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Medical Forum / Diseases and Disorders / Prostate BPH / April 2006PVP reality check - the bill came in the mail
I had my PVP three weeks ago, 57 yrs. old, prostate 45 gm, max flow 3.7 ml/sec., 25 ml retention. Now 15 to 20 ml/sec., immediate initiation, no retention, no burning, but still some urgencey which forces me to go before I'm really full, especially when walking. Also some sensation (not really a burn, but uncomfortable) at the end of urination, and still passing about a clot per day. All of this is normal at three weeks out, I am told. I was feeling pretty smug about all of this, and then my bill arrived in the mail. $12,600! The uro's charge was about $2500, the rest was hospital charges. My out of pocket with insurance will be a couple of thousand, which I expected, but I was pretty shocked at the total for an outpatient procedure. I guess I'm just out of touch. How can any normal person do this without insurance? > I had my PVP three weeks ago, 57 yrs. old, prostate 45 gm, max flow 3.7 > ml/sec., 25 ml retention. Now 15 to 20 ml/sec., immediate initiation, [quoted text clipped - 8 lines] > shocked at the total for an outpatient procedure. I guess I'm just out > of touch. How can any normal person do this without insurance? If they don't have any assets they probably get it for free. As I see it the hospital is "padding" the bill to pay for those they treat that don't have insurance. Bills I have received from hospitals have had some of those $20 Aspirin etc. Unfortunately it is the "Normal" person that can get hit really hard. However, as we were discussing here just a while ago it appears that many if not most countries with Socialized Medicine don't pay anything for PVP. TURP is a lot cheaper and they have the advantage of not having to pay the U.S. level of malpractice insurance. Your insurance probably works out a special price with the hospital. > I had my PVP three weeks ago, 57 yrs. old, prostate 45 gm, max flow > 3.7 ml/sec., 25 ml retention. Now 15 to 20 ml/sec., immediate [quoted text clipped - 9 lines] > procedure. I guess I'm just out of touch. How can any normal person > do this without insurance? You can't. Hospital charges are way out of whack, and part of the bogus provider markup game between the providers and the insurance companies (I call it the two sets of books syndrome and I have written in here about it before). What I have noticed over the many years (for my insurance), the insurance companies may only pay 20-40 % of the surgeons fee (ie their allowed negotiated amount for PPO's), but they will accept almost all of the hospitals charges, which are even more inflated than the surgeons fees. I always get the itemized bill for hospital charges (and I have to ask for it, or you just get a bill with a total number on it), and it is incredible. The list of charges is longer than your arm, and the cost of the OR (even though only ambulatory) is out of sight. Rich's comments are also acknowledged, as always :-) ...Pete >> I had my PVP three weeks ago, 57 yrs. old, prostate 45 gm, max flow >> 3.7 ml/sec., 25 ml retention. Now 15 to 20 ml/sec., immediate [quoted text clipped - 23 lines] > > Rich's comments are also acknowledged, as always :-) ...Pete I was just looking over the new plan that Massachusetts has. Arguements are always the same. Those against it say the problem is the high cost of Medical care. What they don't want to acknowledge is that the reason health care gets so expensive is because of the new innovations making it superior to the old. If you are willing to revert back to 1960 level of care you can also have 1960 prices. But if you want PVP, Robot and Endoscopic Surgery, and the latest medications you will have to pay for it. Got an enlarged Prostate Problem? Keep the treatment cost down, do like Ben Franklin. Use a reed:-)!!! I was just following a company that had some great ideas for new medical equipment. They lost everything. We pay for those Merck thought they had a winner with Vioxx (and so did the customers). Now Merck is going to have to raise prices to pay off the damages. Looks like Pfizer may get hit with claims against Celebrex. Even if the malpractice lawyers lose, the consumer is still going to pay the price for the defense of the company. I have lots of excuses for what happens but no solutions. Kind of gets down to the final statement that you get what you pay for. And, sadly, there is no possible way that everyone can afford the highest level of care. I didn't know Ben Franklin invented the foley catheter too. Did he self-cath or did he have to call the meat wagon to take him to the ER? > I didn't know Ben Franklin invented the foley catheter too. Did he > self-cath or did he have to call the meat wagon to take him to the ER? I really don't know if that story is a myth or the truth. However, after reading all the things that Ben did do I am inclined to believe it. So this has prompted me to do a little research. More ancient than Ben is the story. He may have used such an implement: http://www.prostatepointers.org/prostate/lay/apilgrim/chapter4.HTML "Over four thousand years ago the Egyptians used a