Good News

I met with the Pulmonary doc and he believes that another debulking of the lung tumors is good. He scheduled it for October 25th, and he said the surgery would be shorter than the last one. My breathing is adequate, but he told me this maintenance debulking could last a year and not 9 months.......that would be great because I go on Medicare after my 65th birthday in December. I am also in the process of getting approved for a specialized scan called an Octreotide scan to be completed before surgery. This will locate bone mets and they can work on relieving some of my discomfort. The European PRRT treatment trial begins at Northwestern in January, but Medicare will not cover the same until FDA approval.....which I will probably be dead.....but it is good to have Mr. Markle tell me how good the American system is when I am on blogs in Europe where folks have virtually been getting cured in Europe for five years.........Americans pay the highest rates for medical care and have the shortest life spans in the Western world.......and to talk about improvements makes one a socialist.

The debulking does not cure or eradicate, but simply buys me more time. Time is good.

  So happy for you!

I'm glad. Way to be proactive too.

Congratulations Seaoat.

Congrats Seaoat.

ppaca wrote:Congrats Seaoat.

Were your ears burning? I was talking about you today....and how you helped me with the waiting period glitch.

2seaoat wrote:I met with the Pulmonary doc and he believes that another debulking of the lung tumors is good. He scheduled it for October 25th, and he said the surgery would be shorter than the last one. My breathing is adequate, but he told me this maintenance debulking could last a year and not 9 months.......that would be great because I go on Medicare after my 65th birthday in December. I am also in the process of getting approved for a specialized scan called an Octreotide scan to be completed before surgery. This will locate bone mets and they can work on relieving some of my discomfort. The European PRRT treatment trial begins at Northwestern in January, but Medicare will not cover the same until FDA approval.....which I will probably be dead.....but it is good to have Mr. Markle tell me how good the American system is when I am on blogs in Europe where folks have virtually been getting cured in Europe for five years.........Americans pay the highest rates for medical care and have the shortest life spans in the Western world.......and to talk about improvements makes one a socialist

The debulking does not cure or eradicate, but simply buys me more time. Time is good.

As you know, and has been proven to you many times, the cost of health care has nothing, whatsoever, with our life expectancy.

How does it help you to deny FACTS?

Yeah, blogs and anecdotal evidence prove everything!

Thanks for the good wishes, but the only negative is my last double shot of sandostatin is November 30th as I will apply for Medicare as soon as those shots are completed. Medicare will pay for one 30mg injection of sandostatin, it will not pay the second one which the stats say is keeping people alive. My supplementary Medicare policy is Cigna who has approved my two shots through July 2017, but I have been told that the new policy will only pay for what Medicare would have paid........so my strategy has to be to somehow get into the clinical on the PRRT and have some kind of price reduction which is a three month process, which if successful might let me make it through the next year with just the one shot..........Being young and healthy was so easy. Once you get ill the hardest part is navigating this screwed up paperwork and inconsistencies where nobody can give you a straight answer. I am trying to get as many surgeries done before December because my deductible has been met, and if the bone mets which the doctor suspects are there, they will have to be attacked with radiation individually......chemo is not real effective on endocrine tumors, but I have been having pretty good results with tumor reduction with the various surgeries and radiation treatments.

Joanimaroni wrote:

ppaca wrote:Congrats Seaoat.

Were your ears burning? I was talking about you today....and how you helped me with the waiting period glitch.

My ears are always burning in my job lol. Thank you.

2seaoat wrote:Thanks for the good wishes, but the only negative is my last double shot of sandostatin is November 30th as I will apply for Medicare as soon as those shots are completed.   Medicare will pay for one 30mg injection of sandostatin, it will not pay the second one which the stats say is keeping people alive.  My supplementary Medicare policy is Cigna who has approved my two shots through July 2017, but I have been told that the new policy will only pay for what Medicare would have paid........so my strategy has to be to somehow get into the clinical on the PRRT and have some kind of price reduction which is a three month process, which if successful might let me make it through the next year with just the one shot..........Being young and healthy was so easy.  Once you get ill the hardest part is navigating this screwed up paperwork and inconsistencies where nobody can give you a straight answer.  I am trying to get as many surgeries done before December because my deductible has been met, and if the bone mets which the doctor suspects are there, they will have to be attacked with radiation individually......chemo is not real effective on endocrine tumors, but I have been having pretty good results with tumor reduction with the various surgeries and radiation treatments.

