Live data from Hacker News

So...what the hell's wrong with you, Shooter?

news.ycombinator.com

121–130 of 132 posts

Re: So...what the hell's wrong with you, Shooter?

#121

Earlier quoted context omitted.

Wait, WTF? Isn't getting bitten by SuperTick exactly the sort of low probability, high cost event insurance is for? Just because something is chronic doesn't make it low cost.

I'm not seeing how getting bitten by a supertick is chronic. I was responding to the meta-problem (insurance not paying for chronic conditions), not the OP's specific problem.

It sounds like you work for an insurance company. If you start along this path, they will find an incidental causation for every chronic affliction.

Re: So...what the hell's wrong with you, Shooter?

#122
post #60

Earlier quoted context omitted.

There are literally thousands of people with similar stories that are more articulate - and less bitter and angry - than I am. And the media is slowly picking up on these issues. http://underourskin.com/blog/ recently mentioned, for example, the change in stance of Good Morning America's medical correspondent over the course of a year. Enough people are getting sick and raising a ruckus that there are finally some ch…

I think you misunderstood me - I'm not talking about policy/legislative changes. I'm talking about having their office fight, as your wife does, with the insurance companies on your behalf. This is what "constituent services" does .

No, I understood. And I really appreciate your intentions. I just addressed the things that were most relevant to me in more detail. I do have congressman fight insurance companies on my behalf. But, I'm very lucky because of my wife and finances at this point in my life (finally), so I think I can have a bigger impact by thinking outside of my own problems a bit.

One of the people that was very helpful to me in finding treatment (and her sister) are in the documentary I mention, for example, and she died from Lyme complications after filming because she was denied adequate treatment for so long. I know others that have died due to Lyme and associated vector-borne diseases. (A celebrity reference for the HN crowd: Mary McDonnell of Donnie Darko and Battlestar Galactica is an activist in fighting Lyme and associated tick diseases that I occasionally see because she had a family member die of Lyme.) In sum, people are dying - and wishing they could die - because of these diseases, so I also wanted to address other actions I have taken and that others can also take.

Re: So...what the hell's wrong with you, Shooter?

#123

> My wife is pregnant with out first child, and everyone is scared/nervous how I will handle it. I hate to ask this, but as an infectious disease that could be spread by a tick bite, isn't it potentially communicable?

That's actually a really good question, although the answer is controversial.

There is great debate about whether any/all of these diseases are communicable, especially Lyme (because of its prevalence.) Anecdotally, there are many doctors who argue that they are based on their own patients, and there have been a few medical studies that have also shown that they are, but the status quo maintains that they are not. Even though syphilis (which is caused by a very similar, but less insidious, spirochete like the one that causes Lyme) is obviously sexually transmitted, the insurers and their cronies say it's impossible. There is a woman in the documentary I mention that battles with that issue (and miscarriages) and you can also find information online. In my case, my wife had no symptoms, we had her tested for some of the scariest bugs, and we took some other precautions.

Re: So...what the hell's wrong with you, Shooter?

#124
post #73

Earlier quoted context omitted.

Speaking from personal experience, it is the norm. In the US you are completely on your own, and your insurance company is not your friend; no matter how dutiful you were in paying your premiums. If you have a chronic, treatable condition, expect to fight it out with your insurance company 2 to 3 times a year over whether or not they will live up to their contractual obligations. It is my considered opinion that if O…

Perhaps a solution to the problem of chronic, treatable conditions is to make health insurance not pay for them. In short, turn insurance back into insurance (protection against low probability, high cost events).

The intersection of chronic, treatable conditions and low probability, high cost events is not empty. You could find a condition with any combination of being chronic, acute, low probability, high probability, low cost, or high cost.

What you're really looking for is getting insurance out of covering expected medical expenses, but the problem is that doctors and hospital charge higher prices to the uninsured. I had a medical bill once that was denied by insurance, and the hospital wanted something like $12,000. Later we got the insurance to pay, and the hospital only charged them $2,000 or so.

A related problem is that the tax code favors insurance companies by providing a tax break to employers, which is why most Americans get insurance through their employer.

