Mid twenties male with medical dilemma needs some collective advice.

January 22, 2008 8:15 PM

I'm a male in my mid-twenties, active, and have been for the most part healthy. A few months ago I started getting some strange symptoms, and pain in one of my testicles. I was uninsured so I went to the doctor anonymously and paid cash. His thoughts were it was probably just a standard infection, and gave me some antibiotics and told me to come back if the pain persisted. Around that time I also went to an anonymous city clinic to see if it could be an STD and everything up until then checked out OK. There was a test *Syphilis that I hadn't called back on for results, I did so today and they said the test was negative as well, but there was "something else was going on".. Apparently, the second part of the Syphilis test showed them this. I also asked again about the STD related stuff and they said all that was fine.

Up until a couple weeks ago things were feeling better but since then, for some reason, I've been going downhill with symptoms quickly. So I have a few questions (3rd question is most important)

1. I'm not sure the specifics of the test that indicated "Something else" was going on, but I'm guessing it's because of a low blood cell count? If so, that could be anything compromising the immune system right? Or does the second part of a Syphilis test tell something more specific?

2. I'm self employed and thought I could only afford a high 5000.00 deductible plan. As of a week ago I now have insurance, but obviously picked the wrong plan. A few days ago I sent the form to change that to a O deductible higher monthly rate plan, but I have no clue how long this process takes? According to my series of doctor visits at 18 there was a chance I could at some point develop neurological problems (Parent and other family members died of) these "other issues" the clinic was referring to could be related to all this and be chronic. Should I sweat it out not seeing the doctor until my plan changes?

3. If I go in soon to a new doctor, I'm not going to mention the STD clinic visit (Rather not have that on my records, whether things were ok or not), and I can't go back to the first doctor because I went in anonymously and my new insurance will attack me if I disclose this. So what do I say if I go into a new doctor and he asks "Have you recently taken antibiotics for anything"? "Well doctor, now that you mention it I did take some I found lying around ten days in a row, and they didn't do anything for this pain that I hypothetically haven't been treated for". How do I convince him I know something else is going on without seeming like I'm trying to self diagnose?

I'd like some collective input on ANY of these before I pull the trigger. advice? thanks

posted by debu to health (26 comments total)

Advice: don't try to sucker an insurance company after admitting to a pre-existing condition on a public forum. Don't withhold relevant information from your medical practitioner. Vote for socialized medicine.
posted by flabdablet at 8:23 PM on January 22 [2 favorites]

Why don't you just say you had a cold (or similar non-embarrassing ailment) and were prescribed a course of antibiotics?
posted by robcorr at 8:24 PM on January 22

1. You're guessing. See a doctor.
2. Call your insurer and see when the plan takes effect.
3. Your doctor isn't going to make a gestapo-style call to your health insurer to report that you paid cash for another doctor. Don't lie to your physician. See a doctor.
posted by uaudio at 8:27 PM on January 22

Two pieces of advice:
Don't fool around with testicular problems. Mid-20s are a prime time for testicular cancer, for one thing. Seriously. Go to the doctor.

Always be honest with your doctor. Tell him/her about the other visits, other treatments, other tests. Your goal is to help the doctor figure out what's wrong with your body. This is not the time for sneakiness and withholding information. The doctor doesn't care if you went to an STD clinic, and nobody else gets to look at your medical records.
posted by LobsterMitten at 8:30 PM on January 22

If you tell the truth, it may cost you some money.
If you lie, it may cost you your life.

Which is more important to you?
posted by Steven C. Den Beste at 8:31 PM on January 22

Heck, I would explain the situation to the doc- most of them are going to sympathize with you. I am not sure if he has to document it in your chart just because you stated it. YMMV

BUT, if you have something more serious do you really think you want to wait it out? When dealing with my nuts I would assume go bankrupt than lose my balls... or my life.
posted by bkeene12 at 8:32 PM on January 22

You already have the insurance, right? Just find out what your coverage is and go see a doctor. This isn't a "pre-existing" condition according to my meter -- you have been tested for some things and they all came up negative. How is this "suckering" an insurance agency as mentioned above is beyond me. Of course, they're opinion may differ. Admit nothing and get to a doctor as soon as you can and get this sorted out.

Good luck!
posted by amanda at 8:36 PM on January 22

So what do I say if I go into a new doctor and he asks "Have you recently taken antibiotics for anything"?

You say: "Yes, I was prescribed antibiotics when I recently saw a doctor anonymously, before I had the insurance that I have now."

The doctor won't care. If anything, he'll be grateful that you were honest. In fact, if I were in your position, I would definitely go back to the same doctor, who will know what to do next.

Imagine things going south, and six months from now you're on your deathbed, thinking about the sum of your life, your closest friends, and your imminent confrontation with eternity. Is there any chance at all that you'll think it had been worth it to lie in order to save $5,000?

