Medical Rant #3

[LegendKiller]

So, my previous two rants had to deal with medical overbilling.

Now, we come to "preventative medicine".

Why do we even use that word? Since the beginning of time we have tried to diagnose issues and have sometimes succeeded and other times failed. We can do many things to "prevent" issues, yet we do not.

Take for example birth control. Due to the political nature of B-C, it isn't really covered under most medical insurences. Yet, births are. Now, why not just cover $30 pills and not a many thousand dollar birth?

Another example, my wife. For two years she has battled an auto-immune disease that aggressively attacks her thyroid. For two years she has had doctors tell her nothing was wrong except low hormone levels. Then, suddenly, one doctor thinks to have a sonogram done of her thyroid. Low and behold, there are three growths on it!

Instead of finding out what those growths are immediately, they just stick her on another medicine that is supposed to shrink the growths and then sit for 3-5 months and *do nothing* but wait.

Meanwhile she has the stamina of a manic depressant.

They say they can't do anything. I wonder if that's what they told Chief Justice Rhenquist when they initially found growths on his thyroid.


What is so preventative about "wait and see and then die"?

[smeakim]

I feel for you. When I was younger they thought my dad had kidney stones and wanted to see if they would pass. He continued to have problems and went to another doctor which found out it was a tumor (cancer) on his Kidney and it was the size of a grape fruit. Its called HMO they make more by providing less.

Side Note: Most insurances do cover BC at least everyone of them I have ever been on as well as everyone we know.

[LegendKiller]

Side Note: Most insurances do cover BC at least everyone of them I have ever been on as well as everyone we know.


Most of the ones I have ever had or seen cover some, but not all of the cost, more like a 20/80 where you are paying the 80.

[clutchy]

I don't know where people got the idea that insurance was supposed to cover every little thing. Dollar a day pills? doesn't sound like a big deal to me.


you also have to realize that medicine is more knowledge and experience than science. If you get a good doctor then you're in good hands, if not then well good luck.

Auto-immune disorders are sometimes difficult to catch and other times they're not. If she has some problems w/ her thyroid they should just pull it out and start her on a thyroid supplement. You want to talk cheap, those drugs are CHEAP.


if you lived in California I would suggest you come see my dad, he was rated in the top 100 doctors in the chicago land area when he practiced there. He's VERY good.


doctors have also been put in a funny position w/ insurance companies and their own practices. Sometimes they own part of the practice and doing extra tests costs them more money especially if you're a managed care case. So instead of running the battery of tests they'll skimp to save themselves some cash... it's a bummer but that's what happens when you set a system like that. It sounds to me like your insurance/provider is this type.

[LegendKiller]

I don't know where people got the idea that insurance was supposed to cover every little thing. Dollar a day pills? doesn't sound like a big deal to me.


you also have to realize that medicine is more knowledge and experience than science. If you get a good doctor then you're in good hands, if not then well good luck.

Auto-immune disorders are sometimes difficult to catch and other times they're not. If she has some problems w/ her thyroid they should just pull it out and start her on a thyroid supplement. You want to talk cheap, those drugs are CHEAP.


if you lived in California I would suggest you come see my dad, he was rated in the top 100 doctors in the chicago land area when he practiced there. He's VERY good.


doctors have also been put in a funny position w/ insurance companies and their own practices. Sometimes they own part of the practice and doing extra tests costs them more money especially if you're a managed care case. So instead of running the battery of tests they'll skimp to save themselves some cash... it's a bummer but that's what happens when you set a system like that. It sounds to me like your insurance/provider is this type.


$/day or $5000+ for a pregnancy or abortion. The comparison seems a bit odd to me. You could stop a lot of...unplanned...births if you just spent $1/day. The preventative nature is huge but rife with social/moral issues.

Right now she is on the strongest thyroid suppliment made and she is likely to have to go up. They have been "tuning" her for the whole 2 years. The first doc (who was supposed to be the best in FL and was older with lots of experience) just wrote it off as decreased thyroid functioning. The 2nd diagnosed her with the auto-immune, upped and switched her meds, got the sonogram, and added an energy suppliment.

