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Myopic Macular Degeneration treatments?
I was diagnosed last year at age 35 with myopic macular degeneration with a bleed, in my right eye. Was referred to an area specilist, I had a six week old nursing infant. He wouldn't look up any info on what was safe and what wasn't and I felt really harrassed in his office. My other eye was fine so I opted for no treatment. I did start taking the alreds vitamins and a suppliment from the health food store with lutien, blueberry and billberry extract. Fast foward a year later and I have a small bleed starting in my left eye, still have nursing infant though she is a year now. Went back to him since he was all I knew, having done some research online. I just figured to not mention the nursing instead referring to Dr Tom Hale's book on medications and nursing. Anyway I am still really unhappy with this doctor, I tried to ask some questions and get gets in my face and raises his voice and will not let me. The only therapy he would consider is Visudyne. So I have two questions. 1. Is this the only treatment option for Myopic macular degeneration? He told me it was. Nothing else approved and says its my only option. 2. How does one go about finding a second opinion doctor? I have insurance AETNA. Thank you for your time. Oh i live in the Tulsa area. Any recommendations?
I can't help but chime in. Coming from a family full of physicians located in America, Singapore, and Germany, I have exposure to the issues from a more cosmopolitan point of view (yes, it makes for interesting conversations at Christmas time).
While many have spoken endless of the flaws in both systems, I believe some important points get overlooked. One major point is that compared to their peers in other developed countries, physicians in the U.S. are paid outrageous sums. While at the face of it, one may argue that this "buys" talent, it also encourages docs to go into higher paid specialties, to choose procedures with higher reimbursement rates, and devalues more patient-oriented treatment (reimbursements are the same for a cold as for a complex case). And somehow, in the midst of it all, empathy and compassion are often lost. Additionally, because physician salaries are typically much higher than that of the basic scientist, talented persons are drawn to become a clinician as opposed to doing research into etiology and treatment of disease.
I can honestly say that the docs in my family in Singapore and Germany are every bit as talented and intelligent as the docs here in the U.S., despite the disparity in income.
And yes, there is something wrong with a system that puts a hard-working person into bankruptcy through totally bad luck.
The system here could definitely be improved by focusing on preventative measures (just think of the health dollars that could be saved by reducing obesity - e.g., tax put on soda pop, anyone?)
While many have spoken endless of the flaws in both systems, I believe some important points get overlooked. One major point is that compared to their peers in other developed countries, physicians in the U.S. are paid outrageous sums. While at the face of it, one may argue that this "buys" talent, it also encourages docs to go into higher paid specialties, to choose procedures with higher reimbursement rates, and devalues more patient-oriented treatment (reimbursements are the same for a cold as for a complex case). And somehow, in the midst of it all, empathy and compassion are often lost. Additionally, because physician salaries are typically much higher than that of the basic scientist, talented persons are drawn to become a clinician as opposed to doing research into etiology and treatment of disease.
I can honestly say that the docs in my family in Singapore and Germany are every bit as talented and intelligent as the docs here in the U.S., despite the disparity in income.
And yes, there is something wrong with a system that puts a hard-working person into bankruptcy through totally bad luck.
The system here could definitely be improved by focusing on preventative measures (just think of the health dollars that could be saved by reducing obesity - e.g., tax put on soda pop, anyone?)
"I came into this forum with an open mind. The number of patients expressing their disgust with NHS in UK and Canada overwhelming bury the number of people that are pleased with it."
Excellent point but it is simply because they have not experienced the other side of the coin. Sure you get nice leather couches and minimum wait times here, but it is at a hefty price. Most UK citizens assume, as did I, that "insurance" pays 100%. Of course this is very far from the truth and I believe that if they knew this fact, their opinion would change rapidly. That is just my feeling; in short they don't know how good they have it.
