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To amputate or not to amputate - 5/30/2009 2:59:34 PM   
Lorr47


Posts: 862
Joined: 3/13/2007
Status: offline 		In January I broke my wrist.  While they were fixing the wrist the doctors found a tumor that had eaten the lower bone in my forearm in half and hollowed out the other main bone.  Basically a cast thereafter  kept the hand attached to my arm. (right hand of course) They removed the tumor and since part of the tumor was mixed in with the nerves they used two different procedures.  The doctor was concerned with the procedure around the nerve area and sure enough the tumor reoccurred.  The tumor grew more in the 2 1/2 month period than in the estimated initial none months.

Yesterday the doctor said that to reconstruct the hand and wrist and forearm would require cutting out a four inch section of the arm and rebuilding it using bone graphs.  Even then I would not have full use of my hand.  The cost would be in the $30,000 to $50,000 range.

The first surgery cost me about $12,000.00 and I have not paid it all off yet.  I do not have insurance since the carrier wiggled out of any coverage when a dependent started having surgeries which topped $250,000.00.

The alternative is to amputate the arm just below the elbow.  That does away with the tumor and the bone destruction.  Amputation also is cheep.

I have noticed that some here have afflictions that make mine seem picayune.  The doctor has said that "there is help out there" but never has defined what he meant. Can any of you point me in the right direction as to what he is referring to.  He now has two nurses doing making calls since I favor amputation.

Secondly, I am mindful that amputation is drastic but have no intention of spending my last days arguing with bill collectors.  I straightened out my x wife's medical bills and the amount paid by insurance carriers was substantially less than that billed to the individual.  For instance, a doctor sent her a bill for $24,000 but he took $3,500 from an insurance company.  However, they were firm about the $24,000 for my wife when they were dealing with her as an individual.  Are there individuals who deal with this nonsense; what is their job classification? I feel it is better if someone else negotiate with the hospital first since I have no sense of humor and file law suits.

Thirdly, for the last four months it really has been like my hand, wrist and forearm have already been amputated as far as getting anything done.  However, the pain mixed in with the inability to do something may be coloring my thinking.  I am going to the vets facility to ask amputees what they think about the choices. Anyone know amputees and their opinion?

The doctor is not giving me much time.  I pointed out that my kidneys are bleeding again and that puts most operations off.  However, it will not delay anything this time.  He is concerned that my arm will split open from the pressure exerted by the tumor.

I am trying to make an informed decision and can live with either outcome.

Thanks.



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RE: To amputate or not to amputate - 5/30/2009 3:09:17 PM   
marie2


Posts: 1690
Joined: 11/4/2008
From: Jersey
Status: offline 		Are there any other options for treating the tumor, like radiation?

(in reply to Lorr47)
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RE: To amputate or not to amputate - 5/30/2009 3:16:06 PM   
BrokenSaint


Posts: 301
Joined: 10/30/2007
Status: offline 		I'd say look at the likelihood of the tumor reappearing with a reconstruction. If we're talking a good likelihood of yes, and it's not likely to reoccur with an amputation, then it's probably best to be done with it all.

Also I think if his kidneys are in rough shape, that might put a nix on radiation treatments. Not really sure, but it certainly wouldn't help the rest of his body.


< Message edited by BrokenSaint -- 5/30/2009 3:17:09 PM >

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RE: To amputate or not to amputate - 5/30/2009 3:18:20 PM   
kiwisub12


Posts: 4742
Joined: 1/11/2006
Status: offline 		You might try looking up an orthotics business. They are the people who fit prosthesis', so would be able to contact amputees to call you. Someone else you might talk to is an occupational therapist. They are the people who help with the rehabilitation of people with amputations. They would be able to give you a realistic idea of what you could do with an amputation.


You might ask the doctor how  much function you would have in your hand if you had the reconstruction surgery. This would give you more of an idea wheither or not it would be worth having that surgery done. If all you are left with is a numb hand that won't do anything then amputation might be the best option.

And why are your kidneys bleeding? That can be a serious matter, also involving cancer, so you might want to have that checked out too. Have you had a cat scan yet to see if your cancer has metastatised?

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RE: To amputate or not to amputate - 5/30/2009 3:25:04 PM   
FawneTwo


Posts: 98
Status: offline 		I think amputation would be a better choice. The other treatments may not work and sadly money is always an issue and that's a shame.

