"World-class colonoscopy"

[samclem]

Quote:

Originally Posted by GregLee That's sort of ambiguous. Does it mean that when someone fails to die of cancer that curative or maintenance treatment for that survivor costs $400,000?

No, it means that it costs $400,000 to buy enough colonoscopies to prevent a single cancer death (that is, to catch the tumor early enough to prevent a death from cancer that would have occurred had the tests not been given).

The average cost for a colonoscopy is about $3100. So, that $400,000 buys about 130 colonoscopies. That's apparently the number that it takes to find a cancer and prevent a cancer death that would otherwise have occurred.

Rich in Tampa provided some interesting information (NOT medical advice!) on colonoscopies here and here.

[GregLee]

Quote:

Originally Posted by samclem Rich in Tampa provided some interesting information (NOT medical advice!) on colonoscopies here and here.

It is interesting, and thanks for the references. Can't say I buy much of it.

[haha]

Quote:

Originally Posted by samclem The average cost for a colonoscopy is about $3100. So, that $400,000 buys about 130 colonoscopies. That's apparently the number that it takes to find a cancer and prevent a cancer death that would otherwise have occurred.

I suppose that may be the sticker price, though it seems very high for that too. But I doubt any insurance company pays that, and certainly Medicare doesn't.

Ha

[samclem]

Quote:

Originally Posted by haha I suppose that may be the sticker price, though it seems very high for that too. But I doubt any insurance company pays that, and certainly Medicare doesn't. Ha

According to this site, Medicare pays less than $500 for a colonoscopy.

Many of the government-paid programs utilize more economical equipment.

[Meadbh]

Where I live, the physician fee for a simple colonoscopy is $176, if there is a biopsy it goes up to $185, and if a polyp is removed it's $271 CDN.

[Dawg52]

Quote:

Originally Posted by Meadbh Where I live, the physician fee for a simple colonoscopy is $176, if there is a biopsy it goes up to $185, and if a polyp is removed it's $271 CDN.

Wow. Mine 4 years ago was $2100, although I'm not sure what insurance actually paid. I paid $100 for a pre-scope office visit that insurance didn't cover. A bs interview with the doc doing the procedure so he could collect an extra $100.

[Meadbh]

Quote:

Originally Posted by Dawg52 Wow. Mine 4 years ago was $2100, although I'm not sure what insurance actually paid.

It pays to employ insurance people.

[Nords]

Quote:

Originally Posted by GregLee By the way, in case the original poster from Oahu is still reading this, I'll recommend my gastroenterologist, Dr. Jao, who works out of Castle Medical Center (near Kailua).

Quote:

Originally Posted by samclem C'mon, go to Tripler! "We ain't got all day, there's other Joes waitin'. Roll over and smile. Anesthetics is for babies. NEXT"

Well, I made an impassioned plea to my local (civilian) medical clinic to go to a civilian office or hospital, and I'm sure they passed on my sentiments to the Tricare office. (You servicemembers & veterans are already snickering.) At least I was able to ask for the medical clinic's referral over the phone in 60 seconds instead of going up there for an hour to deliver the same message.

So I'm indeed going to Tripler on Tuesday for the consultation. I suspect I'll be going back there for the dirty deed a few weeks later... unless I can somehow convince them that it makes little sense to drive "all the way" to town from central Oahu during morning rush hour when I could just drive a few miles north to Wahiawa or south to Waipahu?

I've been taking notes on all the colonoscopy threads. I'm ready.

[BTravlin]

One more thing for your notes, no jalapeno peppers within 24 hrs of your prep.

[W2R]

Quote:

Originally Posted by Dawg52 Wow. Mine 4 years ago was $2100, although I'm not sure what insurance actually paid. I paid $100 for a pre-scope office visit that insurance didn't cover. A bs interview with the doc doing the procedure so he could collect an extra $100.

Charges associated with my 1/25/11 colonoscopy (plus biopsies taken at that time), that were submitted to my insurance company and that I have been informed about so far:

• anesthesia (nurse anesthetist): $900 (insurance paid $69.70, I paid $362.60 which includes my entire 2011 $350 deductible)
• surgery, outpatient surgery center: $2105 (insurance paid $499.97, I am to pay $0)
• pathology lab: $295 (insurance paid $138.15, I am to pay $24.37)
• diagnostic lab test: $210 (insurance paid $37.55, I paid $6.62)

TOTALS:
Submitted charges: $3510
Insurance paid: $745.37
I am to pay: $393.59
Time I have spent on straightening out double billings and foul-ups related to my charges: 3-5 hours, phone calls, letters, plus 1.5 nights' sleep and the only unhappy day of ER so far. Yes, even the day of my colonoscopy was happier than this.

(This is for the most Cadillac of federal employees/retirees insurance policies, BCBS Standard. )

And get those kids off my lawn!!

[FreeAtLast]

I will go in for one in two weeks. I went to meet the doctor who will be preforming the procedure on Tuesday.

[Nords]

Quote:

Originally Posted by FreeAtLast I will go in for one in two weeks. I went to meet the doctor who will be preforming the procedure on Tuesday.

So what prep & chemicals did they prescribe?

[Ed_The_Gypsy]

Quote:

Originally Posted by Nords So what prep & chemicals did they prescribe?

Are you SURE you want to know?

[WhoDaresWins]

The resurrection of this thread reminds me that I am due to have another one this summer. I am on a 3 year recall because of my family history (Mom died of colon CA at age 61).
Nords, the prep is a annoyance (have some movies on hand that you can pause, and a couple of good books) but the procedure itself is a breeze as you will be three sheets to the wind.
I have to dig up a new driver this year as my old reliable friend for this sort of thing moved home to Alabama last year. I do have someone in the cross hairs...a woman in the office for whom I have done some cat sitting/koi pond upkeep while she was on vacation.
There really is truly nothing to the exam. At least from the patient's perspective. Your DW might want to plan a day's worth of activities away from home the day of your prep, though.

