It’s certainly helpful to have a clear understanding of how this whole process works. I intend to bring these points up during my next consultation with my doctors. Thanks for the insight.🙂 And I'm rooting for the little one.
I am well aware that these medications come with an astronomical price tag. My inquiry stems from some research I’ve been doing regarding various administration protocols, which is why I’m asking. Does the hospital board or the insurance commission approve coverage based on a specialist's recommendation—say, a physical therapist or someone similar—or is there a different bureaucratic process at play? Forgive my persistence; it just seems as though you're the only one here with any actual clarity on the matter.
Thanks for getting back to me.🙂 However, there is a fundamental distinction here: your child is dealing with JIA, whereas I am battling osteoarthritis. It seems to be quite effective at managing inflammation in her case—likely because it exerts an influence over the entire system—which is precisely why I was inquiring if anyone could weigh in on whether these medications offer any relief for advanced osteoarthritis. In my situation, nearly every single joint is compromised.
Does she receive those treatments at the hospital, or are you administering the injections yourselves at home?
I’ll go ahead and drop this question here as well... it's part of a more recent discussion. If any doctors in this group could weigh in—or perhaps those currently managing their condition with biologics—could you clarify how these treatments interact with gonarthrosis in the knee and general osteoarthritis across other joints? Specifically, do they work to dampen inflammation and alleviate pain locally (for instance, targeting just the knee), or is the effect systemic, impacting the entire body? Thanks.
I was hoping someone from the medical community here, or perhaps those currently on biologics, could weigh in on a specific question regarding gonarthrosis. When dealing with knee osteoarthritis—or more broadly, OA affecting almost all joints—do these biologic drugs act locally to soothe inflammation and pain in a specific spot (like just the knee), or is their impact systemic, affecting the entire body? Thanks.
Oh, absolutely... I was offered the exact same thing, and honestly, it might have even been the same physician. 🙄 I decided to do a little digging of my own—a bit of due diligence, if you will—and ended up hitting the same brick wall you did. It’s almost absurd. Even the doctor himself finally conceded, admitting there isn't a shred of guarantee that this procedure will actually yield any results.
Angela Wright said:Surgery makes perfect sense, provided there is actually something tangible that can be surgically removed. Regardless of the outcome, continuing oncological treatment is non-negotiable; the only variable is whether they proceed with Avastin and/or Erbitux, or if they adopt a more pragmatic, bureaucratic stance by opting for an alternative therapy instead. As for lifestyle changes and personal attitudes, we are talking about something deeply intimate. From my experience, blindly following every single instruction a doctor hands down is rarely the best path, but if these shifts are a matter of personal choice for the patient, then we have to respect that autonomy.
Ultimately, how much someone engages with their own illness is entirely up to them. I respect his decision-making process. If surgery is recommended, he will undoubtedly accept it. At that point, my only advice would be to insist that his oncologist performs the necessary testing and considers these specific medications.
vividsailor7 said:To provide any meaningful insight, I would require a significantly more robust set of data points.
I am fully aware of that, but I was asking purely for informational purposes. I don't have the lab results on hand right now—if I did, I certainly would have attached them. He is scheduled to visit his surgeon in New York next week, so I will attempt to get copies of those reports and then follow up with a more informed question. In any case, thank you.
Angela Wright said:Metastatic disease is an inherently difficult circumstance; in that regard, the prognosis worsens because the condition has become more complex and increasingly harder to manage.
For metastatic colorectal carcinomas here in the States, we utilize targeted therapies involving Avastin and/or Erbitux. The latter is indicated specifically if the K-RAS testing of the tumor tissue reveals a wild-type cell structure, which is where this drug has demonstrated its efficacy.
I must highlight one critical point—there have been instances where patients who underwent surgery to remove metastases were denied these specific medications. In my personal opinion, this happens due to purely pragmatic, bureaucratic reasons aimed at cutting costs. There appears to be a loophole in the regulations stating these drugs are for "metastatic disease," yet it isn't clearly defined whether that applies to patients whose metastases have already been surgically removed—even though, from a strictly medical standpoint, those individuals still have metastatic disease. Both drugs are incredibly expensive items on the hospital formulary, and consequently, they cut corners on people, which is entirely unjustifiable. Keep this in mind and fight for the therapy; ensure that a K-RAS test is performed to qualify for Erbitux!
