Navigating the World of the Uninsured: So Now it Begins

Years ago, I injured my back during an intramural football game.  A couple of years after that, I tore my left calf muscle during a rugby practice.  I had health insurance during both of those instances (though the insurance I had for the football injury was my university's insurance).  It was during my recovery from the muscle tear, as i limped around Washington, DC with a cane going to and from work, and traveling for work, that I believe I ignited my original back problem that seemed temporary.  My gait changed with all of that limping, and my body worked to compensate during those weeks of recovery.  It was once I was able to walk normally again, that I noticed a discernible pain in my lower back. 

Now, I did find out that there were symptoms akin to sciatica that I was beginning to experience.  I did a month of physical therapy that was covered mostly by my health insurance.  The therapy helped in ways that I could not imagine.  And as with most people, once I was feeling better, I let down my guard.  I didn't maintain a regime of doing those core strengthening exercises, only revisiting them when my back would act up.

Meanwhile, I decided to leave my job that provided me with health insurance.  It was not a decision I made lightly, and I had some ideas in my mind of what I thought I wanted to do to sustain myself.  I decided to try my hand at independent consulting, mostly to see if it was something that I could do that would allow me to make money.  I found two clients quickly (they called me after they heard of my job departure), but this also happened right in the midst of the Crash of '08.  Talks with other potential consulting clients stopped, and I found myself living off of savings.  I'd also received a notice regarding COBRA that let me know how much I would have to pay in order to maintain my health insurance.  That figure was around $550 per month.  That was not about to happen.

I decided to take my chances.  I did not think that I needed even to consider Medicaid.  I was actively seeking clients (volunteer opportunities more than paid), and getting promises of work when the economy picked back up.  Besides, I felt, and still feel, that there are people in more need than I am for Medicaid.  I am lucky to have a doctor and a physical therapist in my family, and I have relied on them when I've had medical questions and/or problems.  I am blessed/lucky to have them in my family.  And, as an optimist, I knew that I would be able to keep myself healthy enough, and continue to find paying opportunities not only to continue being my own boss and setting my own course, but also to find enough money to get catastrophic insurance just to make sure that if the worst happened, I would be alright.  I even moved back to my hometown from Washington, DC in order to cut costs.

I am giving all of this background just to suggest that I am probably not too different from other people around the country who are uninsured, particularly those who left unhappy jobs in search of something better that they could do on their own.  I also provide this background to say that I found myself in the emergency room last night for excruciating pain in my lower back.  That pain, which my cousin and sister-in-law (doctor and physical therapist, respectively), both called sciatica once I described my symptoms, had made it difficult for me to stand for any length of time, and walking was both a painful and now precarious situation.

The first sign of trouble came on Thursday.  I was heading out to do errands with family, and I noticed a sharp pain in my lower back.  Naturally, I thought of my old PT exercises, and did them during that errand run, and did them without shame.  By Monday morning, thinking that I was under better control, I was researching chiropractors, and hoping to get an appointment for today.  Monday evening, I was in the kitchen preparing to get something to eat, and something went terribly wrong.

I felt a pain in my left buttock that was unlike a pain I'd ever felt before, and it shot up to the middle of my lower back, and down my left leg to my foot.  My entire leg felt like it had been set on fire, and I nearly collapsed on the kitchen floor.  Now, I think that moving back in with my family (in order to save money, as I try this "being my own boss" venture) was a smart thing to do in a case like this.  My mother asked if I was alright, and I answered that I was fine.  Meanwhile, I'd descended to the floor to attempt some PT exercises.  Nothing was changing.  I managed to struggle to the couch in the great room (the longest 12' I've walked in my life so far), and tried to get comfortable.  Didn't work.  Then the debate began.

I was struggling with pain, and what entered my mind next was how can I afford going to the emergency room, and what future costs will this injury incur?  Can I postpone this until the weekend, when my brother and sister-in-law would be down for a visit and get her advice?  How much will this cost?  How am I going to pay for it, not having any paying clients at the moment and negligible savings?  Why couldn't I be in Canada, Britain, or someplace that provides universal coverage right now?  I didn't want to go.  I was becoming more afraid of dealing with the costs, than I was with dealing with my pain.  But the pain won out.  I was taken to emergency.

So now it begins.  In my head right now are two things:  how am I going to be able to afford this, and what can I do get better that will cost me (and my family) the least.  Actually getting better is third in my mind.  And I decided to chronicle this whole process, because I think that people discuss the uninsured without knowing their actual experiences, and judgment runs amok.  Never in my wildest dreams did I think I would find myself in this position, but here I am.