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Notes on My Chemotherapy

charlieharrington.com

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Re: Notes on My Chemotherapy

#71

Post by 01100011 »

Nihilartikel wrote: post #6

Just taking the opportunity to chime in on this thread: Do not hesitate to press for a colonoscopy or sigmoidoscopy if you are worried about your colon health. Something is going on now where demographically much younger patients are getting polyps and colon cancer: https://www.cancer.gov/news-events/cancer-currents-blog/2020... Doctors are still mostly operating under the old wisdom that it is not a problem for thos…

Be sure to have a dialogue with your parents and siblings regarding your family history. My dad has a history of polyps, starting around 40. It's not something I would have known about without talking to him as it's just a regular part of his life to get them removed every few years. I had my first colonoscopy last year at 45 and had a polyp removed. If I didn't know my family history, I might have waited until the normal age of 50 and it might have been too late.

Re: Notes on My Chemotherapy

#72

Post by 01100011 »

epmaybe wrote: post #49

The most frustrating thing to me is that you, the patient, had to ask the doctor who is supposed to help you coordinate your care about one of the most important pieces of the puzzle that was still pending after your procedure. All of the view alerts, the notifications, reminders, people involved in your care, fancy computer systems, read backs, none of that prevented the potential delay in your treatment. It could h…

Once you have dealt with a major illness, you realize there is very little 'care' in health care. I sympathize with health care workers(mom is an RN, wife is in school now), but it is an unfortunate situation.

In my experience, outcomes are determined by how much you are willing to manage your own care and, importantly, fight when necessary.

Re: Notes on My Chemotherapy

#73

Post by 01100011 »

JimTheMan wrote: post #46

A quick question for my stateside brothers. What happens if you get cancer and can't afford chemo? What kind of care will hospitals provide?

My ex mother in law was... a professional patient. She was morbidly obese, and over the 20 years I knew her had:

- non-hodgkin's lymphoma

- pulmonary blood clots

- a section of her abdomen the size of a loaf of bread went necrotic after a suture migrated and pierced her intestines.

- heart failure leading to constant oxygen

- breast cancer

and there's probably something else I'm forgetting. She was a deadbeat who managed to work about 6 months of her life. None of her major health problems started until after 40. She was a welfare mom who married a guy with a meth habit who worked at an automotive parts counter making peanuts. At no point was she ever denied care. She even spent around 6 months in the ICU at University of California Irvine and had amazing reconstructive surgery for the necrotic tissue. Of course she ate her way back to morbid obesity after getting a new lease on life.

The US health care system seems to cause more issues for people with a little wealth, because it will happily take it all away. For people with nothing, in my personal experience, you can get great care.

Re: Notes on My Chemotherapy

#74

Post by beachy »

eterm wrote: post #57
fab1an wrote: post #7

The absurdity of the American health care and insurance system will never not amaze me. It's just sad and weird, and even weirder that you will always find a bunch of intelligent folks to defend it. Wishing the author, who btw is a better writer than most writers, a speedy and complete recovery.

It makes me so glad to be under the care of the NHS. It isn't even about the money, I could afford the $3k out of pocket too, it's more about not having to be a "customer" who has to frequently make choices or shop around. It's also a relief not having to think about the money or insurers. I don't need to collect receipts or bills or phone insurers or providers, I can focus 100% on getting through my chemo. I haven't…

We have a public health system in NZ, i.e. free healthcare.

We also have private health insurance, 30-40 percent of the population take that up.

When you go public you will need to wait in a longer line, you won't get the flowers next to your bed and you might need to ring for a bit longer for a nurse to come, but you'll often be seeing the same doctor you would have seen going private.

Last time I was in hospital the only paperwork was the admission form, and then telling the desk people my insurance number as I left.

