Rebecca Morean

Turning Over Stones

Rebecca Morean

Rebecca Morean
Location
Yellow Springs, Ohio,
Birthday
April 25
Title
Associate Professor
Company
Sinclair Community College and The Antioch Writers' Workshop
Bio
Novelist and mom. Dog walker and goat milker. Warrior against the ravages of ignorance (and time). Addicted to popcorn and sea coasts. Loves Rocks. (Also known as Abbey Pen Baker for one particular series.)

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JANUARY 27, 2012 11:37AM

Good Catch Mom

Rate: 16 Flag

So I have rabies.  My children are probably rabid as well.  At least this is what everyone, and I mean everyone, has told me.  This is the problem with having too much information—the ability to assess risk goes out the window and you find yourself weighing matters in fiscal terms you thought only Tea Partiers were capable of.  And, yes, you too join the ranks of the paranoid.

Four weeks ago my sleepy thirteen year-old man child son stumbled into my bedroom at 6:30 am with, “There’s a bat in my bedroom.” 

This one tiny statement sparked as catalyst to a series of events crystallizing the issues surrounding the abysmal state of health care in this country. 

Because I devour science and nature articles at an admittedly alarming rate, I knew the formula: sleeping child + bat = rabies risk (though miniscule).  But I also knew bat populations are being decimated by white nose fungus.  So when I knocked the little brown bat from his happy perch on the window trim into the pile of dirty clothes on the floor, and he displayed his entire wing span of about five inches and opened his tiny mouth, I only thought of the lack of white fungus.  Lifting him out the window in the pile of dirty clothes to freedom was my first mistake. 

My second was calling the county health department.

I will not bore you with a transcript of the three days of telephone calls it took for me to determine who, if any member of our family, should receive the rabies shots or how and where I should go to actually get the shots. Oh, and how to finance them.  I did call county health a total of eleven times, my own doctor  five times, the state of Ohio six times and our local country hospital eight times within the first two days.  I do have a job by the way—I just so happened to be on winter break from teaching so I had nothing better to do that research a potentially fatal disease.

The end result?  Four shots were required at about $700.00 apiece.  All three of us (myself, Cora, 17, and John, 13) would receive them.  Luckily, my insurance would pay everything and all I was responsible for was a $25.00 co-pay for each shot—a total of $300.00 for all of us.  Pricey, putting a dent in monthly bills, but the alternative?  Foaming at the mouth, paralysis, and a horrible death.

Here’s the irony.  My physician doesn’t stock or order the injections because they are so expensive.  I then called county health again to make certain they did not offer the series.  They don’t because 1) the expense is “prohibitive” and 2) they are off on the weekends and the injection regime requires a strict schedule of 0, 3, 7 and 14 day intervals and, well, this might land on a Saturday or Sunday.   Public health rests on the weekend I guess.

I geared up and called 22 local physicians in my health care plan in my area.  All refused to stock the injections—I might not show up for the full series was the excuse.    I assume they thought I might feel a little foaming at the mouth was acceptable.

I called the hospital again to find out what I would have to pay out of pocket for each injection—it took two days  to get an answer: somewhere between $500.00 and $700.00 a pop—they couldn’t really pin a dollar figure down for me.  Kinda like gasoline prices, it could fluctuate by the hour the nurse happily told me.  I just had to wait for the bill. My family deductible is $800.00 and out of pocket $4,000—at $2800 apiece, I was looking at maxing out all totals with the very slim chance one of us came in contact with rabies.

I contacted the state again to determine exactly the risk of rabies (very minor—only 6% of bats carry rabies).  I called Ohio State University’s veterinary program (all vets are inoculated) and asked who their vendor was – if I could locate that clutch of syringe wielding doctors then I could fall back to the $25.00 copay.  OSU stated they could not release the name of their inoculation source.  I called the hospital at OSU—they don’t even stock the injections and they had no way (read: no field box in their software program) to transfer inoculations from the vet school to the hospital.  Yet, everyone concurred that this was a serious problem and we all better get on a schedule within a day or two.

So I called the state rabies program again and spoke to Dr. Smith, (her real name) a lead scientist and head of the rabies program in Ohio who assured me that just my son needed the vaccine—good news!  The charges dropped from $8,400 back down to $2,800.  But we needed to hurry.  After all, it’s lethal.  But a 6% chance?  I had just downsized to a new home and with moving, had no money.

The people who ultimately helped with risk assessment were veterinarians at three different practices who all confirmed that yes, bat rabies was in the area and the Ohio Public Health state map on the web depicting one case in Green and Montgomery Counties was completely wrong.

After more calls to the doctor and the hospital folks, I was directed to enter the hospital through different doors: either ambulatory care or the emergency room.  Each entry point impacts the fees, the amount my insurance will pay and the duration of time actually spent getting the shot. 

