The good news is that I hit the Medicare birthday and now for the small sum of $144.60 a month I get “free” government health care, as opposed to the “free” government health care I had with Tricare, which cost a lot less. The fact that I am still working and paying into Medicare with every paycheck does not in any way deduct from that amount. The bad news is now that I have Medicare, my body has decided to take full advantage of this insurance program by falling apart.
Case in point: I was trucking along in life with the usual old age issues, then BAM! My heart decided to get in on the act. I noticed I was having shortness of breath and just for peace of mind, I foolishly mentioned this to my primary care doctor, hoping he would tell me I was imagining it. Instead, he referred me for a cardiology work-up. Okay, sounds like the responsible adult thing to do—other than the fact I had no idea what all a cardiology work-up entailed. I thought a stress test was simply walking on a treadmill while hooked up to an ECG. Nope, not that simple. It involves having an IV inserted (I hate IVs) and injecting radioactive substances into my body while taking multiple radiographs of my coronary arteries. Oh, and walking on a treadmill, huffing and puffing into a mask due to Covid. Then on to the ECHO.
An echocardiogram is an ultrasound of the heart. No big deal; no needles, right? On the day of my echo, I dutifully presented myself at the Covid screening table, where a lady asked me if I was checking in for an appointment. I had to fill out a questionnaire with a pen that God only knows how many other germy people had touched. (Hopefully it was disinfected between patients, but I didn’t observe this firsthand.) The lady at the table became alarmed when I checked the box “yes” for shortness of breath. I had to convince her that my shortness of breath was (duh) why I was seeing a cardiologist in the first place and had nothing to do with the pandemic. Past that hurdle, I took my seat and waited for an hour while other patients came and went. Being a medical professional myself, I understand unavoidable delays in appointment times, but finally, I went to the front desk and asked how much longer it would be until my procedure. It turns out I was not checked in. I was only Covid screened. Geesh! That might have been nice to know, as I had been asked at the Covid table if I was checking in and wasn’t told there was an additional step to the process. But fortunately, they were still able to get me in; I just had to wait another half-hour.
Finally, the echo technician brought me back into a room, where she jabbed a cold, slimy probe under my xiphoid, the base of my throat, and finally under my left armpit, where it bounced around uncomfortably against my bony ribs. At this point, turned on my side, I could view the monitor. This is where being somewhat knowledgeable about what things are supposed to look like is a disadvantage. I have done multiple echo’s on dogs, cats, and even a handful of other species, so I’m not entirely clueless.
As I viewed the images on the screen, I commented, “Does my mitral valve look a little floppy?” Of course the technicians, although they know darn well what is normal and what is not, are not supposed to relay this information to patients. This doesn’t stop me from trying. Every so often, I get a technician who will level with me with the caveat, “but the doctor will have to review the results.” This is good enough for me. This technician, however, remained tight lipped. Not only did she not reveal anything to me, she refused to acknowledge the fact I had spoken to her. She simply ignored me. Even when I asked several times. Geesh, you would think she could at least have said, “I can’t really say. The doctor will have to review the images.” So when I watched the pumping of my left ventricle and thought, that pumping action looks kind of sluggish, I kept my mouth shut, as I knew I wasn’t going to get any information out of her anyway.
The next day, I went back to the cardiologist so he could go over my results and tell me my shortness of breath is all in my head. But before he came in, his young nurse-practitioner had to go over all the ground we had already covered. When I mentioned that I thought my ventricular pumping action looked sluggish on the echo, she replied, “Oh, isn’t it neat to see what your heart looks like on the screen?” To which I replied, “Not when it’s my heart that looks sluggish!” She finally confirmed the truth of this less than stellar muscular action on the part of my betraying heart. Then, since I had a captive medical person who was answering my questions, I stupidly began asking further questions. After a couple minutes, she said, “You seem to be worried about this,” as if that were an unreasonable reaction to being told my heart was not cooperating to its full extent. Well, duh, yeah! I may have even said that aloud.
She left the room, probably to get away from my uncomfortable questions, and finally returned with the doctor. Okay, at last, let’s get down to business of what we need to do to make my heart work better. Nope. What we need to do is—wait for it—more tests! Of course. Now we’re up to a full cardiac catheterization. If I had only known, I would have kept my big mouth shut with my primary care physician.
Stay tuned for Medicare, part 2.