However, now they are just sitting and waiting to see if the growths decrease with the new thyroid medicine. Why not just do a biopsy right away? Figure it out ASAP and then take the next step. Why wait a half a year when, if it is cancerous, it could be causing many more issues.

They know something is wrong, they know there are growths, they know it could be cancerous, but they wait and see. It's so damn frustrating.

Its would be like if a doctor took 4 scopes of my knee and then finally said "Well, lets wait a year and see if your patellar tendon moves over 2cm so your knee cap is more stable" instead of just performing the surgery that they KNOW will fix it.

We have the "best" provider our company offers, if that means anything anymore.

[esme]

unf that's how it goes .....really sucks, but not much you can do

my mom had cysts ....she had gone to so many different doctors and they all said she was fine, nothing was wrong. cysts give you some similar symptoms as a pregnancy so she thought she was pregnant. well, after several pregnancy tests she goes to different doctors which all say the same, "no, you're not pregnant, but there's nothing wrong" except for the pain! finally, the last dr she ends up going to has an ultrasound done and there he finds cysts the size of oranges ....she now has several .....they also start her on meds for about another 6 months .....then after noticing that they are not going away and they might be cancerous, they decide to take them out .....well, she's got a "root" were these cysts will continue to come back even after several surgeries so she ends up having a hysterectomy and wans't able to have children again, she was young when they did this too.

[nickel]

So, my previous two rants had to deal with medical overbilling.

Now, we come to "preventative medicine".

Why do we even use that word? Since the beginning of time we have tried to diagnose issues and have sometimes succeeded and other times failed. We can do many things to "prevent" issues, yet we do not.

Take for example birth control. Due to the political nature of B-C, it isn't really covered under most medical insurences. Yet, births are. Now, why not just cover $30 pills and not a many thousand dollar birth?

Another example, my wife. For two years she has battled an auto-immune disease that aggressively attacks her thyroid. For two years she has had doctors tell her nothing was wrong except low hormone levels. Then, suddenly, one doctor thinks to have a sonogram done of her thyroid. Low and behold, there are three growths on it!

Instead of finding out what those growths are immediately, they just stick her on another medicine that is supposed to shrink the growths and then sit for 3-5 months and *do nothing* but wait.

Meanwhile she has the stamina of a manic depressant.

They say they can't do anything. I wonder if that's what they told Chief Justice Rhenquist when they initially found growths on his thyroid.


What is so preventative about "wait and see and then die"?
you really have to do research and be your own advocate for your health care. it's a battle sometimes.
if one doctor is too busy, or doesn't seem as concerned with you as you think he/she should be then it's time to find a new doc.

and i don't get the not paying for birth control pills by insurance companies either. i think that's crap. i guess the only way to get them free is to go on welfare. :hmm:
i'm not asking for them to be free, but they should be covered by my insurance plan just like other medications are. they shouldn't be exempt.

i agree totally with your rant LK.

[eSDee]

I'm sorry to hear about your wife LK. I hope she gets better.

A friend of mine whose sister is a doctor has always told me that when he goes to the doctor, he tells the doctor immediately what the symptoms are and research he has found out about it. Supposedly you only have the doctors attention the first 30 seconds of the exam, and after that he/she goes into diagnosis mode. Of course your wife couldn't do anything like that but just a general tidbit of information for the rest of us. Say all you can in the first 30 seconds, before the docs start ignoring you.

[molecularfire]

I completely agree with you LK on the lack of preventative medicine in the medical field. I think it is absolutely retarded that we will spend billions of dollars on procedures that we know do absolutely nothing to improve quality life span but we don't spend money on good preventative medicine programs which have been shown in many, many countries to increase life expectancy and quality of life.

[Grimm]

Here's why birth control is not included in medical coverage... it has very little to do with the pro-life movement.

$30 x 12 = $360.

