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Anesthesia/Surgery patients 90+ on Medicare

jddgfd

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It would depend on multiple factors.

Being 90+ isn't by itself going to make it the procedure that risky, it depends on the other medical conditions of the patients. Typically the surgeon will not lie about the procedure as they would not be the ones to determine the safety of the anesthetic only of the procedure. If they believe the patient is not a candidate for the procedure they may not offer it.You could find a different surgeon who is willing to go forward with the procedure.

The same, if the surgeon would do the procedure but the anesthesiologist believes the risk of GA is to high for a non-emergent case, then the surgeon would likely have to see if they could find an anesthesiologist willing to provide the service on a high risk patient.

Also you have to consider if there are alternatives to the anesthetic besides general anesthesia for the procedure.

Ultimately it comes down to risk versus benefit. If the risk of the surgery itself and the anesthetic are high for morbidity and mortality and the benefits for the patient would be minimal then it would be hard to get anyone to perform it.
 

bryanphunter

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What kind of non-invasive procedure are we talking about? Cataracts, Carpal Tunnel Release? The procedure drives risk more than patient condition sometimes. Many surgeries can be done with regional anesthetics that are less risky than general anesthesia.
 

bogey21

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FWIW I am 80+ and am a whole lot less likely to have any procedure that requires general anesthesia. If the procedure is absolutely necessary, of course I will have it. If the procedure is a judgement call, maybe I'll pass. Fortunately my Son-in-Law is and anesthesiologist and I will have a long conversation with him if/when the time for a decision approaches.

George
 
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wilma

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I'm not sure I understand your accusations of the "lying". Has the mayo clinic being doing this procedure on people over 90 for 30 years? What is the procedure and if Blue Cross pays out of country (probably because you can't sue out of country) then why not do that.
 

flexible

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George: You are fortunate to have a Son-in-Law to advise you on these issues.

FWIW I am 80+ and am a whole lot less likely to have any procedure that requires general anesthesia. If the procedure is absolutely necessary, of course I will have it. If the procedure is a judgement call, maybe I'll pass. Fortunately my Son-in-Law is and anesthesiologist and I will have a long conversation with him if/when the time for a decision approaches.

George
 
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JudyS

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I am quite confused by this thread.

This part I think I understand: Flexible has a male friend/relative who is about 90 years old. The friend/relative had a bladder obstruction and developed neurogenic bladder. The local doctors refused to operate because of the patient's age.

OK, here is where I'm confused:
....
Surgery was very successful. Urine retention greatly but not completely reduced yet. There is a slight change that a partial dx could be neurogenic bladder but catheters no longer seem to be required thus risk of urinary tract infection is greatly reduced....
Flexible, are you saying that your friend/relative underwent a procedure in Mexico and had a good result? If so, that is great! Or, are you just describing something you read in an article?

Are you asking for advice as to what your friend/relative should do, or has he already been treated?
 

tschwa2

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A few in S and VA, a single resort in NC, MD, PA, and UT, plus Jamaica and the Bahamas
Can you travel to Rochester to have the procedure done at the Mayo Clinic?
 

bryanphunter

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I'd call the Mayo Clinic Appointment phone number. They will call you within 48 hours to discuss your medical concerns and see if Mayo Scottsdale is the place to go for your husband's care. http://www.mayoclinic.org/appointments
 

JudyS

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Flexible, I'm still confused as to what treatments your husband has recently had. I also am confused as to what still needs to be treated.
 

SmithOp

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I've had green light laser prostate procedure 4 years ago, it was outpatient but I was sedated. I have retention but no where near the numbers you relate, my last check was 87 ml. My urologist recommends turp when its over 100ml, I cant imagine 1000ml, its a wonder his bladder has not ruptured. That must be the neurological damage if he cant feel it.

There are self administered disposable catheters that can be use to drain the retention as needed.


Sent from my iPad Mini 4 using Tapatalk
 

Beaglemom3

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f
I'm not sure I understand your accusations of the "lying". Has the mayo clinic being doing this procedure on people over 90 for 30 years? What is the procedure and if Blue Cross pays out of country (probably because you can't sue out of country) then why not do that.

I would like to schedule appointments in the U.S. at either Mayo or Cleveland Clinic because they have great reputations. Since Stanford University four hours it is harder to travel for follow up appointments. Easier to plan to spend months near MN/AZ or OH/FL then to deal with California freeway traffic frequently.

Initially, I want "general physicals" for both my husband and myself. Apparently the shortage of medical doctors in our rural area means that often we are told during "doctor appointments" "Oh I can't prescribe that, I am not a doctor." I understand most hospitalists have RN degrees at best.

About 2011, after meeting a Mayo Clinic secretary at the Rochester hospitals at a resort, she said we should be able to get appointments at Mayo Clinic in Scottsdale, Arizona. After submitting both of our insurance information, they said they could schedule a neurology appointment for my husband to discuss peripheral neuropathy in Arizona but would not schedule an appointment with an internal medicine specialist for a physical in Arizona. They said we could in Rochester, MN though.