Did you get a Medicare Advantage plan or an actual medicare supplement (gap) policy?

If you're going on Medicare Dec 1 I take it you're received your 2016 and 2017 Medicare and you book. You better read it before making a decision on a gap or medicare advantage plan.

From the way I re read your post you chose an Advantage plan and in your condition you should not have.

Let me tell you a story of someone I am a friend with and wrote their original supplement.

Although he had already been diagnosed with cancer before his birthday you have an ICEP regardless of health and no one can turn you down for a supplement, no health questions. Well that cancer has laid dormant and he changes to a Medicare Advantage plan the next year against my advice but to save the monthly premium. Then a year and half down the road is diagnosed with another type of cancer, you cannot go back to a supplement. All company's will ask health questions and the cancer and a hospital stay no way. But CMS does give you an out the first 12 months in an advantage plan if it is your first time in one. You can get out even if it's not AEP time and some company's will not ask health questions.

One thing to really clarify and ponder, a Medicare Advantage plan only pays for what is Medicare approved, therefore if Medicare says only one shot is covered your Advantage plan will cover only one.

So happy for your good news Mr. Oats . . . . .

I will as part of the teacher retirement system my wife belongs and will go on their supplemental policy which is cigna who has approved my shots through July. We have spoke with them and will make our selection the end of November.

Oh it's a group retiree plan? Those are tricky, some supplement Medicare and some are regular group benefits. If they are supplementing your Medicare and paying the hospital deductible's and the other 20% of the Medicare approved amount then the second shot is only going to be covered for their 20% if Medicare won't pay their share for the first. If it's true group then I don't know why they won't pay for two continuously. I imagine it's the latter because it was a large group they should pay first.

I just know that my doctor warned me that Medicare does not cover the second shot. I have spoken with about five seniors who cannot get the second shot.....it is desperate as they decline. One has set something up where he can pay 3k a month to Northwestern to get the second shot. I will not do the same. I will play the cards I am dealt, and I will not be taking with deductibles 40k a year away from my wife after I pass. I have been getting the second shot for three years......yet medicare argues that it is an experimental treatment.....BS.....the clinical results and doctors prove that it extends life, but heck......there has to be a line drawn.......I just did not want it drawn on my life, but heck.....I should have been dead three years ago.....I have no clue why I am still here enjoying each day and celebrating life.

I hate what health care and insurance has come too. Bargaining for your life.

Joanimaroni wrote:I hate what health care and insurance has come too. Bargaining for your life.

You got that right. It's disgusting not only you have to bargain but now it seems like everyone wants a piece of the pie.

ppaca wrote:

Joanimaroni wrote:I hate what health care and insurance has come too. Bargaining for your life.

You got that right. It's disgusting not only you have to bargain but now it seems like everyone wants a piece of the pie.

I think obamacaid only left the insurance middlemen in place to allow the pretense of a free market and as the scapegoat.

Right after my lung was removed in 2008 I had an immensely sad experience in the waiting area of my pulmonary doc. An elderly couple about 70 were both crying as they could not afford the medication which was not covered which allowed him to continue to breath. They had both worked and owned their home and had all but eliminated their life savings and were alternating the medication taking half of what he needed to breath......the horror of these two crying with him in pain.....the desperation......it was at that time that I began to question my life time commitment to being a Republican. It was at this time that I hated big Pharm who spends more money on lobbying and ads than they do on research and development and where my sando costs 3,000 in Canada, but is billed at 11,000 in America......that is why I liked so many of Bernie's ideas......he speaks the truth about the obscene profits of big Pharm and the epi pen is just scratching the surface. As a nation we should negotiate our drug prices to the same level of Canada and Western Europe.

