Welcome to fifty: My first health scare as a middle-aged man

Three weeks ago today, I had a major health scare.

Because it was Monday, I was at the family box factory. I had just finished running payroll and had taken paychecks out to the shop. I exited the building and *bam* my chest just sort of seized up.

“Ouch,” I thought. But, being a Roth, my thought process didn't go much farther than that. (We Roths don't like doctors and we tend to deal with injuries for weeks or months or years before having them looked at.)

On the way back to the office, I stopped to talk to my cousin Duane. He was digging in the dirt, prepping a spot for his summer garden. We chatted about blueberries, tomatoes, and greenhouses. We admired the warm spring day. After a few minutes, I realized that my chest still hurt.

“I don't want to alarm you,” I said, “but I'm having chest pains. It's probably nothing. But just in case it is something, I thought you should know.”

I walked back to the office and sat down at my computer. Instead of going back to work, however, I googled heart attacks. I read the list of symptoms. I wasn't experiencing anything except chest pain but still…Every site said the same thing: Don't mess around. If you're having chest pain, have somebody drive you to a doctor.

Duane came in. “Are you feeling okay?” he asked.

“I'm still having chest pains,” I said.

“Do you want me to drive you to the doctor?” he asked.

I debated things in my mind. “It's probably nothing,” I thought. “Or maybe it's a panic attack like twenty years ago.” In 1998, I experienced two similar episodes that turned out to be panic attacks. I was under a lot of stress then. I'm not under a lot of stress now.

“Plus, if I go to the doctor, it could end up costing a fortune. My health insurance sucks,” I thought. “But if it is a heart attack and I don't go in, I could end up dead.”

“Well?” Duane said.

“Tell you what,” I said. “I know I'm not supposed to but I'm going to drive myself to urgent care. If you don't hear from me in fifteen minutes, come find me.” (There's only one logical route from the box factory to the nearest clinic.)

I gathered my stuff, hopped in my pickup, and drove slowly to the clinic.

Hurry Up and Wait

At urgent care, they expedited my case. Within minutes, I'd been hooked up to an EKG machine. While he worked, the doctor asked me lots of questions about my past and current health.

“Everything looks normal to me,” he said. “Your blood pressure is high, but the EKG is good. So is everything else. Are you still having the pains?”

“Yes,” I said. “And they're now in my back too.”

The doctor frowned. “I don't think you're having a heart attack,” he said, “but we should make sure. I want you to drive yourself to the nearest emergency room.” He gave me a printout that explained my situation and wished me luck.

Twenty minutes later, I was in the ER for the first time in my life. (I've been there for other people but never for myself.) A nurse ran another EKG. “Everything looks fine,” he said, “but we're going to do some more tests.”

First, they drew blood. Then they ran chest x-rays. Then they ran another EKG. Then they ran a CT scan. “Oops,” the doctor said when he saw the results of the CT scan. “They didn't scan the right spot. That's my fault. I goofed up. I pressed the wrong button. I guess we'll do an ultrasound to check out your abdomen instead.” So, I got an ultrasound. Then more blood tests and another EKG.

Can you guess what I thought when the doctor admitted he'd run the wrong test? That's right: “I'd better not be charged for this!” In any other business, if the service provider makes an error, the customer isn't charged for it. Is that the same with hospitals? We're going to find out.

After five hours of tests and waiting, they let me go.

“I'm not sure what's wrong,” the doctor told me. “Your blood pressure is high, but you're the healthiest person I've seen all day. Follow up with a heart specialist. Go enjoy the sun!”

Paying for Pain

Since that heart-attack scare three weeks ago, life has been a whirlwind. We've been planting trees and bushes and flowers and seeds. We celebrated my birthday. Kim had knee surgery. Plus, there's all the rest of Real Life to take care of.

I tried to follow up with the recommended heart specialist but he's out of my network. “You should find somebody on your own insurance,” his office staff told me. I haven't done that yet.

Last Friday, two other things happened.

