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Medical Forum / Diseases and Disorders / Breast Cancer / June 2006Surgery FINALLY scheduled
Well, it's finally scheduled and all funded. Whew. It will be 2 months from the time I first found the major mass in my breast, but I made enough noise and with help from dear friends (and you know who you are <g>), I got funding. My pre-op is scheduled for Monday, at 3:45, at Florida Hospital and my surgery will be the following morning at about 8:30. They'll tell me the time for sure, when I go for the pre-op. My surgeon is Dr. Vijay Ferris and both my husband, Allan (also known as TFM® in certain usenet circles) and I like him, which helps. Florida Hospital isn't known for it's quality care, but I have a skilled surgeon and it's outpatient treatment, so at least I don't have to stay overnight. (Besides, the hospital is a vegetarian hospital! How dare they? <grin>) Here's my surgeon's webpage: http://www.epmc.org/Physicians/docdetails.asp?DocID=181 You can read about him here. So, that's it folks! Wish me luck. I'm scared, but I'm going to fight this and because of my trials, I have vowed to be a breast cancer awareness spokesperson so that no one else has to fight this hard to get medical coverage. kili Good luck! > Well, it's finally scheduled and all funded. Whew. It will be 2 months > from the time I first found the major mass in my breast, but I made enough [quoted text clipped - 21 lines] > > kili Good luck! J, will you mail me please, my addy is valid. Mary > "J" <burglar_of_turds@yahoo.com> wrote in message > [quoted text clipped - 3 lines] > > Mary You want me or the turd burglar (who is pretending to be me) ? J >> "J" <burglar_of_turds@yahoo.com> wrote in message >> [quoted text clipped - 6 lines] > You want me or the turd burglar (who is pretending to be me) ? > J I want the real J, who has asked me to be kept informed about Spouse. That could be an identifier :-) Mary >Well, it's finally scheduled and all funded. Whew. It will be 2 months >from the time I first found the major mass in my breast, but I made enough >noise and with help from dear friends (and you know who you are <g>), I got >funding. Thank God for that, and thank your dear friends as well. >My pre-op is scheduled for Monday, at 3:45, at Florida Hospital and my >surgery will be the following morning at about 8:30. They'll tell me the >time for sure, when I go for the pre-op. Hurrah! The sooner the better. >My surgeon is Dr. Vijay Ferris and both my husband, Allan (also known as >TFM® in certain usenet circles) and I like him, which helps. Florida [quoted text clipped - 10 lines] >spokesperson so that no one else has to fight this hard to get medical >coverage. Good for you! Still praying, Geraldine Wishing you the very best, Kilikini. So glad you've finally arranged treatment. Thoughts and prayers are with you. Barb I had to wait six weeks for my biopsy to my mastectomy. That is standard time. Can you share with us how you got funded? What was the magic trick? Did you file for medicaid? Good luck with your surgery. Alex PS hoping for negative results! > Well, it's finally scheduled and all funded. Whew. It will be 2 months > from the time I first found the major mass in my breast, but I made enough [quoted text clipped - 25 lines] > > kili > I had to wait six weeks for my biopsy to my mastectomy. That is standard > time. > Can you share with us how you got funded? What was the magic trick? > Did you file for medicaid? > > Good luck with your surgery. Alex I'll be more than happy to tell you the magic secret if it helps any other woman out there. Healthy Women Today fully sponsored me. Granted it was through the work of a surgeon friend of mine way up in Missouri. He made a special plea to one of his friends, who made a special plea to one of HER friends, who made a plea to her friend and I got fully funded. Basically, you have to know someone.....which I think, stinks. I'm going to change this, folks. If there is nothing else I do in this world, I'm going to get this changed. I want every women out there to be fully funded if they find a lump. I've talked to my state representatives, I've written the governor, I've written to Oprah, I've written Montel.......... Anyone else have any idea where else I can go to try to make a difference? kili > I'm going to change this, folks. If there is nothing else I do in this > world, I'm going to get this changed. I want every women out there to be > fully funded if they find a lump. No, thats too broad an indication. All those young women with benign lumps! First the biopsy. Make it: All women with a positive lump should be funded.. > I've talked to my state representatives, > I've written the governor, I've written to Oprah, I've written > Montel..........  