Tuesday, March 18, 2014

Promising Drug Therapy for Parkinson's won't be Researched, yet

What if I told you there was a drug that could cause the Mean total score on the motor Unified Parkinson Disease Rating Scale (UPDRS) to improve significantly from 33.1 at baseline to 23.2 after usage and the analysis of specific motor symptoms revealed significant improvement after treatment in tremor, rigidity, and bradykinesia.

If you were a Parkinson's Patient, you might say, sign me up and if you were a doctor, where's my prescription pad.  However, if you're the US government, you'd be saying no, no, no.  Why? because while an initial study done in Israel showed these results, the title of the study was, "Cannabis (medical marijuana) treatment for motor and non-motor symptoms of Parkinson disease: an open-label observational study."  This research is thus nearly impossible to undertake in the US because, federal rules state that experiments can use marijuana only from a single, government-run farm in Mississippi. Researchers say the agency that oversees the farm, the National Institute on Drug Abuse, has long been hostile to proposals aimed at examining possible benefits of the drug.

In the last 10 years, the government had approved just one U.S. research center to conduct clinical trials involving marijuana use for medical purposes — a UC San Diego facility created by the California Legislature.  However, on Friday:
the Obama administration handed backers of medical marijuana a significant victory Friday, opening the way for a University of Arizona researcher to examine whether pot can help veterans cope with post-traumatic stress, a move that could lead to broader studies into potential benefits of the drug.

This is the start and while I don't believe that Marijuana will be the wonder drug some people think it is.  It will be scientific research that proves or disproves that theory, not some anti-drug politician who still believes that evolution is only a Theory.

Tuesday, February 4, 2014

Don't make light of your symptoms

So, I was throwing up Sunday morning around 1:00 am, which I figured was my monthly gag fest due to Parkinson's Medications.  I threw up a bit, but my chest was also hurting.  I didn't take much thought in this, because I was throwing up at the time, but the chest pain continued throughout the night.  When my wife woke up around 6:00 am, I told her of both the vomiting and chest pains and she insisted that we go see a doctor. This is a normal fight between us, as when I was first having PD symptoms, I didn't want to go and when she first had back problems, she didn't want to go and see her doctor.  Nevertheless, I knew better and insisted that we go to the nearby urgent care facility instead of an emergency room or calling 911.

We arrived at Urgent Care at 8:00 am when they opened and I was third in line.  Because I was complaining of chest pain, they took me right away (ahead of the second person) and took blood and ran an EKG.  I told my wife to take the kids to Sunday school and after I was done, I'd get a cab to take me home the 1-2 miles.  Needless to say, I didn't go home.  The EKG read normal but the blood test showed an elevated level for one of the heart enzymes, specifically my Troponin level measured 0.33 which was higher than the acceptable level of 0.10.  Because of this, the urgent care doctor called the local hospital and had me admitted and sent there via ambulance.  In the mean time, I had called my wife to let her know I was being hospitalized and where I would be.  She took the kids out of Sunday school and met me there as the ambulance arrived.

Unfortunately, do to flu season, the hospital would not let kids under 14 into the patient rooms.  Therefore, a friend sat with them as we began to talk to the cardiologist on call for Superbowl Sunday.  They observed me for a few hours and then retook my blood test after eight hours later.  Everyone expected my levels to drop or stay the same because both a subsequent EKG and a ECHO cardiogram the doctor did with a handheld device showed no sign of any problem with my heart.  However, the Troponin levels actually had a 10x increase to 3.9 from the previous level of 0.33.  We were all very confused.  They scheduled me for an angiogram the next day which is  the gold standard test to see if there are any problems and told me it would occur probably around 11:30 am.  The angiogram did not occur until about 4:30 pm Monday afternoon.  However, it showed a nearly 100% blockage in my circumflex artery which they immediately cleared and placed a stent in it's place to prevent further blockages.