hollow reed from those that grew along the Nile river as a catheter for men who had BPH. As any man might imagine, shoving a reed into the penile urethra is not very pleasurable." >So this has prompted me to do a little research. More ancient than Ben >is the story. He may have used such an implement: > >http://www.prostatepointers.org/prostate/lay/apilgrim/chapter4.HTML I don't know who wrote that article, but they have a slight problem with facts. Read a little further, the author refers to a 1/2" resectoscope - good grief, they don't make them in 38 Fr, the 24 Fr the doc used on me was quite large enough, thank you! RD > I didn't know Ben Franklin invented the foley catheter too. Did he > self-cath or did he have to call the meat wagon to take him to the ER? I wonder how many "horse" power the meat wagons were back than :-) . >> I didn't know Ben Franklin invented the foley catheter too. Did he >> self-cath or did he have to call the meat wagon to take him to the ER? > > I wonder how many "horse" power the meat wagons were back than :-) . And how much they charged? The Doctors made house calls then. No formal education and they also served as the local barber. They had all the tools necessary to bleed you to get rid of the bad blood. Reminds me of the old Sat. Night Live skit where Steve Martin is the doctor/barber. He tells the injured Bill Murray that he needs a good bleeding. Murray says "But I'm already bleeding," and Martin says "Hey, who's the barber here?" > Reminds me of the old Sat. Night Live skit where Steve Martin is the > doctor/barber. He tells the injured Bill Murray that he needs a good > bleeding. Murray says "But I'm already bleeding," and Martin says > "Hey, who's the barber here?" That's funny Temujin...I missed that one. >>> [snip] I was feeling pretty smug >>> about all of this, and then my bill arrived in the mail. $12,600! [quoted text clipped - 3 lines] >>> procedure. I guess I'm just out of touch. How can any normal person >>> do this without insurance? >> You can't. Hospital charges are way out of whack, and part of the bogus >> provider markup game between the providers and the insurance companies (I [quoted text clipped - 7 lines] >> The list of charges is longer than your arm, and the cost of the OR (even >> though only ambulatory) is out of sight. >I was just looking over the new plan that Massachusetts has. Arguements >are always the same. Those against it say the problem is the high cost >of Medical care. What they don't want to acknowledge is that the reason >health care gets so expensive is because of the new innovations making >it superior to the old. That doesn't explain the $20 aspirin; it's not new! Nor have the costs of heating and cooling, food and laundry, cleaning and accounting, etc risen at any greater rate than other industries. > If you are willing to revert back to 1960 >level of care you can also have 1960 prices. But if you want PVP, Robot > and Endoscopic Surgery, and the latest medications you will have to >pay for it. Sure but that doesn't explain the difference. In fact we don't know what does because of the incredible cost accounting problems. The suspicion is that there's lots of inefficiency, lots of overpaid people (despite the whining), and above all cost shifting from anyone who can't pay (or pays little such as Medicare) to anyone who can. No one (at least no one who can do anything about it) wants to tackle the issue because introducing rational charges will most likely expose just how much America's poor and elderly are costing the system. If we can't shift their costs to the insured there's only one entity who can possibly pay: the taxpayer. Personally I have absolutely no problem with this but tax increases with the current crowd have as much appeal as the Passover ham! >I was just following a company that had some great ideas for new medical >equipment. They lost everything. We pay for those Obviously their ideas weren't so great <g>. >Merck thought they had a winner with Vioxx (and so did the customers). >Now Merck is going to have to raise prices to pay off the damages. >Looks like Pfizer may get hit with claims against Celebrex. Even if the >malpractice lawyers lose, the consumer is still going to pay the price >for the defense of the company. You can easily fix this one. Make the FDA approval a safe harbor. Unless the mfg screws up in the production or lies about the testing you can't sue him. However protection for the public has to be no fault no limit medical care provided by (guess who) for any injuries caused by an approved drug or device (like we do with vaccines) and a much greater willingness to criminally prosecute and convict the medical industry workers/entrepreneurs who screw up individually. >I have lots of excuses for what happens but no solutions. Kind of gets >down to the final statement that you get what you pay for. And, sadly, >there is no possible way that everyone can afford the highest level of care. We can come pretty close. >>>> [snip] I was feeling pretty smug >>>> about all of this, and then my bill arrived in the mail. $12,600! [quoted text clipped - 69 lines] > > We can come pretty close. I just can't believe any