Showing posts with label Grapefruit. Show all posts
Showing posts with label Grapefruit. Show all posts

Monday, March 11, 2013

Two-Buck Wound Vac (update!)


In the weeks after my right kidney was taken out, I did some research on "wound vac" equipment. Wound Care staff told me it would accelerate healing by drawing fluid out of the incision site and promoting blood flow to the surrounding tissue.

I couldn't afford the $1000-$2000 weekly rental, and I wanted to see if there was a cheaper alternative. There were several writeups about Danielle Zurovcik and her inexpensive hand-operated vac. Her invention was tested in the field in the aftermath of the 2010 Haiti earthquake. The team was only there for ten days, so they couldn't test for quicker healing. But the dressing and negative pressure did keep wounds cleaner than a traditional dressing and allowed for less-frequent dressing changes.

Dr. Zurovcik followed this with a 2011-12 clinical trial in Rwanda. From there she was able to finalize the design.

Her invention is the first product from her new company, WiCare (Worldwide Innovative Healthcare Inc.), which aims to get medical devices to those least able to afford them. If I'm reading things correctly, that includes here in the States.

Thursday, December 6, 2012

Good Times, Bad Times, You Know I Had My Share...


Lots of medical stuff happening, finally.

Ever since I got bumped from Florida's "Medically Needy" program in July of 2011, I've been coasting along on the MediPass program instead. In theory, at least, I've got the same coverage, except that everything has to go through my MediPass doctor, who I only get to see every three months.

If I need to see any of my established doctors (vascular surgeon, urologist, kidney mechanic), I have to call (and call and call and call) the County Clinic and hope that I'll get the Physicians' Assistant--or that she'll reply to my voice mail. So far, I've never gotten a successful referral by phone. I always end up having to wait until the next actual physical face-to-face can't avoid me this time visit with the County Doc.

I'd been trying to get a referral for a urology visit since this past May, but it wasn't until I was in the room with "Dr. County" (or "Dr. Useless") that I finally got two referrals--one for a CT scan to see what my torn aorta has been up to, one for the urologist. I got the CT referral in two days.

The urology referral took more than two months.

CT scan results were bad. My remaining kidney can't handle the iodine contrast required for a vascular CT, so all the CT showed is that my aorta has enlarged significantly from the top of the arch down to the pass-through in the diaphragm. Without the contrast, there's no way to see the dissection.

I had a copy of the report sent to the vascular doc, but I can't go see him without...a referral.

Remember all that horseshit from Republicans screeching about the evils of Obamacare, that it would mean the government getting between you and your doctor?

Well, the reality is that Florida's MediPass system--currently being misadministered by Republicans--is between me and my doctors.

So I have yet to hear back on my calls trying to get someone to write me a referral for this one.


Stuff really started rolling in November, though.

First, Nobel Peace Prize Winner President Obama kicked ass, took names, and humiliated a bunch of billionaires and Mitt Romney. Nothing to do with the medical stuff, but gawddamn it still feels good.

I got a call from the urologist's office, went in, and started the ball (hehehe) rolling to say goodbye to my little friend after a bit more than three humiliating years. Surgery was yesterday. Sore as hell (feels like I took a knee to the groin), can't sleep, walking like a crab, sitting very very carefully. I keep having to reassure myself it's finally gone. For anyone thinking of the do-it-yourself approach, it's just not worth the effort. Aside from the risk of infection, the damn thing will just keep coming back. I've been there, with no medical coverage and unable to pay for much more than a single doctor visit. I was told that the doc's fee alone would be about $1500 for less than an hour's work. Then there's the anesthesia, the hospital fees, and all that. That was in May of 2010, before high blood pressure damaged my aorta and put me onto Disability and Medicaid. Until then, I was making just above minimum wage and couldn't afford my company's medical coverage. Sucks that I had to go through all that to be able to get treated for a hydrocele. Here's hoping that the Affordable Care Act will get everyone at least a start toward medical coverage they can actually pay for.

