Nurses/Medical Professionals??

naughtoj

naughtoj

Cathlete
Ok, technical question.

My brother has no insurance and recently got an ingrown toenail. I think he picked at it, making it worse, but anyway it did not heal. I saw him today and his big toe is all reddish purple near the wound site and his ankles, feet, and lower legs are swollen. Not just on the leg with the ingrown toenail..more so on that leg, but the swelling seems to be in both feet and legs. You can't even make out his ankle bones. He also said that his lower leg was starting to hurt.


I know when I got bit by my cat and my hand turned red and warm and big, they treated it somewhat as a medical emergency.

I told him if it wasn't better by tomorrow I was going to pay for him to get into the doctor.

I am pretty sure the toe is infected. It is draining with nasty stuff (you know what I mean). Question is....are antibiotics required and how much of a medical emergency is this? Can the infection in his toe spread?

Just curious as to the degree in which I should freak out. He is one of those types that never goes to the doctor.x(

Thanks!
 
Yikes! He should go to the Dr. as soon as possible - he could have a staph infection which is something he definitely doesn't want to mess around with. A staph infection can spread to the heart very quickly and...well, I don't need to tell you what can happen.

A good friend of mine just died from a heart infection (I'm going to the wake tomorrow actually) that was caused by some dental work he had done - he was 28, a yoga instructor, fit as could be and he just dropped dead at a restaurant.

Infections are nothing to mess around with. I don't want you to freak out but better safe than sorry...
 
As a microbioligst, I agree with the previous advice to get him to a doctor. Sounds alot like an infection. There's a nasty bug out there, MRSA, which is a Staph that is resistant to most normally used antibiotics. This bacteria can be deadly!! Not to metion other fun things like gangrene and septicemia.
 
Janice,

Your brother should go to the doctors, NOW. A few months ago, my 12 year old complained that his big toes hurt. I looked at his toes and it did look like his nails were ingrown. I didn't really worry about it and told my son it would probably just go away on it's own. Well, two weeks later it was worse, his toes were red, swollen and oozing. The redness started to creep up to his ankles. I took him to the doctors and he had a really bad infection! The doctor told me I should have brought him in sooner.

Alexandra
 
Ok, well, I guess it is the doctor.

Man, I was really hoping I didn't have to spend any $$$. But, I guess my brother's life is more important, LOL!

Thank you for your educated responses!
 
We have had times with no insurance, and still have several friends with no insurance, and I have to say that when you are honest about it most doctors will work with you. You can make payment arrangements, and many give a cash discount. I have actually found that the times I didn't have insurance went surprisingly smooth. Don't worry about that end, just get your brother in to be treated.
 
OK, well, bro wouldn't go the other day. Swelling has not gone down yet, so I called him tonite and he said he would go tomorrow to urgent care.


I was wondering......long shot here........if I went online and purchased a health insurance policy for him, how fast does that go into effect? I was looking on Blue Cross Blue Shield and you could check June as an effective date. I was just thinking I could hurry up and sign him up and then take him to the doctor this coming week? It looks like 50 bucks a month for his age.

I know we should get him in now, I am just afraid they are going to want to run antibiotics IV or something, tetanus shot....my simple cat bite ER visit was almost $900!!

Any advice? He really can't qualify for ACCESS I don't think because he most likely makes too much. He had a one year waiting period at his new job before he could get insurance and never bothered to get any other insurance in the meantime.

Thanks for any help!!:)
 
Janice, I hate to ask you this, but how old is your brother? Apparently, it can't be too bad because he hasn't gone to the ER. If he makes too much money for charity assistance, then he should be able to think of something & work something out. I just don't imagine an ER turning him away because he can't pay the full bill. They typically have payment plans. Then again, I live in a different state.

I do hope he improves, in the mean time, have him soak his foot in warm water & epsom salt to try to draw that swelling & inflammation (pus) out. Hope he improves.

Marla
 
Hi Janice,

Wish I could tell you for sure about the insurance, but I think it may not get covered even if you signed him right up. BC/BS might consider it pre-existing even if he hasn't seen a doc for it before, or there could be a deductible that has to be met.

Now, without looking at him, my guess is that the MD might drain the toe, (if it has a lot of infection trapped in there), then cover it with an antibiotic ointment and a dressing that it can drain into. If it looks bad enough he may get a shot of antibiotics, then get a prescription for oral Keflex or something to take at home. IV antibiotics may be indicated if the redness is really going up the leg, because you do not want that stuff in the bloodstream, or to let it set up in the bones. He really does need to be seen...especially since he has had this a few days now.