I will take a look at that article, thanks for the reference. I take your points on some of the surgeries. Hip replacement is the one that gets a lot of attention and traditionally in the UK it has been a problem too. It is far from perfect but the example I always prefer to use is this. If I suddenly went down with a serious condition in the UK that required immediate surgery, I would get it no questions and without delay. The same would apply here of course but I would be left with a ridiculous bill a few months later, most likely sending me into financial ruin, even with very good so-called insurance. Too me, that is far from ideal and is very much a reality being a single post-doc with poor pay. You could argue for days about what constitutes a "serious" condition, but a good example in this case would be retina detachment.
It is often said that many Americans are one illness away from bankruptcy and I believe it. I am one of them as are most people on this forum no doubt. So if it was a choice between a dodgy hip for a few years or poverty (as the social system is generally inept here too), I know which I would choose. That's just me though.
Excellent point but it is simply because they have not experienced the other side of the coin. Sure you get nice leather couches and minimum wait times here, but it is at a hefty price. Most UK citizens assume, as did I, that "insurance" pays 100%. Of course this is very far from the truth and I believe that if they knew this fact, their opinion would change rapidly. That is just my feeling; in short they don't know how good they have it.
I will take a look at that article, thanks for the reference. I take your points on some of the surgeries. Hip replacement is the one that gets a lot of attention and traditionally in the UK it has been a problem too. It is far from perfect but the example I always prefer to use is this. If I suddenly went down with a serious condition in the UK that required immediate surgery, I would get it no questions and without delay. The same would apply here of course but I would be left with a ridiculous bill a few months later, most likely sending me into financial ruin, even with very good so-called insurance. Too me, that is far from ideal and is very much a reality being a single post-doc with poor pay. You could argue for days about what constitutes a "serious" condition, but a good example in this case would be retina detachment.
It is often said that many Americans are one illness away from bankruptcy and I believe it. I am one of them as are most people on this forum no doubt. So if it was a choice between a dodgy hip for a few years or poverty (as the social system is generally inept here too), I know which I would choose. That's just me though.
MEDICAL PROFESSIONAL
I came into this forum with an open mind. The number of patients expressing their disgust with NHS in UK and Canada overwhelming bury the number of people that are pleased with it.
If there was such widespread satisfaction with NHS Canada there would not be a booming industry of Canadians coming across the border into the USA for life-saving treatments they have to wait up to a year or more for in Canada: examples MRI, coronary artery angiplasty/stents, neurosurgery, cataract surgery, joint replacements.
For instance try reading WRITTEN BY A CANADIAN: "Too Old" for Hip Surgery, Wall Street Journal, 2/9/09 by Canadian Nadeem Esmail (page A17). Among the common horrowing stories are people with brain tumors that can't get MRIs and neurosurgery for 6-9 months and that of a vigorous, self employed man of 57 was refused hip surgery and condemned to live in pain because he was TOO OLD.
You may prefer the NHS but you are a minority on MedHelp eyecare forums.
JCH MD
If there was such widespread satisfaction with NHS Canada there would not be a booming industry of Canadians coming across the border into the USA for life-saving treatments they have to wait up to a year or more for in Canada: examples MRI, coronary artery angiplasty/stents, neurosurgery, cataract surgery, joint replacements.
For instance try reading WRITTEN BY A CANADIAN: "Too Old" for Hip Surgery, Wall Street Journal, 2/9/09 by Canadian Nadeem Esmail (page A17). Among the common horrowing stories are people with brain tumors that can't get MRIs and neurosurgery for 6-9 months and that of a vigorous, self employed man of 57 was refused hip surgery and condemned to live in pain because he was TOO OLD.
You may prefer the NHS but you are a minority on MedHelp eyecare forums.
JCH MD
"Well forces are at work to push medicine into a socialized system like Canada and UK where you will have to see someone whether you like them or not and where you will wait 3-6 months for an appointment to see an Eye MD."
Very out-dated view of the NHS doc. I'm disappointed in you. This is the kind of trash that Americans are fed to scare them away from a socialised system. I have experienced both extensively and I know which one I prefer - NHS!!!!!
