Medical update from SFI

by **SouthernFriedInfidel** » Fri Sep 16, 2011 9:22 pm

American Christian. A rather unique version (all humanity should HOPE so!) that blends the Gospels of Matthew, Mark, Luke and John withe the fifth Gospel of Ayn Rand.

by **Liv** » Sat Sep 17, 2011 2:24 am

That's a good point.

I told some of my lab partners that a) I was a lesbian and b) was considering going to a Catholic school and you should have seen their faces....

...I had to explain that the idea that religion abroad isn't religion here, and more importantly there's a lot of universities who are called Catholic that have Muslims, Jews, and non-theists attend.

That idea to them seemed paradoxical.

by **SouthernFriedInfidel** » Sat Sep 17, 2011 10:43 am

Well, folks, the endgame for this ordeal is in sight. I found out that after the insurance company has its say with my doctor's practice, I'll still owe over $1000. At this rate, I fully expect my hospital's final bill to be at least $4000.

But that detail remains to be seen. Of the hospital charges on my bill, the biggest single item was $16,000 for my 2 hours with the robot. I'll not be at ALL surprised to learn that my insurance will refuse to cover that as a luxury.

My life has been nothing but a disaster since the spring of 2010....

by **Liv** » Sat Sep 17, 2011 12:12 pm

I'm sorry SFI...

Not that it's the same, but financially we're up to ears in debt too with going back to school.

I've accepted the fact I'll never be able to fully pay them back by the time I die.

I suppose this is one of the mechanisms that prevents people from passing wealth on to their children.

It's bloody stupid.

I'm curious as to what this procedure would have cost you if you had lived in the U.K.?

by **SouthernFriedInfidel** » Sat Sep 17, 2011 12:39 pm

What would prostate cancer treatment cost in the UK? I haven't the first clue what they would offer under national health there. They don't want an ancient wreck like me there anyway....

by **Liv** » Sat Sep 17, 2011 1:06 pm

I'm just curious.

I mean this clearly exemplifies what's wrong with America.

This should be your glory years, and yet the system fired you, piled you with medical bills, and doesn't give a damn if you some how falter, lose insurance and require more assistance.

This is how people disappear....

One little mistake, and each on of us could disappear.

I'm mad if you can't tell.

I hate that we don't live somewhere that would have given you the proper care, and financial well being to make this time in your life, humane.

We're treating you horrible, and I apologize on behalf of this idiot nation.

by **A Person** » Sun Sep 18, 2011 12:28 am

Liv wrote:I'm curious as to what this procedure would have cost you if you had lived in the U.K.?

$0

Same in Canada

And Cuba, Indeed any civilized country

by **SouthernFriedInfidel** » Sun Sep 18, 2011 7:19 am

An interesting question would be whether the procedure is available today only as an "open" surgery or do they use robots in Britain and Canada? According to my doctor, had he needed to switch to the open version (he told me afterward that it was a close call -- due to the position they had to put me into, I initially had trouble breathing, but settled down after a couple of minutes), he could have done the operation, including doing the nerve sparing techniques, manually. But my recovery would have been months instead of days.

A quick search in Google appears to indicate that these "less advanced," "socialist" countries indeed have picked up robotic options.

So that settles it: America sucks.

by **Liv** » Sun Sep 18, 2011 1:51 pm

It's just like my bloody tooth extraction.

Set me back enough that we actually had to take a loan out this week to get us by till our grants came in on the 21st.

And my whole tooth thing was under $500....

God forbid if something serious came up, I wouldn't have the money for the gas to school, so I would have been forced to drop out, I would have ruined my financial aid, and I'd be another loser with no health-care in America.

Hell, SFI, probably if this happened in France you would have gotten time off, paid from your job to recover. I know they do it with pregnant women.

by **SouthernFriedInfidel** » Sun Sep 18, 2011 10:23 pm

however, I believe that dental care is not covered by national health. So you'd still be out in the cold for your tooth extraction. Sorry...

by **Liv** » Mon Sep 19, 2011 1:28 am

According to Smiler, because we had a talk about it in Bristol, at least some of it's covered. Unless I'm remembering the conversation wrong.

