Question for Dr. Sam
From: Tine (anonymous@obgyn.net)
Tue, 10 Jul 2001 15:13:43 +0200
Dear Dr. Sam!
I see in a previous digest on pcos-medication that you write about a company where it is possible to buy d-chiro-inositol in its pure form. Do you know the name of the company, and maybe also a link to it?
I would like to try it very much as I am not responding entirely well to Metformin. I am going to try Avandia later on in this month, but as I would like to TTC I would like to find another alternative.
I was a bit dizzy on 1500 mg of Metformin, but when I take 1000 mg a day I feel better than without it. Still I am suffering from fatigue, insomnia, muscle tensions and ocasionally headaches. I am 39 years old, I have got a BMI of 24 and have impaired glucose tolerance and elevated fasting insulin levels. I donīt look too terrible, but I am not feeling well. Are the symthoms I mention connected to IR, and if so, do you think that Avandia can help me?
And what do you mean when you write about BCPs. I take Yasmin as an antiandrogen as it is supposed to reduce my symthoms. However, it seems that they can increase IR?
Hope that you can find the time to answer my questions as I live in Europe and as qualified information is not too available.
Yours sincerely
Tine
>----- Original Message -----
From: anonymous@obgyn.net
To: Multiple recipients of list PCOS-MEDICATION <anonymous@obgyn.net>
Sent: Tuesday, July 10, 2001 6:25 AM
Subject: PCOS-MEDICATION digest 504
> PCOS-MEDICATION Digest 504
>
> Topics covered in this issue include:
>
> 1) Re: Venting on perscription costs
> by Renee Cordrey <rcordrey@earthlink.net>
> 2) Re: lupron
> by anonymous@medispecialty.com (Zowie)
> 3) Re: Venting on perscription costs
> by sb.talbert@verizon.net (Sue)
> 4) Re: causes of pcos -part 2
> by =?iso-8859-2?q?Zalányi Sámuel ?= <zalanyi.samuel@drotposta.hu>
> 5) Yasmin
> by WChung43@aol.com (Jenny)
> 6) Re: PCOS WITH ELEVATED DHEA LEVEL
> by geber826@aol.com (Jenni)
> 7) Feeling like #!>#$%
> by "Kari" <kari95125@earthlink.net>
> 8) Vaniqa Prices..
> by anonymous@medispecialty.com (Tyrany)
> 9) Re: Yasmin - I've been on it for three weeks
> by anonymous@medispecialty.com (Shelly)
> 10) PCOS
> by fvelles@yahoo.com
> 11) Re: Glucophage XR dose?
> by anonymous@medispecialty.com (michelle)
> 12) Re: Venting on perscription costs (long)
> by Renee Cordrey <rcordrey@earthlink.net>
> 13) Re: Venting on perscription costs (long)
> by "Bronwyn De Forrest" <spryte@dnsonline.net>
> 14) Re: Venting on perscription costs (long)
> by Kristy Sokoloski <sokokl@yahoo.com>
>
> ----------------------------------------------------------------------
>
> ----------------------------------------------------------------------
> Date: Mon, 09 Jul 2001 08:14:33 -0700
> ----------------------------------------------------------------------
> From: Renee <rcordrey@earthlink.net>
> To: pcos-medication@obgyn.net
> Subject: Re: Venting on perscription costs
> Message-ID: <3B49CA4B.809DC32A@earthlink.net>
> MIME-Version: 1.0
> Content-Type: text/plain; charset=us-ascii
> Content-Transfer-Encoding: 7bit
>
> All of us in health care learn how to play the game. It's all in choosing the
> right words (literally, the same activity may get paid for or denied depending
> on which buzzwords you use). Putting them on the transitional care unit (the
> "senior citizen" floor you referred to--though it's for all ages who need
> prolonged care at a lower intensity than acute care) can be a great solution.
> However, there are certain criterial of "skilled need" that must be met. So,
> we may buy a few days with with physical therapy or occupational therapy evals
> and a few days of treatment. Or, find an IV med (eg: antibiotic) to put them
> on when oral is all they need.
>
> The way insurance companies get around practicing medicine without a license
> is that they aren't telling the doctors what to do. They are telling them
> what they will pay for. The doctor can still choose to do things without
> payment for him or the hospital, possibly billing the patient. However, most
> hospitals wouldn't appreciate that very much, since they are barely surviving
> right now. (Most hospitals are barely in the black, if even that.) So, the
> insurance companies lay out guidelines regarding what is covered in which
> circumstances, leaving the actual decisions (with strong financial motives) to
> the physicians. When their guidelines match Medicare guidelines, it's not too
> bad. When they're stricter, then it's insane.
