Personal experience: The importance of going outside an HMO

[Masterok]

Вот такое письмо я получил от моего бывшего коллеги. В название топика вынесен Subject его email. Мое личное впечатление от местных докторов еще более усилилось.

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Most of you have probably not been aware that I've been pretty sick for the
last few months. Last December, I had my dentist take a look at white spot on
inside of my cheek, because it seemed to be growing and getting a little sore.
the dentist noticed a couple of other small white areas, including one on my
lip. He said I needed to see a head and neck specialist right away.

So, I went to my primary care physician at Kaiser (I switched to Kaiser when
his whole medical group was aquired by Kaiser a few months ago). He said he
didn't think it was anything to worry about, but upon my insistence he made an
appointment with one of Kaiser's head and neck specialists.

During the few weeks I had to wait to get into see the head and neck
specialist, the white area was expanding and getting more sore. He said it was
"leukoplakia" (precancerous growths) and that because I don't smoke or drink,
there was nothing to worry about -- only about a 3% chance of becoming
cancerous. For the soreness he recommended that I wear a mouth guard at night
to not chew on cheek, which he said was the cause of the irritation. He did a
biopsy of couple areas just to be sure.

That night after the biopsy, I got sick and was in bed for week with a fever.
And the areas of white growths went from 3 to 10 areas of my mouth -- and was
now very sore. The head and neck guy didn't want to see me again, but
reluctantly scheduled another meeting about a month later. In the mean time, I
haven't been doing any work -- just searching MEDLINE and the internet about
leukoplakia. What I learned was thatwidespread and multisite leukoplakia that
was erosive (had sores) had a very high probability of turning into cancer (at
least 30% chance) with a typical 50% 5 year survival rate...

I gave references to the head and neck specialist and printed out one of the
journal articles for him. He still insisted there was nothing to worry about. I
told him I was in constant pain. It was like having a lot of cancer sores in my
mouth and my gums were so sore it hurt to brush my teeth. And my teeth were
becoming very sensitive to cold -- which had never happened before. And his
response was "What do you want me to do about it?" I said I wanted a third
outside opinion from a recognized expert in the field. But, my doctor said it
was extremely difficult to get outside opinions.

Being in constant pain and having the possibilty of converting to cancer, all I
could think about was finding a cure and haven't been spending hardly any time
developing my products.

My wife, Jen, went through a large number of articles on leukoplakia that I
printed out and listed the names of authors most frequently referenced. I then
did a background check on the internet to learn more about the most referenced
authors. One of the most referenced authors is the chairman of the oral
medicine department at Univ. of Cal. San Francisco. I got an appointment to see
him last week.

He looked in my mouth for less than a minute and said I didn't have leukoplakia
at all. He said it was a condition called lichen planus of which there are
several forms that many doctors often confuse with leukoplakia. He gave me a
prescription for prednisone (a cortisone steroid to reduce inflamation).

The next day after taking the first predisone pills, some of pain was gone. I'm
now on the fourth day, and almost of all of the pain is gone and much of the
white areas have disappeared!

Doing internet searches on lichen planus, I learned that there are several
possible causes: automimmune disease where the body attacks itself, some
viruses like hepatitis C, and allergies -- in particularly allergies to gold.
And I think my problems first started when I had some old fillings and crowns
replaced with gold...

Well, I'm back to working on my software products now. And I have learned that
if you're in pain and the doctors say don't worry about it, research and keep
searching until you find an expert that knows what the hell they're talking
about! I also learned that there is HUGE difference between what doctors
(including specialists) believe and what researchers at universities believe.
Had I been less trusting, I would have gotten oustide opinions from world
recognized experts right away and saved myself months of pain and worrying
about cancer...

-George

[thinker]

[quote:6efec421bf="Masterok"]I gave references to the head and neck specialist and printed out one of the
journal articles for him. He still insisted there was nothing to worry about. I
told him I was in constant pain. It was like having a lot of cancer sores in my
mouth and my gums were so sore it hurt to brush my teeth. And my teeth were
becoming very sensitive to cold -- which had never happened before. And his
response was "What do you want me to do about it?" I said I wanted a third
outside opinion from a recognized expert in the field. But, my doctor said it
was extremely difficult to get outside opinions.[/quote:6efec421bf]

Еще одно подтверждение, что HMO - сакс, а PPO рулез. Если у вас есть PPO, то вы идете напрямую к специалисту, которого выбрали и которому доверяете, а не слушаете бред своего лечащего HMO врача, типа:

"there was nothing to worry about" или
"it was extremely difficult to get outside opinions"