Re: So...what the hell's wrong with you, Shooter?

#125

I am assuming you are an American citizen. If you haven't already, you need to: 1) call your Congressperson's local office (not DC) and ask for someone in constituent services who works with health care issues. Do this tomorrow. If your insurance company is denying you any care, and you have a paper trail, they should help. If your Rep can't help, then contact your two Senators' offices. Generally, Reps are much bett…

I don't know if you're familiar with Fox, but they're not running any story that suggests healthcare needs government intervention.

This is false. You must not be familiar with the way local Fox affiliates work. Local news != Fox News Channel.

Sorry if this was just a partisan joke and I missed the humor.

Re: So...what the hell's wrong with you, Shooter?

#126
post #69

Shooter, how did you find this Dr. House? You neglected to talk about this. And I think this is an important piece of information that can benefit us trying to get a resolution for our own mystery illnesses. How do you go about hunting a good doctor?

Shooter was kind enough to tell us the doctor was IFM-affiliated, so that could be a start. (See http://news.ycombinator.com/item?id=868600)

Not all practitioners of functional medicine are the same, though. I would suggest also seeking a more specific recommendation for your condition.

Re: So...what the hell's wrong with you, Shooter?

#127
post #69

Shooter, how did you find this Dr. House? You neglected to talk about this. And I think this is an important piece of information that can benefit us trying to get a resolution for our own mystery illnesses. How do you go about hunting a good doctor?

I feel some people are focusing on the wrong thing, most likely because of my poor presentation. I'll try to answer your question, but I also want to elaborate a bit:

In relaying my story, I kind of 'cast' the diagnosing physician(1) as the hero, in part because it was such a relief to me for someone to finally listen and think logically, because it was relief to me to finally have an answer...and also because I was trying to shorten the post. But remember, by the time I saw this doctor, I had my condition narrowed down to a couple things already, and one of my guesses was correct. A search engine could have had equal billing, diagnostically. This guy didn't have a halo on his head when I found him or a neon sign saying he was "The One." He was not the first person I was told was an amazing diagnostician or "like House." He was just one in a long line of doctors, albeit one of a small number that was compassionate, open-minded and listened. I never brought up my ideas about what I had until I gave the doctors a chance to give me their ideas, because I didn't want to bias them. This doctor was just the first one that hit on the actual problem, and was willing to order confirmatory testing. It was largely odds. If you see enough doctors, it will probably happen eventually...a million typing monkeys and all that. The real heroes are the doctors who will actually treat you once your diagnosed, even at great risk to their livelihood. The real heroes are the ones that will fight the insurance companies and help you while you're going through treatment.

The final diagnosis wasn't really magical, or the act of an amazingly brilliant doctor. Yes, having the diagnosis was a psychological relief, but the most important could be this: the big, insurmountable problem for most people will not be getting a diagnosis but finding - and paying for - a treatment. There is basically a witch hunt in this country for doctors that diagnose and treat complex diseases. Complex means expensive, and insurance companies don't like that. Getting a proper diagnosis can be an enormous problem, but it is often just the start of the journey.

(1) Um, I'm getting tons of emails asking for my specific diagnosing doctor's name - which I simply can't give out. If you have any of these particular diseases, he will not treat you anyway. Remember, he turned me away. He would not even start a battle with the insurance companies. If you have something unusual or that is complex or that is outside of the insurance company parameters, he would send you elsewhere for treatment anyway.

Re: So...what the hell's wrong with you, Shooter?

#128
post #69

Shooter, how did you find this Dr. House? You neglected to talk about this. And I think this is an important piece of information that can benefit us trying to get a resolution for our own mystery illnesses. How do you go about hunting a good doctor?

I feel some people are focusing on the wrong thing, most likely because of my poor presentation. I'll try to answer your question, but I also want to elaborate a bit: In relaying my story, I kind of 'cast' the diagnosing physician(1) as the hero, in part because it was such a relief to me for someone to finally listen and think logically, because it was relief to me to finally have an answer...and also because I was…

That all said, here is how I found "the doctor":

1. I was persistent. I saw lots of doctors. The 22 number I mention in my post is mostly just the specialists I saw - not even all the general practitioners I visited.