Signaturemadiba >> I'm going to change this, folks. If there is nothing else I do in this >> world, I'm going to get this changed. I want every women out there to be >> fully funded if they find a lump. > No, thats too broad an indication. All those young women with benign > lumps! First the biopsy. > Make it: All women with a positive lump should be funded.. That's a noble objective, but realistically, why should taxpayers fund care for breast cancer patients only, and not for others with serious diseases? SignatureJohn Richards > "madiba" <down@thekraal.com> wrote in message news:%down@thekraal.com... > > [quoted text clipped - 8 lines] > care for breast cancer patients only, and not for others with serious > diseases? Because its Kilikini doing the work, not Joan of Arc! She has a specific mission, lets not expect her to find a fix for all the problems in american health care.. Signaturemadiba >> "madiba" <down@thekraal.com> wrote in message news:%down@thekraal.com... >> > [quoted text clipped - 12 lines] > She has a specific mission, lets not expect her to find a fix for all > the problems in american health care.. I think you're missing my point. Kilikini is certainly entitled to petition her elected representatives or anyone else for whatever she wants. But unless American voters perceive the proposed legislative change as fair, there is not a snowball's chance in hell that it will pass. SignatureJohn Richards "> I think you're missing my point. Kilikini is certainly entitled to petition > her elected representatives or anyone else for whatever she wants. > But unless American voters perceive the proposed legislative change > as fair, there is not a snowball's chance in hell that it will pass. John I see your points, I have worked most of my life and times 2 jobs at times to meet my obligations. The American system is based on if your are healthily you work. I'll fight tooth and nail not to pay more taxes. Cancer does not mean you are disabled unless you have advanced cancer. Why should I pay more so people who choose not work can have great benefits. I do think people who can't take care of themselves due to circumstance beyond there control should be helped ( Medicaid Program). Either we have universal health care for all, or healthy people need to work ( and lower income workers can get assistance to have reasonable insurance premiums). In my state if a worker is unable to pay the premiums due to illness, the state will pay the premiums to keep them insured, which I think is a reasonable why to go. Alex > "> I think you're missing my point. Kilikini is certainly entitled to > petition [quoted text clipped - 21 lines] > > Alex All I'm saying is that I think surgery should be considered funded when there is a suspicion of cancer. As it stands, American Breast Cancer Foundation and most of these other Nationally funded agencies cover intial surgeon's consult, diagnostics and needle aspiration biopsy, but not the surgery itself! Why? Why can't this be changed? Why can't more federal money be put into these organizations? That's what I want changed. 22,000 women die each year because they can't get to the surgery phase of their treatment. That's completely insane! That's what I want to fix. kili > All I'm saying is that I think surgery should be considered funded when > there is a suspicion of cancer. As it stands, American Breast Cancer [quoted text clipped - 7 lines] > > kili Where you get that figure? That seems very high? What happend when they are diagnosed who is going to pay for their treatment. Many Americans have access to Health insurance, yet elect not to pay for the "insurance" since it is too expensive. Yet these same people have high speed internet access, cable tv including preminum channels like HBO, and eating like a gourmet champ. Instead of getting a second job with insurance they want taxpaying citizens to fund their lifestyle. America has a safey net called Medicaid. I have never seen a needing person turned away. People who don't fill out the required paper work because they work under the table or want to preserve their second home do have issues. Chumps like me pay taxes and higher preminums to support the people who choose not to have insurance. Alex > > All I'm saying is that I think surgery should be considered funded when > > there is a suspicion of cancer. As it stands, American Breast Cancer [quoted text clipped - 21 lines] > > Alex I didn't choose not to have health insurance. I moved to Florida because I met my husband on Usenet 2 years ago and when I moved in, we didn't have enough money to get a car for me; I flew here to Florida from Maui and I left all, and I mean ALL my belongings. Plus, we kind of live in the sticks. It's about an hour away from any real job. I don't qualify for medicaid and I'm just peddling as fast as I can. I'm trying to help any other woman in my situation. For what it's worth, my whole "doctor-stuff" is privately funded by organizations and doesn't cost tax payers one dime. THAT's what I want to have happen for everyone and I'm going to fight for it. kili > > I didn't choose not to have health insurance. I moved to Florida because I > met my husband on Usenet 2 years ago and when I moved in, we didn't have > enough money to get a car for me; I flew here to Florida from Maui and I > left all, and I mean ALL my belongings. Plus, we kind of live in the > sticks. It's about an hour away from any real job. I don't mean to castigate you personally, but one should always plan ahead such that at least one person in a household has a job that qualifies for family health insurance coverage. I've had to go through a lot of hardships (such as working my way through college) so I could attain that type of employment. SignatureJohn Richards > All I'm saying is that I think surgery should be considered funded when > there is a suspicion