Healthcare, Doctors, and... Money?

I am absolutely livid!

I write a lot about Australia, and honestly, my family and I haven't had much luck with our health. It feels like we’ve been cursed with constant medical issues.

The old folks always say, "Health is wealth,"!
And they aren't wrong, even if it's just my experience.

A fair number of you have been reading my piece, *The Truth About Australia 1969*...
I haven't finished it yet...but I wanted to add here that I actually love where I live. I’m not so nostalgic for Washington, D.C., that I’d move back—even if my finances were better.

I really enjoy life in Australia. I get it; it's up to us to pull ourselves together and live how we want. A lot of people expect too much from others.>

Personally, I’m content living just above the poverty line. A weekly trip to the movies and a little relaxation keeps me happy enough.

BUT I AM NOT HAPPY WITH THE MEDICAL SYSTEM!

I've said it before: between my pension, my wife's, and what little we've saved, we simply cannot afford Mayo Clinic.

What happened next completely destroyed my respect for doctors.

I was out yesterday buying a rolling walker because I can't walk very far anymore. The reason is that I need spinal surgery, though the odds are slim—maybe 50% at most, and even then, it might only be a partial success since a previous Laminectomy back in 1972 didn't go well.

The shopkeeper selling me the walker told me he had a similar surgery and everything worked out fine for him.
I've already seen three different neurologists, and while my condition keeps worsening, everyone's situation is different. All I know is that the man is a Pharmacist, so he knows his stuff.

He gave me the name of the professor who operated on him. I’d actually read up on him already; he patented an artificial spinal disc and is considered a leader in Spinal surgery.
I called the office today, and this was the conversation:

Me: Is Professor Fraser a spinal surgeon?
Secretary: Yes, how can I help you?
Me: I’d like to make an appointment for a consultation.
Secretary: The waiting list is four months long.
Me: That’s a long wait, but please put me on the list.
Secretary: The professor only sees patients with private insurance.
Me: I can pay for the visit in cash; I don't have private insurance.
Secretary: No, he won't see you. If you eventually need surgery, he'd just be wasting his time since you don't have private coverage.

Me: Isn't it hypocritical for a doctor to only treat the wealthy and turn away those who aren't—even though I certainly don't consider myself rich?

Secretary: Unfortunately, that is simply how this surgeon operates.

Me: What if I pay the difference in cash? Usually, standard insurance covers about 65% to 75% of the bill.

Secretary: Oh, the professor charges closer to 125%.

Me: I understand you have to pay for expertise, but roughly how much would it cost?
Specifically for spinal canal stenosis, a damaged disc, and bone cleaning—given the diagnosis requires a Laminectomy?

Secretary: I wouldn't know. We've never had a case where someone without private insurance wanted to pay cash. But I'd guess somewhere between $5,000 and $25,000.

Me: Fine, I want to make the appointment.

Secretary: I don't think the professor will want to deal with the complication of billing. Besides, there's no guarantee you won't change your mind about the surgery after the visit.

Me: Every patient, regardless of their insurance, has the right to weigh their options and consider their chances.

Secretary: Look, sir, it would probably be best to get on the waiting list at the local public hospital, though the wait there is between four and nine months... and that's for other neurosurgeons, not the professor.

Me: Thank you. Please remind the professor of the oath he took as a young doctor: to treat everyone equally, regardless of their money.

I just can't settle down after that. It completely soured my view of them. Most likely, the professor can't do anything for me anyway.BUT I WANT TO BE CERTAIN.

I still love Australia, but I can't stand people who lack
common sense.

I wish everyone good health, because it matters more than money, though it seems like you can actually buy better health and feel better if you're wealthy.

🙂 😉 😎

I am so incredibly sorry you're going through this. Have you given any thought to getting an artificial disc instead?

Or maybe even flying over to the States to have the procedure done here? We have some absolutely world-class specialists who focus specifically on the spine, and I'm sure it would end up being much more affordable, too...

Casey Palmer5 said:I'm so sorry you're dealing with this. Have you thought about an artificial disc?

Or maybe even coming to America for the procedure? We have some incredible specialists here who handle spinal issues, and it might actually end up being more cost-effective.