As almost 1/2 the working age population would take birth control it would raise insurance costs significantly. If 85% of women insured by a company took birth control then it would work out to $153/year a person insured (assuming 50% of the employees and their spouses were women). That's a significant chunk of change. When deciding on a health care provider, many corporations will go for the cheaper plan that does not provide coverage for birth control. Enough so that it is not even worthwhile for a insurer to offer a plan that covers birth control.
Then there is liability. What if the birth control prescribed by a HMO doctor fails to prevent a pregnancy (no birth control is 100% effective). How much is that going to cost them in legal fees and settlement costs? That $153 cost will get bumped up quite a bit...

Insurance is there to mittigate unexpected expenses. Health insurance has deviated from that plan somewhat by offering other services that make it cheaper to insure people. It's cheaper to treat people who have regular checkups, so that is covered. But it is not cheaper to provide birth control. Because they will have to pay for the birth control and then pay for the child later when the mother decides to go off the pills and have a child. Offering free birth control will not stop people from reproducing altogether.

[Mommypooh]

I have looked at several forms of birth control and none are covered by my insurance for me to get them most of the cheapest ones are $50 some a month. I have no problem paying 20 or 30 a month for it. It is the extra that kills us. I think that some of the long term ones should be covered due to is is not that big an expense in the over all scheme. for $500 I can have BC for 10-12 years, I think that should be covered. As for child birth the average cost is between 8-15,000 depending on how many people touch your chart, and how many inteventions they do. I also look at the fact that without BC I have kids that are less than 2 years apart, and have cost my insurance over $20,000 where as if they would cover the birth control for the 3 years I would have saved them a lot of money. I am just pointing that out.

I am sorry to hear that the doctors are sitting on their lazy butts and playing russian roulette with your wife's life.

[ray]

Get a 2nd, even a 3rd opinion.

[molecularfire]

A man suffers from terrible headaches. Finally he went to the doctor, who gave him a thorough examination.

"Well, we're not sure exactly what's causing the problem, but we know a cure. You'll have to be castrated."

The man needless to say, was horrified. "No, doctor. Definitely not," he protests, "I prefer to suffer the headaches."

As time passed the headaches got worse and worse and finally he was driven back to the surgery.

"Okay, I can't stand it any longer. I'll have the operation." And so he was castrated.

Afterwards the man was very depressed and his doctor told him, "I recommend you begin a new life; start fresh from this point."

Taking the advice, the man went to a men's shop for new clothes. The salesman greets him and says, "Let's start with the suit. Looks like you'd take a 38 regular."

"That's right", said the man, "How did you know?"

"Well, when you have been in the business as long as I have, you get pretty good at sizing a man up. Now for the shirt... Looks like a 15 long."

"Exactly!", said the man.

"And for underpants, I'd say a size 36."

"Well, there's your first mistake," said the man, "I've worn 34s for years."

"No, you're a size 36 if ever I've seen one", said the salesman.

"I ought to know," the man replied. "I take a 34."

"Well, if you insist," said the salesman. "But they're going to pinch your balls and give you terrible headaches."

Moral of the story... before doing anything drastic, getting a second opinion might not be a bad idea.

I don't know the details of what tests have been done and what the results are but maybe there is a legitimate reason for them to hold off on the surgery...ex:

1) if her thyroid is making too much thyroid hormones they may be giving her meds. to stop the production of the hormone and waiting for the body to use up the ones that are already there before doing the surgery because of the risk of the thyroids getting squeezed during the surgery and all those hormones getting released into her circulation during the surgery which could be very bad.

2) They may be hoping that the meds. could work so they would not have to do the surgery. They generally you don't want to do surgery unless you absolutely have to because of the risk of taking out the parathyroid glands during the surgery which would be very bad because it controls the body's calcium levels.

3) Even if she has nodules, if they are pumping out a lot of thyroid hormones (aka hot nodlues) - that's what I'm assuming when you say that she's got the stamina of a manic depressant... I'm assuming the manic state... - it is very unlikely to be thyroid cancer (they are almost never hyperfunctional).

