Testing, Testing: The Cost of Health Care for Health Care’s Sake

Marla Jo Fisher, who writes a humor column for the Orange County Register, among other things, read my piece about the downside of too much health care last week and sent me a note about her experience with her son. What she went through was so compelling that I thought I should share it with all of you, and I asked her to write a guest post. I had not been a reporter very long when I met Fisher, and watching her work taught me the value of two traits in particular: being direct whenever possible and being funny when appropriate. The way Marla describes how she navigated her way through the health care system with her son is exactly how I would have imagined it. Here’s her story:

In the end, it all came down to nerves.

My son takes football seriously. And his team had a big game coming up. He practiced hard. He went through all the plays in his head. And, on the day of the game, he was so nervous that he didn’t eat anything during the day.

So he scored a touchdown during the game. Hurray!

Then he fainted. Aggh!

You can imagine how scary that was for him (and for his mom).

I should not have been surprised. I’ve seen him skip meals before and end up sinking into low energy, only to bounce back as soon as food hit his stomach. So, I knew that he would be OK. He ate a protein bar, drank some water and was fine.

But, understandably, his football career took a detour because of the fainting. The coaches wouldn't let him come back to the team until he got checked out. They were worried about danger from what some refer to as “sudden cardiac death.” Agreed. No mom wants that on her conscience. So I took him to his regular doctor.

She would not clear him, either. And she told me to take him to the emergency room because he was potentially in imminent danger. I should note that he had never fainted before, and the doctor’s visit was a week after he fainted, with no other symptoms.

So we went to the ER. We spent the whole day in the ER, in fact. (Insurance agents, get out your calculators.) The doctors were looking for undetected heart irregularities, in particular a thickening of one side of the heart, which, when found in athletes can trigger arrhythmias and sudden death. 

His EKG was slightly abnormal, which doctors said was most likely nothing dangerous. But, that triggered a bunch of new tests, in particular an echocardiogram of the heart muscle. That’s the test that would show an abnormal thickening of the heart walls.  After hours of waiting, the ER doctor came in and said his echocardiogram was fine. Great, we thought. He could go back to the normal life of a school athlete. But wait, the doctors still would not clear him to play.

We had to make an appointment and go see a cardiologist.

Getting a quick appointment with a cardiologist is not easy, as you might imagine. I spent most of the next day calling cardiologists and begging desperately to get in urgently. He had a big football game on that coming Friday. He loves playing, and he is a star of the team.  It would crush him not to play.

Success! We got an appointment with a cardiologist, and his echocardiogram was fine. There was one caveat, though. Even though everything looked okay, the doctor said he would recommend that my son wear a heart monitor halter because his EKG readings had been slightly unusual. But then they didn't give us one, so we left the office.

The good news is that my son was able to go back to playing football. He played so well that he earned a varsity letter. He hopes to play in college, too. He’s never fainted or even been dizzy since, now that he makes sure to eat before the game.

But what did all of that health care buy us? A pretty hefty bill for my insurance company. And quite a bit of anxiety.

Does he really need to worry that he has a heart condition? Or does he (and his mom) just need to make sure he doesn’t skip lunch on game day. Or any other day, for that matter?  

There is the tiniest little voice in me that says, "You're a BAD MOM for NOT making him walk around all day with a heart monitor," even though I know in my gut that would be ridiculous. I want my son to enjoy life to the fullest extent and not be limited by the demand for endless screening, testing, and reassessing of what healthy really means.  I’m still considering taking him in to get hooked up to the heart monitor.

My healthy son scored that game-winning touchdown the same night he fainted. And my healthy son played like a champion – on both offense and defense – in the next game. No screening test in a doctor’s office is going to be able to measure that kind of performance.