Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Be aware of cost savings available to every patient

Diane Scheb, RN
Meds
February 11, 2015
Share
Tweet
Share

Spend less.  Live better.  Except, she didn’t have that long to live.  Maybe ten days … probably not.

Thirty-three years old, an illegal Mexican migrant worker, she was diagnosed in an emergency room with an aggressive stomach cancer two years ago, and she had been fighting for her life ever since.  Multiple rounds of chemo administered through our community medical clinic had not worked.

And now, here she was in my ICU, valiantly clutching to life after yet another horrifying gastrointestinal bleed.  Horrifying to her four children ages 3 to 14, who witnessed the event.  According to the 14-year-old, it was “like her stomach was being coughed up with bright red blood.”  It was these four kids that this mother was trying to live for.  It was because of these kids that she was insisting “everything be done” thereby rejecting hospice care.

My eyes took in the living corpse who seemed translucent, lying in the sterile ICU bed.  Surrounded by machines, monitors, and blood bags infusing into her body, she appeared ghost-like, emaciated, almost surreal.  Her eyes, deep brown and large, said it all, as I held her hand.

“Help me.  My tummy really hurts.”

As crazy as this sounds, my first thought, in this very intense environment, was that I was amazed at her English.  My next thought was, “Thank God she’s here with us.  I can do what I need to do to get her pain under control.”

I have the best job of my professional RN career.  Along with the pharmacy director, I direct the clinical activities of the acute pain service.  Under the auspices of a pain management physician, we use medical staff approved protocols to relieve the pain of hospitalized patients.

I quickly titrated her Dilaudid via the pain pump and she was comfortable five minutes later.  Her hollowed out, deep hazel eyes spoke volumes.  They spoke of fear, suffering and despair and looked markedly out of place in her emaciated sunken face.

I was deeply thankful that she was comfortable but, to be honest, I was far more worried about where we were headed.  No insurance, no Medicaid, no Medicare.  I heard her family lived in a two room, one bathroom efficiency in Northport.  Read that as having zero money.  Indeed, I hear the nurses were ordering guest meals for the family.  One meal easily fed the three kids who were thrilled with the hot meals.  We stabilized her and transferred her out of the ICU.  She was fragile, wanting more chemo and maybe some pain medications for home.  Again she refused hospice, which was unfortunate as they would have paid for her medications.  The challenge was before us.  Find a cheap, easy to swallow pain pill that would keep her comfortable in her last days on earth.

For obvious reasons, we quickly eliminated methadone and Fentanyl patches from the potential medications.  Our research yielded the following information. We knew that Dilaudid 8 mg. every four hours would keep her comfortable.

Pain pill retail cost at Walgreens/CVS

Dilaudid 4 mg (100 pills): $99.90

Oxycodone 10 mg (100):  $144.90

ADVERTISEMENT

Oxycontin 10 mg (100): $249.90

Let’s just say that none of these prices were in the ballpark.  Spend less.  Live better.  Remember that catchy slogan?  Across the nation in these dire economic times, people have been trying to do just that by shopping at Walmart.  As it turns out:

Pain pill retail cost at Walmart

Dilaudid 4 mg (100 pills): $30.00

Everyone on the oncology unit chipped in two dollars, and she had enough medication to last at least ten days.  She only needed enough for five days.  We all heaved a sigh of relief when we heard the news.  Her final days were relatively pain free thanks to the cost awareness of the staff who cared for her and the giving spirit of her caregivers.  The lesson learned is to be aware of cost savings available to every patient.  We can therefore all spend less.  And live better.

Diane Scheb is a contributor, Costs of Care essay contest. 

costs_of_care_logo_small

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.

Prev

We are not powerless to respond after Dr. Michael Davidson's death

February 11, 2015 Kevin 2
…
Next

What doctors can learn from artists and entrepreneurs

February 11, 2015 Kevin 12
…

Tagged as: Medications, Pain Management

Post navigation

< Previous Post
We are not powerless to respond after Dr. Michael Davidson's death
Next Post >
What doctors can learn from artists and entrepreneurs

ADVERTISEMENT

More in Meds

  • The diseconomics of scale: How Indian pharma’s race to scale backfires on U.S. patients

    Adwait Chafale
  • A psychiatrist’s 20-year journey with ketamine

    Muhamad Aly Rifai, MD
  • How drug companies profit by inventing diseases

    Martha Rosenberg
  • Every medication error is a system failure, not a personal flaw

    Muhammad Abdullah Khan
  • Why kratom addiction is the next public health crisis

    Muhamad Aly Rifai, MD
  • FDA delays could end vital treatment for rare disease patients

    GJ van Londen, MD
  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why I left the clinic to lead health care from the inside

      Vandana Maurya, MHA | Conditions
    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • How doctors can think like CEOs [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • Affordable postpartum hemorrhage solutions every OB/GYN can use worldwide [PODCAST]

      The Podcast by KevinMD | Podcast
    • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

      Yousuf Zafar, MD | Physician
    • Psychiatrist tests ketogenic diet for mental health benefits

      Zane Kaleem, MD | Conditions
    • The hidden rewards of a primary care career

      Jerina Gani, MD, MPH | Physician
    • Why physicians should not be their own financial planner

      Michelle Neiswender, CFP | Finance

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 1 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The human case for preserving the nipple after mastectomy

      Thomas Amburn, MD | Conditions
    • Nuclear verdicts and rising costs: How inflation is reshaping medical malpractice claims

      Robert E. White, Jr. & The Doctors Company | Policy
    • IMGs are the future of U.S. primary care

      Adam Brandon Bondoc, MD | Physician
    • Why I left the clinic to lead health care from the inside

      Vandana Maurya, MHA | Conditions
    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • How doctors can think like CEOs [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Health equity in Inland Southern California requires urgent action

      Vishruth Nagam | Policy
    • How restrictive opioid policies worsen the crisis

      Kayvan Haddadan, MD | Physician
    • Why primary care needs better dermatology training

      Alex Siauw | Conditions
    • Why pain doctors face unfair scrutiny and harsh penalties in California

      Kayvan Haddadan, MD | Physician
    • How a doctor defied a hurricane to save a life

      Dharam Persaud-Sharma, MD, PhD | Physician
    • What street medicine taught me about healing

      Alina Kang | Education
  • Recent Posts

    • Why doctors must fight for a just health care system

      Alankrita Olson, MD, MPH & Ashley Duhon, MD & Toby Terwilliger, MD | Policy
    • Affordable postpartum hemorrhage solutions every OB/GYN can use worldwide [PODCAST]

      The Podcast by KevinMD | Podcast
    • When cancer costs too much: Why financial toxicity deserves a place in clinical conversations

      Yousuf Zafar, MD | Physician
    • Psychiatrist tests ketogenic diet for mental health benefits

      Zane Kaleem, MD | Conditions
    • The hidden rewards of a primary care career

      Jerina Gani, MD, MPH | Physician
    • Why physicians should not be their own financial planner

      Michelle Neiswender, CFP | Finance

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Be aware of cost savings available to every patient
1 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...