Re: Notes on My Chemotherapy

#75

Post by peteretep »

Daho0n wrote: post #68
_jaik wrote: post #55

I went through stage IV colon cancer in 2020 at age 37. Just had my 3-month follow-up CT scan today, actually. I had 3 surgeries (colon resection, port installation, liver resection & ablation), 12 rounds of chemo (FOLFOX + Vectibix), 9 before liver surgery, 3 after. I had plenty of fatigue and cold sensitivity in my extremities. I have some peripheral neuropathy maybe 9 months in, and continuing. It was worse, but i…

I just want to add a somewhat different view here. I had cancer when I was 30 (testicular cancer). Healthy today luckily. But everyone said I was taking it very well and clear headed and I think so too if I have to say so myself but some years later I had a massive panic attack and started having huge problems with anxiety and panic attacks. It got so bad all I could do for weeks were to sit in my sofa being scared I…

> I later found out that there is a massive problem with people getting anxiety and panic attacks while on escitalopram

People having issues like that with escitalopram are a small portion of the people for whom it’s a life-changing treatment for anxiety and depression. I put off getting on it for far too long because of scare stories.

Re: Notes on My Chemotherapy

#76

Post by brigandish »

shakezula wrote: post #59
brigandish wrote: post #38

Earlier quoted context omitted.

There’s plenty about it that’s defensible, the part that seems indefensible to me is the regulatory capture that leads to situations covered in the blog where insurance won’t cover cutting edge treatments. There’s a good argument to be made that deregulation would encourage innovation and lead to dropping prices and greater supply - why capitalism should stop working its usual magic when it comes to medicine is a mys…

Capitalism can't work its magic because healthcare is not a free market. It has a unique set of constraints that capitalism is particularly weak at dealing with: lack of choice (you don't get to choose which hospital you go to in a lot of circumstances), high barrier to entry, constantly changing regulatory environment, etc... The reason single payer systems work is because they're at a specific advantage for all of…

> Capitalism can't work its magic because healthcare is not a free market.

That's exactly my argument, regulatory capture precludes a market from being free.

> It has a unique set of constraints

I fail to see how the points you list make it unique.

> lack of choice (you don't get to choose which hospital you go to in a lot of circumstances)

Then make that possible. I live in Japan, I choose the hospital/clinic/doctor that I see, for everything.

> high barrier to entry

For whom at with what?

> constantly changing regulatory environment

Yes, so deregulate and move towards a freer market.

> The reason single payer systems work

Do they? If you have a heart attack in the US vs one in the UK then you are more likely to survive in the US. Blanket statements about what "works" are meaningless when talking about complex systems with multiple outcomes across large populations. The US outranks many countries that aren't using its system in many health outcomes, and if you have insurance then you will get a very high standard of care. Poor health outcomes for those at the bottom are bad but that's only one way to measure efficacy.

Japan has a single payer insurance system but I can also point to many negatives, as well as many positives. None of these provide any refutation to a free(r) market providing the benefits that other markets receive.

Re: Notes on My Chemotherapy

#77

Post by bb123 »

eterm wrote: post #57
fab1an wrote: post #7

The absurdity of the American health care and insurance system will never not amaze me. It's just sad and weird, and even weirder that you will always find a bunch of intelligent folks to defend it. Wishing the author, who btw is a better writer than most writers, a speedy and complete recovery.

It makes me so glad to be under the care of the NHS. It isn't even about the money, I could afford the $3k out of pocket too, it's more about not having to be a "customer" who has to frequently make choices or shop around. It's also a relief not having to think about the money or insurers. I don't need to collect receipts or bills or phone insurers or providers, I can focus 100% on getting through my chemo. I haven't…

I know that love of the NHS in the U.K. is a religion but the truth is the quality of cancer care you will receive is lower, there’s less preventative testing, and longer wait times. All of that means you’re way more likely to die of cancer under the care of the NHS than the American healthcare system.

Re: Notes on My Chemotherapy

#78

Post by johnyzee »

tehwebguy wrote: post #40
fab1an wrote: post #7

The absurdity of the American health care and insurance system will never not amaze me. It's just sad and weird, and even weirder that you will always find a bunch of intelligent folks to defend it. Wishing the author, who btw is a better writer than most writers, a speedy and complete recovery.