Casey Palmer5, thanks so much for checking in. It’s a pretty messy situation. I'm dealing with spinal damage and disc protrusions at L4-5 and L3-4.
I've also got nerve canal stenosis, complications from my first surgery, and a recent chronic inflammation of the nerve's middle protective layer—arachnoiditis.

I've attached the doctor's reports in English. I've spent 12 months visiting the Mayo Clinic just to get a better handle on everything, as I'm managing quite a few different issues.

RE: MR. William Kovacic received 11/11/41

MR LUMBOSACRAL SPINE

•CLINICAL HISTORY: Worsening leg symptoms, suspected worsening stenosis at L4-5 since the last scan.

REPORT: Current films were compared with the MR of 10 December 01. No changes noted in bone marrow signal or alignment.

At L4-5, the broad-based shallow disc bulge shows a slight reduction in midline size, though a persistent lateral recess and foraminal bulge remains. This is more noticeable on the right side, extending into the foramen, though it stays below the slightly thickened right L4
nerve root.

The L3-4 level remains unchanged with disc bulging.

T2-weighted sagittal images through the entire lumbosacral canal show multiple small filling defects within the bright CSF. I suspect these are early venous collaterals typically linked to "significant canal stenosis." These are clearer on today's imaging. The upper lumbar and lower
thoracic regions appear normal.

CONCLUSION: Persistent stenosis in the lower lumbar spine, with a slight regression of the shallow midline disk protrusion at L4-5. Fine nodularity in the CSF likely indicates venous collateral disease.

Thank you for referring this patient.

Niodi Saodh

.................................................. .................................................. .....

Dear Peter,

RE: MR. WILLIAM KOVACIC

I reviewed this patient again on April 1, 2003. I am enclosing a copy of his MRI report. There is some disc bulging at the L4-5 and L3-4 levels, likely due to scarring. I suspect this is the site of his previous surgery.

While there is moderate stenosis at this level, I would advise caution regarding surgery given his other health concerns, specifically his major depressive disorder. Additionally, his physical symptoms include several issues that a Laminectomy wouldn't necessarily resolve (for instance, groin, testicular, low abdominal, and back pain would likely remain unaffected by the procedure).

The only symptom that might
be alleviated by surgery would be his calf pain during walking.

I've suggested he look into pain management clinics and alternative treatment options. If his symptoms progress over the next year, I'd be happy to revisit the surgical option.

Sincerely,
G.A.J. McCulloch

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

Dear Peter,

RE: MR. WILLIAM KOVACIC

I saw this patient again on May 29, 2003. Over the past two months, his condition has deteriorated, with increased tingling, pain, and numbness in his thighs, especially while walking. He mentioned that even a short walk to the garage triggers severe symptoms.

There are clearly some notable abnormalities at the L4-5 level. While some of this might be attributed to arachnoiditis, there’s likely enough going on here to justify a decompression at this level.

I've sat down with him and walked through everything very thoroughly.
I made sure he understands that surgery won't touch his back or abdominal pain; the only potential benefit is relief for his leg symptoms. I also let him know we're looking at roughly a 50% chance of any real improvement. He’s okay with those odds, so I've added
his name to the waiting list at Mayo Clinic.

Best regards,

William Kovacic

P.S. I actually called off the surgery. My wife was so worried about me ending up in worse shape than I am now that I just couldn't go through with it—even after the neurosurgeon gave me the green light.

😎

I am so incredibly sorry. I can only imagine the level of pain you're having to deal with right now...

Casey Palmer5 said:I am truly sorry. I can only imagine the level of pain you're dealing with right now.

Thanks for understanding, it really means a lot.

On a side note, I decided to get a little clever and play the part of the smart Secretary.

I put on my best "foreigner" accent when I called to request an appointment, even telling them I’d pay for the entire surgery in cash!

They didn't bat an eye—just said, "No problem, sir, we'll see you on August 22, 2003, at 4:30 PM."

It hasn't been four months since they last told me, so while I'm not getting my hopes up for wildly different results, I have to give this every possible chance.

Once this is all over, I'll post a full report here to let everyone know how it went.

Best,

🙂 😉 😎

Jamie Clark74, wishing you nothing but the best! 🙂
Maybe it might be worth giving a hospital over here in the States a call?
We actually have some seriously top-tier neurosurgeons around here.

rowdypilot96 said:Jamie Clark74, wishing you the very best of luck! 🙂
Maybe consider calling a hospital back home in America.
We have some truly top-tier neurosurgeons here.

