financial hay while the sun shines, by mis-classifying every flu symptom as COVID-19.)"

    Sorry, Peter, but no. In fact, HELL NO.
    From your personal concern and frustration, you're now spouting the effluvia from the southern end of a north-bound horse.

    Having dealt with COVID and flu patients both some wee bit, while I do not and cannot speak for 10,000 hospitals and clinics nationwide, I can tell you how it's being done, by and large:
    Presumptive COVID patients for admission are swabbed for both common influenza, and COVID, with rapid-result tests (1-hr turnaround).

    We have had hundreds of COVID-positive results, whereas I can count the number of flu cases since September to five minutes ago on my fingers. Through early December, before the latest biggest spike, I could have done it on the fingers of one hand.

    That's because, shocker!, wearing a snot mask, staying 6' apart, cutting personal contact, and using buckets of hand sanitizer kills common flu deader than canned tuna. The flu outbreak this year is negligible.

    That's not recockulous conspiracy theories, it's simple common sense based on behavior. People are slobs, and patients are idiots. Suddenly, they're not, so much, and flu has dropped off the map entirely. that could happen every year, but after 400K deaths, most people suddenly realize this ain't "just the flu". Learning is occurring. Bummer about the neighbors' granny, or your friends' uncle, but some folks are slow learners about this not being a big hoax.
    (cont.)

  13. (cont.)
    As for that fabulous reimbursement 20% bump, you should know that FedGov reimbursement for anyone is about 2¢ on the dollar to what that care costs to deliver. Let me know when you'd like to open a burger stand in that reimbursement plan, and how long McDonald's would stay in business if seniors got their Big Macs for 2¢ on the dollar. Everyone over 65 has been living off their kids' largesse since that magic birthday, since Medicare began in the 1960s. So the prospect of the hospital now getting the princely sum of 2.4¢ on the dollar is not filling hospital administrators with fits of glee as they leap, Scrooge McDuck-like, into pools of gold pieces in their voluminous vaults of cash. Most of them will lay whatever extra they have against the huge losses they took when everything non-essential nearly bankrupted them last spring, in hopes of not closing down this year or next. How selfish of them.

    We're doing everything we can to keep patients out of the hospital, because until mid-January, we were about two minutes from ER docs coming outside, and shunting anyone over 70 or 75 into the "Go over there and die without any care" tent, and letting the under-70s inside to try and allocate resources where they'd do the most good. We were a literal whisker from that, just last month. We had people shoved into every nook and cranny except by duct-taping them to the walls, or putting in bunk beds, and it still wasn't enough room for the seriously ill.

    So we were sure as blistering f**k not dragging flu patients in and calling them COVID, nor would anyone else with a lick of common sense. We were finding and sorting the COVID patients and the not-COVID patients, precisely so we didn't infect the uninfected, with ordinary hospital illnesses, with COVID.

    I get that you're frustrated. Welcome to the new normal.
    I hope you get well. But it's no excuse to spew horse crap.
    If that stung, it was intended to. You knew better than that.

    Rub some dirt on it and walk it off.

  14. And out of pity for your current circumstances, I'm not even going to start on that cart-before-the-horse crapola about how people are overbilled, but the medical establishment gives away free health care because of EMTALA, except to say transients, indigents, and illegals don't get care free of charge, they get it free of them PAYING the charges billed, because they're deadbeats, and always have been, so everyone with insurance picks up that slack, like you have since 1986.

    You don't like that? Go raise hell with Congress, starting with YOUR congressweasel; they shifted those costs onto you back in the 1980s, and nobody but hospitals and doctors have screamed about it, to no effect.

    And the government's solution to how they screwed healthcare? Try and take it over and screw it up completely. Tell them to revoke EMTALA, and fund indigent care separately, out of their (i.e. every taxpayers') pockets, so you can see what the "homeless", illegals, crazies, and dopers are costing you ever year.

    Then raise hell about dealing with illegals, ending lifelong mental illness hospitalization, letting drugs (the "victimless" crime, right?) run rampant, and subsidizing do-nothing indigents and drunks with no penalties, and handsome financial rewards for zero responsibility.

    And friend to friend, perhaps you should step away from the keyboard for a bit, until you're feeling better and thinking straight.

    Take care of yourself, and please, get well soon.

  15. Here in TN the local Health Department's have been providing free Covid-19 testing on M-F week days. In my county, it's a drive-through location and also where they are doing vaccinations.

    At this point in the game if you've taken the recommended vitamins, kept active, forced fluids, and food you've passed the required isolation period. So you'll be dealing with post-Covid symptoms. Some people do, some don't. I had it over the Christmas holidays and am one who is dealing with some of the post-Covid symptoms.

    Best of luck to both of you and keep on keeping on.

  16. Peter,

    One of the comments above referred to "pour on" Ivermectin. Do not do that!

    https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf

    Ivermectin dosing: 200 ug/kg or fixed dose of 12 mg (≤ 80kg) or 18 mg
    (≥ 80kg).[86] Depending on the
    manufacturer ivermectin is supplied as 3mg, 6 mg or 12 mg tablets.
    50-64.9 kg – 12mg
    65-79.9 kg – 15mg
    80-94.9 kg – 18mg
    95-109.9 kg – 21mg
    ≥ 110 kg – 24mg

    Dosing the same as for a horse.

    In our prayers.

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