ADA M. FISHER, M.D., M.P.H.
♦ On my way to the RNC Convention in Washington, DC on January 21st, at 11 a.m. my legs seemed lighter than air as I went to the refrigerator to get some milk for my cereal. Thinking it was a reaction to the pain medicine I had taken for the bursitis, I sat and it passed. Then I was off to get some cash for the trip. I had trouble walking into the building but some kindly gentleman lent me his arm [Thank you kind sir!]. I got my money and got back into the car. Given the weather, the four former Livingstone College male students who had adopted me as their own, decided a few days earlier that one of them would drive me to D.C.
When I picked my driver up, I knew that not only was I not going to drive on that trip, but before we got out of Rowan County, I told him we might need to stop at Duke’s Emergency Room–I knew for sure, they’d have the tPA I thought needed. As we talked I could hear my speech becoming more slurred and without hesitation it was confirmed in my mind that I was having a stroke. Lifted out of my car to the wheel chair to the ER, the rush was on.
TPA or tissue plasminogen activator (abbreviated tPA or PLAT) is a protein involved in the breakdown of blood clots which if administered within 3-4 hours of stroke symptoms makes a tremendous difference in the resolution of sequelae of speech, facial distortions, limb weakness and other problems. After almost a half dozen venous sticks to find a route for its administration, the tPA was begun. The consent form was arduous and took longer to administer than the drug for the side effects can be worse than the stroke if the worst case scenario happens. Whew! At 2:30 pm I was still within the window.
Though my risk factors (high blood pressure, diabetes and obesity) are many despite numerous medicines and the gym two-three times a week; whether the stroke was from a clot or plaque had yet to be determined. So I wrote this three days after my release to home with no restrictions hoping that someone else may benefit from my experience for ye who hesitates loses possible brain function and gains likely preventable disability.
Over 700,000 individuals suffer a stroke each year. I am increasingly grateful for my deceased UW Madison Medical School Professor, Dr. Howard Temins whose Nobel Prize winning work on reverse transcriptase opened so many doors into molecular biology allowing processes to be invented which can enhance our lives. And I am also grateful to my doctors at Duke who keep me in the game of life. Today on March 11, 2014 the first of many bills related to this incident came with the tPA costing over $38,000.
Sitting with me during my stroke hospitalization, one of my brother’s lamented that he didn’t think it was fair that he was penalized $40 per month for now signing up for the prescription benefit which he didn’t have previously. Then I had to think on what just happened. TPA at a minimum at almost $40,000 per dose and an ER visit will run me as much as $50,000. Noting my Medicare, BC/BS and part f coverages, thank G-d I didn’t have ObamaCare which could leave me with high deductibles. The neurologist noted with my coverage I could afford his new fancy medicines to which I groaned appreciating the myth of Obamacare is that it is about access to care, when it really is about who will pay the bill. If I had a $5000 deductible which many with cancelled policies are now getting due to Obamacare, I would be bankrupt and unsure if folks would treat me without money to pay their bills.
Science looks at outcome data which shows those on tPA are more likely to have a brain bleed than without it, but they are sent home earlier rather than to a rehabilitation facility, remain more functional and other challenging data. As there are no other good treatments for ischemic strokes, as Roseanne Rosannadana use to say, “. . .it just goes to show you, it’s always something–if it ain’t one thing, it’s another. I mean, “I thought I was gonna die!” If you have Medicare make sure you have part F as well to avoid financial ruin.
DR. ADA M. FISHER IS A PHYSICIAN, LICENSED SECONDARY EDUCATION TEACHER IN MATHEMATICS AND SCIENCE, PREVIOUS COUNTY BOARD OF EDUCATION MEMBER AS WELL AS THE NC REPUBLICAN NATIONAL COMMITTEE WOMAN. CONTACT HER AT P. O. BOX 777; SALISBURY, NC 28145; TELEPHONE (704) 223-2321 ; DRFISHER@GETADOCTORINTHEHOUSE.COM.