On day three, John and I enter the  ER.  Five hours later we leave.The scenario in the ER was as follows: 

1. Check in –15 minutes, nice smiling receptionist, no eye contact. Makes two copies of my insurance card.  I sign six sheets of paper and they ask John if has fallen down recently.

2. Put in a room after waiting 30 minutes.

3. 30 more minutes roll by because they cannot find the injection.  Pharmacy sent it down, we are reassured, but they don’t know what happened to it after that.

4. Another hour rolls by.  John is offered turkey sandwiches and soda.  Finally serum is found!

5.  Nurse does not know how to reconstitute injection and pours over the four point font type trying to figure this out at the nurses’ station.  She keeps telling those around her that she’s “got this.”

6. A physicians’ assistant comes in after two and a half hours and tells us our use of the emergency ward is abusive and we should have gone to ambulatory care.  I explain I was informed the nurses are sent home when they are finished at ambulatory care and that can be anytime between 1:00 and 3:00 in the afternoon.  My son, after all, is in school.

7. The nurse appears with the syringe.   The shot in the arm takes a second at the most.  Now we wait for 30 minutes to see John has an allergic reaction.  There is none.

8.  Nurse checks vitals, hands me a CDC sheet (which I had read on line before), complete with a cartoon bat and a raccoon and something catches my eye….the first shot must be accompanied with human rabies gamma globulin.

9.  Nurse reads sheet, steps into hall and confers with another nurse.

10.  She calls from the hall: “Good catch Mom.”

At this point we have spent four hours in the ER.  Even though I have remained very calm and respectful, a nurse dressed like an attorney comes in to listen to my frustration over the series of unfortunate events. I leave to have a hissy phone conversation in the bathroom with my best friend in New Jersey.  Upon my return to the cramped ER room, I find John was asked how much he weighed because the dose of gamma globulin is based on weight.  Now, at 13, my son is a bright boy.   But he cannot hang on to a single pair of socks, his lunch bag, or a winter coat and he certainly has no idea what he weighs.  I suggest they actually weigh him. 

Just a mere 25 pounds off. 

We wait some more while they find the gamma globulin and then he has four more shots one in each thigh and cheek. And we have to wait another half hour in case of a dire reaction.  We came in at 4:00 right after school and we left at 9:15 to receive a shot I had called ahead to say we were coming for.  A shot that is considered a public health imperative.  A shot that everyone was just adamant we get.  A shot no one would help us with.  The second and third injections took no less than two hours each in the ER and the fourth a mere hour at Ambulatory Care (I pulled John from school early).

I am lucky.  I don’t work an hourly job where that five hours might mean the difference between making it for the month or not.  I have health insurance, though I don’t think it’s going to end up paying for much of the $2,800.  Bills take months to get and are inscrutable to read. I am not afraid to ask questions or speak up.  And yet, I was stonewalled at every juncture.  Those people who want to get rid of what little health care coverage we have are the same people who are going to need it—they’ve just been lucky so far.  But they will get sick, have an accident....or wake to a sleeping bat.

Me foaming at the mouth?  You bet, but not from rabies.

 

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By turns hilarious and infuriating. Good catch indeed, Mom.
Ouch.

Gotta be merciless with the suspected animal.

The thing I like the least is the insistence that the treatment was essential coupled with the lack of support in getting the treatment.

No one is going to tell you NOT to do it unless the risk is effectively zero. Yet no one is stepping up to actually provide the treatment.

I've had to make decisions for myself regarding very low exposure to malaria and other sorts of stuff. If there is ANY of it in a country, no one will tell you not to bother. But in urban areas, the true exposure is minimal.

A problem is that it is one thing to decide to take a very low risk with yourself -- another with your kid.

Good job -- doing what you had to do.
I've reaad a few stories like this. One thing I've definitely learned is that if I ever find a bat in my house, I'm catching that sucker!
Medical care is narrowing at a truly alarming rate. Patients don't seek help because of affordability and hassle while so many medical practitioners are truly unhappy in their chosen fields. This is a frightening scenario -- those science-minded students who were once steered toward medicine are running the other way. How to practice medicine with integrity while the insurance companies are calling all the shots? Time for us all to get rabid! Thanks for sounding an alarm.
Medical care is narrowing at a truly alarming rate. Patients don't seek help because of affordability and hassle while so many medical practitioners are truly unhappy in their chosen fields. This is a frightening scenario -- those science-minded students who were once steered toward medicine are running the other way. How to practice medicine with integrity while the insurance companies are calling all the shots? Time for us all to get rabid! Thanks for sounding an alarm.
For those "catching the sucker": they will still recommend your getting the shots. Testing the suspect animal doesn't happen immediately, and they're more worried about blocking the progression of the virus than you getting an injection you might not need.