That said...you can just call your new carrier and find out when your new plan goes into effect. It probably happened retroactively from the date you signed the check, or the beginning of that month.
posted by bingo at 8:37 PM on January 22

i feel your pain. literally. i experienced some testicular pain in my early/mid 20s, went to multiple urologists, had my boys ultrasounded, etc.

the best advice i can offer is: don't be shy. these problems are quite common, and you should be able to find a doctor who can help you can talk to you openly and honestly about the issues.

also, unless you can feel a lump ON your testicle, it's probably not cancer. i had painful swollen parts near my testicle that turned out to be a swollen hydrocele and then epididymitis.
posted by gnutron at 8:42 PM on January 22

There are people that are addicted to heroin that talk openly and honestly about what's going on with themselves to their doctor thanks to doctor/patient confidentiality. Be open. Be frank. And if you have concerns – for insurance reasons or any other reason – state it up front when you talk to him/her.
posted by Gucky at 8:57 PM on January 22

"You say: "Yes, I was prescribed antibiotics when I recently saw a doctor anonymously, before I had the insurance that I have now."

The doctor won't care. If anything, he'll be grateful that you were honest. In fact, if I were in your position, I would definitely go back to the same doctor, who will know what to do next."

Yeah, I'd like to go back to the same doctor, we got along well, and he seemed open to everything I said compared to my past experiences. When the receptionist asks "Are you a new patient" I could tell her no, but I don't even remember the false name I used when I paid cash the first time. Seems awkward, but I'd be willing to do it, I'm just concerned about losing my insurance altogether. Also, if some freak malpractice thing happened I'd be totally screwed

My insurance has kicked in I was just waiting for the policy to change over to a better one. The insurance did explicitly ask if I've seen a doctor in the past five years, and I answered No.

I'm having an ethical problem with it all too, but it's not like I ripped the doctor off the first time and when it's my nuts the ends justify the means IMO.

thanks for the opinions so far
posted by debu at 8:59 PM on January 22

Can you describe what these symptoms are that you say are getting quickly worse?

You definitely want to get this checked out. I had testicular cancer, and it's very treatable and generally not a big deal if you catch it early. gnutron is right that it's probably not cancer if you don't feel a lump, but in my case, I didn't feel any lump at all, just one day noticed that it seemed swollen and hard. (You should be checking yourself for this anyway. Mid-twenties is where it's most common. I'm 25.)

There are simple blood tests that can reveal the presence of cancer; ask for them if you're concerned about the possibility. And if they come back positive, don't panic. I'd be happy to talk you through it. Send me a MefiMail; the email address in my profile is too spammy, I rarely read it.

It's most likely something else, though, but you still want to get it checked out. Keep us updated.
posted by CrayDrygu at 9:05 PM on January 22

Also, I think the first doctor was reluctant for further lab testing because I was uninsured. Now that I am insured (With a huge deductible) he, or new doctor, would probably go ahead with these tests I'm guessing. I know insurance companies have things worked out so tests are much less expensive than they are for uninsured. I'm still paying out of pocket until 5000.00. Anyone have an idea of how much insurance rates vs non. are? 10 percent, 25, or something negligible?
posted by debu at 9:08 PM on January 22

The doctor isn't going to run an expensive test without discussing it with you first.
posted by bingo at 9:36 PM on January 22

Steven C. Den Beste writes "If you tell the truth, it may cost you some money.
"If you lie, it may cost you your life.

"Which is more important to you?"

Is this one of your brainstorming answers? I ask because that is a dangerously simplistic view of the american system IMO. There exists the third option where debu both tells the truth and then later dies because he was unable to pay for a course of treatment that his insurance company deemed pre-existing. Even if they are wrong and later end up settling with his estate.
posted by Mitheral at 9:41 PM on January 22 [2 favorites]

debu: The rates probably depends on the insurance company you have, and what sort of deal they have with your provider. In my experience, they were less than half. As an example, one of my treatment sessions was billed at $242, but insurance paid the hospital $114, and no cost was passed on to me.

My total was well over $15k, maybe over 20. Even with a high deductible, if you end up with a serious condition, you'll still benefit from the insurance.

On preview...

Mitheral: Since his initial visit to the doctor was anonymous and paid in cash, as long as it stays anonymous, he should be fine. They won't be able to prove anything, so in essence, it never happened.
posted by CrayDrygu at 9:48 PM on January 22

Debu--if you decide to tell your doctor everything--and I think you should!-- specify that you don't want him to put it in his note. This is not uncommon, but many patients do not know they can request this.

My doctor told me this was an option when I hesitated over some info.

Best of luck to you.
posted by subatomiczoo at 10:18 PM on January 22

Anonymous, a lot of people are talking up thread about the insurance and what to do, but I want to stress one thing:

Don't panic. It's very likely nothing. When I was about 25 I too thought my nuts were going to rot off for a period of a few weeks. I had some discomfort which lasted for a few weeks, enough for me to be concerned. When I saw the doctor he checked me out and found everything to be okay. At the time I had a new, rather *ahem* athletic girlfriend, so there ya go... we gave it a rest and the discomfort went away.

Another friend was convinced he had an STD and submitted to multiple tests. He was worried over a slight burning when he pissed. The doctor told him that he was fine and to stop obsessing over every little twinge and tickle. He was fine too.

The point is, don't panic, but do take the appropriate steps to get yourself checked out - even if that means paying another doctor in cash.