>
> I once had a young woman (33 years old) who burst a blood vessel in her brain
> while giving birth. They actually sent her to a university hospital nearby
> for the surgery to clean up the bleeding and clamp the artery, then sent her
> back to us for the therapy and after-care. She had a lousy HMO (the worst in
> my experience). First, the HMO never used the rehab unit. If someone needed
> therapy, they went to the transitional care unit (TCU). However, the
> intensity of therapy is less, (less cost), and it is by nature less
> comprehensive (rehab psych and rec therapy, etc. are available on acute
> rehab). She presented like a stroke. One side was very weak, and she
> couldn't talk without severe mumbling. We started her with a walker with an
> arm rest (it was too weak to hold the handle). Eventually, she used an ankle
> brace and a cane. We wanted her to go to rehab. Her physician agreed. The HMO
> medical director said no, she was walking too far. (150') Never mind that she
> was an engineer and professor at a respected school, was only 33, and had a
> new baby at home. When she was discharged, the HMO would only pay for one
> discipline of therapy. We decided she was walking "enough," talking and
> understandable "enough," but need occupational therapy the most to use her arm
> better to care for her baby and herself. So, she came in for OT, and stopped
> by to see me for an update on how she looked (I had also gone out to her house
> on my own a couple times to give her some high level balance activities). She
> eventually got rid of the cane, got rid of the brace, and was talking better.
> But, she didn't return to teaching. If she'd gone to rehab, she would have
> reached a higher level of function faster. Ugh!. I will never forget that lady.
>
> Renee
>
> Bronwyn De Forrest wrote:
> >
> > Renee,
> >
> > Back in 1992, when I got pregnant with my son via Pergonal, I also had
> > hyperstimulated ovaries which landed me a 3 1/2 week stay in the hospital.
> > (part of this was due to the fact that the local doctors weren't real
> > familiar with what to do....but I think they were making the right decisions
> > and were working with a specialist in Indianapolis,
> > Indiana).....anyway......FIRST, once the doctor decided I had hyperstimmed,
> > he realized there was no reason for me to have an IV...the last thing I
> > needed was more fluid being pumped into my system (other than liquids I
> > drink).....but, the insurance company said "if she's not sick enough to
> > require an IV, then she should go home)....I told the doc to let them pay
> > for their blanketyblank IV, we'd just forget to put the needle/shunt in and
> > let the dagblamed thing drain into a bucket! Harumphf! Well, he got
> > around needing to do that....but....SECOND...toward the 3rd week, the doc
> > found out he could SAVE my insurance company HUNDREDS of DOLLARS by having
> > me transferred to a "senior citizen" floor where there is minimal medical
> > necessity, but it's staffed by a nurse and within 5 minutes of an operating
> > room, should I need emergency surgery.......Guess what?.....Aww....you
> > already know....YUP....Insurance company, those idiots with business degrees
> > (if that!) playing DOCTOR according to a "BOOK".....practicing medicine
> > without a license, thought that was ILLEGAL??.......well, these idiots
> > fought the doctor about him trying to save them money!
> >
> > Go figure!
> >
> > Hugs,
> >
> > Shelley spryte@dnsonline.net
>> > ----- Original Message -----
> > From: Renee <rcordrey@earthlink.net>
> > To: Multiple recipients of list PCOS-MEDICATION
> > <pcos-medication@mail.medispecialty.com>
> > Sent: Sunday, July 08, 2001 10:08 PM
> > Subject: Re: Venting on perscription costs
> >
> > > You're right. Doctors are fed up with the hoops through, also. I am a
> > > physical therapist, and have to go fill out authorization requests,
> > justifying
> > > why someone needs therapy. I am a wound care therapist, and have to
> > explain
> > > why someone with a huge hole in their leg, foot, or butt needs care, even
> > if
> > > we've been treating them for a while with good success.
> > >
> > > Dealing with insurance regualations and restrictions is the biggest
> > > frustration for students when they come out into the clinic for their
> > > internships. They want to help people, are able to help people, and have
> > to
> > > convince someone else that they should. Someone who has no health
> > training,
> > > and has their approval rates examined for cost controls.
> > >
> > > Renee
> > > (venting from both sides: patient and provider)
> > >
> > > Bronwyn De Forrest wrote:
> > > >
> > > > Hi Kari!
> > > >
> > > > I'm "the office" where I work, and our prescription co-pays went up too.