It is true that many times the Docs will be a little gentle with billing if they know you have no insurance. Also, ask for samples of antibiotics or ointments of whatever!! They get them free, ya know? The last time I took my oldest to an "urgent care" place, the bill was about $80.00, but she walked out with 2 inhalers, antibiotics, cough medicine, an expectorant to loosen phlegm, and an antihistamine to dry her up. Over $100.00 worth of meds...all because she had no insurance. But I hear ya on the ER bills.....



Julie

ETA: Yes, do Like Marla said and have him soak it. In most states now it is illegal for an ER to turn anybody away...they have to at least evaluate the patient and make sure they are stable before letting them out the door....this includes treating obvious stuff like infection.
 
Septicemia is something you don't want to mess with.
I don't know of any facility that is not required to accept indigent care patients, that is how they receive financial support from the state they are in. If not, they will set up a reasonable payment plan.
If he's got this problem, he can't go to work, and if he can't go to work, how will he make the payment. Sorry to sound harsh, but I also know someone that died of septicemia, he needs to worry about his health and deal with the rest later, it will all work out, but not if he doesn't get it together ASAP. I can't believe he's waiting this long(I understand the money issue, but the seriousness of this outweighs the $$ at this time). You never want to say, "if he'd only gone in when it first happened...."
The longer he waits, the more it will cost, more than likely, and just because he's soaking his foot does not cure the infection he undoubtedly has, he needs antibiotics, plain and simple.
Even worse, he could get a bone infection or get a toe amputated possibly(extreme sounding I know and highly unlikely, but you never know, leaving it alone is not the answer).
Hopefully you can get him into an urgent care facility ASAP.
Good luck and keep us posted!
Mary
 
I just have to add here that 1 year ago my 3 year old ,2 then got a sliver from my deck . I took him in right away cuz I could not get it out .... They sent us home with no antibiotics .. 3 days later I almost lost my child he had 4 sessures !!!!! Had a serrious Staph infection Was around his brain !!!!!! I had insurance and it was over 20 thousand dollars by the time it was over ,(4 thousand out of pocket),Now I can't insure him !!!My insurance lapsed betweet jobs !! Now I'm trying to sue !!!! I think I have a case !!!!My main point here is infection can kill !!!! Very scary.Oh This could of been like 90 dollars if that Dr would of taken it out !!!!
 
Janice,

I work for a county hospital and the ER cannot under law turn you away (if it is a county hospital and not a private one). When you get the bill, call and talk to the business office. They will work out payments for you. Usually they ask what you would want to pay. I know our hospital makes it extremely easy for folks in your situation. You are right though, your brother's life has no price. Get him medical treatment right away. I agree with all the other posters... this is nothing to mess around with. Staph infections, especially MRSA, will kill and kill quickly.
 
My brother is 30 years old! Some of you may remember me posting about him before.......and his drug habits. He's not really, shall we say, responsible. I never help him out financially (as my mom does for every sob story she hears) but I did tell him that if it got real bad to call me, that I would take him to the urgent care (and pay). Maybe I shouldn't have said that. I don't have much $$ either for pete's sake. I just get afraid that with the drug use will come lack of concern for himself, or even worse, numbness to the pain, and it will get very bad.....staph....like the others say.


I know he is not going to want to chase around town as some "indigent" (he has a full time job and rents a home with my Dad) and pretend like I can't pay, blah, blah. Think I should just suck it up and go to the urgent care? I thought maybe urgent care would give him oral antibiotics, but maybe not run the IV line if it wasn't necessary. Like I said, I don't think it was necessary for me but they did it anyway. 900 bucks. Thankfully I have insurance.

So, I guess in a way this is enabling my brother. But, I feel bad and I know he needs treatment. Am I wrong to be doing this for him or should I just let him take responsibility for his foot. Scares me too........don't know if he is diabetic or has PVD......he never goes to a doctor. Lord knows what could be wrong with him. This all complicates my struggle with whether I should/should not help him here.......

BCBS is out. I guess that is fraudulous anyway. Not a good idea. Well, he'll be calling in a few hours. What should I say??
 