Because that was right after I had four wisdom teeth pulled out, then flew there.

by **A Person** » Mon Sep 19, 2011 3:51 pm

I'm back from a short vacation and I dug into the robotic surgery thing. It is available in Canada. Health care is a provincial matter so coverage can vary lightly from province to province.

Prostate surgery is covered everywhere, robotic prostate surgery is still being studied to determine if it produces better results. The verdict still seems to be out

To make a long story short, the verdict is not yet in. Although there is general agreement about the standards to use when comparing these different surgical approaches (in order of importance, which provides the best chance of a cure, maintains urinary continence, preserves erectile function, minimizes complications, and maximizes patient convenience), the debate continues. In fact, one article on the subject in the 2007 November/December issue of Urologic Oncology: Seminars and Original Investigations is called just that: “Debate: Open radical prostatectomy vs. laparoscopic vs. robotic.”

In part, it is difficult for the new techniques to offer substantial advantages because traditional surgery for prostate cancer, the open radical prostatectomy (RP), is so good. As Dr. Joel Nelson explains, “In the hands of an experienced surgeon, the bar represented by open RP for the real goals of prostate cancer surgery --- cure, continence, potency --- is high.” Also, there is the matter of definitions. How do various surgeons and researchers define positive margins, possible recurrence (as measured by PSA levels), urinary continence, and sexual functioning? Different definitions seem to yield advantages for different procedures.

All three surgical approaches report high rates of apparent cure and similar results in other areas. Less blood loss, faster postoperative recovery, and shorter hospital stays do seem to be more common with robotic-assisted prostatectomy, however.

It may be too early to make a fair comparison between these procedures. After all, open radical prostatectomy has been practiced and refined over the course of many years while the other two techniques are relative newcomers. And the minimally invasive techniques and technology require a substantial learning curve.

Perhaps, in the end, it’s the singer not the song. The outcome of surgery depends considerably on a surgeon’s skill, knowledge, and experience. And, as the debate continues, surgeons using all these techniques will grow in all three.

Recently British Columbia decided to stop full coverage for the robotic surgery. You can elect to have robotic surgery but you will have to pay $2,800.

I believe robotic surgery is fully covered in Ontario, Quebec and Alberta.

As for teeth, dentistry is covered by the NHS in the UK but not in Canada although emergency dentistry is covered in Canada under some circumstances. My ex-wife had a bad infection/abscess on a front incisor and the dentist immediately referred her to a maxillofacial surgeon. She was admitted to hospital immediately, put on IV antibiotics and operated on that evening. All costs covered.

by **SouthernFriedInfidel** » Mon Sep 19, 2011 4:24 pm

As to the comparison between open and robotic surgery, I only have personal experience to go by. The robotic system does seem to provide some operational advantages that I would think are worth considering, such as providing magnified views of the operation site, less blood loss, better control of tool movements, and correction for wayward hand movements. This is particularly of value when dealing with nerve manipulations. I can't say yet whether THAT aspect is worth the trouble, but I can still hope.

But what I CAN say is that just a week out, and I've not needed any pain meds for several days. What my long-term results will be besides the effort to be cancer free, there's no telling yet.

by **SouthernFriedInfidel** » Wed Sep 21, 2011 2:37 pm

Just got the final word (supposedly) for the anesthesia. We owe only $621 out of a total charge for the operation of $2852.

So far, the total cost out of my pocket has been nearly $2000. The actual hospital bill is still in flux, according to the insurance company web site...

by **Liv** » Wed Sep 21, 2011 4:03 pm

Pain meds are the best part... you got screwed.

If I spend $2000 on robotic surgery, I better be both cancer free, loaded with hydrocodone, and walk out the door with a free flat screen.

$2000.... Only lottery winners can afford that..... My goodness...

Perhaps they could have a "sell a kidney program" for when you go in, they can sell an organ for fixing one.

Still mad.

by **SouthernFriedInfidel** » Wed Sep 21, 2011 5:08 pm

I really don't see the appeal of pain medication. The stuff just made me drowsy, and there really wasn't much pain to bother me, most of the time.

It now appears that the hospital bill should drive my costs up to $5000 total, which is the maximum out of pocket expense the insurance allows. So theoretically, if I end up needing radiation treatments, they SHOULD be free. Time will tell...

by **SouthernFriedInfidel** » Thu Sep 22, 2011 6:28 pm

Another interesting wrinkle coming out of this surgery is a minor problem I have encountered at the pharmacy. One of the side effects of this surgery is (in the best case, temporary) impotence. To minimize the problems caused by this, my doctor called in a prescription for a 30-day supply of daily dosage Cialis. And he gave me a voucher to get the first set of pills for free.