If you want, PM me an e-mail address and I can send you information on the different thyroid diseases for you to read so you'll have a better idea the important stuff to ask the doctors.

[LegendKiller]

She has hypothyroidism, sometimes she has energy but more often she is very tired. My girlfriend of 7 years ago isn't the wife I have today, which isn't wholly a bad thing, but this stuff really hit her about 4 years ago. Doctors let it go undiagnosed for 2 years after she told them something was wrong the whole time, but they ignored her. It's frustrating to see the change and then, for 2 years, have them keep adjusting her all the while ignoring everything else.

There are approx 3 nodules on her thyroid, each of which has increased in size from initial measurements. She is going into the doc on Jan 4th. The auto-immune disease she has is "Hashimoto's Disease"

My whole issue is this. They *knew* of the nodules 6mo ago. They *knew* they didn't belong there. They *knew* she has had many issues, most of which hasn't been cured by simple hormone replacement, which would rule out a simple fix. Yet, they are on this stupid "wait and see" BS. Tyroid cancer seems to be pretty nasty, depending on the type and degree of advancement.


If she goes in on the 4th and they tell her "lets wait for 3-6 more months to see if it goes down" I am going to step in and stop this crap. I understand that they want to explore the cheaper thing first and want to be sure, but at least take a damn biopsy and see if it is malignant.

[molecularfire]

ygpm

[welfareloser]

She has hypothyroidism, sometimes she has energy but more often she is very tired. My girlfriend of 7 years ago isn't the wife I have today, which isn't wholly a bad thing, but this stuff really hit her about 4 years ago. Doctors let it go undiagnosed for 2 years after she told them something was wrong the whole time, but they ignored her. It's frustrating to see the change and then, for 2 years, have them keep adjusting her all the while ignoring everything else.

There are approx 3 nodules on her thyroid, each of which has increased in size from initial measurements. She is going into the doc on Jan 4th. The auto-immune disease she has is "Hashimoto's Disease"

My whole issue is this. They *knew* of the nodules 6mo ago. They *knew* they didn't belong there. They *knew* she has had many issues, most of which hasn't been cured by simple hormone replacement, which would rule out a simple fix. Yet, they are on this stupid "wait and see" BS. Tyroid cancer seems to be pretty nasty, depending on the type and degree of advancement.


If she goes in on the 4th and they tell her "lets wait for 3-6 more months to see if it goes down" I am going to step in and stop this crap. I understand that they want to explore the cheaper thing first and want to be sure, but at least take a damn biopsy and see if it is malignant.

if you want a biopsy, absolutely demand one. tell em you'll pay for it out of pocket if he thinks it's unnecessary, because it's worth the peace of mind for you. if you know a med student/resident/doctor/nurse who's willing to come along, call in a favor... i'm lucky to be able to grab my husband or one of our friends to drag along on emergency room visits (about twice-yearly events around here :P luckily, there's always someone i know on call...), dr appts, etc.

now, i think what would be best is for you to ask the doc how he came to the diagnosis of hashimoto's and how sure he is; ie, how likely is it to be something more insidious? i was actually just reading up on hashimoto's (yep... reeeeal fun bathroom reading around here) and it's really pretty straightforward. it's something that progresses slowly, *usually* takes a couple of years to diagnose, and remains stable over time. hormone replacement is the standard (really, about the only) treatment, and almost always works out just fine.

i don't know anyone with hashimoto's, but i've known 4 people with hyperthyroidism, two of whom had to have their thyroid irradiated to death and then go on exactly the hormone replacement your friend is on... it's never perfect, but with some tweaking they usually get the patient back to pretty much normal.

it's really, really unlikely that there is anything else going on or any further treatment needed... i know the waiting blows, but they do have to wait a few months to see what the medication is doing so they know which direction to adjust it. the best thing to do now is read up on the disorder so you know what to expect, what questions to ask, and how to interpret the symptoms.

and as for "preventive medicine" ... talk to the conservatives and the insurance lobbyists about why doctors can't get paid for it :hmm:

and, to be fair, most "preventive" stuff is hardly "medicine" ... there ain't no "eat right xercise don't smoke or drink" pill ;)

[LegendKiller]

Well, we got the results back today. After 3 blood tests, 3 sonograms, and a sonogram guided biopsy, they have found 3 growths. One has grown 40x in 6 months, the other two have about doubled. Doc recommended the thyroid being removed and if it tests positive for cancer to have irradiated iodine for the remnants.