Rebecca - I'm really surprised you had such a hard time with this in your area! A friend of mine was actually mauled by a rabid cat (she REALLY, REALLY needed these shots) and the hospital got the series going pronto - yes, it cost quite a bit, but there didn't seem to be any confusion as to what was required.

I know I'm probably not supposed to have this sentiment, but I'm glad you let the little bat go, and I hope your son in fine after his ordeal.
The hospital where my husband works stocks the shots, replacing and discarding them when they go out of date, over and over and over, just to have them for that one time when they're needed. The cost is huge, far greater than the cost of the shots they actually administer.

Some states are getting smart and stocking critical but low-demand meds (rabies shots, antivenin, etc.) in a central depot from which they're dispensed when needed. Even in our far corner of the state, they can be here in 8 hours most of the time.

BUT. I know a person whose grandfather died of rabies contracted from, of all things, a cow. At the end, they tied his hands to the bed and feet to the bed so he couldn't attack family members, and when he broke through the cloth strips, they began wrapping them around baling wire. My friend is a park ranger, and he pays for his own rabies vaccine and titers, rather than ever risking that kind of death.
Around my small town it's pretty much a given that if you end up in the ER for anything at all, even something relatively simple like a penicillin shot for strep throat, you are going to be in there a minimum of four hours, & probably more. And it helps to bring a friend so that if you're miserable & in pain, somebody can read the papers & advocate for you. Thankfully you caught that line about the gamma globulin!

Just reading about this made me feel enormously frustrated, so I can easily imagine how it had to feel actually being there!

(I think it was very sweet of you to let the poor little possibly-rabid bat go free, I'd have done the same thing.)
I spent 9 hours in the ER when my daughter broke her leg --- and then they sent us to a specialist hospital the next day, just to be sure. Note, the fracture did not move, so the bone didn't need to be set, just casted to keep it from moving.

There are many flaws with England's NHS, but the coordination of care aspect really made a huge difference. Public health initiatives could be pushed through the health care system in some better way than one official telling you what you needed to do with no back-up system helping you do it.
Gotta love bureaucracy, huh. My county, rural, doesn't have a rabies policy. If you find a rabid animal, they recommend that you shoot and bury it. Rabies being passed in blood apparently doesn't concern them.
I had to work and my horrible job 60 hours a week until the Thursday before my open heart surgery on Tuesday. To keep my HMO coverage.

Afterwards, at the hospital they came in after five days and said, "You have to go home now - your insurance won't pay for you to go to care because you're under 55. Call someone to get you." I could only walk with great difficulty and couldn't raise my arms or lift anything. I lived alone. I am grateful I had any insurance at all.

Insurance is a life or death matter for me, and I cannot guarantee that I will have it. When I worked in the call center, many of my clients lost their homes because someone in the family had become ill and they had lost everything trying to pay the hospital bills.

Why not just admit that we are back to the Robber Baron days, let the buyer beware, and Ghengis Khan mentality. Exploit the weak. Rape, pillage, burn.
Heck of a story...and well told. Kudos. Wow. Rabies just what isn't what it used to be.
I recall having a similar experience about 30 years ago when a kitten we'd brought home suddenly died. The autopsy on the animal by the Health Department in Bexar County Texas indicated the animal didn't have rabies, but I've got to admit you captured so well it brings me back to a different time before the information deluge brought on such paranoia.
For a time, I lived in an area with a lot of feral and partly feral cats. Occasionally, I could be-friend one long enough to put it in a cage and take it for its shots and neutering. However, feral cats really are, you know, feral, and once, a fairly friendly cat, for no reason I could see, turned on me and bit my leg. I took him to the vet for the two week wait, and called the health department. The guy from the health department was very snotty with me about the lack of rabies in the region, etc. etc. He simply refused to move my situation forward. So, I took a calculated risk, based upon the lack of assistance in getting the shot and waited to see what would happen to the cat. The health department wouldn't even take the cat to be tested, which ... well ... they have to put the animal down, but it was my life so ...

At the end of two weeks, the cat was healthy. We neutered his huffy butt, vaccinated him, and put him up for adoption. An old couple with a nice barn full of mice took him. They didn't want an indoor pet, but a working cat, so it all worked out well.

The guy from the health department called a week later in a panic, as rabies had been discovered in the county where I lived. I briefly thought about pretending to be sick, just to be mean, and then dismissed it and told him the cat was fine. Jerk.

Anyway, the problem is training. Someone is not training these people appropriately. Rare or not, it's a deadly, horrific disease that few have survived. Like two or something like that. So, not a great thing to get.
odetteroulette - you should have just told the guy you were dead. Would've served him right.

