Peace of mind has a price: In Trinidad I had to pay

Noelle Khalila Nicolls Surviving Dialysis 2 Comments

I never realized how expensive peace of mind could be before my health insurer kicked me off my policy. Of all the things I took for granted before dialysis, health insurance was definitely one of them.

When I tore my ACL in high school I had insurance to assist with the surgery and physiotherapy. When I learned I had an ovarian dermoid, I had insurance to help remove it. When I decided to change jobs, and my insurer kicked me off my plan, it couldn’t have happened at a worse time.

A few lessons I learned. First of all, it should be illegal in every country for an insurance agent to kick someone off their policy for changing jobs. In my case, I was insured with Generali through my employer the Tribune newspaper. Many people know that entrepreneurship is a risky venture, but not everyone realizes that sometimes the risk is about your health. A few years ago I decided to leave my full time job at the Tribune to step back into my business full time. One of the decisions that affected the timing was what would happen to my health insurance.

I tried to get the Tribune to work with me to buy some more time, but they wouldn’t. I was hoping they’d allow me to have a freelance writing contract of some sort that could keep me on their policy. I tried to get Generali to change me over to a private policy, but they wouldn’t. They cancelled my policy and I had to reapply as though I was starting from scratch. Of course now that I had a pre-existing condition, they squarely rejected my application. If the public hospital didn’t have a dialysis unit, I’d need about $54,000 per year just to pay out of pocket for dialysis.

With health insurance, life is not always peaches and cream, but it can be a lot less expensive. Nowadays, peace of mind has a high price. When I was in Trinidad and Tobago a few months ago, for a cousin’s wedding, I had a major scare. On Monday I was jetting off to Tobago with my sister from another mother. On Sunday, I noticed fresh blood at the site of my catheter, which threatened (in my mind) to throw off our plans.

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Gross. I know.

After each dialysis session the catheter is bandaged up with a gauze bootie and then tapped down with additional gauze pads. From session to session the gauze is barely soiled; the sterile whiteness is still dramatically present. When I looked down at the gauze however, it was stained with a large puddle of dark red blood. Hence the dread about what was happening underneath. Fresh blood is never a good thing. I started to freak out. My mind started to dream up all of these doom and gloom scenarios that my catheter was infected; that I might fall sick and be stranded in Tobago.

Of course I didn’t want anyone to know how I really felt; that I was a nervous wreck. So I asked my sister to drop me to the clinic where I had dialysis on Friday “to pick up something”. Each dialysis treatment abroad puts me out of pocket some $300-600. I was hoping the nurses in the dialysis unit could look at my catheter, redress it and let me know that everything was okay. First roadblock, the dialysis unit was closed on Sunday. The only way I could be helped that evening was if they admitted me into accident and emergency. This of course costs additional money and takes time. My brother and sister were waiting in the car under the illusion that all was well in my world. Too much waiting would surely trigger their suspicion.

I sat on the lonely couch in the hospital waiting room to think, with anxiety welling up inside and tears streaming down outside. I tried to connect to the hospital wifi to whatsapp call a nurse I know. Wifi wasn’t working. I called from my phone and didn’t get through. Each roadblock made the anxiety worse. Finally I got a doctor friend, who I explained the situation to. Using my data roaming, I sent photos of the wound through whatsapp, basically wanting to know, should I stop worrying and go about my business because my fears were just paranoia or should I pay the money to be admitted and go through the A&E process to get checked out. The doctor’s opinion was inconclusive. He couldn’t tell from the photo if the wound looked infected: maybe it was, but maybe it wasn’t.

The fact that he couldn’t rule out the possibility emphatically made me combust with even more fear. An infected catheter is a very serious issue. The catheter is a tube that is threaded through an artery and literally connected to your heart.

When I looked up, there was my brother and sister standing in the waiting room. They looked mortified, observing me in a pool of tears. I confessed everything to them, feeling ashamed for trying to hide and annoyed for being an inconvenience.

I finally decided the only way to guarantee my peace of mind was to pay the money (several hundred dollars) and go to A&E. Rande and Candice didn’t care about the wait; they even volunteered money; like me, they wanted peace of mind knowing I was okay.

Inside the treatment room there was some debate about the condition of my catheter, until a doctor came in and declared emphatically, there was no infection, the wound was fine. I probably exerted myself too hard and knocked it around, which led to the fresh bleeding.

The nurses bandaged me up and ushered me back to the waiting room. I paid my bill and left the building behind my brother and sister. All I could think is that I had spoiled the entire evening for them. But through the shame and frustration I at least had peace of mind.

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