In the "even better" column, a week ago I got a notification of "Case Action" from the Department of Children and Families advising me that I'm back on the "Medically Needy" program as of January 1, 2013. I'll be able to just go to my regular doctors again, flash my Medicaid card, and that's that. No referrals. I've also gotten a mess of medical insurance paperwork, brochures, booklets, and such that I need to go through. Apparently I'm eligible for Medicare coverage of some sort. I don't think it's Obamacare related, given that the chucklehead governor of Florida is still trying to weasel the state out of participation even after voters killed, killed KILLED a mess of state constitutional amendment proposals, including one that would "override" Obamacare (hahahahaha). Whatever it is, it's a State program. Wouldn't be surprised to find that it's linked financially to Governor Chucklehead, the way the drug-tests-for-State-aid clinics are.

Nice little boondoggle he set up: if you want any State aid (medical, food stamps, etc.) you have to submit to a pee test. You pay for the test yourself. If you pass it, the State--not the clinic you paid, but the State--reimburses you. Chucklehead co-founded a drug-testing company called Solantic back in 2001, then handed it over to his wife just before he took office in Florida. Chucklehead (even indirectly) makes money off you, the taxpayers pay you back.


Good news is, only 2 more years of him. Maybe by the time he's gone I'll have read through all those brochures and such.

Monday, January 31, 2011

Possible Good News on Medicaid

A little background, first. Ever since the Grapefruit days, I've been trying to navigate my way through all the ins and outs of getting medical assistance.

The surgery to repair a simple testicular hydrocele--the "Grapefruit" (it still amuses me to call it that, but it's never been as bad as it was before I resorted to the do-it-yourself fix)--would be several thousand bucks. Something like $1500 to the doctor doing the surgery (the same guy who was going to remove my kidney a few weeks ago), a few more to the hospital, some more to the anesthesiologist, and that's all for an outpatient procedure. I'd be home the same day. Since money was an issue, the Urologist sent me to a financial counselor in-house, who pointed me to Medicaid.

I quickly found that I wasn't qualified--too young, among other things.

Then came the torn aorta, a week in the hospital, and close to $53,000 in medical bills, mostly handled by the hospital's Uncompensated Care charity system. The hospital's counselors pointed to Medicaid again, and I tried to explain that I wasn't qualified.

Then it was back to the Urologist, who was concerned about the growth on my kidney that had been found while my aorta was being inspected. He said it had to come out, and again ushered me to the financial counselor, who ran the phones, called the local Medicaid people, and was told that all I needed to do was apply online. Surgery date was set, everything was put in motion, and I went home to work on the application.

Took maybe 2 weeks for them to reply: I wasn't qualified. They didn't say why.

I drove to the local office, and only then--after all this digging--did I learn that I'd have to go through Social Security and apply for Disability. Different social worker at the hospital, more paperwork and phone calls, and now I'm looking at three different pieces of paper from the Medicaid people looking for more information about my condition and proof of citizenship.

I'm hoping their sudden attention's a good thing.

Saturday, July 24, 2010

The Three-Thousand Dollar Grapefruit (part 3)

This is the part I've been most hesitant to write about: the actual procedure.

On June 14th, I just did what these guys did. I'm still amazed when I read that page, especially by the guy called Roger, who recommends using a vacuum pump.

That still kinda freaks me out. It'll definitely draw the fluid out more quickly than the "gravity drip" approach the other posters (and I) used. I just don't like it. Don't try it at home, kids (obligatory disclaimer).

Overall, it took about 2 hours. I sterilized everything, wore gloves, and barely noticed the needle (the cold pack was a lot colder this time). Taped it in place and waited.

Two hours, drip drip drip.

Two. Freaking. Liters.

Credit to the ultrasound tech (in Part 2)! Her estimate was on the nose.

I'd read enough to expect the reddish-amber serous fluid that a hydrocele fills up with. I wasn't expecting two liters of it. You go down the soft drinks aisle of any store and you're presented with bottles 4 inches in diameter and a foot long! It just doesn't seem possible.

It's not a permanent fix, though. A month later, I drew another pint.


