Look into my...ear

November 17, 2009 9:51 PM

YANMD filter. I have had an earache for...a long time. I need a super low cost ENT type visit in the miami/fort lauderdale area.

I've been taking ibuprofen and benadryl to faciltate sleeping at night. This was fine with me until it stopped working.

I'm under employed and uninsured (working 11-15 hours/week, had a hopeful job interview today). Minute Clinic at cvs (a drugstore chain here in Florida) is the cheapest option I can find, but at $62 for the visit, that's just not affordable. I do not have a credit card. I'm not in need of emergency room care, so please don't suggest I go there. I'm not currently enrolled in college classes, so utilizing campus health is not possible.

My google fu is failing me and at the moment my ear hurts so badly that chewing is uncomfortable. I can't put this off until I get health insurance or find a winning lotto ticket in the gutter.

I have a broward county bus pass and a bike. I could use the Miami buses. I might be able to get a ride someplace from a friend. So, transportation is a challenge, but less of a barrier than money.

Is there a clinic with a sliding scale? Does anyone have a doctor friend in Miami who could look into my ear and say, 'yup that's infected.' (I've had a lifetime of ear infections. I'm 70% certain that's what it is. Of course, I'm not a doc, and even if I were, I'm not physically able to look into my ear. So my guess at what the problem is doesn't amount to much. What I know is, it hurts and before I consider drinking myself to sleep, I need to see a doctor.)

posted by bilabial to Health & Fitness (18 answers total)

You can't afford $62 but the emergency room is off limits?

That doesn't follow.

Go to the emergency room, tell them you're indigent, and get the care you need.
posted by dfriedman at 10:12 PM on November 17, 2009

Response by poster: My sister says try similisan, but when I search that I mostly find information put out by the maker of that product (surprise). Has anyone used this product?

I'm sorry, dfriedman, I firmly believe that the ER is for emergencies. Deep cuts, broken bones, heart attacks, possibly infected appendices. My current health status is not an emergency. I am experiencing discomfort. I will not be missing work tomorrow because I don't have a job to do tomorrow. Of course, I'd prefer to keep this from becoming an emergency. Not to put to fine a point on it, but there's a reason the ER is not called 'the discomfort room.'

The expectation that the most expensive setting for health care is an acceptable place to send relatively minor ailments does not seem reasonable to me.

Further, the ER isn't supposed to deny me care because I cannot pay (in an emergency), but they can bill me for that care over a long period of time. So, expensive care, (plus interest,) is not my recipe for getting out of poverty. With or without bootstraps)

(As a related sensitivity issue, asking for this kind of advice is tough for me, since in my immediate family the response to broken bones, deep cuts, and a possibly infected appenix is, 'oh, grow up, quit your whining.' My childhood ear infections became emergency room situations where an aunt had to take me in an hold me down so that someone could touch my face. So, really, there has to be a better option for my particular current situation.)
posted by bilabial at 10:34 PM on November 17, 2009

I had an ear infection a few months ago and the only solution was antibiotics.
posted by k8t at 10:37 PM on November 17, 2009

Go to ER, plead poverty, get it taken care of before something happens to your hearing. They must provide care for you (with a few hospitals as exceptions, see below).

According to the Federal Emergency Medical Treatment and Active Labor Act, you cannot be denied care.

"It requires hospitals and ambulance services to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay."

"EMTALA applies to 'participating hospitals', i.e., those that accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program. However, in practical terms, EMTALA applies to virtually all hospitals in the U.S., with the exception of the Shriners Hospitals for Children, Indian Health Service hospitals, and Veterans Affairs hospitals."
posted by zippy at 10:37 PM on November 17, 2009

Response by poster: And I meant to also say to dfriedman, thank you for not telling me to 'just deal with it and stop whining.'

I know metafilter isn't a place where that kind of answer would be tolerated, but, well. Those kinds of fears are emotional more than they are a reflection of current reality.