I really appreciate the kind wishes... it isn't that there's a shortage of specialists (we actually have world-class experts right here),
it’s more about the complications, the risks, and the slim chance of success.
Thanks for the concern and the advice.

🙂 😉 😎

During my last two visits to my primary care physician, we discussed
arachnoiditis. He actually called in a neurosurgeon who confirmed exactly what I’ve been suspecting: the pain isn't going away because of damage to the middle meninges, likely a complication from an Epidural or during the
Laminectomy L5/S1.

So, unless they absolutely have to remove more bone to clear out the spinal canal,
I don't expect any miracles.

Honestly, I'm just relieved with how things are now; anything else would be worse.
Until my next specialist appointment.

🙂 😉 😎

Jamie Clark74 said:Thanks for understanding, it really means a lot.

Anyway, I decided to try being a bit clever—acting like a smart assistant.

I introduced myself with a heavy foreign accent, asked for an appointment, and told them I’d pay for everything, including the surgery, in cash!

"No problem, sir. We'll see you on August 22nd at 4:30 PM."

It hasn't even been four months since they last told me. I'm not expecting miracles, but I have to give this every possible chance.

Once this is all over, I'll submit a report to let you guys know how it went.

Best,

🙂 😉 😎

Just my luck... late tonight, around 9:00 PM on August 20th,
the doctor tells me he has to head to London for a funeral... they said they'd likely be able to see me in about a week.

I'm so tense just waiting to hear what they think. My legs are getting weaker, and I'm starting to worry it's permanent damage from Arachnoiditis.
I'm terrified I might end up partially paralyzed in my legs. Even my GP thinks that's a possibility...

We'll see. Best regards.

🙂 😉 😎

Jamie Clark74, why the hell did you choose to turn off your PMs?

William Morris2 said:Jamie Clark74, why did you choose to disable private messages?

Personally, I prefer using email.
I get plenty of messages from folks here via email, so I'm happy with
that setup.
Thanks for the comment.👍

🙂 😉 😎

William Morris2 said:Jamie Clark74, why did you choose to disable your private messages?

As of today, August 29, 2003, my PMs are open.!

🙂 😉 😎

Friday, August 29th, 2003, is finally here. It’s been a week I won't soon forget.
On Tuesday, I saw my psychiatrist, and Wednesday was an appointment with a dermatologist... had to have a little skin carcinoma removed.
Thursday marked my first time ever seeing a Urologist, and I'm actually feeling pretty good about it.
My prostate numbers have hovered around PSA 1 for years, but I'm dealing with chronic
epididymitis in both testicles... plus my testosterone levels are incredibly low.
The current medications aren't doing anything for my impotence, either... so I need to follow up with biopsies and another blood test for testosterone. Hopefully, that will make getting hormone replacement therapy a bit more affordable later on.

Most importantly, I sought out a surgical opinion from the legendary Professor Fraser. I already knew he was world-renowned and one of the best out there, but a friend sent me a link to look him up online... the man has made massive contributions to spinal research. He's internationally famous and even received an award from Ford two years ago
for his research and advancements in spinal surgery.

As far as my own case goes, he’s been one of four leading specialists I've consulted over the last year. All four of them are in total agreement... they say I'm stubborn, and while I move slowly and with difficulty, I'm doing everything possible for my health. None of them recommend surgery. It's ultimately my call, but the chances are slim, and if I go elsewhere, they might not be able to help me unless it's specifically
to help me walk a little easier—but that's a gamble. I could end up worse off, perhaps even in a wheelchair.

The only scenario where I'd jump straight into surgery, regardless of the odds, is if I lose significant leg function, run into bathroom issues, or struggle with urinary retention. In those cases, I'll take the risk.

Right now, any movement or walking feels like absolute hell; I get this burning sensation in both legs immediately. Still, I can manage a little walking, which is vital for my other organs. The pain is constant. Standing or walking is the worst part; sitting helps for a bit, but I constantly have to shift positions.

At night, I'm either waking up or just lying there unable to sleep for three or four hours because my legs feel wooden and are burning. This is what my life looks like now. I could just live with the pain as I get older, but right now,
I'm heading to a specialized Pain Clinic on September 9th after a long wait. Honestly, though, I've already tried almost every medication available, so I'm not expecting much of a change.

