this post was submitted on 12 Sep 2023
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[Outdated, please look at pinned post] Casual Conversation

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So I have an ulcer. I dry heave at least once a day and I haven't eaten in 21 days. (Please do not give me advice, I hate it, I don't want medical advice from people over the internet. At best, if you do, I'll respond with a "thanks.")

I'm in a somewhat smaller town, not really small, about 80,000 people maybe. There is exactly one gastroenterologist in this town. I went to him when I hadn't eaten in 6 days. For a $50 copay, he said to take some Mylanta along with the Protonix I was already taking and call him in two weeks if I wasn't better. So I call him yesterday. I talk to the nurse. I tell her all my symptoms, none of which have changed. She sounds very concerned.

I hear nothing all day. This morning, I call again. The doctor hasn't even gotten to my information. So the nurse sends a message that I called again, which he probably also won't see.

I have tried to get a second opinion, or just another prescription for something, but there is not a single gastroenterologist within a 90 minute drive that would see me within three months. I'm pretty sure if I don't eat for three months, I'll be pretty dead. I mean, I'm living on Ensure and Gatorade, but I doubt that will get me to three more months.

Oh, and this is the second time this has happened. The first time, I had to take a bunch of tests like a CT scan and an X-Ray and a blood panel and they found nothing. I had a scheduled colonoscopy anyway, so they just went down my throat as well and that's when they found the ulcer. No one even suggested an ulcer before that.

Why am I saying all of this? I'm not even complaining about all of this. I'm complaining about the fact that this has cost me almost $2000 already and I feel lucky because I have good insurance. I'm not poor, but I don't really have $2000 to spare. I'm paying it off in installments, but god damn, I have to pay all of this money and they have stopped even giving a shit about me.

What would someone in my position without insurance even do? Die? That's what conservatives fucking want.

We need universal healthcare and a complete overhaul of the healthcare system now.

And any time you hear someone complain about how long a wait you have in Canada or the UK to see someone to help you and how America has the best healthcare system in the world and how people from other countries come here for treatment, send them to this post before telling them to get fucked.

TL;DR No one gives a shit about you in American healthcare except maybe the nurses and all they do is suck money out of your bank account.

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[–] dudinax@programming.dev 88 points 1 year ago (3 children)

My doctor's nurse called me up and said I had a high liver enzyme. "What does that mean?" "You can't drink alcohol." "But what's going on with my liver?" "I don't have the details, you'll have to talk to the doctor." The doctor moved away before I could get in to see her.

I called her partner. "New patients are six months out." Six month's later: "Sorry the doctor moved away."

Pick a random doctor in the phone book. "New patients are six months out." Six months pass. I miss the appointment. "I want to reschedule." "Sorry, the doctor won't see patients who miss their first appointment." I'm trying to get in to the next doctor. So far I have no idea what's wrong with my liver.

Among other problems, it turns out our local health care group was bought out by venture capitalists. Their mismanagement is part of why so many doctors are leaving.

[–] FlyingSquid@lemmy.world 35 points 1 year ago (2 children)

When I talked to the nurse yesterday, she asked how much Ensure I was drinking. I said I had a bottle twice a day. She said, "that's all you're having?" I asked if I should drink it more often and she said, "I would, but don't take my advice because I'm not the doctor." Gee, thanks lady.

[–] AttackBunny@lemmy.world 13 points 1 year ago (1 children)

I know you don't want advice. I know, but, there are meal replacements, that aren't nothing but sugar, corn and soy crap, and are much more nutritionally complete. May be worth looking into them. Huel and Soylent (sold in Target for sure) are the first that come to mind. I understand if your reply is "thanks" just wanted to throw that out there, because I feel your pain.

I have ALL kinds of GI issues. The latest GI I saw, after waiting like 2 years during covid (had one appt before lockdowns, and then had to wait), and then another like 4 months after I called to book an appointment, ran a HIDA scan, which came back as low/abnormal. His answer? Oh, well it's too close to normal to do surgery, so just take miralax and don't eat fatty foods. Gee thanks, why didn't I think of that, professionally trained guesser extortionist? When asked if there were going to be long term effects from taking a laxative, like, idk making constipation worse, his answer? IDK, maybe?

Good luck

[–] FlyingSquid@lemmy.world 6 points 1 year ago (1 children)

I don't think I could handle Soylent from what I've seen and read about it. I can just about take the Ensure without feeling too sick. I think the sweetness actually helps.

But now I'm just stunned. The gastro's nurse just called me back and said first thing, "he wants you to have small and regular meals." I don't know how many more times I have to tell this asshole that I'm not eating.