If my continued search turns up no low enough cost option, I promise I'll go to the ER on Monday morning at 6am. Because what's left of my hearing is important to me.
posted by bilabial at 10:40 PM on November 17, 2009

I would check out some of the clinics in this database:
http://findahealthcenter.hrsa.gov/.

Good for you for not using the ER unless/until it becomes an emergency.
posted by needs more cowbell at 10:51 PM on November 17, 2009

I'm very happy to hear that you will go to the ER on Monday if needed, although I hope others will have good suggestions for alternatives as well. You have every right to have your ear taken care of now, before it's an emergency and before it's horribly painful.

Not to get too psychoanalytic on you, but: Given what you said about your childhood experiences, consider the possibility that you might be flirting subconsciously with replaying that childhood scenario now. I only say this because your initial insistence on waiting to go to the ER until it's a life-threatening emergency sounds a lot like your childhood and (to many people) doesn't seem to make much sense objectively. So if you find yourself postponing the ER visit on Monday even though you haven't found other options, maybe keep this thought in mind and remember that you're in charge now and have the right and ability now to take good care of yourself.
posted by pitseleh at 10:55 PM on November 17, 2009

Try the Broward Community & Family Health Centers. If that won't work, there are a few more community clinics (which generally means sliding scale) that may be able to help you.

Give them a call in the morning and ask what their rates and walk-in clinic hours are. I'm confident it'll be way cheaper than the $62, although you may have to wait around for a while, so bring a good book with you.
posted by stefanie at 11:01 PM on November 17, 2009

"my ear hurts so badly that chewing is uncomfortable."

The "emergency" in emergency care includes "hurts badly, can't function normally."

I'm not trying to dissuade you from finding an alternate to the ER - a walk-in clinic that treats the poor would be ideal. Like you say, even though an ER has to treat you, they'll bill you something ridiculous, and there's nothing preventing them from sending your account to collections.

What I am trying to say, though, is that ears are important, and pain indicates an emergency - something emergent that has to be dealt with.

Unfortunately the only person who really can tell whether your ear pain is an emergency or not is a medical professional who has had the chance to examine you.

So, try to find a clinic, but if you haven't soon, please don't rule out the ER.
posted by zippy at 11:05 PM on November 17, 2009

This site has some free clinics listed in Miami, only one in Ft. Lauderdale. Some seem to be in schools so you might have to search around for one that sees adults.

http://www.freemedicalcamps.com/vcity.php?stateid=FL

There's a previous Ask Mefi question about ear infections that mentions using diluted vinegar to help clear it up. I've never tried it but you can read the post and decide for yourself.

http://ask.metafilter.com/119266/my-pain-is-a-special-snowflake
posted by stray thoughts at 11:11 PM on November 17, 2009

Response by poster: Frankly I don't give a damn about the wait at any facility. I'm concerned about the financial cost. To myself in the short and long term, as well as to society. Every cotton swab used on me in the ER is one resource that's not going to someone who is in a crisis situation, and in this metropolitan area we have a lot of car accidents, heart attacks, and drug/alcohol overdoses. And while I'm broke and under-employed, I don't label myself as indigent. Additionally, I have the resources and inteligence (I thought) to seek out care that is more appropriate to my particular situation. Beer on a beer budget, so to speak.

I feel like the continued insistence that the emergency room is my solution are ignoring the fact that I'm trying to be fiscally responsible. Like, you're telling me to buy a Jaguar instead of a Honda because the Jag dealer is open later/likely has no other customers but me/will give me credit even though I can only afford a used Honda, and I don't want a Jag. My arguments that the metaphorical car I'm driving is not a Pinto, unsafe at any speed, and that I don't need leather seats or debt seem to be falling on deaf ears. Yes, the ER is the fast, convenient option. But in the long run it's expensive, and in the short run it puts me in a setting designed to handle emergencies. Because I do not actually have a genuine emergency (by any stretch of the imagination) I can legally be refused care at the ER. Even if I did have an emergency, I would have to pay my medical bill(a).
I will be extra cautious about any temptation to put off treatment when Monday rolls around. Both for the sake of my ear, and because I don't want to get to the screaming in pain through practically closed lips stage. The psychological aspect of that would suck.

