General Medical issues thread

[Quickstatus]

does it sound right that the hospital billed me under the same item #s as the surgeon?

Yes the hospital can only bill under the same medicare item numbers. The numbers then refer to a negotiated hospital schedule under which the hospital is reimbursed by the health fund. Its better to use the same numbers.

 

[Quickstatus]

While there are lists of radiology places that have MRI machines, there are only a certain number (12?) of radiology practices in Brisbane who are licensed by federal government for Medicare bulk billing

The downside is the "Medicare eligible MRI" is always the busiest, and often a waiting list.
Some MRI are "Partial medicare eligible" depending on the type of scan done.

 

[Quickstatus]

Is that the "long life" one?

SF6 or C3F8 are the long duration gases. But C3F8 is longer lasting than SF6
A short duration gas o f days would be sterile air. not often used.

Its not the gas bubble that presses on the detachment but rather the bubble causes a surface tension of fluid to lie over the detachment and the tension provides the necessary forces.

 

[RooFlyer]

Yes the hospital can only bill under the same medicare item numbers. The numbers then refer to a negotiated hospital schedule under which the hospital is reimbursed by the health fund. Its better to use the same numbers.

As long as the health insurance pays in the end, I'm not terribly disturbed, but I still think its odd that the hospital is billing ME for a service whos description to ME is quite different from the service they actually provided!

The hospital has a 'relationship' with the insurer, so I get that its all arranged before I even set foot in the door, but I still reckon its odd that they can't have their own item number for the particular service they are actually providing to me. It would still work the same - it could even work that "Item 123 (hospital) is only payable if item ABC has been charged by surgeon". I've seen such linked charges/items before. Of course that would only help the public / the patient, so definitely wouldn't be thought of any use!

Its not the gas bubble that presses on the detachment but rather the bubble causes a surface tension of fluid to lie over the detachment and the tension provides the necessary forces.

Hmmm. I asked the surgeon once, after he said there was nothing I should avoid doing, short of bungee jumping or operating a jackhammer.: "So I have this gas bubble sloshing around in my eye as it reduces ... why wouldn't it damage the retina again by mechanical action? " He gave me a potted explanation - now, I like to think I'm sorta informed on how things work (I'd done a bit of web reading by this time), but he blew me away in a few sentences and I renewed my admiration for him especially and all eye cutters.

Your note still doesn't answer that question - how can a retina, torn by just a covering layer falling off the front of it (first time) or fluid getting behind it (second time), survive agitation by a bubble sloshing around for a month?

 

[Quickstatus]

it could even work that "Item 123 (hospital) is only payable if item ABC has been charged by surgeon"

Makes it worse for administrators because they have to look up 2 numbers. better to be the same so there is no argument.
The hospital bills you (Health fund pays of course) for their services which are based on the same item number as the surgeon uses.
They just use the same number different descriptors. Any pushback the health fund just says well thats what the surgeon used.

 

[Quickstatus]

Your note still doesn't answer that question - how can a retina, torn by just a covering layer falling off the front of it, survive agitation by a bubble sloshing around for a month?

It just does.
Its one of those "trust me Im a doctor" OR you could keep the same posture as you had to immediately after the surgery but for the next 4 weeks... it would make a Covid-19 quarantine seem like a holiday.

 

[love_the_life]

It just does.
Its one of those "trust me Im a doctor" OR you could keep the same posture as you had to immediately after the surgery but for the next 4 weeks... it would make a Covid-19 quarantine seem like a holiday.

Friend's daughter was flat on her back for several weeks and (probably many years earlier) friend's brother spend weeks in hospital in Sydney with the same thing. They all have Marfan's so it's common - they all have had lenses removed now.

 

[Quickstatus]

Friend's daughter was flat on her back for several weeks and (probably many years earlier)

That would have been the oil.

Imagine if the surgeon used a bubble. Would have to be face down...

 

[tgh]

Interesting conversation .. sorta edgyewkayshional like…...