government can do better than free enterprise. From what I have seen few of the medical systems implemented in other countries can approach, as bad as it is, what we have here now. The elderly medical coverage is already by tax through Medicare. Their payments may not cover all the doctors expenses. Many will no longer accept their coverage. What we are looking at right here is a good example. The Laserscope equipment is expensive. I just heard that a fiber costs about $1000. A short time ago Dr. Sancha said on this group, that a PVP on a 150 gram prostate can use three or four of them. When some bureaucrat makes the decision of using PVP or a $100 knife, guess which wins? TURP still wins here with many doctors for the same reason. Perhaps more because their hospitals have not invested in the equipment. Another factor beyond equipment cost but also the storage and maintenance of the larger machines. Around here I find that it depends on the hospital they use as to if a doctor uses PVP or TURP. That is an area I should think could be corrected by sharing equipment between hospitals. Of the 10 to 20 in the area I think about 4 have PVP equipment. For a while I thought something similar was going to happen with MRI. Here, the MRI are owned and operated by small private businesses. As for lawsuits it isn't just the somewhat valid ones but also the frivolous lawsuits that are expensive to defend and must be paid for by higher prices. Only ones benefiting are the lawyers and of course the courts. The lawyers should be penalized for even bringing them to court. Just a short time ago a suit was filed in a local court against GM for building a defective truck. The fellow had hit a power pole. The first witness testified that the driver was drunk and the case went downhill from then on. In that one the Judge rightfully fined the Lawyer. >I just can't believe any government can do better than free enterprise. I didn't suggest it could (one way or the other). My post was directed to the shock of the OP at his hospital bill. > From what I have seen few of the medical systems implemented in other >countries can approach, as bad as it is, what we have here now. I don't know where you get your information from because by practically every measure all of them beat us. Moreover why do we have to adopt some other country's system? Learn from them and use the best. Anyway I didn't intend this to be a general far-ranging debate on the replacement health care system. >The elderly medical coverage is already by tax through Medicare. Their >payments may not cover all the doctors expenses. Many will no longer >accept their coverage. Both the elderly and the worker pay a regressive per head tax that neither corresponds to their usage, potential usage, nor ability to pay. Of course the payments won't cover the doctor's (read medical industry) charges! That was exactly what I was saying. The shortfall is shifted over to the privately insured so part of your hospital bill for PVP should read: "Subsidy for the LOL in intensive care" or "Subsidy for emergency room treatment for the heart attack of the 80 year old transferred from the nursing home". But it won't. Those costs insofar as they exceed Medicare's reimbursement rate will be buried in the $20 aspirin and other item overcharges. Only the very high-end medical institutions can afford not to accept Medicare. Most people die in hospital and their expenditure in the last few weeks of life is stupendous. Without their volume the hospitals and MD's would go out of business. >What we are looking at right here is a good example. The Laserscope >equipment is expensive. I just heard that a fiber costs about $1000. A [quoted text clipped - 5 lines] >beyond equipment cost but also the storage and maintenance of the larger >machines. But you already have the bureaucrat making those decisions for people on Medicare and Medicaid and Veteran's Admin. It's so much better (sarcastic) if the decisions are made by a corpocrat whose year-end bonus depends on how much he saves in claims of policy beneficiaries or HMO members. I realize this NG is a cheering group for PVP but in reviewing the last 1000 or so postings I notice quite a few complaints about the results and in googling the term I don't see too many (any in fact) evidence-based-medicine-type studies showing a significant advantage of PVP over other surgeries. I understand the slavering fan boy aspect to having a specialist in the procedure (the Spanish MD) acknowledge the group's existence but that shouldn't bias the choice. That much maligned bureaucratic decision to use TURP instead of PVP may or may not be also in the patient's best interest. We just won't know until there's good evidence for one over the other or for some other procedure entirely. > Around here I find that it depends on the hospital they use as to if a >doctor uses PVP or TURP. That is an area I should think could be >corrected by sharing equipment between hospitals. Of the 10 to 20 in >the area I think about 4 have PVP equipment. For a while I thought >something similar was going to happen with MRI. Here, the MRI are owned >and operated by small private businesses. And vastly