[nvestysly]

.... the prep sucks. Early morning appt. if possible. The procedure is not that bad and I suggest staying awake. You definitely need a driver to take you home. Recuperation was minimal but had lots of gas due to the "inflation" during the procedure.

I had a first AM appointment and I stayed awake during the procedure. Watching that scope picture was really interesting.

For me the worst part was the prep. My doctor gave me two options 1) a drink mix they said had a pleasant citrus taste, or 2) tablets that you take with water. I chose the tablets. Well..... there are many, many, many tablets to take and you have to drink lots and lots of water. Wow! I never drank so much water. At some point I stopped taking the tablets with only a few remaining because I simply could not drink any more water.

Unfortunately, I got a late start on the prep - supposed to start at 5PM but I was delayed and did not start till 8PM. Big mistake. That meant I was up till way past midnight and my appointment was for 7AM. Oh well.

My doctor gave me an intravenous (sp?) and said I could have as much or little as I wanted. I opted for very little and decided to stay awake and watch. I found it very interesting - particularly when the scope came around the corner to the small intestine. I was surprised how by the well-defined the transition from colon to small intestine. It looked just like a biology book picture.

Wishing you the best.

[Nords]

Quote:

Originally Posted by Ed_The_Gypsy Are you SURE you want to know?

Hell, I don't even really want to bother with the whole thing, except for all those pesky little polyps my father's had removed from his colon. And his prostate-cancer surgery. And my lifetime occupational exposure to ionizing radiation, along with all the other interesting substances I've been subjected to in the military.

But (especially now that it's scheduled for a military hospital) I'd like to know what's new/better in the prep in order to avoid getting some 19th-century technique that's deemed exceptionally cheap "good enough".

I'm just glad that Dave Barry had the moral courage to mention the vodka:
Dave Barry: A journey into my colon -- and yours - 02/11/2009 | MiamiHerald.com

[Animorph]

I did the lots and lots of pills (OsmoPrep by Salix) and water, preferred by my doc. I have to take it slightly earlier than normal for optimal results. OK, but another annoyance on prep day.

I get real anesthesia, by a full doctor, instead of the usual twilight drugs. Both knocked me out cold, but apparently I "thrash" with the usual stuff. Must not really be far enough out, but you don't remember it. The real anesthesia has a quicker recovery time for me. I'm awake before going home. The other stuff lingers longer, I'm out for the afternoon and don't remember the ride home.

Lucky me, I get to do this yearly since the doc keeps finding polyps. Twice within a couple of months when he couldn't get everything out with me thrashing on my first visit. One of the reasons finding private medical insurance when DW finally retires may be expensive to impossible.

[GregLee]

Quote:

Originally Posted by Nords But (especially now that it's scheduled for a military hospital) I'd like to know what's new/better in the prep in order to avoid getting some 19th-century technique that's deemed exceptionally cheap "good enough".

The prep agent I took for my first colonoscopy in 2005, Fleet's Phospho Soda, has been recalled by Fleet because of some association with kidney failure. But the pills I take currently, Osmoprep, have also been held responsible for kidney failure. The tale is told in the Wikipedia entry Phospho soda - Wikipedia, the free encyclopedia . The danger probably lies in not drinking enough liquid for people with preexisting kidney problems. The alternative to this type of prep agent is polyethylene glycol in various forms, also described in a Wikipedia entry: Polyethylene glycol - Wikipedia, the free encyclopedia . I'm not aware of any recent changes in the prep or any big differences among the various prep agents, though people have their preferences. Just drink plenty of liquid.

[W2R]

I wasn't given a choice, and had propofol anesthesia (the Michael Jackson anesthesia). Out like a light, and didn't remember a thing after "take a deep breath".

Quote:

Originally Posted by Nords But (especially now that it's scheduled for a military hospital) I'd like to know what's new/better in the prep in order to avoid getting some 19th-century technique that's deemed exceptionally cheap "good enough".

Believe me, I understand. Sometimes the Navy hospitals do some odd things (though I had some cool state-of-the-art stuff done at the Navy hospital in Portsmouth, near Norfolk). Anyway, from what I read on the internet I don't think that any of the preps are going to be much fun, modern or not, although some apparently taste bad and are hard to swallow.

I had the Miralax and Dulcolax prep, which I looked up on the internet and it's supposed to be one of the better, latest&greatest ones. BUT, it was still miserable and I had to start on Sunday at 4 PM for a Tuesday morning procedure (which meant little to no sleep for two nights). I think it would have made no difference if I had started on Monday but I followed the instructions that I was given. One advantage of Miralax is that it is almost flavorless when mixed with just water (some other preps apparently taste awful).

I read a statement online by a doctor who said that after this prep one would visit the bathroom 15 times or so - - and I laughed at the dark humor of such a severe underestimate.

[hakuna matata]

Good luck! It was a breeze except for the prep. Worst part was the day before when you can't eat anything. Nothing worse then chicken broth that sort of tastes like chicken soup with nothing in it!

My team at work, bless their souls, decided that was the day to send me pictures of food all day. I am sitting at home and all day long I get photos of hamburgers, etc Man did that food look good that day! The food the next morning after the procedure was the best breakfast I have had in a long time.

But it almost brought a tug on this hard cold Project Manager heart of mine - this shows they are almost ready to become Project Managers. It is tough to watch the kids move on! Little ungrateful b***ards! I will pay them back at their reviews this year!