of cancer. As it stands, American Breast Cancer [quoted text clipped - 4 lines] > women die each year because they can't get to the surgery phase of their > treatment. That's completely insane! That's what I want to fix. If I'm not mistaken, American Breast Cancer Foundation is funded by private donations, not government funds. Their current budget level is not sufficient to pay for surgery. As far as providing government funding, that would require controversial new legislation. The question that you will be asked is: "Why cover breast cancer surgery and not heart bypass surgery or kidney transplants?" It's an issue of fairness. We taxpayers can't fund one specific type of surgery without also funding all the other life-saving surgeries, and that can't be done unless we switch to the type of single payer, socialized medicine that Canada and England have. The chances of that happening in the US are pretty remote. SignatureJohn Richards > John > I see your points, I have worked most of my life and times 2 jobs at times [quoted text clipped - 10 lines] > illness, the state will pay the premiums to keep them insured, which I think > is a reasonable why to go. I think that's a legitimate reaction. It's quite common for people to remain on jobs they would rather leave simply to secure their health benefits. I did. In fact, I have never personally known anyone who did not have health insurance - it seems such a dangerous thing to do if you live in the US. But Kilikini's situation posed a moral dilemma for me - her symptoms were such that if she were covered, she would have received immediate attention. She didn't just have a questionable lump but a series of other very troubling problems. I don't think we just let individuals lay by the wayside when their health is so endangered even though we may question their wisdom in not securing coverage. The punishment for lack of coverage should not be the death penalty. We do something for them, then lecture them later about a more responsible approach. If she is diagnosed with cancer, and I sincerely hope that will not be the case, I wonder whether she can now get insurance, given a pre-existing condition? Lois > > John > > I see your points, I have worked most of my life and times 2 jobs at [quoted text clipped - 35 lines] > > Lois That's exactly my dilemma now, Lois. I can't get it. Even if we could afford it on my husband's, which would be $327 a month, *prior* to my diagnosis, I don't know if I can get it. This is what I want to fight for. Coverage for people who can't afford it and coverage for post-treatment. BUT, I don't want it coming from tax-payers pockets, I want it coming from the government's abundance. Heck, they pay billions to other countries. Give us some. kili > That's exactly my dilemma now, Lois. I can't get it. Even if we could > afford it on my husband's, which would be $327 a month, *prior* to my [quoted text clipped - 8 lines] > > kili (Well, in fact the source of the government's abundance is the tax-payers pockets. :-) It's a question of priorities, isn't it.) In any case I'm wishing for the best outcome (on Monday?). I have been praying that you would find a solution. Now that you have, we can hope that you will eventually get the best possible news. Lois > > That's exactly my dilemma now, Lois. I can't get it. Even if we could > > afford it on my husband's, which would be $327 a month, *prior* to my [quoted text clipped - 17 lines] > > Lois Thank you, Lois. I'm really nervous, but heck, if they can fix this eternal pain in my armpit (lymph nodes), I can handle it! kili From a (mostly) lurker, ] Kili, First of all, I want to wish you the best of luck with your surgery. Now, there's just one little thing I wanted to point out. You said: > BUT, I don't want it coming from tax-payers pockets, I want it coming from > the government's abundance. Heck, they pay billions to other countries. > Give us some. So where does all that government abundance come from? Isn't it the tax payers? If nothing else, you have certainly set off a lively discussion about health insurance. In my own case, I was "lucky" because five and half years ago when I needed a lumpectomy, followed by a mastectomy, followed by 8 chemo treatments and 35 radiations, I was covered by Medicare (over 65) and a supplement that cost me $50/month. Everything was paid for, including the 8 chemo treatments which cost between $3,000 and $4,000 EACH. I don't even know what the radiation cost, but it must have been way up in the thousands. Considering Medicare, our government pays for a lot. Is it enough? Well, I will go no further. Right now I don't want to argue with a lady who is about to go into the hospital for surgery. You will be in my thoughts and I hope you let us know the outcome as soon as possible. S.K. > "madiba" <down@thekraal.com> wrote in message news:%down@thekraal.com... > >> > [quoted text clipped - 17 lines] > But unless American voters perceive the proposed legislative change > as fair, there is not a snowball's chance in hell that it will pass. I understand the problem, hence my suggestion. By keeping costs down it would have a slightly higher chance of getting thru than the snowball you mentioned. Selling it to the voters is lawyers/politicians work. Signaturemadiba . >> But unless American voters perceive the