overused according to some sources (generally those who don't have a financial interest in the machines). >As for lawsuits it isn't just the somewhat valid ones but also the >frivolous lawsuits that are expensive to defend and must be paid for by >higher prices. Only ones benefiting are the lawyers and of course the >courts. I don't think the courts (judges and others) are actually benefiting. You're correct about the lawyers and the cost of defense but this is largely because the courts have allowed the discovery process to spin out of control which in turn is because of the cost-shifting that occurs here too. >The lawyers should be penalized for even bringing them to court. Just a >short time ago a suit was filed in a local court against GM for building >a defective truck. The fellow had hit a power pole. The first witness >testified that the driver was drunk and the case went downhill from then >on. In that one the Judge rightfully fined the Lawyer. Maybe in that case but lots of what we hear are partisan anecdotes. Some of course never even happened. We hear about huge jury awards but never about the reduction on appeal. > I don't know where you get your information from because by > practically every measure all of them beat us. None that I know of offer PVP with their Socialized Medicine plans. A friend in London was told he would have to wait 9 months for an EKG!! That's better? Fortunately he went to a pay for service. > I realize this NG is a cheering group for PVP I was just commenting that those, such as Forlorn Hope, that get almost miraculous immediate results don't return. I happened to talk to a doctor who had PVP a while ago. He was really upset. He woke up to find that the PVP machine had broke down. Instead of stopping where they were at and rescheduling they finished with TURP. You usually have to give permission to switch to TURP if necessary. His recommendation is to make it clear that is only if medically necessary. I had sinus problems a few years ago and got some excellent recommendations from their newsgroup. I noted the same thing there. Those that found a relief and/or had successful surgery (much worse or at least dangerous than TURP or PVP) quit posting to the group (As I did). Once in a while I go back to give support and recommendations. > I don't think the courts (judges and others) Sort of. Without the cases they would be out of a job :-). >> I don't know where you get your information from because by >> practically every measure all of them beat us. [quoted text clipped - 19 lines] >> I don't think the courts (judges and others) > Sort of. Without the cases they would be out of a job :-). The machines seem to break down fairly often. We have had mentions of that in the past year including Forlorn Hope who was initially wheeled out of the theatre when the machine failed it's start up test. When I went for my six month check up. I asked how many procedures had been done since my one in July. It was not that many as the machine had been broken down for a while. Derek. >>> I don't know where you get your information from because by >>> practically every measure all of them beat us. [quoted text clipped - 25 lines] > July. It was not that many as the machine had been broken down for a while. > Derek. That is good to know. When (IF?) I go in I will be certain to specify that TURP is only to be used if medically necessary. Due to other activities I will probably postpone it until September. I am not really in a panic yet. Unlike your having to go every 45 minutes, I can wait hours during the day. Only at night I have to get up at almost every two hours, often every hour. I loved where Forlorn Hope said he told his wife that he thought of asking the surgeon to demonstrate his skill by peeling an apple for him. What I am getting out of the information here is that all methods are intended to accomplish the same thing. That is to remove excess tissue. From experience I have found that TUMT has marginal results. When cut we bleed. When burned our tissue is cauterized. We know that from old movies where the cowboy or whatever heats up a poker to sear a wound. Therefore I can't see much argument that PVP is the better procedure. The surgeon can see better what is happening and the patient has very little if any bleeding. The skill of the surgeon for any procedure is of prime importance. When faced with having to have endoscopic sinus surgery I did a lot of searching for a doctor, after hearing from a couple individuals who suffered brain damage. I kept hoping to find someone who would say it was a "piece of cake". When I said something like "I understand this operation is getting easier" to the fellow prepping me, he frowned and said "It's getting to be more routine". Believe me, it was no piece of cake. The next two weeks were misery but instead of one continuous infection, I have not had one since. I without a doubt have the surgery again. That surgery might be better performed with a laser but I rather doubt I would want it used so close to the brain. >>>> I don't know where you get your information from because by >>>> practically every measure all of them beat us. [quoted text clipped - 62 