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A costly anomaly on a brain MRI

Kevin Davis
Patient
December 14, 2014
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It started with a mild case of nausea and got progressively worse. I became dizzy and shaky, but tried to ignore it. There was work to be done that afternoon. We were moving boxes into storage at my in-laws’ house in Michigan, and I needed to be strong. I carried boxes on unsteady feet, catching myself before bumping into walls. By early evening my legs were wobbly, and I felt like I was horribly seasick.

The room was spinning and I had to lie down. I vomited. I laid back down. I vomited again, violently. I kept vomiting until there was nothing left. I had severe vertigo and couldn’t sit up without my head spinning, my stomach in spasms. My family called an ambulance. That’s when the meter started running on a medical bill that never seemed to end and when I got a diagnosis that marked me as someone sicker than I really was. I was a self-employed husband and father of a 1-year-old boy. We had a private health insurance plan that carried a $7,500 deductible. The bills would be crushing.

The medics came, checked my vitals, hoisted me onto a gurney, gave me an EKG and rushed me to the ER. The good news: It wasn’t a heart attack. At the hospital, they gave me IV fluids and rolled me into an MRI machine to scan my brain and neck. They found nothing unusual. A resident physician said it was probably labyrinthitis, an inner ear disorder that causes vertigo. They gave me anti-nausea medicine and sent me home with a script. By time I left the hospital five hours later, I owed $11,648.05. About three hours later, as we were driving home to Chicago, someone from the ER called my cell phone. A radiologist saw something on the MRI that another overlooked. Tiny spots of light, foci, indicated a tiny brain infarction. Then came the dreaded word: stroke. I needed to see a neurologist right away.

Stroke? How could that be? I was in my mid 40s and healthy. I exercised 3 to 4 days a week. Quit smoking years ago. They wanted lots of tests: TEE, CTA of the head and neck, with and without contrast, Holter monitor and recording, echocardiogram-doppler, hypercoagulation panels and more. It would cost $9,000. My expenses were pushing $20,000 now. A radiologist reported I have severe arterial plaque. I might be at risk for another stroke.

The neurologist ordered me to take blood thinners, cholesterol and high blood pressure meds. A week later, I learned a test was misread. I didn’t have severe arterial plaque or blockage. I was normal, not at high risk for stroke, but they kept me on the meds anyway as a precaution. I had to pay more than $300 a month for Lipitor for my moderately high cholesterol (188), the blood thinner Plavix and lisinopril for high blood pressure. My primary care doctor thought this was excessive. He believed I had labyrinthitis that caused such severe vomiting I may have dislodged a small blood clot during a violent bout of retching. My neurological tests showed no damage from this alleged stroke. But insurance claim forms and bills marked me as a stroke victim. I couldn’t get a decent life insurance policy.

A year later I got dizzy at the playground with my 2-year-old son. I felt seasick and wobbly. I rushed home to lie down. My doctor ordered another MRI. It would cost $3,000 out of pocket. He recommended a place that discounted if you pay cash or credit. I paid $1,200 on a credit card. My brain was clean. No sign of stroke. It must have been labyrinthitis again. My primary care doc had another radiologist take a look. He confirmed there was no stroke. I probably didn’t have one the first time, either. Whatever showed up on that initial bran scan was an anomaly. A costly one. Was all that testing and drug therapy necessary?

Bills from the hospital, physicians, specialists and diagnostic services totaled more than $20,000. I’d had to shell out $7,500 to make the deductible, plus 20 percent for out of network costs because I was at an out of state hospital. In one year I paid $14,700 (including monthly premiums) before I could see a dollar in coverage for a diagnosis that grew more dubious each day.

Four years later, I’m still paying, and have become well aware of the cost of care. It’s dizzying.

Kevin Davis is a participant, Costs of Care essay contest.

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This post originally appeared on the Costs of Care Blog. Costs of Care is a 501c3 nonprofit that is transforming American health care delivery by empowering patients and their caregivers to deflate medical bills. Follow us on Twitter @costsofcare.

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