Lown-Ganong-Levine. Those are the last names of the three physicians who "discovered" the diagnosis I was given two years ago (after performing an EKG on myself at work when I felt my heart try to run a marathon while I was sitting at the computer, charting), a re-entry tachycardia characterized by a short PR interval, no delta wave, and the tendency of the heart to jump into paroxysmal tachycardia at the slightest hint of aerobic exercise, not to mention frequent premature ventricular contractions and occasional runs of paroxysmal tachycardia for no reason at all. Lown, Ganong, and Levine apparently decided that they wouldn't be outdone by Wolff-Parkinson-White, the trio who discovered another self-named re-entry tachycardia also characterized by a shortened PR interval, but differentiating itself by having a delta wave.
I knew what WPW was, as well as all that other mumbo jumbo, being a paramedic, but I had never heard of LGL. In fact, when I Googled it, what I found was that LGL is considered an outdated diagnosis, and it falls under the umbrella diagnosis of PSVT, and nobody really knows what causes it or how to cure it, but it can be controlled by medications that lower the heart rate and prevent it from increasing. Medications I am unable to take because my resting heart rate lives in the 50-60 beats per minute zone, and if I were to take a medication to control my heart rate, I would most likely pass out any time I tried to stand up.
That is not at all helpful.
I should mention, at this point, that this "diagnosis" came on the fly from a couple of different sources, none of whom were really within their scope of practice to diagnose in the first place. However, the insurance that came with my horribly underpaid job at the urgent care had a $5000 deductible and a $70 specialist co-pay, which meant that I wouldn't be seeing a cardiologist anytime soon. Some of my cohorts and I performed a ghetto-style stress test during a slow stretch at work, putting me on a treadmill and hooking me up to the EKG machine just to make sure that when my heart rate shot up to 190 that at least it stayed regular, with no underlying dysrhythmias. That was quite fun for everyone but me. I found some relief with acupuncture at a community clinic-- twice weekly treatments prevented my heart from going above 165 during aerobic exercise, but even at $20 per treatment, that added up quickly.
The physicians I worked for hemmed and hawed and told me I really should go see a specialist, but they understood my financial predicament and were willing to care for and monitor my condition, so over the last two years I've felt fairly safe knowing that if anything did happen, my heart would be in good hands--theirs.
And then we moved.
Now, I find myself with no health insurance at all (not even catastrophic, with its $5000 deductible), and a potentially fatal cardiac condition. Life has suddenly become terrifying. For the first few weeks after we moved, I lived in fear that I would twist an ankle, fall on a wrist, cut myself badly enough that I would require sutures. Then I started worrying that I would contract pneumonia again, or get a UTI. I know what a self-pay urgent care visit costs for lab tests, x-rays, point of care testing, and medication. It is not cheap. Specialists cost even more. And in the high desert, acupuncture isn't cheap, either-- at the community clinic here, one treatment costs $45, and that's at the bottom of their sliding scale.
I have, at times, in the last few months, gotten incredibly depressed at what this means for me. If I were to be hit by a car, found unconscious, fall down a mountain (snowboarding or hiking), break a bone. . .if my heart goes into PSVT and doesn't paroxysmally go out of it, I will need to go to a hospital, and the bills will bankrupt me. End of story.
I saw first hand in my work on an ambulance, in the ER, and at an urgent care how desperate the need for a single payer health care system is, and if you don't think it has anything to do with you because you happen to have fantastic health insurance, you are very, very wrong. There are people presenting to ERs day in and day out with primary care issues, people who go to the ER because they have no money for primary care. The ER must evaluate them regardless of ability to pay due to EMTALA laws. These patients have no preventative care, no education regarding wellness, no resources except the beleaguered health care providers in the ER who don't have the time or the inclination to discuss well-being and general health, which means that those patients are going to be right back to the ER with their next headache, abdominal pain, etc. Every uninsured patient that walks in to an ER becomes the burden of the insured. Follow the loop, here: uninsured patient = probable unpayment of bill = hospital write off = increased hospital billing rates to insurance companies = increased insurance costs for the insured. Here's the icing on the health care cake-- the higher the rates the hospital bills out at, the less likely the uninsured or underinsured are going to be able to pay the cost. This is the very definition of a vicious cycle. And I may find myself in the middle of it very soon.
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