I'm glad to have an online community where I'm comfortable reaching out, and where strangers are kind enough to stop and give me advice. I can tell that you care, even if your advice doesn't match my needs.
posted by bilabial at 11:33 PM on November 17, 2009

Response by poster: 'Not functioning normally' is not a logical definition of emergency. Are these emergencies- Carpal tunnel, a limp, bit your tongue so it hurts to move food around in your mouth?

No, no, and no.

(I probably should have left that for someone else to say, but I am a grumpy bear.)

I'll call all those places tomorrow and get myself seen, ASAP, by hook or by crook. And again, if none of these promising looking links pans out, I'll hie myself to the emergency room and turn to pan handling to pay the bill. It'll be worth it if I know it's really the only option.
posted by bilabial at 11:42 PM on November 17, 2009

If you can't get seen by any of these clinics, don't wait until Monday to go to the ER. I've been there, and I know how bad that kind of situation sucks. (It sucks when you've got a job bad enough that getting a job at Burger King is a major step up... and then you get an ear infection and wonder how you're going to pay the bill. Been there, done that, got the shirt to prove it.) First of all, you may not have a life-threatening condition, but you have something that legitimately needs to be taken care of. No ER doc is going to say, "Hey, this isn't an emergency, get out of here!" This isn't a case of the sniffles. This is something that is extremely painful and can possibly lead to dangerous complications such as mastoiditis or hearing loss if left untreated. Waiting until Monday won't make the treatment any cheaper (and it could make it exponentially more expensive); all it will do is make sure you suffer for several more days than you need to. Explore your options, but make sure you get yourself seen sooner than Monday.
posted by azpenguin at 12:28 AM on November 18, 2009

I'm going to Nth being seen asap, though I deeply sympathize with the long term stess of financial burden.

I've had two ear infections and the pain was ridiculous. First go 'round was cured by anti-biotics; second by Olive Leaf capsules. I swear by them.

They MUST have 15% - 20% Oleuropein for effectiveness. Not cheap, but they kicked my second ear infection just as easily as the anti-biotic.

I took two 250mg, four times a day. I'm a very lightweight female so your dosage will likely be higher.

Also, ease up or eliminate mucous forming foods like dairy. Hope you are feeling well again soon.
posted by Feisty at 12:53 AM on November 18, 2009

Try your local health department(s). Upthread someone listed the ones for Broward County; these are the health department clinics for Dade County, if you want to try there. I'd call those before going to the ER, myself.
posted by dilettante at 3:59 AM on November 18, 2009

worst case scenario is a fulimnant abcess that literally explodes through your temporal bone into the brain. Does this make your decision easier?

Now I personally know only one person who died like that.

He was 33 and had a three week history of increasing severe ear-ache.

But I guarantee you his wife and 2 small kids really wish he'd gone to the ER.

He also had a long history of ear-aches all treated successfully with ABs until this episode.

Please go to the ER, this is exactly what it is for.
Ear-ache may seem minor to you but any infection that close to the brain, get it checked out. NOW!

I'd be saying the same if you had burst a pimple on your nose and it became infected, small potatoes to you perhaps but also potentially fatal.
posted by Wilder at 9:43 AM on November 18, 2009

Response by poster: Hi all. I'll be seen tomorrow by a slightly more affordable place.

Thanks for the concern, and the helpful lists.

I'm really glad I've grown into an adult who is relatively confident about having a right to adequate care. Clearly my sense of entitlement may be deficient, but it's worlds ahead of where I was even a year ago.

Thanks to everybody here for affirming that I'm worthy of, well, being cared for. Now, if you'll excuse me, I have something in my eye.
posted by bilabial at 3:13 PM on November 18, 2009

Response by poster: I was seen. I was instructed to use Similasan. And was told it was largely stress related, as the muscles in my upper back, shoulders, and neck were very tense.

So the Rx was: relax.

Haven't had amy ear pain in a few weeks and am working on relaxing.
posted by bilabial at 12:19 PM on December 18, 2009