To be honest, I was about 30% hopeful that Professor Fraser might suggest surgery... but I think I'll listen to the experts. When almost every specialist tells you they wouldn't opt for surgery if they were in your shoes, it's probably best to listen.

Wishing everyone good health,

🙂 😉 😎

Casey Palmer5 said:I am really sorry you're going through this. Have you looked into an artificial disc replacement?

Or maybe even traveling to America to get the surgery done? We have some incredible specialists here who deal specifically with spinal issues, and it would definitely be more affordable.

Ha, ha. Sounds like you don't quite grasp how things work over here—if you have the money, you have the options.

quietfox17 said:Haha, sounds like you don't quite get how things work around here—whoever pays the bill is the one calling the shots.

Well, honestly, the surgeons at the local hospital perform top-tier spinal surgeries; I really think they stay right in step with Western standards. And if you're paying out of pocket, the cost for an operation is probably much lower here than it would be abroad...

Casey Palmer5 said:The specialists at the local major hospital perform top-tier spinal surgeries; I think they stay very much in step with Western standards. Plus, the cost for private patients is likely lower here than abroad.

Casey Palmer5, you know my situation well. You've seen the reports, and you know I had that surgery back in 1972—which didn't work out—and that I'm dealing with Arachnoiditis. There isn't really any other way this goes. I suppose I should just be grateful I managed to push through the pain all those years, even if it means facing a future of it.
I find that hard to believe. I'm heading to the Pain Clinic next week, but I doubt they'll be able to do much.

And you know I'm dealing with Asbestosis, too. What else is there to say?

Best to everyone,

🙂 😉 😎

So, what’s your take on this kind of pain management approach?

"Spinal cord stimulation (also known as dorsal column stimulation) is ideally used for back and leg pain stemming from adhesive arachnoiditis,2 failed back surgery syndrome,3 causalgia,4 phantom limb or stump pain,5 and ischemic pain." You can read more about it here:
http://www.dcmsonline.org/jax-medici...rosurgical.htm

They actually perform procedures like this right here at the Mayo Clinic. At least, it seems to be something in that vein, though I don't have all the specifics handy...

Hey Casey Palmer5,
I really appreciate those links. I’ve actually known about this stuff for quite a while now... nerve stimulators and morphine pumps.
The downside is the cost. Between the surgery and the implant itself, I’m looking at roughly $45,000.
Around here, you can get these procedures done, but usually only through private hospitals...
That means you're on the hook for everything—the hospital stay, the procedure, and then the stimulator or the morphine pump.

Like quietfox17 mentioned, we basically have two systems: one for the wealthy and one for everyone else.

Regardless, thanks for the advice. I’ll just have to see what next week and the future hold for me.

Best,
🙂 😉 😎

Just wanted to give a quick update.
After ten visits to one of the top specialized Pain Clinics in the world...
I’ve seen all the specialists, and they’re all in agreement: there isn't much they can do for me.
They even tried an all-day infusion to see if any Narcotic would take effect, pumping different types into me every two hours—40 mg at a time via a pump—including a Placebo.
They claim this method is 500 times more potent than pills, but nothing really worked, except for one based on an anesthetic.

I was actually able to pinpoint exactly which narcotic was being used and when they switched to a Placebo.

Following the medical review, their only recommendation is that I stick with hydrotherapy. I’ve tried medications designed to block pain from my spine to my brain, but given the side effects, it just wasn't worth it for the minimal relief I received.

So, I went through with another Epidural... but the results were underwhelming. It helped for about a week, and you're limited to only two per year.

Because of that, I’ve scheduled another appointment with my Neurologist. I'm essentially taking a 50/50 shot at whether things might be easier after surgery.

I'm not afraid; I've been living with this pain for 33 years. My only real fear is ending up paralyzed, which is something nobody can ever truly guarantee.

What’s killing me most right now is waiting for the Neurosurgeon to see me again and finally put me on the surgical waiting list at the hospital.

I honestly wish it could just happen immediately so I wouldn't have to sit here wondering what's going to happen.

Here is a LINK for anyone interested (in English); many doctors themselves don't actually know much about this condition:ARACHNOIDITIS

Maybe you’re actually missing America after all, seeing as you're hanging out on this forum👋