[–] SkyezOpen@lemmy.world 9 points 1 year ago

That's a severe calorie deficit. A friend who had ulcers told me about ensure plus, it's like 350 calories per bottle vs 220 for regular ensure. 3 or more a day should help keep you from wasting away while the medical system does what it does. The nurse probably isn't legally allowed to give medical advice, but they absolutely know their shit and I would definitely listen to whatever "suggestions" they give you.

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[–] WoahWoah@lemmy.world 8 points 1 year ago* (last edited 1 year ago)

You're the person that made the "shitting out the neck of their shirt" comment that had me dying laughing. 🤣

I've started just getting bloodwork done out of pocket instead of: going to a doctor, getting the blood work order, going to the lab, getting the draw, making an appointment with the doctor again, returning, and then getting the results.

Now I just pay $50, get the results myself, and then go to a doctor if I need to address something in the results that I can't figure out by googling. I know it's absurd, and I have insurance, but to get one blood test is an hour to go to the doctor, wait, go to the clinic room, wait, talk to the doctor for 5min, leave, go to the lab, repeat, then go back to the doctor abs do it again. It ends up being like 3-4 hours over multiple days and in the middle of the workday. For the doctor, it's two 5min conversations that are PART of their workday.

So, yeah. I tend to just run my own diagnostic blood tests and Google. That's how inconvenient and frustrating the medical system is even WITH insurance.

And, to be clear, I don't suggest anyone else do this.

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[–] qyron@sopuli.xyz 75 points 1 year ago (1 children)

That was morally painful to read.

As someone who lives in a country with a national healthcare system, this kind of situation just disgusts me.

You'd probably be in an hospital bed here, waiting for emergency surgery, considering your condition.

I sincerely hope you can find any other doctor capable of helping you, quickly.

[–] FlyingSquid@lemmy.world 29 points 1 year ago

Thank you very much. I appreciate it. I wish I lived in a sane country.

[–] BallShapedMan@lemmy.world 23 points 1 year ago (1 children)

It's fucked and I'm sorry you're a victim to it.

There are small pockets where it doesn't suck. My current company has amazing benefits where my youngest had to have major surgery and it literally cost $100. My previous company however my wife had to have minor surgery and 6 years later we still owe them $23k. We're paying it off slowly.....

[–] FlyingSquid@lemmy.world 16 points 1 year ago (1 children)

$23k is insane. This is what I mean. It's so broken.

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[–] Nemo@midwest.social 18 points 1 year ago (1 children)

Honestly, I got much better and more attentive medical care when I was broke and on Medicaid than in the years since I got private insurance.

Like you said, it takes forever to get an appointment (which might get cancelled without rescheduling) and when you do go in, they just refer you somewhere else, possibly out-of-network. At the Medicaid clinics, they do it all in-house and typically same-day.

I'm fully on the Medicaid for All train.

[–] FlyingSquid@lemmy.world 14 points 1 year ago

I'd say Medicare for all. It's even better than Medicaid.

[–] Furbag@lemmy.world 18 points 1 year ago (1 children)

I'll commiserate with you on the fact that the healthcare system is totally broken. My Mom has had a problem with one of her leg nerves for over a year and a half now, and she has been going in to see specialists, getting told "this is what you have, here's what we can do", getting the prescription/treatment, having it not work at all, and then gets told to get back in line for another appointment with several weeks, if not months, of lead time. Even when she gets put on a priority list for when there are cancellations, there's almost never a cancellation that let's her get in earlier than her original appointment.

In her case, I'm not blaming the doctors. They are trying their best. I just don't understand how it can take 1-2 months per visit, or even upwards of 6 months, and meanwhile she is in agonizing pain whenever she stands or walks too long.

Meanwhile, I just paid out $6k in dental bills this year alone because my regular dentist missed a cavity until it became bad enough that it required a root canal, but they tried to fill it first and it didn't work, so then I had to pay for the botched filling procedure (partially covered by insurance), and a root canal that sadly doesn't seem to have made the tooth any less sensitive, and copayment fees to other dental providers for second opinions because my tooth still hurts even after all they did to it and I want to know what else could do to help, and now I am looking at paying another $3000+ to have the tooth extracted and replaced with a prosthetic implant, which was an option in the first place but they encouraged me to try the fillings and the root canal to "save" the tooth first. Now, I'm trying to wait until January 1st to have my benefits reset so it softens the blow significantly, but until then I'm suffering with this zombie tooth rotting away in my mouth.

The healthcare system in America is fucking garbage and needs to be destroyed and rebuilt with a human-first mindset, not a for-profit mindset.