proposed legislative change >> as fair, there is not a snowball's chance in hell that it will pass. > I understand the problem, hence my suggestion. By keeping costs down it > would have a slightly higher chance of getting thru than the snowball > you mentioned. Selling it to the voters is lawyers/politicians work. Has been tried many times. Yes a single payer health care system would cut costs. But the side effect would be millions of people unemployed. Also Americans like choice which a single health payor system would limit choice. Alex > Has been tried many times. Yes a single payer health care system would cut > costs. But the side effect would be millions of people unemployed. Also > Americans like choice which a single health payor system would limit choice. ---------------- For example, if I'd lived in the UK I wouldn't have gotten Herceptin and I might not be talking to you now. I always envied people who lived in countries with universal health care until I found out about that. Eva > > "madiba" <down@thekraal.com> wrote in message news:%down@thekraal.com... > > >> > [quoted text clipped - 20 lines] > would have a slightly higher chance of getting thru than the snowball > you mentioned. Selling it to the voters is lawyers/politicians work. The fundamental problem lies with Americans' attitude to taxation. They are not willing to tax themselves to the extent necessary to provide a viable health system - foolishly in my opinion - since they wind up paying for the current system in higher costs and less than world-class healthcare. Lois > > > "madiba" <down@thekraal.com> wrote in message news:%down@thekraal.com... > > > >> > [quoted text clipped - 33 lines] > > Lois Exactly. DING, DING, DING! kili > The fundamental problem lies with Americans' attitude to taxation. They are > not willing to tax themselves to the extent necessary to provide a viable > health system - foolishly in my opinion - since they wind up paying for the > current system in higher costs and less than world-class healthcare. As Alex remarked, most people in the US are covered by insurance obtained through their employer. I belong to an HMO and pay premiums of only $93 per month (my share) which entitles me to unlimited world-class healthcare. So what is so wrong with that picture? SignatureJohn Richards > I understand the problem, hence my suggestion. By keeping costs down it > would have a slightly higher chance of getting thru than the snowball > you mentioned. Selling it to the voters is lawyers/politicians work. "By keeping costs down" I understood you to mean we should cover only diagnosed breast cancer. But why cover breast cancer surgery and not heart bypass surgery or kidney transplants? It's an issue of fairness. We taxpayers can't fund one specific type of surgery without also funding all the other life-saving surgeries. But that would open up Pandora's box. John Richards I'll be more than happy to tell you the magic secret if it helps any other > woman out there. Healthy Women Today fully sponsored me. Granted it was > through the work of a surgeon friend of mine way up in Missouri. He made [quoted text clipped - 10 lines] > I've written the governor, I've written to Oprah, I've written > Montel.......... Thank you for sharing, I could not find the details of the program, but you need to plan ahead. If you have cancer you need to probably find another source for ongoing treatment. Medicaid will pay for your care if you fit the income qualifications. If you income is over you can spend down until you qualify. The easiest way is to get private insurance. Many jobs will let you get insurance working part time such as Starbucks. Your husband can work part time so you don't have to go through this again. If you are cancer free, get a job with insurance, there seems to be plenty at the hospital near you. Good luck with your surgery. Alex > Well, it's finally scheduled and all funded. Whew. It will be 2 months > from the time I first found the major mass in my breast, but I made enough [quoted text clipped - 9 lines] > Hospital isn't known for it's quality care, but I have a skilled surgeon and > it's outpatient treatment, so at least I don't have to stay overnight. My sympathies -I assume this is a tumorectomy, not a biopsy. You go home even if they take out all the LNs from your armpit? > (Besides, the hospital is a vegetarian hospital! How dare they? <grin>) > Here's my surgeon's webpage: > http://www.epmc.org/Physicians/docdetails.asp?DocID=181 You can read about > him here. Interesting hospital, the radiology dept seems to be run by techs.. Suppose thats why its called an 'imaging service', the images are sent elsewhere for reporting. > So, that's it folks! Wish me luck. I'm scared, but I'm going to fight this > and because of my trials, I have vowed to be a breast cancer awareness > spokesperson so that no one else has to fight this hard to get medical > coverage. > > kili I'll be holding thumbs for you on Tuesday. Signaturemadiba > > Well, it's finally scheduled and all funded. Whew. It will be 2 months > > from the time I first found the major mass in my breast, but I made enough [quoted text clipped - 20 lines] > Suppose thats why its called an 'imaging service', the images are sent > elsewhere for reporting. Oh, it's the worst hospital, if you can call it