> > > > According to the insurance companies, prescription costs are where the
> > > > largest jumps in costs are occuring. Meanwhile, IF we got these exact
> > same
> > > > drugs overseas or in Canada....these same drugs that were manufactured
> > in
> > > > the USA....we'd be paying just a fraction of the cost. Now....it
> > doesn't
> > > > take a mathematician to figure out something's rotten......
> > > >
> > > > My latest battle with MY Insurer....American Community....is over a
> > > > "Epi-pen". This is a pen shaped device that delivers an injection of
> > > > epinephrine (spelling?) for life threatening allergic reactions....(mine
> > is
> > > > to insect stings like bees....I nearly died when I was 13).....Well,
> > > > American Community is insisting on a "note from my doctor" to explain
> > just
> > > > WHY I need this drug! I thought a written prescription signed by the
> > doctor
> > > > was a "note from the doctor that this drug is needed"!!! Believe
> > me....I'm
> > > > really angry. I can imagine how these doctors feel at having to jump
> > thru
> > > > all these hoops for stupid little rules like this!!! The most
> > frustrating
> > > > thing is.....there's really no one to complain to about this outrage!!!!
> > I
> > > > will, however, try to contact my state's insurance commissioner and see
> > if
> > > > they feel this is rediculous too. It's not like this drug is something
> > I
> > > > could really sell on the street, like barbituates or something....ARGH!
> > > >
> > > > Needless to say, we're currently in the search for new
> > coverage........and I
> > > > absolutely HATE insurance companies. I do, however, always make sure to
> > > > warn the person on the receiving end of my upset phone calls that I am
> > NOT
> > > > angry with them, personally, but at the SYSTEM.......they're only the
> > low
> > > > guy on the totem pole anyway.
> > > >
> > > > Done venting for now......thanks for listening!
> > > >
> > > > Hugs,
> > > >
> > > > Shelley spryte@dnsonline.net
>> > > > ----- Original Message -----
> > > > From: Kari <kari95125@earthlink.net>
> > > > To: Multiple recipients of list PCOS-MEDICATION
> > > > <pcos-medication@mail.medispecialty.com>
> > > > Sent: Saturday, July 07, 2001 7:24 PM
> > > > Subject: Venting on perscription costs
> > > >
> > > > > I've always had pretty good insurance but the past few months i've
> > gotten
> > > > so
> > > > > perturbed. It's impossible to predict what i'll be charged with my
> > Blue
> > > > > Cross California Care. I've heard nothing, gotten nothing in months
> > from
> > > > the
> > > > > insurer as to perscription prices, so I feel like I'm being ambushed
> > at
> > > > > their whim. First the copay was $10, then 15, then 20. In April I was
> > > > > charged $50 for one Rx and the pharmacy said that a new deductible for
> > > > name
> > > > > brand drugs had been instituted. Then in May and June I just paid the
> > > > > copay. Today I went to pick up Avandia and Wellbutrin - two meds
> > without
> > > > a
> > > > > viable generic substitute from what i've been told - at a cost of
> > $170.00
> > > > > for 30 days worth! (A higher deductible went into effect in July they
> > > > say.)
> > > > > We are obviously paying for all the TV advertisements these companies
> > are
> > > > > running. Perscription drugs should not be advertised in my opinion,
> > > > > regardless of how it affects costs. I was almost in tears, it's not
> > like
> > > > I
> > > > > want to take them, I need to take them.
> > > > >
> > > > > Anyone know what's up with BC CaCare's Rx benefits? They've certainly
> > not
> > > > > been informative. Any other alternatives?
> > > > >
> > > >
> > >
> > > --
> > > Renee Cordrey, MSPT, MPH, CWS
> > > ---
> > >
> > > Don't follow in the footsteps of the masters. Seek what they sought.
> > > --Zen saying
> > >
> >
>
> --
> Renee Cordrey, MSPT, MPH, CWS
> ---
>
> Don't follow in the footsteps of the masters. Seek what they sought.
> --Zen saying
>
> ------------------------------
>
> ------------------------------
> Date: Mon, 9 Jul 2001 10:28:57 -0500 (CDT)
> ------------------------------
> From: anonymous@medispecialty.com (Zowie)
> To: PCOS-MEDICATION@OBGYN.NET
> Subject: Re: lupron
> Message-ID: <200107091528.KAA13874@mail.medispecialty.com>
>
> Hi Tami,
> I'm on the Lupron Depot shot and haven't had ANY problems. Not even hot
> flashes. I'm currently on my 2nd 3 month shot to put me in a menopausal
> state of hormones. I'm doing just fine with it. I've never heard of
> any serious reactions to it though. For more info, I use http://www.rxlist.com
> for looking up side effects, drug interactions etc. I've looked up
> Lupron on their database before, and I can't remember it stating
> anything like the problems you've described---but I don't remember all
> of the info either. Hope this helps!