That's a tough one. Have you talked to your parents?
Drug use opens a whole other can of worms in the healing/infectious disease process.
Oral vs. injectable drug use, they all take their toll on the body.
If your mom is as involved as she sounds and he lives with your dad, then I'm curious as to why he hasn't involved them as they seem closer in physical proximity(esp your father)to help him with this.
I didn't mean indigent in the realm of homelessness, just without insurance. If he's got a job, why do you have to pay? A Urgent care should be able to help him out and be cheaper than an ER bill(lower overhead and all).
Hmm.....,though he may be so used to his family taking care of him and not having to take responsibility for different things because family always helps him out, it sounds like he doesn't really appreciate what you all are doing for him.
Family members with drug(or other)addictions are tough on the rest of the family in dealing with this issue as it involves so much more than the drugs, etc., themselves.
Keep us posted!!
Mary
 
Oh Lordie.....is my whole family situation hard to explain in typed words.:)



Well, I took him. I should have let his legs rot off though. Honestly. He did have an infected toenail, but according to the MD that did not account for the lower leg/foot/ankle edema. As of this morning he had some weird rash around his ankles where the swelling was.....almost looks like patches of broken capillaries. It was a lot worse. The MD did not seem to understand why both lower legs were swollen, didn't make much sense to her. She took urine and chest X-ray. While my bro was in the bathroom giving his sample, I confided in the MD about his drug use (which I knew he would never disclose). Urine and X ray came back OK..he's not diabetic. She gave antibiotics and basically hinted on about cirrhosis, liver failure, or kidney failure. Or, she said, for some reason he just had edema and the rash was just coincidental. Very hard to swallow. We kept telling her that he has NEVER EVER had anything of this sort...not even slight edema. She told him not to drink water (!) because if he was in kidney failure that would make it worse. She told him to make an appt with an internist this week who could do a complete physical and bloodwork. In the meantime, if it gets worse, ER.

He couldn't even stay alert in the dr office waiting room. We thought he had stopped with the CNS depressants, but apparantly he has started up again. He practically falls over out of his seat asleep! They call it "nodding off". Totally embarrassing. Seeing him anymore makes me so sad because all I can do is feel so terrible for him and what a pathetic life he has chosen to lead. I get angry because I don't see why he can't get to a point where he can see what this is doing to him! Last week he told me he had given up fast food, was going to start working out, he looked GREAT. This week I see him and his eyes are rolling in the back of his head, he can't stay upright, his legs are swollen, he looks like HELL, and he really tries to pass it off as normal. Like there is nothing at all wrong with him!!! Does he think we are blind???

So..........I guess I was stupid. I paid for the urgent care visit and his antibiotics..total of $170. Like I said, in hindsight, I should have let his toes get gangrene or something. Sadly, in many ways I wish he was in kidney failure. Maybe it would wake him up. He was scared for a minute in that office when she started on with the chest x ray and urine sample. But, when she came back and said they were OK, you can see him just switch back into that denial mode, "See, I knew I was OK". Yeah right. Maybe he needs the pants scared right off of him.

I am just so sad because I cannot do anything about any of it. I just get to sit and watch it happen. You try to talk to him, he gets angry. Deny, Deny, Deny. What will it take to wake him up??

Now, let's hope the antibiotics work. I was trying to get him to go this week and get bloodwork from inside the grocery store (healthwaves) so atleast we would know his values. But, he is so in denial, he left the brochure in my car. Doesn't even care. Was getting home to get high again. Couldn't even hold his head up while I drove him home. So sad. :-( :-( :-( :-(

I will spend my whole life watching people crash and burn. I swear.:-( :-(
 
I give you A LOT of credit for what you are doing for him. It shows what a caring person you are. What you should take from this is your conscience is clear regarding your brother. You can not make someone do something that YOU think is right, even if it has dire consequences. You did everything(and went above and beyond)you could, and leave it at that.(easier said than done)
You need to focus on yourself now, put yourself first.
Keep your chin up!!
Mary
:)
 
Ditto to what Mary said.

I really feel for you. Been there, done that, finally had to let go.
But you did what you could, when you could. You are *not* stupid......you're a sister, and no telling where that infection could have gone if he hadn't been seen and put on antibiotics.
I'm hoping that the antibiotics will also help clear up his legs.

Take care,

Julie
 
Oh Janice,

I feel so bad for you. What a mess. But you can't be responsible for other family member's bad choices. Just do the best you can. A psycologist who evaluated my special needs son once told me do just do what I know is right, and not to worry about the bad behaviors of others that are out of my control. Sounds like you are doing as much as you can for your brother. Are there other family members to help share the burden, both finacially and emotionally? Best of luck, and you and your brother will be in my thoughts and prayers.
 
Oh sweet Janice! I have a goofy family as well, and I know these things are not easily explained. We love them, in spite of them sometimes:)

All I have to say is what the bible says, which is "you reap what you sow". You have done a good thing, and you will be rewarded for it!! The money you have spent, and the time and energy that you put into this situation will come back to you. It just works that way.
It can be an awful feeling to think you are enabling someone, but I just hope you are encouraged by your good treatment towards your brother. I like to think that it is alright to make a mistake if there is a chance I am making it in their favor rather than against them.

Hang in there!
 
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