When I went to the pharmacy, the told me I could only have 4 pills, because that's what my insurance allows for that drug. Now, normally, this place is calling me incessantly to ask if I'm ready to refill this or that prescription, or if they notice any potential problems with my insurance. For this... There was silence. They apparently thought I was just looking for some drug-enhanced fun in bed, and it didn't cross their mind that I might need this stuff for serious therapeutic reasons.

And by the way... The results of using this stuff was for me rather painful. And just a tiny bit bloody. I'll be taking rather carefully for the near term at least. I'm definitely no fan so far...

by **SouthernFriedInfidel** » Mon Sep 26, 2011 9:23 am

Going to see how working in the office works this week. As always, my managers are being very helpful and offering to accommodate my medical needs in any way I might need. I don't think I'll need much help, like working from home any more, but it is nice to know they are willing to let me try that if needed.

Back to the "salt mine," then!

by **Liv** » Mon Sep 26, 2011 10:32 am

Good luck!

by **SouthernFriedInfidel** » Tue Sep 27, 2011 12:12 pm

Well, I guess my adventure into the world of high-end American medicine is about done. My first day working in the office went pretty well, so I expect to stay with the old routine from now on. My work on regaining continence is progressing pretty well, so hopefully, that will not be a problem much longer. I'm pretty sure that my total bill for all this will top out at $5,000.00.

The only real question remaining open now is whether there's any danger that I have some cancer cells left behind, requiring me to go in for radiation therapy. My guess is that it's pretty unlikely. If that changes, I'll let you know. But that won't happen until November at the earliest.

Until then... Toodles!

by **A Person** » Tue Sep 27, 2011 3:05 pm

Toodles indeed!

Good news is hard to come by, I'm very glad to hear yours

by **SouthernFriedInfidel** » Thu Oct 06, 2011 8:39 am

Interesting. I just saw that the coach at St. John's, Steve Lavin has decided to go with surgery to remove his cancerous prostate. Looks like he's in better physical shape than I am, so he should have no problem getting back up and running in plenty of time for the season to start next month. Interesting...

BTW, I went in for physical therapy yesterday. They gave me a list of TWELVE exercises to do twice a day to help improve my recovery in the area of continence. These require me to buy some props. Holy moley!
:doh:

by **Liv** » Thu Oct 06, 2011 9:59 am

So I suppose I'm a bit ignorant on the whole thing, but the article talks about "early detection"...

Are they speaking only from a prostate exam?

by **SouthernFriedInfidel** » Thu Oct 06, 2011 12:40 pm

Prostate exam and PSA blood tests are initial indicators. They are used by doctors to decide when/if further investigation is needed. The actual confirmation of cancer comes when a biopsy is done, when they use an ultrasound wand and probe to obtain tissue samples for examination. The after-effects of THAT process are ... disturbing. But I expect there's really no other way to know for sure.

by **SouthernFriedInfidel** » Sat Oct 08, 2011 7:29 am

NOW they tell me: Don't do PSA screenings... According to these people, it's rare for prostate cancer to become "life-threatening" or even develop far enough to show any symptoms.

Perhaps.

I know that my brother has a very aggressive form of the disease, and it is eating his pelvis to the point that he can't really use it any more. My Dad's cancer did show up much later in his life, and was a slow-growing sort, so it's rather possible that he could have ignored his. But they chose not to... and the treatment ended up making his bones far weaker, and he ended up breaking his hip, which led to his death less than a year later.

In my case, my cancer had spread extensively through the gland, but had not yet affected it to the point of enlarging it or giving any symptoms. But it WAS showing signs of starting to mutate to a more aggressive form like my brother's. I think that's ample reason to believe that surgery was the best option. In the meantime, I'd say that the side-effects of the surgery have been minimal, and to be honest, I'm rather happy that I'm sterile... but far from impotent. After all, even if I was a younger man, I really don't think I'd want to be fathering any more kids, and passing on what is basically a set of poisoned genes. Good riddance, IMO.