It's so cruel that it's hard for me to call it absurd. For instance this part from the article: Instead, insurance wants to make sure that you really-super-duper-need whatever it is they're going to give you, to the point where there's basically no way they can say no. is directly connected to this part: And, then, when my company switched insurance providers at the beginning of 2021, this nurse service stopped abrup…

I suspect that 'nurse service' was basically the insurance company checking that they weren't paying for more than was needed.

Re: Notes on My Chemotherapy

#79

Post by eterm »

bb123 wrote: post #77
eterm wrote: post #57

Earlier quoted context omitted.

It makes me so glad to be under the care of the NHS. It isn't even about the money, I could afford the $3k out of pocket too, it's more about not having to be a "customer" who has to frequently make choices or shop around. It's also a relief not having to think about the money or insurers. I don't need to collect receipts or bills or phone insurers or providers, I can focus 100% on getting through my chemo. I haven't…

I know that love of the NHS in the U.K. is a religion but the truth is the quality of cancer care you will receive is lower, there’s less preventative testing, and longer wait times. All of that means you’re way more likely to die of cancer under the care of the NHS than the American healthcare system.

There's less diagnosis for sure, but wait times for actual treatment has been absolutely amazing in my experience.

The diagnosis took way longer, in the US I'd have likely been diagnosed months earlier.

However, I was diagnosed on a Thursday, started steroid treatments by Monday in preparation for starting full treatment a few days later, and also went from an PET/CT scan to having radiotherapy just 3 days later.

I'd be wary of looking too deeply into survival statistics, especially since the much greater emphasis on diagnosis means that a lot of the cancers treated in the US are an earlier stage which is reflected in the survival statistics.

It's also important to consider that there aren't people made homeless through medical debt in the UK. There aren't people who avoid going to the doctor because they feel they can't afford it (regardless or whether they could with the appropriate allowances etc).

It's not a "religion", it's just experience of 70 years of fully public healthcare which is reflected in things like our vaccine rollout which when compared to our neighbours we have been miles ahead.

Even those countries with socialised healthcare but private provision (public insurance + private provision) have massively lagged behind because having a single provider of healthcare has been monumental in coordinating a massive vaccination effort, and as a result the UK is almost top of the per capita vaccination rate with only the much smaller Israel and Bahrain above it.

But again, I can't stress how good it is that I don't have to worry about my wallet when getting treated.

I was able to change jobs even while undergoing treatment because I didn't have to worry about losing access to health insurance. I may be wrong but if I were working the US I'd feel trapped in my previous job because I'd have been worried about not being covered for a time.

The TLDR is that I value living in a society where the poorest and the middle class both have access to the same healthcare. (And yes, like other countries we also do have a private healthcare industry, which is popular especially for elective stuff.)

Re: Notes on My Chemotherapy

#80

Post by simonswords82 »

bb123 wrote: post #77
eterm wrote: post #57

Earlier quoted context omitted.

It makes me so glad to be under the care of the NHS. It isn't even about the money, I could afford the $3k out of pocket too, it's more about not having to be a "customer" who has to frequently make choices or shop around. It's also a relief not having to think about the money or insurers. I don't need to collect receipts or bills or phone insurers or providers, I can focus 100% on getting through my chemo. I haven't…

I know that love of the NHS in the U.K. is a religion but the truth is the quality of cancer care you will receive is lower, there’s less preventative testing, and longer wait times. All of that means you’re way more likely to die of cancer under the care of the NHS than the American healthcare system.

Interesting, I went away to look in to your statement and found this article:

https://fullfact.org/health/which-safer-us-hospital-or-engli...

I think it's hard to compare the two health systems purely on their data as there is a culture of healthcare that it is difficult to factor in.

E.g. how many people don't go to hospital and then die in the US because they cannot afford healthcare? I witnessed this first hand in New York when somebody was knocked out and as I was dialling 911 they woke up and shouted not to call an ambulance because they couldn't afford the cost.

Equally, understand that the NHS does not have the funding that the US healthcare system and that wait times are generally longer.

etc etc...

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