She's feeling a bit worse lately, super super dry skin, many other symptoms. They also increased her medication to 225 from 200, she's almost at the highest dose of synthroid.

Cancer % is ~10-20%, factor in her age, the rapid growth, other medical issues, they are saying her chances are much higher that it is cancer.

Luckily, she's young and there is no corellation between thyroid and other cancer incidents.

We finally have answers, just not great ones. Thanks for the tips Welf and all.

[eSDee]

Sucks man sorry to hear that she is still suffering. She's in my prayers.

[Grimm]

Best wishes to your wife. :(

[clutchy]

If she has some problems w/ her thyroid they should just pull it out and start her on a thyroid supplement. You want to talk cheap, those drugs are CHEAP.



I told you to lop that thing out awhile back...

Glad she's doing better, and I hope she recovers quickly and w/o remission.

[ShawnLee]

I'm sorry to hear that man, I hope for the best.

[Burzhui]

damn sorry to hear that, what are you guys planning to do?

[avlena]

sorry to hear it LK - i'll keep my fingers crossed that it works out well!

[molecularfire]

Cr@p, sorry to hear that. Best wishes to you and your wife.

[oblongmelon]

Get a 2nd, even a 3rd opinion.
I agree..and sorry to hear about your wife. Her state of affairs is a disgrace to the AMA, and insurance companies all over the US. I'm not sure of your location, or where you have gone for opinions/treatment-but there are some FABULOUS CLINICS out there that could give you the action you are looking to take. I know within an hour of me in a few different directions we have Upstate Medical (in Syracuse-home of Nickel) and Guthrie Clinic in Sayre Pa..two of the top rated clinics in the United states..perhaps you should try a place like this..if your finances allow. I realize that's the worst part..you pay out the nose and get no results..it's a vicious cycle.

[LegendKiller]

My wife has been going through doctors more than I change my...er..underwear.

We have found out she has a very high chance of cancerous growth. Due to that she was also approved to go see one of the best doctors in the field at Memorial Sloan Kettering in NYC on March 28, with a surgery followed soon.

They are somewhat concerned about the possibility of lymphoma cancer also, along with remnant thyroid cancer.

She is also now on 250micromg of thyroid suppliments.

We are optimistic but I am still a bit worried. The doctor only takes people who are high-risk patients...

http://www.mskcc.org/prg/prg/bios/28.cfm

As far as I know, MSKCC is out of network, so this is going to be a costly procedure. However, we need to seek out the best if we can get it.

[guiseppewv]

you really have to do research and be your own advocate for your health care. it's a battle sometimes.
if one doctor is too busy, or doesn't seem as concerned with you as you think he/she should be then it's time to find a new doc.


:stupid:

You def have to be your own advocate and ALWAYS get a second opinion on serious stuff.

[guiseppewv]

My wife has been going through doctors more than I change my...er..underwear.

We have found out she has a very high chance of cancerous growth. Due to that she was also approved to go see one of the best doctors in the field at Memorial Sloan Kettering in NYC on March 28, with a surgery followed soon.

They are somewhat concerned about the possibility of lymphoma cancer also, along with remnant thyroid cancer.

She is also now on 250micromg of thyroid suppliments.

We are optimistic but I am still a bit worried. The doctor only takes people who are high-risk patients...

http://www.mskcc.org/prg/prg/bios/28.cfm

As far as I know, MSKCC is out of network, so this is going to be a costly procedure. However, we need to seek out the best if we can get it.

Even if it is out of network you have to get the best care possible. You are doing the right thing.

I will say a prayer for your wife.