Soliris was the first one. New drug is Ultomiris.
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Interesting. Hadnāt seen those yet. My mom is getting better on prednisone and mycophenylate though.
Also no one believes you and they tell you shit like āwe love our private insuranceā while making a false equivalence to some minor health thing they had which was quickly resolved. Then they usually offer some terrible medical advice for a disease they first heard about 15 seconds ago. In fairness, itās tough to appreciate rare chronic disorders without experiencing them directly.
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Have lived every letter of this post.
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Anyone have fun stories about getting insurance to pay for warfarin? Or other fun stories about being on blood thinners for the rest of your life?
It is looking the many years of dodging open heart surgery will be coming to an end in the upcoming months. Iāll probably post a little bit more about it, especially any ridiculous bills that cross my path.
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Iām guessing youāre getting a mechanical valve since youāre talking about warfarin.
Warfarin is super cheap though. The expensive ones are Xarelto, Eliquis and Pradaxa. Costs a few bucks a month cash. Generally the newer ones arenāt used for mechanical valves because the evidence isnāt there yet.
Good luck with the warfarin, the constant INR checks are annoying but itās proven effective and easier to reverse than the other ones.
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Ya, looking at an aortic valve replacement + ascending aortic aneurysm repair. The surgeon has given two options for the valve: mechanical valve or Ross procedure. The drawback of the mechanical valve being the blood thinners for the rest of my life. The drawbacks for Ross being that it is a slightly more complicated surgery up front, plus the high likelihood of future surgical intervention required to repair or replace either of those valves (Iām upper 30s for age).
It will definitely be warfarin from what the surgeon said. He mentioned potential for other options in the future ( think it was Eliquis specifically named), but that the studies havenāt shown it to be effective. So maybe in the future something different will be developed but Iād rather account for worst case scenario. Glad to find out it is cheap and seems easy to find in most places.
Iām kinda just getting caught back up since I know I did some research on warfarin before, but I think it was when I was first diagnosed with the bicuspid aortic valve about 20 years ago. I appreciate the feedback!
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I checked on costplusdeugs too and itās $4.80.
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Shit, I was diagnosed with that a few years ago (I turn 47 this year). Hasnāt caused me any problems and the doc said it was ok for now. Need to get a scan every couple years (due for one soon) to check it.
The last time they scanned it, the doc said it might not be bicuspid after all and that the third flap was just runty. So functionally bicuspid.
Found it by accident. Was feeling sick, went to my PCP. They did an EKG and saw a āblip,ā so he sent me to the cardiologist. Turns out I was fine, heart was strong (though Iāve since been diagnosed with hbp), but they saw the valve issue.
WCGW with turning our healthcare system over to private equity firms?
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Been going on for a long time and is a huge controversy in my field. More skeptical readers will note em doctors have a lot to gain by locking out PAs/NPs.
Overall, evidence in this arena isnāt great. However, Iād say that itās highly likely that the EM docs who have done 3-4 years of residency are much more likely to have better training, and that fits with my clinical anecdotal experience.
Article is a little annoying, because it starts off with what seems like perfectly fine management to me. It likely was a rule out ectopic or threatened abortion situation, which will bounce back a lot if they canāt follow up with obgyn.
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Iāve seen those signs around LA.
You can run cold and draw a bad doctor, but Iād take my chances with that over a NP / PA any day. Surprise, PEās plan for America is Charge More + Donāt Pay Anyone = More Yachts and is still undefeated. Friend of mine is a general surgeon outside of Detroit and has been on the wrong end of this understaffing thing for a long time now. Our convos used to mostly be about how much he hates his job and how many hours heād spend in meetings with these cockroaches asking him to take more call for less pay.
Approximately two years ago I began experiencing L elbow pain. After about 6 months of mild, episodic pain I went to see an orthopedist. I was given an appointment with a PA. After a brief discussion and exam, he said I had tendonitis. I asked about getting an a x-ray just to make sure it wasnāt something else. He seemed irritated by my questioning him but sent me down the hall for some films.
When I came back into his office he was sitting behind his desk looking at the images. When I asked him how they looked he replied, āIām sure itās tendonitis. I donāt see any other issues. You can see for yourself if you donāt trust me.ā I made him show me the images. He discussed the nature of tendonitis, and then sent me on my way.
Was this PA a douchebag, or did I step on his toes? Paging @CaffeineNeeded
PA is a douchebag. Youāre advocating for yourself and have no reason to blindly trust an actual doctor, much less a PA
When patients request something like that I usually will say something along the lines of āX-rays generally show broken bones only and this is clearly a soft tissue injury. I donāt think you have a broken bone because x, y, z. If you want, we can get the X-rays done, [insert joke about everyone else doing work and me clicking buttons], but it will mean you are here for another hour or soā
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When patients request something like that I usually will say something along the lines of āX-rays generally show broken bones only and this is clearly a soft tissue injury.
I guess my concern was either some type of tumor/growth or possibly a loose body, given that I already had a history of loose fragments in my knees. Can an orthopedic PA rule-out both of those with just history taking and an exam?
Pretty much yeah. Nothing is 100% though. If you told me you were concerned about those things I wouldāve happily ordered an X-ray. Nbd
Yeah but freedom though