After reading this thread's posts , I have to say that I find it somewhat all over the place starting with the original redacted post referring to surgeons as "lying". Agree with Wilma here.

It seems that you base a lot of your actions based on one nurse's opinion, "She said "The Anesthesiologists refuse to perform anesthesia on patients near 90 years old in our county." My guess is they might if it is non-elective life/death like a heart attack but I don't know for sure if they would" is not well thought out.
ETA: Get opinions from gerontologists and anesthesiologists. Seek information from the experts.

Age is a always a consideration, but underlying medical conditions and general health are, too. It's all individualized and on a case-by-case basis. Painting with a broad stroke is never a good thing.


Hospitalists are occasionally NPs (Master's prepared RNs with 300-500 clinical training hours in addition to an intensive internship of sorts), but the large majority are MDs and these are usually board-certified internists,never RNs who cannot diagnose or prescribe due to their scope of practice limits. Hospitalists oversee the care of hospitalized patients and are in communication with the patient's primary care clinician, at least here in Massachusetts. Googling "hospitalists" is helpful.

Mayo is very good for urology, but so is UCLA's Ronald Reagan Center as well as Hopkins and the Mass General.

IMHO, we have the best specialized care in the U.S., far from perfect, but damn good.

-
 
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wilma

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Can't wait to see the next iteration of the story. :ignore::ignore:
 

PStreet1

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I am a Mayo patient/health care consumer in Arizona, and can offer only encouragement. When we first moved to Arizona, our primary care doctor was at Mayo. Shortly before Obamacare was begun (not political--just a fact) Mayo sent a letter to all patients of Primary Care doctors and said they could no longer continue as Mayo patients, but were welcome to see specialists, which I do. Since that initial letter, some specialists will no longer take Medicare patients: dermatology for one. General physicals are simply not an option.

Having said that, before any surgery/treatment, the patient is examined thoroughly/tests are run (many, many tests) and a team of doctors meets to discuss the case and how it should be handled.

I have Medicare with supplemental Blue Cross/Blue Shield and have had to pay out of pocket very, very little money for quite a few "pretty big deal" treatments and hospital stays.

They are kind and thorough. If you are coming from out of state, tell the scheduler, and multiple appointments will be made for you all in the same day--I've had at least 4 in a day before, and that wasn't even a particularly tight day as the schedule worked out.
 

flexible

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Thanks PStreet1.
PM sent & received.
Kind regards,
Flexible


I am a Mayo patient/health care consumer in Arizona, and can offer only encouragement. When we first moved to Arizona, our primary care doctor was at Mayo. Shortly before Obamacare was begun (not political--just a fact) Mayo sent a letter to all patients of Primary Care doctors and said they could no longer continue as Mayo patients, but were welcome to see specialists, which I do. Since that initial letter, some specialists will no longer take Medicare patients: dermatology for one. General physicals are simply not an option.

Having said that, before any surgery/treatment, the patient is examined thoroughly/tests are run (many, many tests) and a team of doctors meets to discuss the case and how it should be handled.

I have Medicare with supplemental Blue Cross/Blue Shield and have had to pay out of pocket very, very little money for quite a few "pretty big deal" treatments and hospital stays.

They are kind and thorough. If you are coming from out of state, tell the scheduler, and multiple appointments will be made for you all in the same day--I've had at least 4 in a day before, and that wasn't even a particularly tight day as the schedule worked out.
 
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PStreet1

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I'd check the facts with Mayo itself regarding a physical. It may have been possible "before" in Rochester, but that doesn't mean it is now. From the letter we received years ago, I assumed the Phoenix policy changes would apply to all locations, but I didn't check because I'm in Phoenix. They are easy to deal with on the phone--wonderful in fact--and Mayo itself is definitely the only source to put any faith in regarding Mayo policies/procedures.

I can't see that w/wo long term care insurance would be a factor; Mayo doesn't do long term care.

I've found that a call to the insurance company itself is the best source of information regarding what they will/won't cover, too. They know. Mayo will do all the billing for you and will send you a monthly summary of how things are coming along on the insurance front. You don't pay your portion, if there is any, until all insurance funds have been received. Some Medicare and Blue Cross/Blue Shield payments are made directly to you. When that happens, call Mayo's accounting and pay for the exact line item you received the check for. I had a billing mess that lasted two years (yes, "years") because I didn't know that the first time. The Mayo accountant who straightened out most of it said, "Never just apply the amount to your bill; do the line item; you'll never have a problem that way," and so far, so good.
 
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Tia

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wilma

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Talent312

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It seems that there's less to this story than meets the eye.
.
 
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JudyS

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I feel like I wasted my time trying to understand the situation and maybe help out. I don't like putting people on "ignore," but if I can't figure out what the person is saying, and their posts keep changing, I guess that's the best choice. :(
 

Sugarcubesea

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I agree, why post and then go back and delete the posts and say you will re post later...I feel a lot of folks tried to help and I look at her taking the posts down as disrespectful...
 
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