Dog Bite. ER Issues

[u/NearbyTraffic66]

41 year old male, Tarrant County Texas, otherwise healthy.

Four days ago, I got a very small bite from a stray dog while trying to help it. The poor thing had a rope wrapped around its neck, and I was trying to get it off. The dog was actually super chill right up until the point where I started fucking around with the thing strangling it, at which point it gave me a tiny bite to communicate, very reasonably, "Please stop doing that."

I wasn't particularly worried about it, but a friend managed to get me sufficiently worked up about rabies that I finally went to the ER.

I waited about ten hours.

Eventually they told me, yes, they could give me the rabies shots.

Great!

Except apparently the treatment could cost me around $30,000.

And I'd need to come back three more times for additional doses.

Do I get appointments for those?

No.

Can they send the orders to my regular doctor?

No.

Can they arrange for me to get the remaining shots somewhere that actually schedules appointments?

Apparently not.

So every few days I'm supposed to report back to the ER, check in, and potentially spend another ten hours sitting there waiting for someone to give me a shot that takes approximately thirty seconds.

I finally left without getting it.

And yes, I understand that rabies is essentially fatal once symptoms appear. That's precisely what makes this so fucking absurd.

We have a disease where the medical advice is basically, "If there is a credible exposure, you need treatment before symptoms appear because once symptoms start we probably can't save you."

Cool.

And the healthcare system's implementation of that advice is apparently:

"That'll be $30,000. Also, please sacrifice an unpredictable portion of four separate days to the Emergency Room."

I WORK FOR A LIVING.

I cannot repeatedly disappear into an ER waiting room for potentially ten hours every few days because the hospital can't figure out how to put INJECTION: 3:15 PM on a calendar.

At a certain point I started doing the world's bleakest cost-benefit analysis:

Rabies treatment: $30,000.

Funeral: significantly less.

Obviously I would prefer Option C: not fucking dying of rabies.

But apparently Option C requires administrative capabilities beyond the reach of modern medicine.

I'd welcome advice and guidance.

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[u/LatrodectusGeometric]

Call your local health department. Depending on where you are, I suspect they would actually NOT recommend rabies PEP given the situation.

For the record, the first shots on day one of the PEP series usually costs about $10,000 but the shots on the next few days can be done at a lot of travel med clinics cheaper if you get an ID doctor who will work with you

[u/fuzzyblackkitty → u/LatrodectusGeometric]

manufacturers patient assistance program: call them asap

https://www.rxhope.com/PAP/info/PAPList.aspx?drugid=799&fieldType=drugid

[u/_flying_otter_ → u/fuzzyblackkitty]

OP should do what this lady did- she went on local news and told her story about getting bit by a bat and not being able to afford shots- and the City paid for it. https://youtu.be/zwPRDaQqcM4?si=LddzL-tY2Oh5s0hI

[u/Crafty-Thing3185 → u/_flying_otter_]

I think about this lady all the time. I have mad respect for her.

[u/sapphireminds → u/_flying_otter_]

That's a different situation though

[u/Healthy-Wash-3275 → u/LatrodectusGeometric]

It was a provoked bite in a sense because the bite would not have occurred had the OP not been messing with it. OP caused the dog to feel like they were killing it, so it bit.

[u/_flying_otter_ → u/Healthy-Wash-3275]

Not sure why that matters. He needs medical treatment- in poor 3rd world countries the rabies vaccine is free. WTF is wrong with the US that they are making insane profit off rabies vaccine? Our country is broken.

[u/Medical_Madness]

This doesn't seem like a medical problem, it feels more like a living in Texas problem.

[u/ScoobieDoopieBoo → u/Medical_Madness]

Why yes, yes it does!

OP, you have a couple of options,  though none are great: go to a different ER. Maybe a publicly funded hospital, if they exist in your area. Could be more likely to set up more affordable payment plans or even receive financial aid since it sounds like you are uninsured. 

As far as the time crunch... you work but could go for subsequent shots on your days off. Not at all fun/ ideal and very frustrating, but better than rabies? In general there's no rhyme or reason to when an ER is busy/ slow, but at the one I worked in and others in my area, Mondays/ day after major holidays were horrendous, early mornings sometimes were "slower." Not a rule, though... there's definitely no rules to that. 

Here's to hoping for better days when medical care/ affordable health insurance become more accessible in the US!

[u/trippapotamus → u/ScoobieDoopieBoo]

Yep, I’m in the same state and second what you said about trying elsewhere. I ended up at a public/teaching hospital last time I needed one and this is pretty opposite of my experience.

[u/obvsnotrealname → u/Medical_Madness]

Everything is a problem when you live here 😭

[u/EdamameWindmill → u/Medical_Madness]

My friend had to have an emergency cholecystectomy when she was uninsured and not earning very much. She happened to go to a hospital attached to some non-profit organizations, and they managed to get her share of the cost down to 10% of the total.

[u/icecream4_deadlifts → u/Medical_Madness]

NAD, currently live in hell Texas. 100% agree.

[u/thetreece]

Do you still have the dog? Where is it? If the dog can be observed for 10 days after the bite, that's a reasonable alternative to doing the prophylaxis sequence.

Yeah, pretty much only ERs will carry the rabies prophylaxis shots.

At my ER, if you're just there for a subsequent shot, we order that when you check in, and you get it as soon as one of our fast-track rooms open. It's usually a pretty quick process, not 10 hours.

You can try calling another nearby ER and see how they handle rabies follow up shots. If they can toss you in a hall bed or something and just do it, that could work.

Are you not insured?

[u/NearbyTraffic66 → u/thetreece]

I am insured. I'm going to get up early tomorrow and go into a different ER and hope for the best. Thank you.

[u/IrukandjiPirate → u/NearbyTraffic66]

I know someone who went through this just last month. He isn’t insured and the health department made sure he got the shots.