Breathing Freely: An Expensive Endeavor

I’m officially jealous of my friends with diseases and maladies.  Only because all of them can visit the doctor.  Because at the slightest worry, they can call up somebody, see somebody, and potentially get a prescription all for a nominal fee.  It’s a horrible thing to say, and truly, I’m not really jealous of their ailments, I’m jealous of their health insurance coverage.   Especially their prescription coverage.

A little less than two years ago I had one of the worst asthma attacks of my life.  I was laying on my bedroom floor, wheezing and gasping for air, just hoping that hey- maybe I’ll just die and I won’t have to worry about it anymore.  Breathing seems like such an easy thing until you can’t do it anymore.  Nate nearly drove me to the emergency room, but instead we went to Walgreens and I bought an over-the-counter inhaler to get me through the day so I could go see the doctor on Monday.  A  trip to the doctor and Walgreens is FAR cheaper than a trip to the emergency room, let me tell you.  Far cheaper.  (For example, when I hit my head at work and got a concussion and had to go to the ER because I was still dizzy, headachey and eyes all crazy dilated it cost about $700.  A trip to Walgreens for an OTC inhaler + a doctor’s visit? About $90.  Neither are affordable, but one is more affordable than the other.)

At that point, the doctor told me I had to start using some sort of daily controller for my asthma.  She prescribed Advair, and because I don’t have insurance, she gave me a bunch of samples– about four months worth.  She also gave me samples of my rescue inhaler and said that even if I stopped the Advair, it was extremely important to always have a rescue inhaler.

I listened. I did.  And I almost always have my albuterol rescue inhaler on me (unless, of course, I forget it on my bedside table). I make sure I have $50 at all times in case anything happens and I need to replace it.  I wish I could afford to have one my bedside and one in my purse at all times, but that’s unlikely at $50. a pop. I barely have anything left over after bills, so it’s not like I can just come up with some imaginary money to get two inhalers.  Luckily, I don’t have to buy an inhaler EVERY month… but close.  About every 5 – 6 weeks.

The Advair is a different story.

I used the samples and it made a world of difference.  For four months, I didn’t fall asleep to the wheezing sound of my chest.  I didn’t feel like I was gasping for air. I barely used my rescue inhaler.  Even changes in the weather didn’t affect me the way they had.  (When it changes abruptly, or if it rains for long periods of time, my asthma gets pretty bad.)  It was like living with the lungs I had as a teenager!

I developed asthma in my 20s.  The first asthma attack I experienced was after I had spent the day at Nate’s house.  We had just started dating, so this was 1999.  His parents had tons of cats.  My mother, who is deathly allergic to cats and has terrible asthma related to cats (among other triggers) was the one who finally put it together: I hadn’t had a summer cold ALL summer– I was allergic to the cats!  Since her insurance still covered me, Mom took me to the doctor, who confirmed: Beth + Cats will not equal good things due to her allergies.

In any case, on that day, Nate and I had spent most of our time downstairs watching movies (on a revolutionary DVD player, haha).  When we left so he could take me home, I felt a little wheezy and out of the ordinary. He dropped me off, I went up to my room and the wheezy, out of the ordinary feeling continued.  I ended up having a coughing fit which woke my mom, who fished her inhaler from her purse and made me use it.    A few months later we moved to Colorado, sans felines, and I didn’t think about it again.

The next time I had an attack was after another night at Nate’s house.  We had moved back from Colorado and it was a game night.  We probably spent about 5 hours at his folks’ house.  His sister was living there with her cat, along with all the cats they already had. Midway through playing the game I started having serious trouble breathing. I was pretty sure it was an asthma attack, but I didn’t want to spoil the night so I just sat there.  Ultimately we had to leave before the game ended  so I could retreat to the catless environment of our tiny little studio apartment.

After that, I avoided being around more than two cats as much as I could. That was the amount I could handle: two.  Mike and Lisa’s cats bothered my allergies, but didn’t invoke an asthma attack.  One cat alone didn’t cause problems– it was when there were three or more cats around that provoked a negative response.

And, of course, there was the fact that I had smoked cigarettes since I was 13. That didn’t help at all.  Funny thing, though- when Nate and I moved back from Colorado, I quit smoking for two years, and it was during those two years that the game night incident occurred.   But in any case, smoking was never a GOOD thing for my lungs.