>
> At Sun, 8 Jul 2001, tami wrote:
> >
> >has anyone had any experience with lupron? my reproductive
> >endocrinologist
> >put me on the injections 3mo ago. i just got out of the hospital(after
> >3 wks)i almost died! my spleen ruptured and had a pleural effusion-no
> >trauma. doctors wouldnt say but speculate it may have been the lupron.
>
> --
> Good luck! -- Zowie :)
>
> ------------------------------
>
> ------------------------------
> Date: Mon, 9 Jul 2001 10:38:09 -0500 (CDT)
> ------------------------------
> From: sb.talbert@verizon.net (Sue)
> To: PCOS-MEDICATION@OBGYN.NET
> Subject: Re: Venting on perscription costs
> Message-ID: <200107091538.KAA17654@mail.medispecialty.com>
>
> Like the rest of you, prescription cost is a pet peeve of mine. Our
> insurer insituted (for the first time on our plan) a "three-tier"
> coverage--basically meaning that if there is not a viable generic, you
> pay more. And if it's not considered "normal," (i.e., on the
> formulary), you pay even more. So between Actos (no generic), my
> inhaler (no generic), my allergy meds (again, no generic), and the blood
> thinner (no generic AND it's considered "not normal"), my medication
> costs are well over $100 per month. Frustrating!
>
> BUT--my perspective is likely a bit different. There's a large part of
> my brain that's very grateful for the insurance coverage I have--the
> blood thinner alone would run me close to $700 per month if the
> insurance didn't cover it at all. Then there's another part of me that
> remembers when doctor's office visits, prescriptions, and other medical
> needs weren't so expensive. I remember when it became expensive--it's
> when the Federal gov't stuck its big nose in and started telling these
> companies what they HAD to cover and what they could and couldn't do. So
> when I think about Canada and all the "perks" over there, I remember
> that when someone gets a grave diagnosis over there, they often can't
> get the appt or treatment they need quickly enough and end up crossing
> the border to *here* to get treatment. Seems that the more gov't
> interference there is in the private sector (no matter how
> well-meaning), the more things costs us "average joes."
>
> Anyhow, that's my two-cents on the whole thing--it's a shame we can't
> put the genie back in the bottle, so to speak, and get back to where
> medicine didn't cost so much and good care wasn't so hard to come by at
> a reasonable price.
>
> ------------------------------
>
> ------------------------------
> Date: Mon, 9 Jul 2001 07:03:55 +0200
> ------------------------------
> From: =?iso-8859-2?q?Zalányi Sámuel ?= <zalanyi.samuel@drotposta.hu>
> To: "Multiple recipients of list PCOS-MEDICATION "
> <pcos-medication@mail.medispecialty.com>
> Subject: Re: causes of pcos -part 2
> Message-ID: <DPG.WIN.324.0107090703550390214195@drotposta.hu>
> MIME-Version: 1.0
> Content-type: text/plain; charset="US-ASCII"
> Content-Transfer-Encoding: 8bit
>
> Hi Char,
>
> Forget about the link between PCOS and tubal ligation. PCOS is a metabolic disorder the core of which is insulin resistance (IR). You may have had IR earlier as indicated by the two huge babies. Causal treatment for PCOS is insulin sensitizers.
> For your info
>
> Sam (Ob/Gyn,RE)
>
> > i have read a variety of info on natural healing on pcos. one recomendation
> >
> > is to use castor oil hot packs. one day i will get around to trying it.
> > pcos does not run in my family. i have had beautiful skin and normal
> > periods
> > and three normal pregnancies, except the last two were huge babies. after
> > my
> > third i went through post partum depression as she had failure to thrive
> > syndrome. ok now of course. anyway, i never got my cycle back after the
> > 3rd
> > child. i also had a tubal after having her. anyway they gave me a shot to
> > start my cycle and it never started, so i went back and got another shot and
> >
> > seemed ok. about a year or so later i started developing pcos symptoms.
> > didnt know i had a hormonal disorder just figured it was adult acne...facial
> >
> > hair. hey i was so busy trying to keep up with it that i didnt go to a dr.
> >
> > anyway i was diagnosed 2 years later i think. the longer i have had it the
> > worse it gets.
> > so now when a book tells me that tubal ligations cause pcos i believe.
