CATHY'S WORDS OF WISDOM about ARD...

From: Helen Dynda (olddad66@runestone.net)
Tue May 21 12:08:52 2002


Cathy, thank you for sharing this excellent information!! I couldn't have said it better myself)!! Cathy is "right on" in regard to the reimbursement that surgeons receive from insurances (including Medicare, Medicaid) for performing very difficult and very risky adhesiolysis procedures!! This information is worthy of being printed out and saved!!

How can we, who suffer from adhesion related disorder (ARD), begin to make a difference regarding ARD? Please consider contacting government representatives from your state and the district, where you live. Re: Help - my sister is very sick; From: cathy:- (anonymous@medispecialty.com); Tue, 21 May 2002 09:33:24 -0500 (CDT) Rosemary, the surgeon who is probably the most skilled laparoscopic surgeon in the US practices out of St. Vincents in lower Manhatten. His name is Harry Reich. If there is anyone in the world who can go in there and clear the bowel obstruction(s) without doing any more damage than is already there, Dr. Reich is it. His group of surgeons has a web site -- http://www.adlap.com . Besides all of the info for getting in touch with them, the site has excellent articles about adhesions and laparoscopy. You need to be aware that they do not take insurance. This means that your sister would have to pay for all of the treatment out of pocket and then get her insurance to reimburse her. Be aware that the typical insurance reimbursement for adhesiolysis (the often grueling 8-12-hour surgery to painstakingly remove adhesions) is like $2000-$3000, while the surgery costs like $20,000-$40,000. In order to pay the difference, your sister will need to pay it out of her own money, have fundraisers, take legal action against the insurance company, sue the surgeons who have gotten her into this position for malpractice, etc. If your sister were to have surgery simply to clear to obstruction without trying to clean out the adhesions, then it's very possible that the insurance company would pay the full cost of that surgery -- that's something I have no real feel for.

When your sister gets over this immediate crisis then what she needs is a referral to a pain management clinic. These are multi-disciplinary clinics run by anesthesiologists who are not worried about curing you of whatever is causing the pain, they are only concerned with relieving the pain. They vary widely in quality and general sensitivity, though, so you really need to ask around the staff at the hospital, and if possible talk to other patients to get the "inside scoop" on where the best places are. For example, your sister is depressed because she is in intractable pain and the medical professionals are refusing to treat it. The depression will magnify her experience of pain. There are some idiot doctors out there who think that in her situation an anti-depressant is all she needs. Well if that is her condition, then she needs effective pain relief AND she needs an effective anti-depressant in order to relieve BOTH the pain AND the depression. If she only gets one and not the other, she won't get relief from either the pain or the depression... The advantage of a good pain clinic is that there are both anesthesiologists and psychologists on the staff.

And have your sister come here. It is a wonderful supportive group of people who will listen to her during her ups and downs, and are chock full of useful information and experience of what works and what doesn't.

Cathy


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