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Wednesday, December 12, 2007

Interesting, ethically and medically

Face-Transplant Patient 'Satisfied': Some Who Criticized Procedure Are Impressed With Results

One of the US centres that is mentioned in the story as being interested in doing face transplants is Kleinert Kutz and Associates, who did the first US hand transplant. The Lexington office branch of that practice did my carpal tunnel surgery. I feel a bit like I'm playing six degrees of separation. My surgeon's in a different practice now, but I'd recommend either Kleinert Kutz or Dr William O'Neill of Bluegrass Orthopaedics if you ever need hand surgery.

It's funny, I'm very lucky that I live in a very medically- and specialist-dense town, and since I live within a couple of blocks of a major hospital (St Joseph East), there are a plethora of physicians and specialists whose offices are nearly in my backyard. Not to mention the fact that I have top-notch insurance through UnitedHealthcare. They paid every penny of my surgery, which ran about $10,000 altogether. I had no idea how crippled I'd become. Now I can use my hands freely. I've heard horrible stories of how much nerve conduction studies hurt since I had mine. I had no idea. My carpal tunnel was so bad I didn't really feel any of it. So I'm glad to have my mobility back, to be able to feel my hands, and to have them not draw up in pain at night. Plus, if I were ever to have children (let's face it, it's not bloody likely), it would cost me $10. Period--just the co-payment of the first office visit. Wow.

Of course, I went for years without insurance, so I really appreciate it more. I probably had a broken foot years ago, for example, when Bill fell on me. I just hobbled around in pain for months. Not to mention the various blows to the head I've had that I never went to see about. Hmm...maybe that really is part of my problem.

I'm not out of the woods in terms of medical expenditures, though. I have a flexible account that helps with any of my co-payments. But I'm on a slew of medications that are in the upper tier of what the insurance will pay for, so my co-payments are mostly $45 a pop. My flexible spending account ran out at the end of November (so at least I used it all--you lose the money if you don't--and it was much better than last year, when it lasted until May); but for December I really am struggling with enough bills that I simply can't get all my medicines. There are 2-3 absolutely vital ones; the rest I'm not filling until January. I normally take 7-9 depending on time of year (I take Lasix and potassium in the summer, when my ankles swell). I'm taking the opportunity to chuck Avandia entirely. I haven't felt any difference than when I took it, and there are just too many studies stacked against it. If my blood sugar tests show my sugar still up, I'll see about going on Actos. Otherwise I'll keep with just the Janumet, if Dr Nesbitt concurs. I found some samples of one of my drugs 'my smart medicine' as one friend puts it, so I'm using those for now. And of course, there's one I take that can cause a horrible skin-sloughing rash if you stop and go back on it, so I'm staying on that one as a priority. :) Plus I have plenty of metformin, so I'm temporarily on that instead of the combined Januvia/metformin Janumet. And I found some extra strips so I can check my sugar levels.

I know, it's not ideal, but it means $45 in drug costs this month rather than the normal $277 I'd spend a month out of pocket (with insurance!) ($291 in summer), with the occasional albuterol ($7) and then any over-the-counter medicines I get. (I'm off the aspirin, for example, now that I'm out of the boot). That flexible spending account is a lifesaver. I opted for the same amount next year since part of the expense this year was my glasses, which I shouldn't need again. That should get me through the year okay. I do have one doctor's appointment this month, too, but I've budgeted for that.

Okay, didn't mean to make this all about me, but I guess the article was just a jumping point for my thoughts. Hopefully January will bring a new debit card (we're going with a new provider this year--I hope they're as good as the last one) and I'll get back on track again.

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