I put down a fully vaccinated dog awhile ago. Since it had been less than 10 days since he had last bit me he had to be sent to the state lab for the rabies test - just in case. The vet sprang this on me while the dog was on the table, waiting for his final shot. I can accept the need for this policy but I could also have waited a couple of days to kill the dogs.

Rebecca, you should send this post to every local politician and policy-making health official and newspaper anywhere near you. Your situation just leaves me speechless.
Yes, I agree with Nerd Cred. Publicize, FB and shout your story in as any places as possible. I'll do my share and share on my FB page and ask everyone to pass on. The health situation in this country is beyond scary, and I'm sick and tired ;-) of Republican and Fox talking points about "Obamacare"! Also, Odetteroulette's story is just as scary!!!!!! Anyway, I hope you and your son are ok now.
The culture and polity of the United States is suffused with capitalist puritanism, the idea that everything must cost you, and therefore anything that is free or low cost must by necessity not work. Much as the Soviet Union dyed of the theory that no one should make a profit, we are dying of the theory that everyone must make a profit no matter how non-sensical the end result. In the Soviet Union the most visible evidence of their senselessness was the endless lines for food staples and toilet paper. Here in the United States it is the homeless, and the state of healthcare.

It makes no sense whatsoever to allow shortages that immiserate people's lives, in the same way it makes no sense for people with no money to be directed to ERs. No sense, unless you are thinking ideologically. Then it makes perfect sense. Until we break right wing hold on our socio-economic reality, our nation will make no sense.
My god... I was immersed in this.

Question:

Why was your son the only one? Was he bit or scratched?
When you caught the bat, you said his mouth was open. Did he snap at you?
I was always told that these shots are painful and they go in the stomach. Has that changed? Or are there levels when they do this.

Is your son okay now? Is he being observed by a doctor?

I am way too curious, but like you I savor this kind of read.

pm me the answers if you like.
To answer your questions (though not in order)...you can't see bat bites all the time. "It's like looking for a needle mark without the bump," is what Dr. Smith told me, and is nearly impossible to find. Plus my youngest son in African American and this makes it nearly impossible to see any kind of tiny tiny little bite. Yes, it's little mouth was open and he hissed and that was the reason our doctor first though I had to get the shots as well (saliva spray). Turns out when they hiss at you they really can't spit the saliva, so not a big deal. The reason he though we should all et the shots is because we were asleep. Any time there is a bat found in a house with a sleeping child, drunk person or someone who can not communicate they shoul dhave the series. My son sleeps so hard fire alarms can go ff and he does not wake. This is NOT an exageration, so, clearly, he had to be inoculated as the bat was in his room. He is fine. Well, he has a twisted ankle now, but other than that, he's fine.....
Facebooking this post, and Rob Anderson your comment is one of the best summations of our current situation I've ever read. Can the rest of us share it via social media, too?
I agree with the comment about Ron's post. I responded to him earlier over OS mail.
What an incredible saga. Your story would be laughable if it wasn't true.
I'm glad I live in Canada with its socialized health care. My son was bitten by a wild cat last year and needed a rabies shot. The local hospital had the vaccine in stock which was given there and then, total time from the cat bite to leaving the hospital was 2 hours. No health insurance companies to argue with either.
Horrible. I could feel your pain and frustration. I would have been frothing at the mouth as well. Glad it all turned out in the end and everyone is okay.
Gotta love bureaucracy, huh. My county, rural, doesn't have a rabies policy. If you find a rabid animal, they recommend that you shoot and bury it. Rabies being passed in blood apparently doesn't concern them........
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Four weeks ago my sleepy thirteen year-old man child son stumbled into my bedroom at 6:30 am with, “There’s a bat in my bedroom.”
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This is the problem with having too much information—the ability to assess risk Hotels Davos
I've definitely learned is that if I ever find a bat in my house, I'm catching that sucker!cleaner southampton
Gotta be merciless with the suspected animal. covoiturage
do it unless the risk is effectively zero. Yet no one is stepping up to actually provide the treatment. auto louer
thing to decide to take a very low risk with yourself -- another with your kid.
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They didn't want an indoor pet, but a working cat, so it all worked out well. Weinklimaschränke
thigh and cheek. And we have to wait another half hour in case of a dire reaction.http://www.swimwearplace.net/tankini/
If there is ANY of it in a country, no one will tell you not to bother. But in urban areas, the true exposure is minimal.

Symptome Multiple Sklerose
Those people who want to get rid of what little health care coverage we have are the same people who are going to need itCrystal buttons
Those people who want to get rid of what little health care coverage we have are the same people who are going to need itcheapautocarinsurancequotes.org
How to practice medicine with integrity while the insurance companies are calling all the shots? Time for us all to get rabid! Thanks for sounding an alarm.
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