Thank you very much for the response, even though I realize I haven't provided any concrete data. I will absolutely pass along the information regarding the drug testing. It hasn't even been decided yet if he will proceed with surgery. They are supposed to make that determination at the Mayo Clinic next week. Though... does the surgery even make sense at this stage? Mr. Zapavo hasn't changed his behavior or his diet one bit since he fell ill, despite my attempts to suggest things based on medical literature. However, they simply stick to whatever the doctor dictates... he goes to chemo, and that's that. Actually, they have actually suspended his treatment momentarily until they see what the specialists in New York decide.
Greetings. I am looking for some perspective regarding the prognosis when colorectal carcinoma, following an initial surgery, a stoma, and several rounds of chemotherapy, has progressed to metastasize in the lungs and liver. This concerns my father-in-law. I don't have his specific lab results on hand, but this is the gist of the situation based on a recent PET scan. He currently lives near a small town in the Midwest and has been receiving treatment at a local regional hospital, but his oncologist is now referring him to Dubrava to consult with a surgeon to determine if those metastases can be surgically addressed. Beyond the outlook itself, I am also wondering why Dubrava was specifically recommended—is such a referral truly justified in a case like this? Many thanks.
My sincere thanks to urbanscout50 for such an exhaustive and thorough explanation. If I had you as my physician in the real world, I suspect I’d feel significantly less trepidation regarding everything that lies ahead. Best regards.
electricpanther82, unfortunately, the saga of these surgeries isn't over yet, and there’s no clear timeline for what comes next. It’s an endless cycle of orthopedic procedures; I'm dealing with such advanced osteoarthritis that there is always some new complication requiring immediate intervention. On a brighter note, I’ve never actually had issues with anesthesia—neither going under nor waking up. Everything has been remarkably smooth in that regard, and I owe a debt of gratitude to the anesthesiologists for their skill. However, the spinal block remains a persistent nightmare when it comes to my first attempt at using the restroom. It is an agonizing experience; I feel as though my bladder is moments away from total failure, yet nothing happens. The whole system only seems to function properly once I am able to sit down and finally find relief.
electricpanther82, I haven’t actually encountered this theory regarding brain damage before—though perhaps we just haven't collectively realized it yet, 🤷—but I have certainly overheard enough people insisting that every single bout of anesthesia effectively shaves five years off your life expectancy 👎. If that were true, it would mean I don't exactly have a massive reservoir of time left to spend, 😕. So, when the opportunity arose to ask the experts who actually know what they're talking about, I figured, why not? Let's take the risk. In my estimation, while anesthesia is technically just a drug like any other, we aren't talking about micro-doses here; these are significant amounts, so the possibility of side effects remains a valid concern. But honestly, I'll cross that bridge when I come to it. Best,
So, you're telling me there are no lasting consequences? I find that somewhat difficult to swallow, honestly, but if it’s coming straight from the doctor's recommendation, then I suppose I can proceed with the same approach 🙂. Dr. Anthony, I truly appreciate the clarification.
Personally, I find myself wondering about the cumulative damage caused by the sheer frequency of general anesthesia versus the various other types out there. At the end of the day, we have to acknowledge that all these substances act as "toxins" in some capacity. It’s why, regardless of which anesthetic is used, you always find yourself being urged to hydrate aggressively—it's a desperate attempt to help the body flush those harmful compounds out of its system as quickly as possible.
Greetings, everyone. I find myself posing a question to this group regarding a matter that has been weighing heavily on my mind. I am curious about the potential cumulative consequences of undergoing frequent surgical procedures combined with various types of anesthesia. To provide some context, I returned home just a week ago from my eighth surgery, which was performed under spinal anesthesia. Looking back at my medical history, I have navigated two instances of general anesthesia, two more involving spinal blocks, one axillary nerve block, and I believe two sessions of local anesthesia. While I haven't encountered any major complications thus far—aside from the typical difficulty with urination following the spinal procedure—I cannot help but feel a sense of apprehension regarding the long-term impact on my system. This concern is amplified by the fact that I am facing at least two more scheduled operations in the near future.