So, yes, I did have a heart attack at age 42.  Luckily, it was the circumflex artery and not another.  Also, the EKG and ECHO tests showed no real damage occurred to my heart.  Therefore, once again we were very lucky.  I was given an additional 3 medications to use at least for the next year as well as baby aspirin.  I am also not going to be racing in the LA Marathon next month for Team-Parkinson, but will look into another race this summer.  I was released from the hospital today, but will see my cardiologist in the next couple of weeks to do a stress test and discuss with him my future options.  Also, with the new medications (particularly the aspirin and additional blood thinner) I probably will not have an opportunity to discuss making my Deep Brain Stimulator bi-lateral.

Take care, and I hope if you get anything out of my experience, don't take new symptoms or feelings or pain lightly.  If your gut tells you there seems to be something wrong, go with it, because there just may be something wrong.

Thursday, December 12, 2013

I should pay my plumber more than my neurosurgeon

Yumabev made a joke about one of my posts on twitter, that I've been mulling over for a few days.

After a few days, I realized, no shit, her plumber should be making more.  You see, when you get a bill from the hospital, it is usually includes everything, including that $20 aspirin that they charged you 5 times for, but you only took once.  But I digress.

Included in that bill is the amount that the neurosurgeon is paid for the 5 hours of surgery that he performed on my head.  However, the neurosurgeon is only being paid for his time.  He didn't bring in a scalpel, anesthesia, gloves, gowns, let alone the actual device that was implanted in my head.

When you pay your plumber, you are paying for everything, including all of his overhead and expenses.  The better question is after the plumber paid for vehicle expenses to get to your home, parts, a staff at the office to take your appointment, all the inventory he/she has to carry, let alone all the specialized equipment he/she had to buy and maintain, what is he taking home at the end of the day and what is the neurosurgeon.  I'd say the neurosurgeon is taking home an amount much closer than to $1500 than the plumber is, let alone the $2500.

Why Are American Health Care Costs So High?

Best explanation I've seen of the problem with healthcare in the US. EVERYTHING is overpriced and costs to much and there is no sense in why things are charged except to screw over the patients and get as much money out of them as possible. Most interesting fact: We spend more on government provided healthcare in the US per capita than any other nation, but don't provide everyone with healthcare.

Sunday, December 8, 2013

How is anyone supposed to make sense of health care costs?

I got my bill for the hospital stay when I had my DBS electrodes installed.  Granted this did not include my stay at rehab due to my stroke or my subsequent outpatient surgery for the pulse generator.  What pisses me off, confuses me and/or frustrates me is the nonsensical billing system we have in the US.

Without giving exact numbers, the hospital billed my insurance company approximately $171k for my surgery and stays.  The insurance company paid just about $24k of that.  There is also a line that states adjustments for approximately $146k.  If you look up hospital adjustment online it states,
“Adjustment” refers to the portion of your bill that your hospital or doctor has agreed not to charge you.
Now, I understand that insurance companies get discounts for bringing in large populations of folks.  However, my insurance company paid basically 15% of what the hospital charged.  I wonder how many folks without insurance or with worse insurance than mine could possibly get the hospital even close to that value.

The fact that most people probably don't know this is even more incredible.  When I hear of doctors not wanting to take ACA or medicaid/medi-cal or some other non-premium insurance, I just have to laugh, because the premium insurance companies are definitely not paying full price, let alone wholesale prices.

UPDATE:  Another issue with this is the way co-pays are calculated.  Luckily, my insurance is a flat fee co-pay for a hospital stay.  However, if I had a percentage based co-pay, my co-pay would have been calculated based upon the original hospital bill of $171k.  Therefore, I would have been liable for 10-20% of that bill up to my out of pocket maximum, while the insurance company knew it would be paying the lower fee.

Either the insurance company is paying less than even $24k for the surgery if my co-pay is calculated based upon a percentage of the $171k.  Or the hospital is getting more money because they can take the $24k the insurance company agreed to plus my co-pay.  Either way, there is no incentive for either the hospital or the insurance company to bill the patient correctly and the patient gets screwed.  The higher the hospital makes the bill, no matter what they've negotiated with the insurance company, the more money comes out of the patients pocket while the insurance company possibly reduces what they are paying the hospital or the hospital brings in more money and the patient gets screwed.