You didn't ask - but amputation below the elbow shouldnt wreck your appeal. jmho.

blessings and love

< Message edited by FawneTwo -- 5/30/2009 3:26:00 PM >

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RE: To amputate or not to amputate - 5/30/2009 3:27:09 PM   
popeye1250


Posts: 18104
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From: New Hampshire
Status: offline 		Tell them you're an illegal alien. Then everything's free.

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RE: To amputate or not to amputate - 5/30/2009 3:32:55 PM   
Lorr47


Posts: 862
Joined: 3/13/2007
Status: offline
quote:

ORIGINAL: kiwisub12

You might try looking up an orthotics business. They are the people who fit prosthesis', so would be able to contact amputees to call you. Someone else you might talk to is an occupational therapist. They are the people who help with the rehabilitation of people with amputations. They would be able to give you a realistic idea of what you could do with an amputation.


You might ask the doctor how  much function you would have in your hand if you had the reconstruction surgery. This would give you more of an idea wheither or not it would be worth having that surgery done. If all you are left with is a numb hand that won't do anything then amputation might be the best option.

And why are your kidneys bleeding? That can be a serious matter, also involving cancer, so you might want to have that checked out too. Have you had a cat scan yet to see if your cancer has metastatised?


After reconstruction, I would not be able to role my wrist.  I believe he is saying that the wrist will be frozen.  However, my fingers will have function.  I will be able to type for example.

Since the Marine Corp my kidneys have bleed.  To me it is no big deal except if they stop or I have kidney stones.

Some doctors have said it is cancerous while others have said it is not.  I have simply accepted  the benign designation with the "it is a vicious" language that several doctors have labeled it with.  One doctor said that if it spreads it has turned cancerous.  I have learned medicine is not an exact science.

< Message edited by Lorr47 -- 5/30/2009 3:33:50 PM >

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RE: To amputate or not to amputate - 5/30/2009 3:34:26 PM   
ThatDaveGuy69


Posts: 978
Joined: 6/22/2007
Status: offline 		OK, now I don't feel so bad about being unemployed.

As tough as it sounds, it's looking like amputation is the more medically sound procedure.  And while the art and science of artificial limbs has made enormous advances over the last 20 years, it sounds like much of that will be denied to you. 

I'm sure you'll encounter all sorts of people who have gone on to do great things after an amputation.  My brother-in-law's brother has an old-style 2-hook elbow-down prosthesis.  He's a twin-engine rated commercial pilot.  Sadly, he's also a dick.  Hopefully that won't happen in your case :D

Best of luck to you and keep us posted on your progress.

BTW: Pick up a book or 2 by cartoonist John Callahan - callahanonline.com .  My favorite: He Won't Get Far On Foot

~Dave


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RE: To amputate or not to amputate - 5/30/2009 3:37:02 PM   
Lorr47


Posts: 862
Joined: 3/13/2007
Status: offline
quote:

ORIGINAL: popeye1250

Tell them you're an illegal alien. Then everything's free.


I have been trying to delay this thing until universal health care.  I will not make it. If I renounce my citizenship does that make me an illegal alien?

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RE: To amputate or not to amputate - 5/30/2009 3:37:02 PM   
BrokenSaint


Posts: 301
Joined: 10/30/2007
Status: offline 		Well there are actual prosthetics you'd be able to get at least that much use out of. You should look into myoelectric ones. Amputation isn't always a your stuff is less effective now. In some cases, people with various prosthetics can outperform people without, and tech is always improving. If you have to get it done, think of it less in terms of oh I don't have a hand, and more in terms of, in 5 years I will have a kickass robot hand.


< Message edited by BrokenSaint -- 5/30/2009 3:38:46 PM >

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RE: To amputate or not to amputate - 5/30/2009 3:42:00 PM   
Lorr47


Posts: 862
Joined: 3/13/2007
Status: offline
quote:

As tough as it sounds, it's looking like amputation is the more medically sound procedure.


I agree and feel that so far amputation is the best option.  Maybe I could get a job as a pirate.The major point making me consider amputation is my age.


< Message edited by Lorr47 -- 5/30/2009 3:43:44 PM >

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RE: To amputate or not to amputate - 5/30/2009 3:44:04 PM   
Rule


Posts: 10479
Joined: 12/5/2005
Status: offline 		Amputate. Get rid of the cancer. They botched it the first time; they should have amputated then.

