Monday, September 25, 2006

After All, It's Still A Business

After all, it's still a business.
These words still ring in my head.
He was a pleasant young man in his thirties. A bit of a worry-wart. But then again, with his medical history, who wouldn't be? He had his first myocardial infarct (heart attack) in his early twenties. Since then, he's had another 2. He's had so many angioplasties that he's lost count. The stack of medical records that came with him told of the 9 coronary stents he has. I didn't even know you could get that many stents.
Yes, he has a reason to worry.
His L_D_L was over 500 mg/dL (in his situation, should be below 70). Despite being on maximal doses of 3 medications to lower this. Familial hypercholesteroloemia*, refractory to the usual. In a last-ditch effort to lower this, we suggested L_D_L-phoresis. Think of it as hemodialysis for the kholesterol*. When I saw him next, his numbers were in the 200's. Still shitty numbers, but the best they've ever been, and very likely will impact his survival.
Until he called me recently, upset. His insurance company is now balking at the cost of the treatment, and will soon stop payments.
I wrote a very strongly worded letter to them. So did her other doctors. Without his treatment, there's a good chance he won't live into his 5th decade. But I'm not sure this will do anything.
When I confided to a mentor, who's seen this one too many times, he just sighed, and said:

After all, it IS still a business. These people make money out of the sick, or those who fear illness.

Healthcare isn't cheap. In the meantime, the physicians are helpless, while the sick die.
*Yes, I do know how to spell. Some words misspelt intentionally to avoid inadvertent Googling.