No one seems to know what causes them. But I've got a theory, based on the last couple of months' medical crap I've gone through. Remember that the price tag on all of this came from getting shuffled to the Emergency Room for high blood pressure (280/150).

For the past ten years, I've been aware of my BP running high, typically in the 180/110 range. I've had some occasional swelling of both legs below the knees, had both knees messed up by fluid accumulating in them, and more recently my right elbow "went out" the same way for several days. It makes sense that excess fluid's got to go somewhere (assuming the excess blood pressure interferes with the kidneys' filtering function), so maybe that's what gave me the hydrocele.

My theory was given a boost when I went to the ER again on July 12. They set me up with IV fluids...and damned if I didn't end up with something bigger than a baseball. It grew pretty steadily on its own until it reached its "normal" humiliating size.

Maybe I'll set up an experiment--empty it out for the third time and see how my medication-enforced lower blood pressure affects things.

[Update (Aug. 25, 2012): the lower blood pressure didn't seem to slow things down. I only bothered draining the thing 4 times in total--once each in June, July, and September 2010 and in January 2011. Each time, it came back. Now I'm just waiting for the Medicaid doctor to get his stuff together so I can get a urology appointment to get this damn thing dealt with once and for all.]

Friday, July 9, 2010

The Three-Thousand Dollar Grapefruit (part 2)

Yup, I chickened out (read Part 1), unable to move that needle, unable to rid myself of the most humiliating thing my body could have done.

Nothing for it but to call a urologist, set up an appointment. The visit alone would cost $150.00. I was willing to pay it at that point--I just wanted the damn hydrocele GONE. I set up a May 20th appointment.

Montage: Wake up on the 20th, shower, breakfast, drive to the urology center, sign in, fill out 15 pages of name, address, phone numbers, medical history, allergies, sit and wait, my name is called, I give a urine sample and sit in the exam room.

Nurse comes in to check my blood pressure. Hand-held electronic all-in-one tester, pretty cool, but holy crap is the cuff supposed to be so tight that my hand goes numb?

Nurse looks confused. Tries it again. My fingers tingle and she looks confused again, goes to get a different machine. It does the same thing, my fingers tingle, she looks confused, and now she's gone looking for a regular cuff & bulb. I already know I've got high blood pressure, but she can't look confused now that three different tests show something like 290/150.

Holy crap.

The doctor comes in shortly, has me drop my pants, looks the grapefruit over, tells me there's about a liter of fluid there, asks why I waited so long, and tells me to get my ass to the ER to have the BP looked at. He calls for an ultrasound of the grapefruit while I'm there. I'm out the door.

Cost so far: $150.00.

Montage: Drive to ER, park, walk a lap around the Emergency department until I find the admissions desk...another blood pressure test, a thermometer...ushered to a small exam room, drop the pants, show off the grapefruit, why'd you let it get like that, no money, no insurance, left it alone because it wasn't a problem until now, follow me...another exam room...put on this backless robe and hop on the bed...it's quiet, so I whip out the current "Dresden Files" and read...family arrives, encumbering me with company...nurses arrive in a swarm, poking, prodding, and now I'm wired to an EKG machine, bleeding into sample vials, and talking to another doctor, answering all the standard questions with standard answers.

I'm wheeled to the Radiology department and the first woman to touch my junk since 1996 works her ultrasound machine, confirming that I've got a hydrocele, there's no cancer, and there's no communication between the hydrocele and my abdomen: no hernia. She found both testes, showed me that there was good blood flow in both, though the right one was being crowded by that freaking fluid reservoir dangling there. She even used the machine to estimate that I was toting about 2 liters of fluid therein.

TWO freaking liters?

Back to my exam room. I'm told that I need to produce another urine sample...or they're going to put in a catheter. I order everyone out and do it.

Montage: Doc shows up, writes a scrip for BP meds...a social worker for the billing department comes in, talks about the paperwork she's about to give me...the nurses return and unplug me from the EKG, pull the IV out of the back of my hand...clothes back on, gather my stuff, out the door.

The prescription was 4 bucks. I wish that were the most expensive item.