I hope you are able to get the treatment you deserve. Stay strong and stay positive.

[–] FlyingSquid@lemmy.world 12 points 1 year ago (2 children)

Thanks, I appreciate it. My father got $20,000 worth of dental work for free in Costa Rica and got a vacation in Costa Rica out of it.

[–] DharmaCurious@startrek.website 6 points 1 year ago (5 children)

How free? My mom needs all of her remaining teeth extracted (23), plus dentures made.

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[–] Agrivar@lemmy.world 5 points 1 year ago (1 children)

My father got $20,000 worth of dental work for free in Costa Rica and got a vacation in Costa Rica out of it.

HOW?!? I probably need close to that much dental work done and there are literally no dentists in a 50-mile radius that are accepting new patients.

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[–] medgremlin@lemmy.sdf.org 15 points 1 year ago

As a former healthcare support staff professional and current medical student, I want you to know that I hate it just as much as you do. I can't make any explanations for that GI, but my least favorite part of medicine is when there isn't a good answer, or enough time, or the right treatment is just too expensive...I hate it when the capitalist bullshit medical system gets in the way of actually practicing medicine.

[–] AA5B@lemmy.world 15 points 1 year ago

What would someone in my position without insurance even do? Die?

Even those who have good insurance and can afford ….. my doctor’s office stopped refilling my prescription, stopped returning my calls, after he had expressed concern about not wanting me to “stroke out” over my condition. I doubt it magically fixed itself, but I’m still having a hard time overcoming inertia to find a new doctor

[–] andyburke@kbin.social 14 points 1 year ago (1 children)

I know you don't want advice, but I want to share some information that may be important and helpful for you: recent studies have shown ulcers are essentially an infection and antibiotics have some success in treating them.

For too long doctors thought it had to do with stress or diet, but it's an infection.

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[–] Jackthelad@lemmy.world 11 points 1 year ago (4 children)

I've never heard anyone say that the American healthcare system is the best in the world. Even from critics of universal healthcare.

The best systems are mixed systems like you see in Germany or the Netherlands. As someone from the UK, don't fall for the propaganda about the NHS. It's really not very good.

[–] PugJesus@kbin.social 14 points 1 year ago* (last edited 1 year ago) (1 children)

I’ve never heard anyone say that the American healthcare system is the best in the world. Even from critics of universal healthcare.

Count yourself lucky. I live in a conservative area in the US, and it is a constant refrain.

Worst part is, these people bitch about their own healthcare quality and costs all the time. It's just...

... exhausting.

[–] Mog_fanatic@lemmy.world 4 points 1 year ago

Second this. I've heard it many many many many times. "You may have to pay but you won't wait and it's the best in the world! People come from all over the world here for treatment!"

[–] FlyingSquid@lemmy.world 10 points 1 year ago (1 children)
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[–] merridew 5 points 1 year ago (4 children)

It's not very good now that the Tories have starved it of funds for over a decade with a view to selling it off.

In 2005, Direct Democracy: An Agenda For A New Model Party was co-authored Jeremy Hunt Michael Gove, David Gauke, and Kwasi Kwarteng, among others.

On page 78, it states that

Our ambition should be to break down the barriers between private and public provision, in effect denationalising the provision of health care in Britain.

And on page 74 asserts that

patients, either through the tax system or by way of universal insurance, [should] purchase health care from the provider of their choice

NHS c. 2009 was excellent. Don't forget that.

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[–] Blaze@discuss.tchncs.de 10 points 1 year ago (1 children)
[–] FlyingSquid@lemmy.world 7 points 1 year ago

I appreciate it.

[–] fkn@lemmy.world 9 points 1 year ago (1 children)

This probably won't help you since you live in a small town.

Finding a doctor in the united states sucks. Literally the worst experience I have ever had was transitioning to a PPO insurance policy after being in a combine managed HMO / healthcare group.

People told me for years "oh, that health care provider sucks. You get sub par care and nobody ever knows your name." You know what else I got? Same day doctor visits and same day specialists, literally anytime I wanted or needed anything. I had reasonable medical care at a reasonable schedule for a reasonable price.

When my insurance switched to a PPO, people told me "oh, you will love this doctor! He is so great!" And... every... single... time... it is exactly as you described. "New patients are 6 months out." And when I finally got a primary care doctor, they would recommend specialist who were their friends also in private practices with 6 months waiting lists.

Private practice medical care is an absolute joke. It's another shitty system the boomers saw their parents use successfully that simply doesn't work today.