lines] > That surgery might be better performed with a laser but I rather doubt I > would want it used so close to the brain. I have a recurring corn on the side of my foot. I asked the chiropodist why they cannot do laser surgery to cure it for good. That left her speechless. Re the 45 minutes, I posted this as part of the write up about my PVP. " Three days after my PVP I felt 100% well and set off for a day at the local racecourse. Just like any normal day dodging around from the paddock to the bookies and climbing up the grandstand to get a good view. With G8 riots going on in Edinburgh we had to take an indirect route. Our journey took 90 minutes using busses rather than the usual 40. Normally I get off the bus and go straight to the toilet but not yesterday. I had two large mugs of coffee and was getting worried that I had not needed yet and tried about 4.45 and probably passed only 200ml" Derek. >> I don't know where you get your information from because by >> practically every measure all of them beat us. >None that I know of offer PVP with their Socialized Medicine plans. A >friend in London was told he would have to wait 9 months for an EKG!! >That's better? Fortunately he went to a pay for service. And Canada has far fewer MRI machines than we do. But that wasn't the sort of "measure" I was referring to. Things like longevity and infant mortality (both bad for US) are not biased by a particular type of treatment. If you could find something that marked a "cure" for bph, say number of ml per second of urine by age group, and we turned out to be great in comparison to other countries then our system would be undoubtedly preferable at least for that problem. Maybe your London friend didn't really need an EKG? Would an EKG have changed his treatment? Anyway he's no worse off than if he were here. My in-laws are English and seem to have no problem getting all that they need medicine-wise. In fact, with a couple of exceptions, the UK would be better off pulling the plug on all of them, such is their consumption of medical services <g>. > Maybe your London friend didn't really need an EKG? Would an EKG have > changed his treatment? Anyway he's no worse off than if he were here. He "needed" the EKG. Because he went to a pay for service clinic he is still alive today. He could not have lived the nine months without treatment. > My in-laws are English and seem to have no problem getting all that > they need medicine-wise. In fact, with a couple of exceptions, the UK > would be better off pulling the plug on all of them, such is their > consumption of medical services <g>. And sadly, that is what would have happened to him if he had not gone outside the service. Which still gets me back to the argument that total free medical service for everyone is probably not possible. Lets say even if the U.S. government should enact such a thing I really can't imagine that the President and his staff and members of Congress will stand in line with the rest of us for service. Or for that matter the members of the Rockefeller, Kennedy or similar families. Norway supposedly has the best system. Everything is paid for. I was told by someone there that doctors are not allowed to treat for pay. A bureaucrat may make a decision as to if you are worth the treatment. If he decides against you, the only way to get treatment is to go outside the country. Even in that country I just can't imagine that there are not exceptions for government officials. Similar to here where members of congress don't "need" Social Security. Wouldn't it be nice to have a guaranteed retirement with cost of living that results in retirement pay greater than what your original wages were? >> Maybe your London friend didn't really need an EKG? Would an EKG have >> changed his treatment? Anyway he's no worse off than if he were here. >He "needed" the EKG. Because he went to a pay for service clinic he is >still alive today. He could not have lived the nine months without >treatment. I don't understand this. An EKG is not treatment. It's just a handy little graph of heart operations that the cardiologist produces in his office. In my case when I used to have fully-paid annual physicals my PCP used to have to do one. He just hooks you up to a machine and it produces the graph. He looks at the output and says, "Your heart is fine" or "Cripes, call an ambulance immediately!" <g>. Even with inflated specialist fees it's still a cheap test so I don't see why any health care system, even the UK's, would deny one. This is the problem with second-hand anecdotes. I suspect you haven't got the full story. Maybe they denied him a visit to the cardiologist? [snip] >Which still gets me back to the argument that total free medical service >for everyone is probably not possible. Lets say even if the U.S. >government should enact such a thing I really can't imagine that the >President and his staff and members of Congress will stand in line with >the rest of us for service. Or for that matter the members of the >Rockefeller, Kennedy or similar families. >Norway supposedly has the best system. Everything is paid for. I was >told by someone there that doctors are not allowed to treat