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RE: To amputate or not to amputate - 5/30/2009 3:47:08 PM   
PanthersMom


Posts: 2215
Joined: 11/26/2007
From: Cleveland Ohio
Status: offline 		i've only had toes amputated, so my opinion isn't going to be worth much, but i was all in favor of getting rid of the root of the problem, the toes, rather than risk the infection i had spreading elsewhere.  i'd be worried about the possible spread of the tumor and want it gone. 
PM

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RE: To amputate or not to amputate - 5/30/2009 3:51:57 PM   
angelikaJ


Posts: 8641
Joined: 6/22/2007
Status: offline 		First, likely you have searched out state sevices but in case you haven't:
http://www.michigan.gov/mdch/0,1607,7-132-2943---,00.html 

When I was a home health aide I gave care to a lovely lady who had a tumor in her wrist.
Her prognosis was excellent if they amputated.
She would not allow that.
Eventually, the cancer killed her.

It is admirable that the doctors tried to save your hand.

I think your better prognosis as far as non-recurrence goes is amputation.

I wish you a great outcome.

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RE: To amputate or not to amputate - 5/30/2009 3:55:13 PM   
Lorr47


Posts: 862
Joined: 3/13/2007
Status: offline
quote:

ORIGINAL: Rule

Amputate. Get rid of the cancer. They botched it the first time; they should have amputated then.


I have several friends in the prosecutor's office who had tumors.  They say the same thing.  "Do not screw around with it any more."  They had all the insurance you could ask for and opted for amputation of the subject limb.

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RE: To amputate or not to amputate - 5/30/2009 3:55:34 PM   
masmiss


Posts: 494
Joined: 2/16/2009
From: New Jersey
Status: offline 		Amputation will eliminate the problem of the tumor once and for all.  You will have better function with a decent prosthetic which can be fitted at a point when you are financially able to purchase one.  It will still be cheaper than extensive surgery which may not help you after all.
Your problem is a profound illustration of why I am such a cheerleader for universal health care in this country.  I'm a health care professional and I see too often patients who come into the hospital for treatment when they are already beyond hope because they didn't have health insurance and couldn't seek medical care while their problem was still curable.  It's a disgrace.


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RE: To amputate or not to amputate - 5/30/2009 4:03:09 PM   
Lorr47


Posts: 862
Joined: 3/13/2007
Status: offline
quote:

First, likely you have searched out state sevices but in case you haven't:
http://www.michigan.gov/mdch/0,1607,7-132-2943---,00.html


Thanks.  I was never aware of it before but the major problem with cost is the hospital.  The doctor is talking with the hospital.  Out of the approximately $12,000 expense for the first operation the hospital's bill was $7,000.00.  All I can see that the hospital supplied was the facility because I received smaller bills from everyone else.  I tried to get my doctor to go to one of the independent outlying facilities but he is only affiliated with the hospital.

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RE: To amputate or not to amputate - 5/30/2009 4:06:14 PM   
snappykappy


Posts: 616
Joined: 3/5/2005
Status: offline 		this has nothing to do with amputation but i am on the national transplant list for a double lung transplant

all of the major stuff is being picked up by the va and the only thing i am paying for that i know of is the drugs i get which are roughly 8 dollars per month and then a 50 dollar sorta co pay when i visit the pulmanist

being that sarcoidosis is a pre existing condition i cannot get any insurance\

the cost of the double lung transplant is 550,000 and if i have to have a heart transplant at the same time then it is 850,000 so as one can see if i could not get it done then i would just do what i am doin as long as i can

i am also on liq1uid oxygen 24/7

so i am very thankful for the va system

wishing u a omg-ridiculously-improbable-can't-f'n-
believe-it-actually-happened
super duper fantabulous awesome day
thomas michael
just a simple wish

i have sarcoidosis it does not have me
i will kick its ass
i refuse to lose

thomas michael kappler

< Message edited by snappykappy -- 5/30/2009 4:49:00 PM >

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RE: To amputate or not to amputate - 5/30/2009 4:08:03 PM   
angelikaJ


Posts: 8641
Joined: 6/22/2007
Status: offline 		Could you ask him for his recommendation for another surgeon at a different (less expensive) hospital?

(As amputation is fairly straight forward?)

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RE: To amputate or not to amputate - 5/30/2009 4:12:38 PM   
angelikaJ


Posts: 8641
Joined: 6/22/2007
Status: offline 		Another thought, since you seem to have fallen through the cracks and seem to not qualify for VA services, could you call your congress-person and aske them to see if they can cut through red tape to get you in there?

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