I knew, with the first welt, that I needed to see a doctor. Without any insurance, however, the idea turned in my head registering with dollars and cents. This was going to be expensive.

A few years ago I was diagnosed with a hyperthyroid. That experience was almost the same as my most recent, except that it was charted with an insurance card. From my primary care physician I went to a lab, for blood work, and then back to my doctor. No answer. She sent me to an allergist, more blood work and tests. I lucked out and was seen by someone at the practice who knew what to look for beyond possible environmental or food allergies. He tested for thyroid antibodies because my symptoms lent themselves to an alternative diagnosis. That was it. I walked away with a prescription and no more problems.

But, at some point, I simply stopped taking the medication. I don’t like medicine. The symptoms never came back until a short time ago. But, like I said, now I would really pay, the kind of payment that requires discomfort in the billfold.

My doctor, different than the family doctor I was seeing a few years ago - that change also due to a new insurance plan - knew I no longer had insurance. She would limit the blood tests and allow me to make payments on the bill if necessary. I told her I knew what the problem was, even what to look for, and after the test came back all I would need is a prescription. It was all in my medical history. She tested my blood - three times - for the wrong thing. I paid for an office visit and am now waiting for a bill from the lab. She ignored, or misunderstood, my concerns and tested for what she thought was wrong, even wanting to begin tests on my liver, all to be billed directly to me.

All the while the antibodies were multiplying in my body, along with painful welts and swelling on my face and extremities. After a week, and waking up unable to swallow, one eye nearly completely swollen shut, I drove to the emergency room. I felt stupid. I wasn’t bleeding, or dying, and I was sitting in an emergency room for something that could have been treated a week earlier had my doctor paid attention. And, I was uninsured. You’re treated differently without insurance. Nothing noticeable, almost unperceptive, but I knew that they knew. I am uninsured.

I explained to the emergency room doctor my history and all I would need is a test for thyroid antibodies. She has never heard of such a thing, and seemed pretty sure I hadn’t either. No, I insisted, it exists, and that is my problem. After some steroids and Benadryl, the swelling went down and the doctor told me to visit a local clinic to get the blood test results. I would have to wait two days. “I can do that for you,” she said, after I explained I had tried the clinic and was a month out from getting an appointment.

I arrived at the clinic a half-hour before my scheduled appointment. There were only a few people there when I walked in, but, after waiting for an hour, then two and then three the place began to fill-up. Two men who were there when I arrived were still there when I left. I had to fill-out forms, then wait. I was called to a side counter to register, and then wait again. Many people greeted each other when they came in, locals I guessed, they knew each other from the neighborhood. I didn’t know anybody. I watched as mothers wheeled their babies into the lobby in strollers. And I watched as they were called for their appointments.

Later I learned I was an “add-on,” meaning the next available doctor that could pick up my appointment would see me. The emergency room physician had done me a favor getting me here, now I waited on the favor of another doctor who wold feel like picking up the folder labeled JONES and see yet another patient during an already busy afternoon.

I was seen, and diagnosed and given a prescription. The doctor was nice, confirming my suspicion that I have Hashimoto’s Disease, and prescribed a thyroid hormone as way of treatment. Luckily, the generic version of the drug is listed with my local grocery store and pharmacist as part of a wellness program where I can get a three month’s supply for less than ten dollars. That will be the cheapest part of this ordeal. The very thing I knew I needed, even the name of the drug and dosage strength, took a trip to my doctor, an emergency room and a clinic to receive. And I get the bill.

Walking out of the clinic with a sheaf of papers in my hands I felt relieved. Better days are ahead, I would have to stay on this medication for the rest of my life, but, that’s all right. Now I would just have to wait for the bills to start arriving.