 

[Tassieoptom]

The oil is generally scheduled for removal after an appropriate time. All vision is radically disturbed by the vitrectomy and gas/oil bubble. This sometimes takes weeks and months to settle. Yes side effect of cataract is almost 100% seen within a year. So any major diopter vision shifts are able to be corrected then.
Good rule of thumb is any vision you gave after retinal detachment/vitrectomy surgery is a bonus. As without the surgery you would be blind.
So patience is essential, surgeons generally are somewhat dismissive of visual complaints post op. I regularly prescribe a Shaw lens design for patients dealing with significant anisometropia they are designed after complex calculations to eliminate image size disparity between the two eyes. Did you have your surgery in Tasmania? Feel free to send me a pm or text if wanting more private advice.

 

[cove]

@Quickstatus that colchicine tablet just has a slightly yuk taste. Most folks would not choose to chew a prescription medication. This is a strong gout busting medication where some folks experience stomach upsets.
It lowered heart attacks and strokes in the trial group who received it. I was on it for about 4 years and have recommenced taking it now that the results are good.

 

[love_the_life]

That would have been the oil.

Imagine if the surgeon used a bubble. Would have to be face down...

Actually I was mistaken. She was flat on her tummy.

 

[RooFlyer]

So patience is essential, surgeons generally are somewhat dismissive of visual complaints post op.

My surgeon has been brilliant. From the outset he gave me his mobile number for me to contact him with any concerns. I haven’t complained, but have texted him 3 times times when something changed. Each time he offered me a consult and was very patient and understanding of my concerns. Might have helped when, after the first contact, he found the second tear!

Today’s development is that 2 little subsidiary bubbles have formed, after I jogged across a road. Not a concern, just distracting!!

 

[Cossie]

SWIMBO currently in day surgery for arthroscopy on left knee, hopefully this will be it until she gets that knee replaced in a few years.

 

[Quickstatus]

From the outset he gave me his mobile number for me to contact him with any concerns

It’s a toss. Some surgeon don’t believe in giving out their mobile. Some do. Some are selective - you don’t want a nutter ringing you for every symptom post surgery

 

[prozac]

I injured my hand, well the tendon in my ring finger, the first week of July. Don't know what I did but suddenly developed quite an uncomfortable pain from finger down into my palm and it was difficult to straighten the finger. Been waiting for it to improve, and it has become less painful and can open fully, but eventually I relented and saw a hand surgeon who said it was trigger finger. He gave me a shot of steroi_, and a painkiller which contained adrenaline and that set my heart going a bit. Even my dentist knew not to give me adrenaline this close to major heart surgery. Never mind, i got over it after a few hours.
It's been 2 weeks, how long before the steroi_ is likely to take full affect to cure this condition as I still do not have full strength in the hand?

 

[Quickstatus]

Need to see a hand physiotherapist

 

[RooFlyer]

Did you have your surgery in Tasmania?

At the South Hobart day surgery place. First op < 24 hrs after optometrist diagnosed retinal issue and referred me to surgeon ( seen same day). Second time was 2 hours after the second tear was found by the surgeon, on a Saturday! I recounted this upthread.

Very satisfied customer.

 

[Pushka]

I injured my hand, well the tendon in my ring finger, the first week of July. Don't know what I did but suddenly developed quite an uncomfortable pain from finger down into my palm and it was difficult to straighten the finger. Been waiting for it to improve, and it has become less painful and can open fully, but eventually I relented and saw a hand surgeon who said it was trigger finger. He gave me a shot of steroi_, and a painkiller which contained adrenaline and that set my heart going a bit. Even my dentist knew not to give me adrenaline this close to major heart surgery. Never mind, i got over it after a few hours.
It's been 2 weeks, how long before the steroi_ is likely to take full affect to cure this condition as I still do not have full strength in the hand?

Mr P had steroi_ injection in shoulder yesterday. Barely slept last night, not from pain but the inability to sleep. He too had a painkiller. Maybe that was the issue.
He was told it would take two weeks - the ultrasound operator thought it was the start of a frozen shoulder, the Dr thought it's bursitis. Both require different placement of cortisone injections. They went with bursitis. He will know in 2 weeks if that was the right guess.

 

[Quickstatus]

Barely slept last night, not from pain but the inability to sleep. He too had a painkiller. Maybe that was the issue.

Was the roids