one. But, my surgeon will be the same no matter what hospital I go to and it's outpatient, so I'm not worried. If I had to spend the night, I'd be worried! > > So, that's it folks! Wish me luck. I'm scared, but I'm going to fight this > > and because of my trials, I have vowed to be a breast cancer awareness [quoted text clipped - 6 lines] > -- > madiba Thank you! :~) kili For those of you in socialize medicine countries, I have news for you. Your system is less then perfect. My experiences: My daughter did an exchange in University to Australia where we had to pay $500 dollars in healthcare fees despite the fact my daughter was fully insured ( and we could produce evidence of coverage). She thought she sprained her ankle and went to the local emergency room where she was turned away X2 times by the clerk. Was told that there was no treatment for a sprained ankle. Her friend had to rent crutches with no instruction on how to use. A few weeks ago, after numerous md visits, PT, steroid injections, MRI, etc....she had the last resort an ankle arthroscopy. She was in agony preop due to the fact she had to stop the Advil. Result is that she had high impact injury with scar tissue ...I can only think if she had proper treatment in the country that treats everybody she would not have had the pain and surgery. I have taken care of Canadian patients who had car accidents, in the US. They had bought supplemental insurance for there travels. The Canadian company insists on transferred patients thousands of miles but they are medically ready, and remember this is the barbaric US where we don't treat patients right. These are trauma cases where the patient are vented and have multiple breaks and unstable spine. The resolution is the US hospital has to eat the cost of these patients until the attending doctor feels comfortable allowing the patients to travel....perhaps this is the one of the reasons for the $2K emergency room visit? I rather have a system where people are treated, granted non emergent cases may have to jump through hoops. Then a system where people are turned away at the door or make seriously patients travel long distances for care. > For those of you in socialize medicine countries, I have news for you. Your > system is less then perfect. [quoted text clipped - 14 lines] > only think if she had proper treatment in the country that treats everybody > she would not have had the pain and surgery. You must differentiate between 'healthcare for all' and the brit. Commonwealth el cheapo version. :-/ In continental western Europe your kid would not have been triaged by a clerk (or a nurse for that matter), a doctor would have determined whether she needed assistance. She would not have got an MRI or an arthroscopy that day, but she would most likely have been x-rayed and/or (depending on her age) soft-tissue ultrasounded, and had the ankle supported with a bandage. > I have taken care of Canadian patients who had car accidents, in the US. > They had bought supplemental insurance for there travels. The Canadian > company insists on transferred patients thousands of miles but they are > medically ready, and remember this is the barbaric US where we don't treat > patients right. These are trauma cases where the patient are vented and have > multiple breaks and unstable spine. Let me guess why they urgently want them back in Canada: The healthcare costs in the US? The quality of care? :-/ > The resolution is the US hospital has to eat the cost of these patients > until the attending doctor feels comfortable allowing the patients to > travel....perhaps this is the one of the reasons for the $2K emergency room > visit? You mean as long as Canadians stay in a US hospital they are not covered despite having supplemental insurance for their travels? Thats hard to believe.. I imagine the costs are capped and this ceiling is reached too soon if the patient is seriously injured and cant be moved. > I rather have a system where people are treated, granted non emergent cases > may have to jump through hoops. Then a system where people are turned away > at the door or make seriously patients travel long distances for care. I had similarly insightful experience in Cuba a few years ago. Complete rupture of an achilles tendon in a holiday resort. The resort doc was friendly, but totally incompetent in such matters. Cuba's health program has other priorities... Back in Havana there wasnt soft tissue ultrasound let alone MRI available anywhere (despite good travel insurance) so I vented my frustration on the insurance doc by telephone. This at least got me upgraded for the flight back home where MRI and the op resolved the problem. Signaturemadiba > You must differentiate between 'healthcare for all' and the brit. > Commonwealth el cheapo version. :-/ El cheapo versioin? > In continental western Europe your kid would not have been triaged by a > clerk (or a nurse for that matter), In UK she would. Triage is undertaken by trained nurses, not clerks. > a doctor would have determined > whether she needed assistance. She would not have got an MRI or an > arthroscopy that day, In UK she would have done, if the doctor said she needed it. > but she would most likely have been x-rayed and/or > (depending on her age) soft-tissue ultrasounded, and had the ankle > supported with a