Three weeks have passed and DH is still alive. Hale and hearty even. We are all grateful and relieved.
So….
Remember how DH helped break up a dog fight and had to get tetanus shots and I purposefully didn’t get the dog’s information because it was an intact pit bull and I didn’t want it to be put to death? (Turns out that is not a thing in this state– they would have just quarantined it for 10 days.)
A month later, DH came back from a business trip feeling nauseated off and on, with a headache off and on, and chills off and on. After reading on the internet about how the incubation period for rabies is 1-3 months but can last up to 6 years, and reading up on the symptoms of rabies, and how you die within 1-3 weeks once symptoms have started (so far only 10 people have survived after symptoms started, and 8 of them had been vaccinated prior to getting bitten), he also developed anxiety and insomnia. Which are also symptoms of rabies. On the fourth day he started getting muscle twitches.
Early on in this process, we’d looked for places to get first of four rabies shots. Walgreens has rabies vaccine, but not the first shot which has human blood in it and isn’t very shelf-stable. None of the urgent care places in town had it. No doctor we were recommended carried it. Everyone said it had to be gotten at the emergency room. DH’s insurance said they do not cover the rabies shot under any circumstances. So to the emergency room it is. This will be a minimum cost of 10K, and I would not be surprised if it tops out at 13K including the cost of the first shot.
At the emergency room they told DH he didn’t need to get the other three shots at the emergency room and recommended a couple of urgent care places or the department of public health. Neither of the urgent care places would give DH the second shot. The department of public health said the emergency room was smoking crack and they never give out rabies shots. They said their protocol was to get the first shot at the real emergency room and to get the remaining three doses at the emergency room place without actually going into the emergency room and seeing a doctor in order to save $.
So I told DH to call the emergency room to make sure that things could work that way. He called, but did not ask about the not seeing a doctor or the money stuff. He just basically confirmed that they had the second shot. Then he went and saw a doctor and had more unnecessary tests done. So… >$20K so far.
I was not annoyed about the first emergency room shot, as I figured that was an unavoidable (albeit expensive) way to decrease DH’s anxiety, but I’m not that happy about the second shot given that he didn’t actually ask about the protocol the department of public health suggested. He did talk to the emergency room billing again after, but they basically said they couldn’t talk to him about the bill until after it had been refused by his health insurance. So there’s some hope he might be able to negotiate it down. But who knows.
When he got his second shot, he got all the info about the shot (and the third and fourth shots) and it turns out those are exactly the same ones they give out at Walgreens as pre-rabies vaccines, so he could have just gone to Walgreens for the second shot and been done after paying $350. Which he did for the third and fourth (and final) shots. So $700 paid on credit card.
I don’t know when we’re going to get our actual insurance bill for the emergency room visits. If we do end up paying more than $20K, that puts a really big bite into my car fund in addition to cutting into the emergency fund. Which I guess makes the choice of cars easier as the options become much more limited.
So, you ask, why didn’t you just get the information for the pet owner? It takes at most 11 days for an unvaccinated dog to die of rabies. If the dog is still alive, then DH didn’t get rabies.
Well, we didn’t have the contact info for either of the dogs. We posted on nextdoor (the neighborhood social media site) and on day 3 an anonymous neighbor pointed us in the direction of the golden retriever owners. They were very nice about everything and gave us the contact information that night for the pitbull owner, but warned us that they thought the pitbull owner’s house was for sale. And indeed it was. For sale and empty of furniture. DH tracked down the facebook page of the dog owner’s son which was blank, and then to the son’s wife which had lots of oversharing posts. The posts mentioned the grandparents moving to the closest city (~2 hours) and it sounded like they were taking a dog with them, though no guarantee it was the dog in question. But also no mention of sad dog deaths in the previous month. The son’s wife did not respond to a FB friends request or any of DH’s queries.