And, of course, there is the fact that I have never had good lungs to begin with.

Ever.

As a kid, I had multiple lung infections: there was the pneumonitis that nearly prevented me returning from Arizona to California when I was eight.  There was pneumonia the next year, which required hospitalization (it was only for a few hours but still, I got a wristband) and a good three weeks to recover from.  And then bronchitis, my old friend, year after year after year.  I can’t even count the number of times I’ve had bronchitis.  There were a few years in high school that I managed to avoid bronchitis, and in the past five years I’ve only had bronchitis twice, so it’s gotten better, but when I was younger… man.  Is it October?  Better gear up for bronchitis.  Or pneumonia, which always loomed as a threat if not an actuality– though not as often as bronchitis.

Why I ever thought smoking cigarettes was a good idea, I cannot say.  If you can go back in time and ask my 13 year old self, I’m sure it would have something to do with pissing my parents off and being cool.   And why I smoked and smoked and smoked, I cannot say.  At least I kept trying to quit and as of today, it’s been over 6 months since I quit. (I have to admit I fell off the wagon twice.) I can say that NOW on the days I have desires to smoke cigarettes (and I don’t give in) all I have to do is think of the expensive asthma attack it will likely induce and I can keep my cravings at bay.

Which leads me to today, when I live with two cats.  These cats found us six years ago, we didn’t find them.  And I love them more than I love just about anything in the world.  I take allergy medicine every day so we can keep them around.  It was two years into living with these gatos before I really noticed anything going on with my lung capacity or my breathing, and it was only after a bout of bronchitis that I noticed it at all.  I went to my primary doctor, who basically told me I was imagining things.  I persisted (this was also the doctor who told me the tumor in my thumb was nothing but a cyst and not to worry about it), and she sent me to a cardiologist, who confirmed my suspicions: I was suffering from asthma.  The cardiologist prescribed me a twice-a-day inhaler and a rescue inhaler, which I used and found relief.  At the time I was employed with the county, had great health insurance coverage and didn’t worry about spending $40 a month plus another $30 for allergy medicine.  No big deal.

Until I didn’t work for the county anymore.  I couldn’t afford all the prescriptions without insurance, so I had to choose one, and the allergy medicine won out– it seemed if my allergies were bad, it would make the asthma flare up, so if I could control the allergies, I could control the asthma.

This worked for almost two years.  I rarely felt asthmatic (of course, I smoked, so any raspy wheezing was blamed on cigarettes) and spent the money for meds on Zyrtec– $80 a month seemed like a small price to pay to keep my furry companions.  (Zyrtec wasn’t available OTC yet.)   Until the day almost two years ago when I had the worst asthma attack of my life, and nearly had to visit the ER. (And worried Nate nearly to death.)

Because I ran out of the samples, I haven’t used Advair in over a year.  I knew it was expensive, and the rescue inhaler seemed to do the job just fine, so I didn’t worry about it.

Until the last month or so.

My asthma has gotten bad.

Bad.

As in, not good AT ALL.

I don’t know what’s triggering the situation- if it’s a build-up of not controlling my asthma for 18 months, or if it’s the abrupt changes in weather… if it’s the amount of moisture in our house… if it’s mold from when the house flooded (maybe it wasn’t completely dry? maybe there’s mold in the walls?)… if it’s because we need a new mattress… I don’t know.

On Friday night on the way back from the city, I had an asthma attack.  Actually, it started as Amoreena and I were driving over the bridge into the city (if you know me, you know that I don’t like bridges in general and the bay bridge very specifically) and I realized that my inhaler was at home.  I focused on not thinking about being stuck in traffic on the bridge, which makes me a little panicky and can cause me to start breathing shallowly and rapidly which can cause an asthma attack.  We got to the Levi’s store and I felt a lot better- still a little tight, but nothing that made me concerned.  On the way back, I started to feel more asthma-y, and then we were on the bridge, and then it was pretty much downhill from there.  Full-blown can barely breath through pursed lips. Amoreena took me to the house where I had to use a double dosage of the inhaler, and it was still a good two hours before things restored to normal.