bandage. That usually sufficient. If a bone was fractured she would have had a modern support 'plaster' applied. If she needed it she would have been given a crutch or crutches. If she couldn't manage those because of age she would have been given a walking aid. >> You must differentiate between 'healthcare for all' and the brit. >> Commonwealth el cheapo version. :-/ [quoted text clipped - 22 lines] >she couldn't manage those because of age she would have been given a walking >aid. Thank you Mary. I was about to make those remarks myself. How anyone could call the NHS "el cheapo" I can't understand. It's very far from cheap, being funded from taxation, but it *is* free at the point of delivery, thus saving all the problems and heartache poor Klikini has been through recently. I was operated on by our "cheapo" NHS within 4 weeks of first seeing my doctor when I found the lump. And, although I was dying to get out of hospital, I was kept in for 10 days, rather than having to go home and have a fairly squeamish husband empty my drains. I wouldn't have been happy about that at all. There are a lot of things wrong with the NHS, as there are with any health system, but a lack of qualified medical care in casualty is not one of them. very best wishes Klikini, it will all be over before you know it. Kathleen xx >>> You must differentiate between 'healthcare for all' and the brit. >>> Commonwealth el cheapo version. :-/ [quoted text clipped - 42 lines] > health system, but a lack of qualified medical care in casualty is not > one of them. ... > Thank you Mary. I was about to make those remarks myself. > [quoted text clipped - 5 lines] > I was operated on by our "cheapo" NHS within 4 weeks of first seeing my > doctor when I found the lump. Mine was found by a routine (free) annual mammogram at the hospital at the bottom of the street. The lump was out in four weeks. That was in 1998, I'm still monitored and have had Rolls Royce treatment. > And, although I was dying to get out of hospital, I was kept in for 10 > days, rather than having to go home and have a fairly squeamish husband > empty my drains. I wouldn't have been happy about that at all. Mine would have enjoyed it but I wanted to stay in the little nest I'd made for myself. I was told I could go out when the drain was removed, I was so shocked I curled up and (metaphorically) sucked my thumb until they said I could stay an extra night. > There are a lot of things wrong with the NHS, as there are with any > health system, but a lack of qualified medical care in casualty is not > one of them. Absolutely not. I've just realised who you are! Mary >I've just realised who you are! Ah! So it *is* you! I wasn't sure. > > You must differentiate between 'healthcare for all' and the brit. > > Commonwealth el cheapo version. :-/ > > El cheapo versioin? Yes, dont tell me you haven't heard about the NHS skimping on costs? Its the laughing stock of the Continent, which sends planeloads of surgical teams over to deal with their waiting lists. Oncology-wise its much improved, I'll admit. > > In continental western Europe your kid would not have been triaged by a > > clerk (or a nurse for that matter), > > In UK she would. Triage is undertaken by trained nurses, not clerks. Hmmm, this is where the NHS skimps big time.. Not much nurses dont do in the UK nowdays, I think they have been spared brain- and heart surgery so far.. ;-/ To be fair, nurses in the US have also been coerced into doing sigmoidoscopies etc. I think its wrong, esp when there are complications and in borderline situations. > > a doctor would have determined whether she needed assistance. She would > > not have got an MRI or an arthroscopy that day, > > In UK she would have done, if the doctor said she needed it. well, thats the point. The doc sees the patient and makes the decisions. But the UK patient needs to get past the nurse to be even considered for MRI. MRI for a sprained ankle is waaay over-the-top BTW.. Not sure what a 'high impact injury' means in practical terms. Bedrest I suppose. > > but she would most likely have been x-rayed and/or > > (depending on her age) soft-tissue ultrasounded, and had the ankle [quoted text clipped - 6 lines] > she couldn't manage those because of age she would have been given a walking > aid. Ah, fracture-treatment is controversial in orthopaedic circles. There the pros and cons of immediate intervention (osteosythesis, external/internal traction) can generate hours of debate. We wont go there. A light cast is sufficient in most cases, I suspect. Signaturemadiba >> > a doctor would have determined whether she needed assistance. She would >> > not have got an MRI or an arthroscopy that day, [quoted text clipped - 4 lines] > MRI. MRI for a sprained ankle is waaay over-the-top BTW.. Not sure what > a 'high impact injury' means in practical terms. Bedrest I suppose. Good to know UK is a bit better, since my son is going over in September. The school also has an onsite clinic. MRI was needed, by the time my daughter came home the swelling in the ankle was gone. She had terrible pain, went to the local Ortho who xrayed the foot( no break) then had her do PT. No relief from the PT. Went back to the local Ortho who then ordered an MRI ( which showed nothing). He didn't have anything to offer. He sent to an ankle surgeon. He