We also called the agency that handles dog licensing in our county, since your rabies vaccines have to be up to date to be licensed. But of course the dog wasn’t licensed. So that, too, was a dead end.
On the morning of DH’s second shot, DC2 woke us up to let us know zie had thrown up in the night, the first of several throwing of ups. As I groggily listened to hir, I realized I too felt nausea. The nausea came and went. So did a headache. And chills. All three symptoms would come and go randomly, seemingly completely unrelated to each other. The chills were particularly disturbing. I can understand how DH thought something out of the ordinary was happening. (Though it turns out this weird virus has just been going around– it doesn’t last as long for most people because most people sleep instead of googling things that cause anxiety. DC2 was better in a day and I was completely better by day 3.)
And that is our expensive and exasperating story. My colleagues think it’s hilarious, and indeed, it is hilarious given that DH is still alive and we’re not going to have to go into major debt, just buy a cheaper car or sell some stocks. Most insurance companies don’t cover rabies vaccines for people because they’re expensive and usually they’re just being given as anti-anxiety shots. (Obviously if you’re bitten by a wild animal, you should get them if they can’t autopsy the animal in question. But for pet dogs who are behaving nicely towards humans, not as clear.)
Morals: If you’re breaking up a dog fight, use water, or lift the back legs of each animal. Do not mess with their mouths. If you get bitten by a pet dog, get the name and contact info for the @#$23ing dog so you can see if it dies in 11 days or not. If you do get the series of four shots post-bite, get the first one in an emergency room and the remaining 3 at Walgreens (using a different schedule than the one that Walgreens will want to use– talk to the emergency room doctor about the schedule for all four shots).
May 6, 2019 at 2:53 am
Jeez Louise! That’s gotta be terrifying to think you’re gonna die of rabies!! Glad he’s OK!
May 6, 2019 at 5:48 am
Us too!
May 7, 2019 at 4:23 pm
Very scary! I’m glad DH is all right. Had no idea that the rabies shots were so expensive and not covered by insurance.
May 7, 2019 at 7:29 pm
Us either!
May 6, 2019 at 5:44 am
Oh dear, I am so sorry. Glad you had the resources to deal with this, and I share CPP’s sentiments. But how annoying on so very many levels.
May 6, 2019 at 5:47 am
During our various google searches trying to figure out what to do, we found a ton of articles about people in debt because of bat bites that their insurance wouldn’t cover. That seems wrong.
May 6, 2019 at 11:01 am
Um, yes. Really, really, really wrong. Yikes.
May 6, 2019 at 6:27 am
Yikes!
And it really does seem wrong not to cover rabies shots.
May 6, 2019 at 6:29 am
In this specific case, the insurance company was right– it was a big unnecessary expense. The dog was friendly to DH. We could have worked harder to get the dog’s info early on so it could have been quarantined. But as a blanket rule, it isn’t good.
May 6, 2019 at 10:44 pm
Of course, you’re not going to gamble with a fatal illness. It seems to me that if all of these shots were indeed clearly unnecessary and just for DH’s peace of mind, then the DOH and the emergency room doctors really dropped the ball, as they should have told this to DH before he spent $10,000+ the first time and then had the additional vaccines. DH should not be expected to know this.
Also, with a bill that large, you can probably get the hospital to let you spread out the payments if you want and if it will help you avoid having to dip into savings/sell stocks. And I don’t know if you want to go this route, but the dog’s owner may be liable for DH’s medical bills due to the dog bite.
May 7, 2019 at 6:04 am
They did tell him that it was highly unlikely. But the only way to know for sure is to take a brain sample, or to determine that the dog did not die.
We have the money because I have been planning to buy a car this summer. Definitely do not want to deal with the dog owner.
May 6, 2019 at 7:20 am
Oh gosh, I’m glad you guys are all okay but that does sound like it was a terrifying and confusing month.