for pay. A [quoted text clipped - 5 lines] >guaranteed retirement with cost of living that results in retirement pay >greater than what your original wages were? I doubt that a system where "everything is paid for" is the best system. Even under the current US system with, in most cases, deductibles and co-pays there's still vast overuse and misuse of the medical resources. Hey, I'm paying out all these bucks for my medical insurance so I might as well use it. If I don't someone else will. So we get out-of-control costs like we have today and at the other end of the scale people without insurance or with minimal insurance getting no health care or ultra-expensive and inappropriate emergency care. [Oh, well, I've gone this far... <g>] We need to use competitive free-market capitalism for what it's good at and government command economics for those things that capitalism does badly. We tend to do the opposite. For example by keeping most meds as Rx-only we incur enormous and unnecessary costs of people going to the MD for an Rx where, with a tiny effort especially in today's internet age, they could prescribe for themselves. We even have the absolutely ridiculous example of a drug being both Rx and OTC (such as antacids). For myself it's far cheaper to go to the Pcp and have him write an Rx rather than to buy essentially the same thing OTC. (Actually I use Sodium Bicarbonate and avoid the whole problem.) Stop the paternalism. Move the whole lot (except antibiotics and narcotics) to OTC. Just as the LOL had to get used to the idea of supermarkets instead of the hand-holding corner grocer she'll have to face up to the problem of choosing her own medication. I think most guys won't have a problem choosing between Viagra, Cialis, and Levitra <g>, and the females in choosing which pill or other device. However, we still have the problem of cost of medication. There's two parts here: marketing and research. The research should be NIH funded and the final drug should be available to anyone who wants to produce it. Yep, the taxpayer pays. We do anyway; it's just different taxpayers. Big pharma which does well at marketing can then produce in quantity and sell the drug. No more patents except on the production process. That means Pfizer and Merck can go head to head to sell you Tamsulosin which one will call "Flomax" and the other "FlowQuick". I can just see the sales this week: "Five free Viagra with every twenty FlowQuick" . And if they get too greedy there always the cheap-jack Chinese version. How about those procedures, your EKG for example? The EKG shop is right in between the CAT scan shop and the MRI shop on Main street. You feel the urge to get yourself an EKG? Go right ahead, but you pay for it (up to a certain maximum). The guy running the EKG store isn't an MD; he's an EKG specialist. He's done courses (probably quite involved and long), sat exams, and had an apprenticeship on doing EKG's. Don't ask him about delivering a baby or treating your colon cancer or dealing with your depression; he doesn't know anything about those subjects and he doesn't charge anything like the same as the people now who do. You don't need a transmission specialist to change your tires! And while we're dragging the medical profession into the late twentieth century, let's get rid of the "visiting privileges". MD's work for hospitals (or clinics if you prefer). You roll into the Jerry Falwell Memorial Hospital for your PVP and one of their employees does the job. Not Dr X. It's up to the hospital to ensure they have qualified people just the same as if you go to a large law firm with (say) a patent law problem. They've got the specialist. Urologists don't know how to deliver babies either. Oh, and how about some radical new ideas from the wonderful world of capitalism: the money back if not satisfied guarantee. But the government still has a role of seeing that the medical people don't rip off the public. Prices have to be disclosed up front, there have to be performance measures which are available to all and customer (previously and insultingly called "patients") satisfaction indexes. And we're not talking about some obscure "Ask us about our latest health inspection report [and we'll spit in your food]": put it on one website (the FDA's?) and make it available for all to see. What about payment? I said before that you pay and for Mr. Normal you do up to a certain level which, not being a govt bureaucrat, I don't know. I guess it would be around $3,000 per year per person. It's the amount Mr. Average could afford to pay essentially out of current income. He's not going to lose his house, his retirement savings, or his kids college fund but he might have to give up the plasma TV or the vacation in Europe. Not everything is included in the $3,000. The items have to be medically justified and approved and not for fun (like Viagra or breast enlargement) and only a standard amount will be acceptable (the Wallmart generic price). If you want to buy Bayer at pharmacy de luxe the excess doesn't count. After you've spent the $3,000 the government (i.e. taxpayer) starts to pay (and to ration). You can have your PVP but if it's not an approved