I got the bills a few days later:

Doctor: $314.00
Ultrasound tech: $133.00

ER:
Venipuncture...$52.00
ER visit "high severity"...936.00
UA automated w/micro...$72.00
Metabolic Panel total CA...$38.00
CBC w platelet auto diff...$85.00
Vascular study limited...$649.00
US exam scrotum...$461.00

$2,293.00

Twenty. Three Hundred. Bucks. Add in the doctor's and tech's fees, and it's $2740.00.

Heh. Where is the money going to come from? No insurance, no health plan, and I make at best $15k per year. I put in for the charity/financial help plan from the social worker, but I've yet to hear anything out of them, even after a few calls. I've already paid the two least expensive fees--the doc and tech.

I did a follow-up to the urologist a few weeks later. Another $150.00, so now we're looking at $3,000 in total costs from the medical folks...with nothing to show for it. The urologist wanted to do surgery, was all set to make the appointment, but I reminded him that there's no money there. He set me up with a finance counselor; she gave me a photocopy of a brochure, I did the Google hunt, and I quickly found that I don't qualify for Medicaid or Medicare. I went looking for medical insurance plans.

Heh.

The plan I could afford had a $10,000 deductible. The one I wanted had a $500 deductible, but would eat one paycheck a month.

Okay, screw that.

I dug around, looked at Blue Cross/Blue Shield, didn't even bother to fill out the qualifying survey. By that point, I just didn't care anymore. Tired of the crap. Time to go back to the do-it-myself approach!

Saturday, July 3, 2010

The Three-Thousand Dollar Grapefruit (part 1)

Imagine, if you will, carrying a good-sized grapefruit around all day, all night. It's there when you sleep, when you wake, when you use the restroom.

Did I mention that it's in your scrotum? Think that through. Imagine for most of a year having no idea what the hell this thing is or what caused it, but pretty much overnight your pants don't fit.

Add to this a lack of medical insurance and no money at hand to pay for an ER trip.

That was me in July of 2009. I did a bit of Google searching, sorting the crappy fake-med "information" out from the real thing, and quickly eliminated cancer as a possible cause. It wasn't a hernia. It took several tries to get the right combination of words in a search, but once I figured out that it was fluid that had collected in there, the answer popped up quickly in a search: hydrocele testis. Yeah, I know I should have gone to a doctor, and like that, but that lack of money was a bigger worry than a painless thingie. I don't have any credit cards. Never have. I live entirely within my means, or I do without.

I took to wearing long shirts. Once it got cold enough, I wore a jacket. I tended to avoid public places when I could. All the while, I was wondering how I was going to get rid of the damn thing.

Sometime in April 2010, while hunting for urologists and trying to find out how much surgery was going to cost, I found sites like this one, where several guys described a do-it-yourself approach using a #20 gauge needle and some surgical tubing. Simple!

But I freaking hate needles.

Surgery's a 30-minute outpatient thing, 2 weeks of recovery...easily a couple thousand bucks for hospital time, doctor fee, anesthesiologist, and whatever else. Did I mention the money thing?

The do-it-yourself approach...under twenty bucks.

I read that forum a few times, and it seemed really straightforward, except for the damn needle. Seems crazy, sitting here re-reading the forum and my own post, here--my little 'inner dialogue' voice shouts, "Are you INSANE?! Go to a freaking hospital! Find a doctor! You're asking for an infection!"

Screw it, I thought. I'll do it myself.

Montage: It's May 15th. Hopping into car, driving, shopping, finding the supplies, drive home.

The next morning (May 16th), I had everything set: needle, tubing, 2-quart bottle, a cold-pack (anesthetic--you put an ice cube or whatever on the spot to be poked, get it numb, and you're done), rubbing alcohol.

I could describe the process in a montage...but there's no need.

Goddamn needles.

A #20 gauge, half-inch needle doesn't look like much until you're sitting there about to jab it into your body.

Goddamn needles.

I sat there, shining steel a millimeter away from The Grapefruit. I sat there long enough that the cold pack was a lukewarm pack and I could feel the goddamn needle.

I chickened out.