did some steriod injecttons and more PT including soft tissue ultrasound and immoblization. The pain continued. This was over an 18 month period. It is not normal not have a 21 year old unable to walk due to pain. A couple of weeks ago she had her scope. The Periosteum was stripped off the bones and the gutter of ankle was filled with debris. She is pain free immediately after surgery. > The pain continued. This was over an 18 month period. It is not normal not > have a 21 year old unable to walk due to pain. I remember a similar story from an american friend. A wave tumbled her in Hawaii and she landed on her feet and suffered for months with foot pain. X-ray neg, much later in the MRI they found one of the little foot bones had become necrotic. She's limped ever since. > A couple of weeks ago she had her scope. The Periosteum was stripped off the > bones and the gutter of ankle was filled with debris. > She is pain free immediately after surgery. MRI negative - steroid injections - PT - deperiostation. See a certain pattern here? The deperiostation itself is not treatable so it must have been the debris causing the pain at that stage. Signaturemadiba >>>In continental western Europe your kid would not have been triaged by a >>>clerk (or a nurse for that matter), [quoted text clipped - 16 lines] > MRI. MRI for a sprained ankle is waaay over-the-top BTW.. Not sure what > a 'high impact injury' means in practical terms. Bedrest I suppose. I don't think "triage" in this situation ever involves actually turning people away. What the UK casualty triage nurse does as I understand it is prioritise the incoming cases for attention by a doctor, more a "diage" really - urgent or normal. The lowest priority in our area generally involves about a 3-hour wait to be seen. I never heard of anyone being refused attention except where they were violent to the medical staff. I had the experience recently of my immigrant stepson (13) being sent home from a school PE class with a pulled thigh muscle. As he insisted he could not stand on the leg, we duly trekked off to casualty. It was a quiet day and so we only waited about an hour to see the doctor. He could find nothing wrong, ordered an x-ray just to be sure, and informally diagnosed "lead swinging" and prescribed a couple of paracetamol (acetaminophen to those in the US). Sure enough the problem had gone away by bedtime and was not mentioned again. Despite the boy's lack of citizenship, there was no charge. Tim Jackson . > I had the experience recently of my immigrant stepson (13) being sent > home from a school PE class with a pulled thigh muscle. As he insisted [quoted text clipped - 5 lines] > had gone away by bedtime and was not mentioned again. Despite the boy's > lack of citizenship, there was no charge. This evidently applies to travelers also. A friend's cancer was discovered while he was visiting the UK. He became ill and was admitted to the hospital there without proof of insurance so far as I know. I wonder how foreign travelers fare in the US in these circumstances since one doesn't get beyond the gate without those insurance cards? Lois > >>>In continental western Europe your kid would not have been triaged by a > >>>clerk (or a nurse for that matter), [quoted text clipped - 11 lines] > >> > >>In UK she would have done, if the doctor said she needed it. Half-year waiting times for MRI if its not urgent, I believe.. > > well, thats the point. The doc sees the patient and makes the decisions. > > But the UK patient needs to get past the nurse to be even considered for [quoted text clipped - 8 lines] > anyone being refused attention except where they were violent to the > medical staff. Ok, so no-ones sent away, but if they land in the low priority group they need patience or nerves of steel.. The aussies it seems are more up-front: 'take a hike mate'.. > I had the experience recently of my immigrant stepson (13) being sent > home from a school PE class with a pulled thigh muscle. As he insisted [quoted text clipped - 3 lines] > informally diagnosed "lead swinging" and prescribed a couple of > paracetamol (acetaminophen to those in the US). :-/ > Sure enough the problem > had gone away by bedtime and was not mentioned again. Despite the boy's > lack of citizenship, there was no charge. > > Tim Jackson Signaturemadiba > I had the experience recently of my immigrant stepson (13) being sent home > from a school PE class with a pulled thigh muscle. As he insisted he [quoted text clipped - 7 lines] > > Tim Jackson Have you remarried? Last I heard your girlfriend was moving to England. Are congrats in order? Alex >>I had the experience recently of my immigrant stepson (13) being sent home >>from a school PE class with a pulled thigh muscle. As he insisted he [quoted text clipped - 11 lines] > Are congrats in order? > Alex She and her children are at last here. We haven't married yet, we are still settling in, and checking out how things work. It is a big cultural difference from Kenya. Tim > She and her children are at last here. We haven't married yet, we are > still settling in, and checking out how things work. It is a big cultural > difference from Kenya. > > Tim I bet the differences are huge, but glad to hear you are working things, Alex >> well, thats the point. The doc sees the patient and makes the