My insurance company once refused to cover an HPV blood test because it was done the same day as a Pap smear. I hate arguing over test coverage with the insurance company and my PCP now likes to order unnecessary tests I didn’t ask for and the insurance company won’t cover.
May 6, 2019 at 7:43 am
That’s super irritating.
May 7, 2019 at 4:02 am
GOVT HANDS OFF MY HEALTH CARE DEATH PANELS HENNMGGGGGHHHHH!
May 6, 2019 at 8:27 am
Yikes! I’m glad DH is okay, but what a pain. And thanks for the tips about breaking up a dog fight–I wouldn’t have known what to do either.
May 6, 2019 at 8:52 am
I knew what to do (not the legs thing) but I couldn’t find the hose! And DH was too distracted to tell me it was locked in the shed (also I think he has the key on his key chain).
May 6, 2019 at 12:04 pm
Even if insurance won’t cover the cost of the shot(s) & ER visits, be sure that the hospital only charges you the negotiated rates for your insurance or the cash-pay amounts – which should be approximately 1/3 of what they bill the insurance company.
May 6, 2019 at 12:10 pm
We will keep that in mind! We’re hoping for a bigger discount than the negotiated rates, and from past experience we know that they don’t have a specific “cash pay” amount for the ER– it depends a lot on how many people you are willing to have in-person meetings with.
May 6, 2019 at 12:52 pm
Thank goodness DH doesn’t have rabies! How crappy that he had to be the first one to catch the virus and therefore think he had it and had to go through all that nonsense and expense.
I’ve broken up multiple dog fights safely and yet every single time I forget to do it the smart way. SMH. I don’t know why my common sense fails me in those moments but I’m grateful I haven’t paid the price in dog bites or scratches. PiC was a bit of a wreck after breaking up Sera’s overreaction to a dog snapping at her but he wasn’t bitten, just terribly scraped up.
Usually, when fights involved my own dog, I would yell REALLY loud if we have no water access since loud noises can startle them into breaking off if they’re just reacting at each other and not truly aggressively going for it. The back legs thing works much better when the other owner has enough presence of mind to help, so it would be a good thing to get them to do the same thing, otherwise you’re just making one of the dogs a slightly better target for the other one. Which isn’t a bad thing if the other dog isn’t the aggressor and is just protecting itself or their owner!
May 6, 2019 at 1:15 pm
The 10 year old was yelling super loud– that’s how DH knew to run out there. I guess I could have tried clapping close to the dog’s ear, but I was still trying to source a hose (DH’s hands were full!).
May 7, 2019 at 11:05 am
I’m sure you all did the right thing in the moment with what you had! Not all things work with all dog fights. I was mainly mulling over why I so fail at remembering all the smarter things to do when I’ve seen many of these.
May 6, 2019 at 3:26 pm
I had no idea about this but there seem to be a lot of articles online about how the rabies vaccine is so expensive and not generally covered by insurance (e.g., https://www.vox.com/policy-and-politics/2018/2/7/16851134/rabies-treament-expensive-emergency-room). My understanding is that if it is not covered at all by your insurance there would not be a negotiated discount, but perhaps you would still be able to get a discount on the emergency room and facility fees. It does seem to be covered by Medicare Part D–I wonder if you could use that rate to negotiate the fees down.
Around here in upstate NY, we periodically have news involving attacks by rabid wild animals (bats, deer, coyotes, etc.) and even a rescue cat at a shelter. Any contact with a bat is presumed to have resulted in rabies exposure. If you think you may have been exposed to rabies, you’re supposed to contact the Department of Health. Interestingly, I found this statement on the NYS DOH website: “Each county outside of New York City is required by the state to authorize all treatment of individuals who have been exposed to the rabies virus within their county. With this prior authorization, it is likely that you will not have to pay for the cost of treatment. Without prior authorization, you may be responsible for treatment expenses.” Since you’ve already contacted your own DOH, maybe they can help out with getting some coverage.