Very out-dated view of the NHS doc. I'm disappointed in you. This is the kind of trash that Americans are fed to scare them away from a socialised system. I have experienced both extensively and I know which one I prefer - NHS!!!!!
Thats very wise about the insurance. I bet it saves a lot of confusion. The doctor I saw wouldn't do lucentis even when I said I could pay out of pocket for them. I think he's out of touch with the latest as odd as it sounds. I have found someone in OKC that I am going to try and see, he's in my network, and freely discusses Avastin and Lucentis on his site. So I feel I should get the treatment I want there. The only "fun" thing is two hour drive there and back. And hoping he can fit me in. (crossing fingers)
MEDICAL PROFESSIONAL
That's why I never discuss insurance with patients. Its too complex, varies from person to person, company to company. all Insurance at our offices is explained by an insurance expert not an optom or ophthalmologist.
JCH MD
JCH MD
I saw that hidden little tidbit in the new "stimulus" package. And called my state reps. Scary state of affairs, especially for elderly patients who will likely suffer more.
Working on the hiring of a different MD. We just caught this doctor in a flat out lie about what our insurance will or will not cover.
Working on the hiring of a different MD. We just caught this doctor in a flat out lie about what our insurance will or will not cover.
MEDICAL PROFESSIONAL
Well forces are at work to push medicine into a socialized system like Canada and UK where you will have to see someone whether you like them or not and where you will wait 3-6 months for an appointment to see an Eye MD.
Until then you can fire your MD and move on to someone you like better and whom you feel comfortable with.
When you call be sure you mention myopic macular degenration and likely macular neovascular membrane requiring urgent RX.
JCH MD
Until then you can fire your MD and move on to someone you like better and whom you feel comfortable with.
When you call be sure you mention myopic macular degenration and likely macular neovascular membrane requiring urgent RX.
JCH MD
Thank you for your reply. I have been on the phone most of the day trying to get a secondary appt but its proving very difficult.
The lawsuits are getting crazy I agree. Thankfully Dr Hale's book is widely available. For treatments with (lucentis, avastin, or visudyne) a temp weaning of 24-48hrs is sufficient. I didn't even attempt to discuss such things with this physician though. He became so irate over me asking the aternatives to visudyne, it was really disturbing.
I saw him last year for my right eye, baby was only two months old, and he was offended by breastfeeding at that stage, so he obviously has something against it, more than the usual.
The lawsuits are getting crazy I agree. Thankfully Dr Hale's book is widely available. For treatments with (lucentis, avastin, or visudyne) a temp weaning of 24-48hrs is sufficient. I didn't even attempt to discuss such things with this physician though. He became so irate over me asking the aternatives to visudyne, it was really disturbing.
I saw him last year for my right eye, baby was only two months old, and he was offended by breastfeeding at that stage, so he obviously has something against it, more than the usual.
MEDICAL PROFESSIONAL
You live in a metropolitan area so you have a choice of retina MDs find another near you at www.aao.org
This should be treated as an emergency. ACT NOW.
Usually Avastin and lucentis are preferred to visudyne therapy. So I think a separate new opinion is in order. But act now if more bleeding occurs the damage can be permanent and no treatment may work.
You can use the search feature and read many many informative posts on your problem.
By the way all their concern about nursing or pregnancy is due to the extremely high rate of lawsuits in the USA. It's killing the economy and adding billions to the cost of health care just to line the pockets of obscenely wealthy trial lawyers.
JCH MD
This should be treated as an emergency. ACT NOW.
Usually Avastin and lucentis are preferred to visudyne therapy. So I think a separate new opinion is in order. But act now if more bleeding occurs the damage can be permanent and no treatment may work.
You can use the search feature and read many many informative posts on your problem.
By the way all their concern about nursing or pregnancy is due to the extremely high rate of lawsuits in the USA. It's killing the economy and adding billions to the cost of health care just to line the pockets of obscenely wealthy trial lawyers.
JCH MD
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