decisions. >> But the UK patient needs to get past the nurse to be even considered for [quoted text clipped - 7 lines] > involves about a 3-hour wait to be seen. I never heard of anyone being > refused attention except where they were violent to the medical staff. All that is true. What's more, the nurses are very professional, highly trained and usually specialised in their area of care. I'm not keen on the triage system but I can understand that it makes better use of doctors' time and that it is good to make a priority of those in most need. I do wish it were called something else! Mary > I'm not keen on the triage system but I can understand that it makes > better use of doctors' time and that it is good to make a priority of > those in most need. I do wish it were called something else! >> > Mary Triage is a necessary part of medical practice, otherwise people would die. I think you are questioning whether a MD should be doing that, nurses do this function very effeciently. I question a hospital for rest?????The patients I take care of can't wait to go home to get rest. When I was in the hospital, I was woken up every few hours for nurses to check me. A medical emergency can make the nursing unit like Grand Central Station. Alex > I had the experience recently of my immigrant stepson (13) being sent > home from a school PE class with a pulled thigh muscle. As he insisted Reminds me of a problem my ex had in London whilst attending a course at Hammersmith. During a lunchbreak she swallowed a fishbone which stuck in her throat. She found it less than amusing to be triaged by a tired nurse and kept waiting for hours. I suppose the bone would have had to pierce something vital like an artery or the airway for her to be 'upgraded'. Back in her hospital she would have been attended to immediately.. Signaturemadiba > In UK she would. Triage is undertaken by trained nurses, not clerks. > [quoted text clipped - 9 lines] > > That usually sufficient. I feel if she had proper treatment such as immoblization the injury would have been contatined. I have taken care of English patients who were told that despite almost total artery occulsion they would have to wait years for surgery or intervention only to come to the US and have a heart attack requiring cardiac surgery ( once again - free)! The patients where shocked, that surgery was scheduled immediately and nobody hasseled them for money. Hence the $2K emergency room fees. Alex >> I have taken care of Canadian patients who had car accidents, in the US. >> They had bought supplemental insurance for there travels. The Canadian [quoted text clipped - 6 lines] > Let me guess why they urgently want them back in Canada: The healthcare > costs in the US? The quality of care? :-/ No the patients and the their families wanted to stay, When you are being treated by Harvard trained physicians (usually the one who wrote the textbook) why would you want to go a regional hospital? It was the case manager of the secondary Canadian plans who want the patients more despite the patients injuries. I have seen - on TV that England has a similar program, a patient broke his hip and the travel insurance demanded that the patient fly home in less then 24 hours after having his hip pinned on a commercial plane ( easy jet). When the patient arrived at his regional hospital there was no bed available and he had to sleep on stretcher. At least the Canadians use an air ambulance. >> The resolution is the US hospital has to eat the cost of these patients >> until the attending doctor feels comfortable allowing the patients to [quoted text clipped - 5 lines] > believe.. I imagine the costs are capped and this ceiling is reached too > soon if the patient is seriously injured and cant be moved. The supplemental insurance demanded the patients moved, the US Hospital refused to release the patient. The patients were not charged for the extra days. > >> I have taken care of Canadian patients who had car accidents, in the US. > >> They had bought supplemental insurance for there travels. The Canadian [quoted text clipped - 12 lines] > manager of the secondary Canadian plans who want the patients more despite > the patients injuries. OK, so it was for cost reasons. > I have seen - on TV that England has a similar > program, a patient broke his hip and the travel insurance demanded that the > patient fly home in less then 24 hours after having his hip pinned on a > commercial plane ( easy jet). When the patient arrived at his regional > hospital there was no bed available and he had to sleep on stretcher. At > least the Canadians use an air ambulance. > >> The resolution is the US hospital has to eat the cost of these patients > >> until the attending doctor feels comfortable allowing the patients to [quoted text clipped - 9 lines] > refused to release the patient. The patients were not charged for the extra > days. I get it, but whats the point in taking that kind of (extra) insurance if it does'nt help when needed? Signaturemadiba I am so happy for you. You will be scared. I just had my mastectomy on May 5 so I am here for ya. Proud of ya!! Pami > I am so happy for you. You will be scared. I just had my mastectomy on May > 5 so I am here for ya. > Proud of ya!! > > Pami Thanks, Pami! kili |
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