The solution was to find a high quality medical group in my city. It took me nearly a year to figure it out. Same day doctor visits? Done. Same week specialists? Done. Same system / in network urgent care at the same price as a regular doctors visit? Done.

I don't care which doctor I see, I just need medical care.

[–] FlyingSquid@lemmy.world 6 points 1 year ago

Exactly. I just want someone to help me. Apparently that's too much to ask.

[–] dan1101@lemm.ee 9 points 1 year ago (1 children)

Sorry to hear about everything you're going through and how much it costs for no treatment. I think a lot of doctors do care but they are overworked and have to constantly battle hospitals and insurance companies. A lot of them seem to be seeing less patients which is not going to be good, and many are retiring or burning out. There are also now more seniors than people under 17, the seniors require more care. Article on the doctor shortage: https://time.com/6199666/physician-shortage-challenges-solutions/

[–] FlyingSquid@lemmy.world 13 points 1 year ago (1 children)

Thanks. I understand what you're saying, but when I tell a doctor I'm not eating twice and he says to me keep taking your pills before you eat, I don't think he gives a fuck. He seems like a nice enough guy, but he's apparently a terrible doctor. And I don't have anyone else I can go to. I mean I know why. This is one of the shittiest towns in the country, Terre Haute, Indiana, but still...

[–] dan1101@lemm.ee 7 points 1 year ago (1 children)

Yeah that doctor definitely is not doing their job. What do you call the person that finishes LAST in medical school? Doctor.

[–] FlyingSquid@lemmy.world 8 points 1 year ago (8 children)

I was concerned when I first met him. The guy has terrible teeth. That alone is not a good sign of a doctor. A doctor that doesn't care about his own health?

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[–] AllonzeeLV@lemmy.world 9 points 1 year ago* (last edited 1 year ago) (2 children)

Just another symptom of how rigged our economy is!

https://www.cnbc.com/2021/10/18/the-wealthiest-10percent-of-americans-own-a-record-89percent-of-all-us-stocks.html

Unless this is ever addressed, the symptoms will only get worse over time. The system is designed to siphon the nation's capital to the owner class, they aren't interested leaving you enough to get medical care, quality food, acceptable education, etc. You are nothing but livestock to the people that control this nation through the economy and the fully captured government, and they use it to make sure you don't have a scrap for yourself.

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[–] PugJesus@kbin.social 9 points 1 year ago (1 children)

Wait, they didn't prescribe you anything when they found the ulcer?

[–] FlyingSquid@lemmy.world 9 points 1 year ago (1 children)
[–] PugJesus@kbin.social 6 points 1 year ago (1 children)

Huh. That doesn't seem like much for something that stops you from eating, but I guess I'm not a doctor, or privy to the details of your ulcer. I remember when I went in with an ulcer they acted like it was full red alert.

Anyway, I sympathize. I still have to bounce around between gastroenterologists because I have the same problem getting in - and half the doctors in my area leave after a short time here. "You need a new gastroenterologist" invariably ends up with a lot of "We're not taking new patients, please call back in a couple of months".

[–] FlyingSquid@lemmy.world 7 points 1 year ago

Thanks. We did research on it and loss of appetite is one of the symptoms. See here, for example under 'loss of weight.': https://www.manhattangastroenterology.com/8-signs-you-may-have-a-stomach-ulcer/

[–] JPAKx4@lemmy.sdf.org 7 points 1 year ago

I'm so sorry you have to go through all this crap. I'm lucky that I live in the Houston area, so tons of doctors and even luckier that I have amazing health insurance. Still had to pay thousands of dollars for a surgery since the insurance didn't want to cover it (it was slightly "experimental", but it also worked). The US system is screwed up, favors the wealthy, and has lots of profit motives that are counter productive for the "consumers".

What I hate is that people defend it. I hear arguments about how if there was a one payer system then doctor choice and quality would go down, or that it would hurt rural hospitals. And it's just all false, but no matter how much you show studies or explain they just keep pivoting. It's not even a majority of people, but since it's a vocal minority that votes more, it still hasn't changed.

[–] PraiseTheSoup@lemm.ee 6 points 1 year ago (2 children)

I canceled my dermatologist appointment last winter because it was a 30 mile drive to the clinic and it was the worst blizzard we'd had all year. The soonest I could reschedule was 7 fucking months out. In truth all I needed from that visit was for him to renew my prescriptions, but I'm forced to go in and pay $300 for an office visit to do it.

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[–] eochaid@lemmy.world 6 points 1 year ago (2 children)

My problems aren't anywhere near as bad as yours, but I'll add my own complaints to comiserate at least.