May 6, 2019 at 3:52 pm
Sadly we live in a red state. All the doctors thought the DOH gave out the last 3 shots but they never have done so.
May 6, 2019 at 4:59 pm
Ten thousand dollars for a rabies shot??? WTF is wrong with the US medical system. (Aside from the obvious)
May 6, 2019 at 5:42 pm
10k for the emergency room visit. Another 2 or 3 k for the first shot.
May 6, 2019 at 7:06 pm
Very similar thing happened to my husband – got bit by dog and didn’t get information. I FREAKED out when he got home, so he started looking. Luckily, it was a pretty distinctive situation – it was a pack of three dogs off leash owned by a deaf guy in a park in a fairly remote location. The local animal control was able to locate them and quarantine them for the 10 day period – no rabies. Thank goodness. But 100% agree with your moral – if you get bit by a dog, GET CONTACT INFORMATION. No matter what. You never know.
May 7, 2019 at 6:07 am
The DOH sent us a letter after DH got the tetanus shot telling us we needed to find the dog so it could be quarantined.
May 7, 2019 at 11:27 am
WOW!
Learned a lot from this.
Glad no rabies.
WOW!!!!!!
May 7, 2019 at 11:39 am
Wow so sorry you guys went through that, it all sucks
May 7, 2019 at 1:01 pm
it would have been worse if DH actually had rabies, though!
May 7, 2019 at 5:22 pm
Glad your spouse doesn’t have rabies and now he’s been vaccinated and wouldn’t need the IgG again! My spouse was exposed to a bat last year but had already been vaccinated and so just needed the actual vaccine (which our health dept DID supply!)I
For some more healthcare cost outrage let me recommend this paper, which estimates the total PEP cost including IgG as $177 per person. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4743100/
May 7, 2019 at 7:26 pm
Yup, if this happens again he can go straight to Walgreens for the booster!
May 7, 2019 at 6:21 pm
Wow! I’m glad he does NOT have rabies, but I can understand how the decisions you made were optimal, given the information you had.
I wonder how health insurance companies should handle situations like this. “Never under any circumstances” seems to be too hard line, but I see the point about the shots being very expensive anxiety treatments. I would err on the side of saving lives, though!
We’ve done the whole grab the hind legs part, but as Revanche points out, you need a second person grabbing the other dog, or the fight doesn’t stop. It worked fine at puppy socials (yes this is a thing we did!) when everyone was instructed this at the beginning, and we were just dealing with puppies…
In real life.. We’ve had two incidents with our dog. In one case my husband was there, and smartly did the hind leg thing. The other dog was smaller, so even though he kept coming at my dog (who was now restrained and hanging by his hind legs basically), the 2nd dog wasn’t able to inflict any real damage. The other owner eventually gained their cool and pulled the other dog away to end the fight. The second situation was similar-ish – a pretty small dog ran up to my larger dog, who was on leash. (I think the small dog initially had good intentions, but didn’t have the social skills to take “no I don’t want to play” for an answer.) My dog was restrained by a leash the whole time. I was there instead of my husband, and stupidly tried to use my leg to separate the dogs, and got bit by my own dog. Luckily, I knew he did not have rabies (and also knew he did not die within 11 days of the incident). The other dog finally ran away off after my dog nipped his ear, and honestly, I still can’t blame him. I’m not sure how else the interaction would have ended.
May 8, 2019 at 11:36 pm
Oh geez, I missed this when it happened! I am so glad your DH is OK! I am not a dog person and would have no idea what to do to break up a dog fight. Pretty much my only “avoid rabies” info is NEVER TOUCH A BAT. Having never been remotely tempted to touch a bat, that is easy advice for me to follow.
And now I’m going to ask my sister what my county does about rabies shots. I have a vague impression you can get them from the county here, but I suspect it is a sliding scale payment like the more prosaic shots they offer.
May 27, 2019 at 1:51 am
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