However, I also temper this belief in my own regard. At some point we all come to an end. It is not a bad thing. It is life. It has a beginning and it has an end. We have made great advances in medicine and I have lived a wonderful life of relative comfort and happiness, but lines do have to be drawn. We cannot spend millions on the elderly to give them no real opportunity to live beyond a year. As sad as it is knowing what I will face with just one shot, I know that the greater good must require lines being drawn. I am thankful that for three years my shots were covered, and I am ready for the next stage of my remaining life.......

2seaoat wrote:Right after my lung was removed in 2008 I had an immensely sad experience in the waiting area of my pulmonary doc.  An elderly couple about 70 were both crying as they could not afford the medication which was not covered which allowed him to continue to breath.  They had both worked and owned their home and had all but eliminated their life savings and were alternating the medication taking half of what he needed to breath......the horror of these two crying with him in pain.....the desperation......it was at that time that I began to question my life time commitment to being a Republican.  It was at this time that I hated big Pharm who spends more money on lobbying and ads than they do on research and development and where my sando costs 3,000 in Canada, but is billed at 11,000 in America......that is why I liked so many of Bernie's ideas......he speaks the truth about the obscene profits of big Pharm and the epi pen is just scratching the surface.   As a nation we should negotiate our drug prices to the same level of Canada and Western Europe.

However, I also temper this belief in my own regard.  At some point we all come to an end.  It is not a bad thing.   It is life.  It has a beginning and it has an end.   We have made great advances in medicine and I have lived a wonderful life of relative comfort and happiness, but lines do have to be drawn.   We cannot spend millions on the elderly to give them no real opportunity to live beyond a year.   As sad as it is knowing what I will face with just one shot, I know that the greater good must require lines being drawn.   I am thankful that for three years my shots were covered, and I am ready for the next stage of my remaining life.......

Mr. Oats your post advocates both for and against . . . . the upside and the downside . . . . the merciful side and the realistic yet merciless side . . . . . your experience has delivered wisdom and as we all know there is a beginning and an ending to all things.

In a few months my care will be paid for by Government. Yes, I contributed for fifty years for that care, but sadly my measly contributions will not cover my end of life care. I think in America we need to have a realistic discussion on end of life care. Please do not misunderstand me, I would like to get as much quality life as providence will allow, but at what cost to society.

A budget is the setting of priorities. I am done with military adventurism and would like to see the estate tax collect money which would pay for infrastructure improvements, and improvements in our health care system. However, there are only so many road and bridge improvements which are beneficial to this nation, and there are limits in the health care we can provide for our citizens. Nobody wants to see seniors in their family suffer, but sometimes we need to change our expectations and talk about limits. As soon as we do we will be accused of death panels where government decides who will live and who will die.

I would suggest a national bipartisan effort to get citizen and medical input in regard to a wide spectrum of diseases and procedures and set national guidelines which are not static, but dynamic which are reviewed by permanent citizen panels in every state in the union. I will only get one shot. It saves around 10k a month. That same 10k could provide prenatal services to a hundred women. Perhaps one child with a lifetime of health issues can be helped prior to birth with proper screening, yet because we do not have resources that child is born and suffers a lifetime as taxpayers pay the bill. So instead of blanket critics attacking prioritizing what we pay for in health care, it should be the focus of our citizens, medical community, and government. Ignorance and fear is not the best way to attack health issues. We need a national debate without the poison of politics. We can do better, and yes I wish I never saw that elderly couple crying while suffering, and yes I would love to get two shots, but at some point we need to take on the pricing of big Pharm, stream line our health care, and get citizens involved in the process. We as a nation have gotten lazy, we expect a magic man or magic bullet to solve our problems. It takes hard work to solve problems, but the journey must start.