Good luck.
posted by wfrgms at 10:48 PM on January 22

I didn't think that prescriptions could be anonymous. Can they? If your name was on a prescription for antibiotics then your name, the doctor's name, and the date are connected in a database that your insurer has access to. However they'll probably not bother to compare those kinds of records to your application unless and until you have a very expensive condition that they'd rather not cover.
posted by nakedcodemonkey at 10:57 PM on January 22

My name wasn't on the prescription at all, I doubt they check ID unless it's something like painkillers.
posted by debu at 11:04 PM on January 22

The US medical system is crap. There may be a lot wrong with Australia, but at least I can go to a goddamn doctor and get my nutsack poked without having to behave as if I'm trying to sell nuclear secrets to the russkies. But I digress.

I had a similar issue to this about 18 months ago. The pain persisted for some time before I went to a doc. By that stage I had identified it as being specific to the junction of my left testes to the various bits of tubing and the like that plumb it into the rest of my body. I was referred for some ultrasounds. After this I was diagnosed with epididymitis. Inflammation of the epididymus. I was given some anti-inflammatories and told to take them as needed. It worked, the pain went away.

Not all pains in the nuts mean you're about to become the new Lance Armstrong. Sometimes it's just an example of a sensitive part of the body having a little inflammatory glitch. Sometimes it's not. Don't let fear of what it might turn out to be put you off. Get the diagnosis sorted. Good luck
posted by tim_in_oz at 11:44 PM on January 22 [1 favorite]

I can't go back to the first doctor because I went in anonymously and my new insurance will attack me if I disclose this.

Why exactly do you think this is the case?

If it's a pre-existing condition concern, you should read your insurance plan documents to see if they have a narrower definition of pre-existing conditions than HIPAA does. You could also call the company anonymously (I'm sure you can figure out a way to do this), and tell them you have some questions about pre-existing conditions. As it stands, pre-existing condition exclusions require that the condition be one "for which medical advice, diagnosis, care, or treatment was recommended or received within the 6-month period ending on the enrollment date." I have no idea how the absence of a diagnosis plays into that requirement, but you can ask the insurer how they view it. Anonymously.

Also, note that pre-existing conditions exclusions can't last more than a year (18 months if you're a "late enrollee."

I think you might be blowing the likelihood of losing your insurance out of proportion. For one, I don't think any notes about previous clinics are likely to appear on their reimbursement forms. And let's say you tell your new doctor that you went to a clinic, that the STD tests came back negative but they said "something else was going on," that you have no idea what's going on, and you want to get it checked out anew. I guess I'm missing where in that narrative you're going to say, "By the by, I lied to the insurance company about going to that clinic, and I went anonymously for some reason and paid cash, so I'm concerned that this is fraud and I'm going to lose my insurance."
posted by averyoldworld at 7:36 AM on January 23

When you are in the room talking with the doctor, say you have a concern about your sexual health, then say "My new insurance excludes preexisting conditions. May I say a few things without you putting them in my records?". They will know what's coming up, but you haven't yet said anything that they would be required to reveal. If they are uncomfortable with this, find a different doctor, but most doctors won't have a problem with this.

If you revisit the first doctor, don't start talking to the front office staff about how you have been there before, they will get confused and probably end up screwing things up with your insurance.

You have probably signed or will need to sign something giving your insurance company permission to look at your medical records. Doctor/patient confidentiality doesn't stop your doctor from sharing this information. You will need the insurance to pay for treatment if it turns out to be something serious.
posted by yohko at 11:10 AM on January 23

I had a text exchange with a friend who's an Anesthesiologist in another state. His advice was if the doctor viewed it as fraud he may be compelled to report it to insurance company. His words were don't risk being reported, sued, or losing your insurance. I wasn't diagnosed before and people say things off the record often so I'm not sure how it would be fraud? I may not have given him enough info in the text but made appointments with old and a new one. decisions :/
posted by debu at 2:02 PM on January 23

Seconding averyoldworld's suggestion to anonymously call the insurance company. Only the insurance company knows when the insurance company will change the insurance company plan to a zero deductible, and only the insurance company knows what the insurance company considers a pre-existing condition (is it when the condition arises on a cellular/biological level? Later, when the patient first notices the strange green rash? Or even later, when a M.D. has actually diagnosed the condition?). The insurance company will know.

Also, I am uncertain why the OP thought he needed to give a fake name to receive medical care while uninsured. Because he was worried from day one about pre-existing condition exclusions in the event he did ever get health insurance? His question makes it seem like he had no idea he'd eventually get insurance when he made his first, pseudonymous visit.


anymajordude, Americans in the 1930s did band together to create non-profit insurance companies, called Blue Cross/Blue Shield. Many (not all) of the blues are still non-profits. The American health care crisis isn't going to be solved just by filing more 501(c)(3) forms. /derail
posted by hhc5 at 8:46 PM on January 23

"Also, I am uncertain why the OP thought he needed to give a fake name to receive medical care while uninsured. "

Because I thought it might be STD related (It's not) and didn't want that on my medical record.
posted by debu at 5:00 PM on January 25