And then I woke up on Saturday with the beginnings of a cold.  And by Saturday night, the beginnings of that cold had traveled straight to my chest, where every cold I’ve ever had takes up residence.  (Seriously, I’d love to have a head cold over a chest cold.  Because I always have chest colds.)  Yesterday was pretty bad– I had to use my inhaler more than I’ve had to use it in some time.  The weather isn’t helping, with all the rain.  Last night I woke up about 8 times because I couldn’t breathe very well.   Coughing fits, wheezing fits, the horrible sound of lungs sucking in and releasing air… It’s very hard to sleep when it sounds like something is screaming in your chest.  I’m just saying.

This morning I knew: I have to do something about this.  The rescue inhaler just isn’t cutting it.  I can’t depend on something to control my asthma if it’s only supposed to be used for “rescue” during an asthma attack.

So I called around to the various pharmacies to do a price check on Advair (which, btw, as far as I can find, has no generic.)

Target: $186.

Walmart: $194.84

CVS: $203.99

Walgreens: $218, or $173.99 with their prescription savings club (which is $20 a year).

Basically, I hung up the phone with Walgreens and burst out crying.

I can’t afford ANY of that.

I can barely afford to pay our bills and put food in our bellies.  Nate’s stretched to the limit, too.  In order to afford that, I basically have to cut out anything extra in the budget– and that means cable, internet, et cetera.  And honestly, since I already spend so much time at home because we are eternally broke (that’s what living in California does to you) I don’t WANT to get rid of those extras.  If I cut off the cable, that’s only an extra $60 a month, which won’t cover the cost of the prescription.

So someone says to me, just get rid of your cats.

Excuse me?  Can I shoot your daughter? Get rid of my cats?!? Are you fucking crazy? Are you fucking loonytunes nutzoid? Can I kick your baby into a river?  Can I throw your son in a bag with rocks and toss it into the ocean?  It amounts to the same thing. These are the ONLY cats I will ever have, and you’re insane if you think I’m going to give them to someone else or have them euthanized.  What the french, toast?

A while back I posted something about health insurance and the ongoing debate in my status update on Facebook.  I think I was complaining about the hole in my tooth (still there) and the cost of asthma medicine.  Not to mention that I’m telling myself the little bump I feel in my thumb is just scar tissue, not another giant cell tumor (benign, but can cause functionality problems and thought to be a precursor to rheumatoid arthritis).  Someone responded to my status with, “I don’t want to have to pay for your health coverage”.

You know what?  Fuck you.  Fuck all of you who think that health coverage and being able to afford prescriptions and visits to the doctor are not a basic human right. Seriously. FUCK YOU.  Because you obviously are living high on the hog and don’t have to worry about whether your tooth is going to fall out, your lungs are going to fail, or your thumb is going to stop functioning. You don’t have to worry about the what ifs– what if I trip going down the stairs taking the garbage out and break my leg?  What if I have an asthma attack so bad I do have to go to the ER?  What if I step on a rusty nail, what if I go camping and sprain my ankle climbing a hill, what if I burn myself cooking, what if I accidentally cut myself chopping vegetables and superglue isn’t the answer? What if, what if, what if?

So here I am, back at the beginning: Can’t breath and don’t have the money to make breathing happen.  I’ve researched private insurance, and it’s pricier than the meds and then I have to pay extra for the meds on top of the insurance- so that’s not a viable option.  My next phone call will be to my doctor to see if she can A: prescribe me something else, something cheaper without me coming in for an office visit (she’s surprisingly understanding about the no health insurance thing) and B: does she have any more samples she’s willing to part with?   I went online and filled out a bunch of questionnaires to see if I was eligible for any sort of assistance or program to help me with my prescription… but unfortunately, I make JUST enough money that I’m not qualified for any of it.  But GlaxoSmithKline, makers of Advair, can give me a $10 coupon off my next refill of Advair.

Oh, how generous!  That’s going to put a big dent in the $200 I need to shell out for better breathing.  How kind!

But mostly, it just makes me sad, because my ailments aren’t that bad compared to others who don’t have any prescription coverage or health insurance.  There are people far worse off, and I guess in a way I should be happy that I can afford anything at all.   I might be able to be happier later, when I can breathe, but for now I just want the sounds in my lungs to stop and to be able to laugh without having an asthma attack.  Seriously.

It would be nice to be able to breathe freely.

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