procedure (and TURP is) you get the amount for TURP and you pay the excess yourself but note that it's in a competitive environment (see above). There are two other classes: the seriously chronically ill and the poor (or those who just don't like paying anything). The seriously chronically ill (like people with Lou Gehrig's disease) are paid from the $0 mark. The poor, well that's where the govt funded (i.e. taxpayer) free clinic comes in. The requisite technical people (MD's, Urologists (not MD's), EKG technicians, midwives, etc) are all employed by the free clinic and you can get free treatment (until you've notionally spent $3,000). Not a pleasant place, long waits, lots of MD's in training, lots of foreign MD's, but at least you get care. And while we're talking about free clinics, there are certain procedures we want the public to have: like vaccinations and STD testing. They're free and we (the government) should jump through hoops to make sure it's easy. The vaccination bus stations itself on Main street every Saturday. Your tetanus up to date? Roll up your sleeve. Flu? Other arm please. And for kids I never understand why we can't do these on the first day of school at school. No more deduction for employer-provided health care; in fact insurance companies would become useless. [As you can see once I get started I can go on forever but that's enough for the moment] >>> Maybe your London friend didn't really need an EKG? Would an EKG >>> have changed his treatment? Anyway he's no worse off than if he [quoted text clipped - 150 lines] > [As you can see once I get started I can go on forever but that's > enough for the moment] Wow...I thought I was bad. I have the same affliction when I get badmouthing doctors :-) You know what? I wouldn't give my PVP back for any amount of money - not a million - not a billion - (assuming the deal was once I got the money it would be impossible to ever get another one and I would have my bph forever). Al > I had my PVP three weeks ago, 57 yrs. old, prostate 45 gm, max flow 3.7 > ml/sec., 25 ml retention. Now 15 to 20 ml/sec., immediate initiation, [quoted text clipped - 8 lines] > shocked at the total for an outpatient procedure. I guess I'm just out > of touch. How can any normal person do this without insurance? > You know what? I wouldn't give my PVP back for any amount of money - > not a million - not a billion - (assuming the deal was once I got the > money it would be impossible to ever get another one and I would have my > bph forever). > > Al I am getting ready. I tried TUMT a year ago without much success. Went to see the URO a couple weeks ago. He had me try some Uroxatral. I even got side effects from that. One morning I had trouble focusing one eye for about an hour after I got up. Other times just didn't feel good. Only tried it about 5 times but decided it just isn't worth it. I rather get up three or four times a night than suffer that stuff. I tried Flomax a couple years ago and had the dizzy and back ache problems. I have never been bothered by medications before but that stuff sure hits me. Might expect that anything that affects muscles will likely do other things. So I go back to see him in about two weeks. He wants to take a look inside again. 65 gram prostate. If it is what I expect I will go with the PVP. A year ago he said he had done about 50. Later in the year he said over 100 so I will now guess he might be at the 200 mark. He is in Denver. I have things scheduled for the summer so may put it off until September. I can live with that. >I had my PVP three weeks ago, 57 yrs. old, prostate 45 gm, max flow 3.7 > ml/sec., 25 ml retention. Now 15 to 20 ml/sec., immediate initiation, [quoted text clipped - 8 lines] > shocked at the total for an outpatient procedure. I guess I'm just out > of touch. How can any normal person do this without insurance? Forlorn Hope who had his PVP in London last year was expected to pay his bill three weeks prior to the procedure. He later claimed a refund for an item on the bill that was not done. Derek. >> I had my PVP three weeks ago, 57 yrs. old, prostate 45 gm, max flow 3.7 >> ml/sec., 25 ml retention. Now 15 to 20 ml/sec., immediate initiation, [quoted text clipped - 13 lines] > item on the bill that was not done. > Derek. Has anyone heard from him? The outstanding success stories just go away. The failures keep coming back here hoping for something. >>> I had my PVP three weeks ago, 57 yrs. old, prostate 45 gm, max flow 3.7 >>> ml/sec., 25 ml retention. Now 15 to 20 ml/sec., immediate initiation, [quoted text clipped - 15 lines] > Has anyone heard from him? The outstanding success stories just go away. > The failures keep coming back here hoping for something. Yes, I keep in touch with him. He has had no problems. He treked in the Himalayas a couple of months after the operation and at the moment is treking on La Gomera in the Canary Islands. As for me I toured New Zealand by Intercity Bus last month with up to four hours between rest breaks without a problem. Last year I would not have dared go on a bus for more than forty five minutes without being worried. Derek. |
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