My wife is a type 1 diabetic. I have a pre-diabetic A1C (type 2) that i inherited from my mom. My insurance (Blue Cross Blue Shield) claims they cover preventative care. But they refuse to cover our regular A1C tests - it's not preventative because they already know what you have. As a BCBS support person told me, if they're throwing spaghetti at the wall, its preventative. If they're aiming for a spot - it's no longer considered "preventative". So thats like $600 - $1000 a year. Chump change compared to many in this thread, I know.

Also, for some reason, they only offer coverage for one type of insulin - novolog - which happens to be the one insulin that causes my wife issues. She's type-1, so her immune system killed her insulin production at around 5 years old. She's dependent on insulin to survive and uses an insulin pump. Novalog is less effective than literally every other insulin for her - which means she has to take more - which means more risk of long term problems. This insulin also requires a pre-bolus (basically taking insulin) of 1-2 hours before every meal. That means every meal has to be preplanned and prepared for or she starts a rollercoaster of highs and lows. Humalog, aphidra, fiasp? All work more efficiently and within like 15-30 minutes.

The local HMO my work used before offered tiered options. We could pay a bit more for a better option. I would have no problem paying double to get her Humalog. BCBS says no. Novalog or pay out of pocket.

I have occasional headaches that start in the back of my neck that turn into bouts of depression followed by mania a few days later. My neurologist wanted to do a full MRI panel to look for issues. Insurance denies it - medically unnecessary. The neurologist appeals and they're like "fine fine, but we'll only cover the head, not the neck" even though the pain started from my neck. They don't find anything in the head. So the neurologist says, "well unless you want to pay out of pocket, we can't check the source so.....assume it's just migranes?"

Oh and by "cover", I mean they paid a small part of it. It still cost me $1,500 to do the ones that were "covered".

That's a smattering of the interactions I've had with my insurance that I can remember right now.

My parents are retired and on medicare. They pay far less and get way better medical care than I do with one of the biggest private insurance chains in the country. Go figure.

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[–] Cris_Color@lemm.ee 6 points 1 year ago

Christ, thats fucking horrible

[–] jeffw@lemmy.world 5 points 1 year ago

OECD data actually puts the USA in the middle of the pack for wait times for specialty care for developed nations. I believe it could largely be solved by companies switching to advanced access/open access scheduling models, but most are too afraid to upend their business model.

Lmk if you have any questions about navigating appointments, I’m actually in grad school studying healthcare business. My only real suggestion at this point is to use your doctor’s electronic portal for communication. In many cases it’s more effective than a phone call, plus you have written records.

I know you said no medical advice, but I’d ask a doc about H Pylori. Always something that should by ruled out in cases like these.

[–] negativenull@lemm.ee 5 points 1 year ago (6 children)

My gastroenterologist story:

Chronic GERD. Talk to family doctor, who refers me to a gastroenterologist (one that is "in network" for my insurance"). My insurance is from my wife's job, who works at a hospital, which you'd think was good. More on this tidbit later.

Go to Gastro doctor (took 2 months to get in), recommends an Endoscopy, which is scheduled for 1 month later. Initial visit is covered (mostly/kind-of) by insurance.

One day before Endoscopy, get a call saying my insurance won't cover the procedure there, and I'd have to pay out-of-pocket if I proceed ($5k estimate). I say no thank you.

I call insurance company about better location, and am referred to another gastroenterologist. I tried to just get an Endoscopy at new location, but they refused to do so with an Gastro doctor visit with THEIR doctors. I schedule visit at new office (1 month to get in).

Go to NEW Gastro doctor, recommends an Endoscopy, which is scheduled for 1 month later. Visit is covered (mostly/kind-f) by insurance.

One day before Endoscopy, get a call saying my insurance won't cover the procedure there, and I'd have to pay out-of-pocket if I proceed. I say WTF. Turns out the Insurance company recommended me to a Doctor who was In Network, but their procedure location is NOT in network.

Apparently, despite having a PPO insurance, there is "In Network" and there's "in IN network", since my insurance is through my wife's hospital plan. I have to have the procedure at an official hospital location that is part of my wife's hospital network.

I schedule an endoscopy at a 3rd location (1 month out again). Finally get an Endoscopy completed.

From initial referral to Gastro, until completion of Endoscopy, was 6 months. This was on supposedly good insurance (which was obviously a lie). We don't have that insurance anymore.

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[–] Fuck_u_spez_@sh.itjust.works 5 points 1 year ago* (last edited 1 year ago)

To your point about delays, I waited over two years to see a psychiatrist in a huge university hospital system -- one of the only places which would even accept my shitty insurance -- as a person with suicidal ideation. It's so fucked.

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