https://mobile.twitter.com/Tierney_Megan/status/1207418807041626112
Years ago, I ended up getting a hair stuck in my ear (yes, yes I did). I assumed it was from my dog and maybe it ended up on my pillow or something. Went to the ENT doc, who fished it out easily - basically a really good tweezers and a fancy magnifying glass.
I ended up getting charged hundreds of dollars because it was billed as āsurgery.ā I got them to change it to something else to bring the cost down.
In regards to pharmacy payments, I take an eye drop daily. I never have any idea how much the tiny bottle is going to cost. Iāve had to pay well over $100 for it, but sometimes itās as low as $25. Sometimes itās in the middle. Sometimes I use a coupon. Sometimes the pharmacy automatically applies one. Itās so dumb. Fortunately, the drops last a few months, so even if it is on the pricey side, the costs are spread over lots of drops.
In case youāre wondering, this is going to kill Obamacare
Love Office Space
Also what was the price?
Itās astounding how much better HC is in Europe. Like I have a better neurologist in Prague than I had in America. Thereās shit that my doctor in the states never talked about that has improved my quality of life greatly when I found out about it here. I also pay fuckall for it. The tests, the appointments and the medication* are all covered so long as they are being used to treat a known condition.
*In most cases, only the generic medication is fully covered. Pretty rare that the labeled stuff is, though even then itās partially covered.
If at any point in your life, for any reason, you find yourself using a fucking coupon to buy medicine, you know something has gone horribly wrong.
(the system, not you dlk)
$50
*With coupon
My step-dad went to Spain last summer and ran out of one of his medications, so he stepped into a pharmacy and picked up another for less than his co-pay here. He said the EOB shows a payment of close to $100 here and he paid less than $3 there with no insurance, but yeah, USA#1.
Decades ago when I was a broke ass med student I went to Cancun every Thankgiving and Iād buy a years worth of prilosec that was about $100 a month in the states and $5 in Mexico. At the time Customs and Immigration didnāt care at all - dunno if itās still that way, but I was really happy at the time.
MM MD
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Without looking, does anyone know the most-prescribed medication in USA#1 in 2019? @hobbes9324 ineligible.
Xerzarntryc? Or something similar.
I would have guessed wrong. I always forget about synthroid, and EVERYONE is on it - I would have guessed a cholesterol med.
Nexium is #4 which is fucking insane. Omeprazole is generic a fraction of the cost, and the same goddam chemical with a hydroxyl or methyl group (I canāt remember which) stuck at the other end of the receptor. Completely insane.
MM MD
Thatās not the difference. Omeprazole is a racemic mixture of two enantiomers of the same molecule. Basically itās two molecules that are mirror images of each other but otherwise the same. Nexium just only has one of the two (the more biologically active one).
Put another way Omeprazole = Nexium plus some extra stuff.
I remember reading that there is some evidence that Nexium is a bit more effective in some people. But I could be misremembering and I canāt be arsed up to look it up.
Yeah I had no idea levothyroxine was a list topper. I know hypo is pretty common especially when subclinicals are included, but there arenāt that many endos and a good number of them are conservative with treatment. So does that mean PCPs are writing the bulk of these?
Iād happily take your explanation - I just remember that I was at a talk where I obviously misremebered the specifics, but completely remember the lecturer noting that there was no actual indication that the medication did anything more useful than the generic omeprazole - thanks for the information - amazing what you can learn around here.
MM MD
Just an assload of old ladies with low/borderline thyroid studies - pretty much a harmless med in most cases, some people feel better, itās cheap. You could do worse. I fairly often see patients on what are to my mind homeopathic doses, and they as far as I can tell arenāt having their levels followed.
MM MD
It looks like both of you are right. The actual pharmacological potency is the same for both the left and right types. However, they are stereoselective for whatever P450 enzymes they get metabolized by, and this appears to make Nexium (very marginally) better per dose; itās more available and has less inter-subject variability.
Okay, which one of you is actually awvall?
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Not me - I happily defer pretty much all of my pharm questions at work - we have Pharm Phdās 24-7, thank god.
MM MD
I havenāt been reading this thread and this is probably not what the thread has been for and about, butā¦
I grew up with Kaiser and thought it was fine and then had Blue Cross at a job and kept Blue Cross for a while as self-employed. I hate all the separate billing and having to do so much choosing and at the time Kaiser was less expensive, so we switched to Kaiser. Iāve kinda had it. They suck. We are getting virtually no attention. They try to do everything though the nurse line on the phone. They are just handing out antibiotics literally without a thought as to whether or not they are working for one of my kids. They keep sending the other kid to the wrong doctor. Hold times are horrendous. Appointments are weeks out. They suck.