First, I had to go back to urgent care. (When was the last time I sought medical help twice in three weeks? Has it ever happened?) I have miserable allergies this time of year, but my throat seemed even more raw than normal.

Turns out, I have a simple canker sore…on the back of my throat. The doctor prescribed a numbing agent. “Your blood pressure is pretty high,” he said before I left. “You might want to have that checked out.” He suggested that I buy a blood-pressure monitor while I was picking up my prescription. So I did. (Nothing says “I just turned fifty” like browsing blood-pressure monitors at the pharmacy.)

When I got home with the meds and the monitor, there was an Explanation of Benefits waiting in the mailbox. I opened it to learn the initial cost estimate for my ER visit. (For non-Americans, the Explanation of Benefits is a statement we receive after health care but before we receive actual bills. My understanding is that it's an estimate of what is being billed to whom. But it's not always 100% accurate.)

According to the Explanation of Benefits, I'm on the hook for $6858.49. That's enough to give a person a heart attack! (Haha.) I'm under the impression that my insurance plan covers all emergency room visits, so this number could change. Right now, though, I assume I owe nearly $6900 for my four hours in the ER.

A Change of Heart

Over the weekend, I tested my blood pressure several times. It's high. I haven't figured out my new blood-pressure monitor well enough to state definitively that I have hypertension, but it seems as if I'm pre-hypertensive at a minimum. In any case, it's clear that I need to make some changes.

Over the next few months, I want to:

• Scrutinize the hospital bill. I want to know what I'm being billed for and why. (I'd better not be charged for the mistaken procedure in the ER!) As much as I hate phones and confrontation, I might have to use both. Good thing I just read this article on how to fight expensive medical bills. I'm curious to see what I'm actually billed for compared to the estimates on the Explanation of Benefits.
• Look into health savings accounts. This is one of my financial blindspots. I've never read about HSAs, so I don't know the pros and cons. I don't know anything about them. From what little I do know, it sounds like an HSA might be a way for me to cushion unforeseen medical expenses.
• Get serious about my physical (and mental) fitness. For the past few years, I've been coasting. I've been overweight and out of shape during most of my adult life. In 2010, I lost fifty pounds and gained muscle. I was the fittest I'd ever been. I maintained that for a few years, but have gradually softened. I've made occasional half-hearted efforts to change. It's time to give 100% effort again.
• Find a primary care physician. I had a primary doctor I liked but when Kim and I left to explore the U.S. by RV in 2015, my doctor moved. I haven't had a regular doctor now for four years. This is enough of a passive barrier to keep me from seeking medical help. Dumb but true. I need to find a new doctor.
• Find a therapist. Like last year, I'm struggling with depression this spring. It sucks. It's not as bad as it was in 2018, but it's still enough to sap me of motivation. I need to get some help.
• Be proactive with my heart health. My family doesn't have a history of heart disease. We have a history of cancer. I've been worried about cancer all this time, but what if I should have been caring more for my heart? Fortunately, managing high blood pressure doesn't seem too onerous.

There's on other thing I'm going to do — especially if my final bills do amount to $6900 and I can't get them lowered.

My health insurance carries a $7900 annual deductible and $7900 annual maximum out-of-pocket expense. If I end up owing $6858.49, then there's only $1050 left until I reach the maximum I can possibly pay this year. That gives me a strong incentive to get as many medical procedures done this year as possible.

Final Thoughts

I'm glad that I didn't have a heart attack. I'm disappointed with myself for allowing my fitness to erode, but I'm trying not to beat myself up to bad. I can get back in shape. And I can lower my blood pressure. It'll take time and effort, but it's doable.

In 2012, I was worried about my lack of energy. I asked my doctor to run some tests. “You have nothing to worry about,” he said when the numbers came back. “You're one of the healthiest 43-year-old men I've ever seen. I'm serious.”

No doctor would say that about me now at age fifty. But if I apply myself, maybe in a few years my doctor will tell me, “You're one of the healthiest 53-year-old men I've ever seen.”

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