Monday, November 25, 2013

Conservative 'logic' on Obamacare

A relative has been going off on facebook for weeks/months about Obamacare.  I've stopped engaging because he is always changing the subject and is so over the top that I just got tired of it.  However, I'd really like to understand the logic, if there is any.  So, based upon his posts, this is what I understand is his thinking.

The fact that people under 27 have an option for lower price insurance under their parents plan is bad, but the fact that they don't buy insurance when they are young was okay because they shouldn't have to buy it and their irresponsibility is their problem, even though those of us who bought insurance were covering those who didn't in the past because they would usually skate on the bills when something did happen. You are also okay with the fact that if young people waited to buy insurance, they would not be able to after the fact because of the no-pre-existing conditions clauses or they often were buying cheap insurance policies that would drop them at the hint of filing a claim because of some technicality the insurance carrier found or they'd often reach their lifetime max just when they'd need their insurance the most.  
The biggest issue to worry about with respect to access to insurance is that a website doesn't work from the get go, even though folks have three months to sign up and statistics have shown that historically younger people wait until the last few weeks to sign up.  And the costs are way too high, even though the CBO, a non-partisan entity, has shown that the ACA will actually reduce deficits.  And the fact that most of the dropped policies are irrelevant to the 90% or greater that do not buy insurance on the individual market and 75% of those who buy on the individual market are eligible for subsidies does not matter because one anecdotal story or even 100 anecdotal stories are more important than the millions who have already seen the benefits of the ACA even if they are one of those anecdotes.

Am I missing anything?

Thursday, November 14, 2013

Why I will never buy a Kenmore appliance or any other appliance from Sears again

We bought our Kenmore dishwasher in 2010.  It has now broken for the fourth time.  The interesting thing is, the same part keeps failing; however, Sears still wants to charge me for my fourth Control Panel to install myself.

When it broke the first time (13 months after we bought it, one month after the warranty ran out) in December 2011, we had an appliance repairman, whom I found on yelp.com, come out and fix it because he charged $35 for the visit plus parts, while Sears wanted much more.  The other thing the repairman did was show me what he was doing so I could fix it myself if I had too.  I have degrees in Mechanical Engineering and Computer Science, so I am able to understand how to fix appliances when shown.

Low and behold, eight months later,  in August 2012, the same part goes out.  I went on SearPartsDirect.com and found the part and ordered it myself and did the install as instructed.  It then failed another 9 months later in May 2013, so I ordered and replaced the same part again.  These dishwashers are the same as Whirlpool and Maytag brands as well, and if you do a google search on control panel failures, you can find a huge number of people with similar issues.

This brings me to last month, when for the fourth time, the control panel failed again.  I called Sears, including their executive helpline, and explained the situation, including the providing the order numbers for the multiple control panels I had ordered.  I was told, that earlier this year, Sears changed their parts warranty and instead of one year, it is now 90 days.  Hmmm, I wonder why?

The dishwasher itself cost less than $400.  I have now spent over $300 in parts, and Sears wants to charge me another $112 so I can fix it again.  My wife and I decided that even with Thanksgiving coming up and 15 people over for dinner, we can do without a dishwasher for a while.  Sears sold me and I suspect a lot of people a lemon of a dishwasher and they will not get another cent from us.

UPDATE: Sears noticed my tweet of this post and called me to offer me a brand new dishwasher at 25% off.  Wow, what a deal.  That only puts me another $200-$300 in the hole to Sears.  Are you kidding me?  I also have no guarantee that this one won't fail and if I buy a more expensive dishwasher to make sure it does not fail in the future, I will be out even more money than I paid for the original dishwasher 3 years ago.  I told them that their deal was not acceptable and I would now no longer shop at Sears.