2. If I were to rank the doctors I saw, the better ones were either members of IFM (functional medicine), they were DOs (shady origins, but a more holistic viewpoint), and/or they were internal med doctors. Rheumatologists only seem capable of seeing certain things. Neurologists only seem to see certain things. In general, specialists were unable to see or care beyond their specialty. Which, I guess, is somewhat understandable. [The specialists did find clues, however, like the lesions and the hormone issues that eventually helped me find the underlying cause.]

3. I asked around for someone who had a good reputation as a diagnostician. I asked doctors, business leaders, and hospital administrators. Unfortunately, many doctors seem to pride themselves on their amazing diagnostics skills, whether they actually possess them or not. So, I also asked for "open-minded" and "compassionate." Compassion implies a good listener, which is probably the most important thing because you can't find a pattern if you didn't hear about it. Some of the worst doctors I visited were the famous ones. They were too busy to listen. IIRC, I think the final diagnosing doctor had been trained at a podunk med school in Cuba or something.

4. I was an informed patient. I used to work in the medical field (piss-collector, clinical drone, researcher, and software developer.) I researched extensively on my own. (This can backfire for some people, because they develop cyber-hyperchondria.) In any case, I knew - or learned enough - to get a lay of the medical landscape and I used that to my advantage.

5. I kept a 'journal' that listed what symptoms I had on what day, etc. - it helped me find patterns. Some organisms have a specific lifecycle, so that helped me in my own search. Sometimes the only pattern was that there was no pattern, but the journal exercise was still very helpful. Just be careful about looking like a nutjob if you carry a handwritten book of your woes into a doctor's office.

6. I was an inpatient patient. I know doctors are just average schmucks like the rest of us and they make mistakes, because I've worked with them. So, if a doctor didn't listen or was a jerk, I never went back. Some people think doctors are holy or something, and they continue going to visit a jackass in the hopes that something will change. That can kill you. That tendency is especially prevalent in older people.

7. I acted professionally when dealing with doctors. Enough of them thought that I was nuts that I didn't need to confirm their suspicions by acting too emotional or unreasonable. Even though I was often emotional, I kept it under wraps.

8. I tried to find doctors that kept up on the latest research, or that at least seemed to care about new research and treatments. To be honest, I knew more about the most current medical studies than any doctor I visited, including the final diagnosing physician. I was more motivated and I had more time on my hands. But I used my knowledge to separate out the doctors who read the bare minimum for their CEs from the ones that were genuinely interested in their field and read broadly for their own benefit.

9. To restate an above point: I never brought up my ideas about what I had until I gave the doctors a chance to give me their ideas, because I didn't want to bias them. I had to remain open-minded too. You may not like the answer you get, but if there is compelling proof about it you have to accept it.

10. Read and know your insurance policy if you're in the US, and fight for your rights.

Re: So...what the hell's wrong with you, Shooter?

#129
I know someone who was incorrectly diagnosed as having MS but it turned out (apparently) to be Lyme disease. A couple factoids:

* Lyme tests can often give (even repeated) false negatives. The bacterium can lie dormant or hide. This is why it's a good idea to get a lyme test as a baseline if you're going to be doing a lot of outdoors stuff.

* Most doctors are not educated about Lyme disease, so if you think you might have it, it is important to find a specialist or a doctor who is "Lyme-literate".

Also, how is this not on the front page with 300 points in 17 hours? Flagged too much?

Re: So...what the hell's wrong with you, Shooter?

#130
post #63

Earlier quoted context omitted.

In Japan MRI is covered by public insurance. You only need to pay around $60-$80.

For a low quality scan (resolution about 1/3 what you get in the US). A 2 tesla scan (what you get in the US) will cost the same as in the US (though the government may subsidize it). I've heard it suggested that Japan got "scan-happy" (patients want a scan, kind of like how US patients want antibiotics for their virus), so they built cheapo MRIs to give them what they want.

Thanks for the info. I didn't know.
Post reply on HN