> > every
> > other person i have met in person who has pcos has had a tubal......
> > when i find the book i will let ya know.
> > char
>
> ------------------------------
>
> ------------------------------
> Date: Mon, 9 Jul 2001 15:20:47 -0500 (CDT)
> ------------------------------
> From: WChung43@aol.com (Jenny)
> To: PCOS-MEDICATION@OBGYN.NET
> Subject: Yasmin
> Message-ID: <200107092020.PAA11325@mail.medispecialty.com>
>
> I haven't read these boards in a long while. Three + weeks ago I was
> hospitalized with major menstrual bleeding (I always said that I was one
> of the "lucky" ones with PCOS who bled). I ended up getting 4 units of
> blood which didn't help much but they kept me from bleeding to death.
>
> Now I find out I have 4 fibroid tumors ranging in size from 0.5-2.0
> inches in diameter (that is, up to 5 cm). And my GYN has put me on
> Yasmin to help control the bleeding. When I got it, I checked here to
> see if anyone was taking it. All I found were some posts from January,
> 2001, asking if it was available in the USA. Well, it's here and my
> insurance doesn't cover it. Fortunately it cost $30 and I could afford
> it.
>
> Now for my question...Are fibroids common in PCOS? I know from the lists
> of symptoms I've read that some women rarely have periods and some
> hemorrage every month and everything in between.
>
> I see my GYN on Thursday and we decide what to do.
>
> --
> Jenny
>
> ------------------------------
>
> ------------------------------
> Date: Mon, 9 Jul 2001 15:51:52 -0500 (CDT)
> ------------------------------
> From: geber826@aol.com (Jenni)
> To: PCOS-MEDICATION@OBGYN.NET
> Subject: Re: PCOS WITH ELEVATED DHEA LEVEL
> Message-ID: <200107092051.PAA24501@mail.medispecialty.com>
>
> I can't give you any advice, I am sorry this is happening, but it is
> nice to know someone who is having the same problems. I was diagnosed
> with PCOS about a year ago. Since then I was on 2550 mg of Glucophage
> per day and Spirolactone for 3 months 100 mg per day, and Desogen BCP.
> My DHEAS has consistantly remained in the 760 range. All other levels
> have responded to the medications and dropped into the normal range. I
> had a CAT done to check my adrenal, apparently no tumor. All other
> blood work seems to be OK.
>
> I am currently having DR trouble and start seeing a new one in 2 days. I
> hope that this one can help. I want to start thinking about children in
> a couple of years but in the mean time, I want to fix my body problems.
>
> Anyway, remember you are not alone.
>
> --
> Jenni
>
> ------------------------------
>
> ------------------------------
> Date: Mon, 9 Jul 2001 16:02:25 -0700
> ------------------------------
> From: "Kari" <kari95125@earthlink.net>
> To: <pcos-medication@obgyn.net>
> Subject: Feeling like #!>#$%
> Message-ID: <000b01c108cb$38fef1e0$848bf7d1@oemcomputer>
> MIME-Version: 1.0
> Content-Type: text/plain;
> charset="iso-8859-1"
> Content-Transfer-Encoding: 7bit
>
> To add insult to injury, the Avandia that I paid so dearly for appears to be
> making me feel like crap. Funny enough it seems like monthly crap - first
> several months at beginning of cycle, now week before. The past two weeks
> i've felt anemic, tired all the time, headachy, today just feel like crap.
> Have RE appt on Wednesday. I feel like options are running out since I
> already did Metformin.
>
> If doc takes me off Avandia, I have $70 worth to waste.
>
> ------------------------------
>
> ------------------------------
> Date: Mon, 9 Jul 2001 20:10:55 -0500 (CDT)
> ------------------------------
> From: anonymous@medispecialty.com (Tyrany)
> To: PCOS-MEDICATION@OBGYN.NET
> Subject: Vaniqa Prices..
> Message-ID: <200107100110.UAA11153@mail.medispecialty.com>
>
> Don't get ripped off... Go to drugstore.com..you can get Vaniqa for
> about $30.00 a tube..instead of $60.00. Just trying to pass along
> information... Good luck..
>
> Sincerely..
> Tyrany..
>
> ------------------------------
>
> ------------------------------
> Date: Mon, 9 Jul 2001 20:57:40 -0500 (CDT)
> ------------------------------
> From: anonymous@medispecialty.com (Shelly)
> To: PCOS-MEDICATION@OBGYN.NET
> Subject: Re: Yasmin - I've been on it for three weeks
> Message-ID: <200107100157.UAA27280@mail.medispecialty.com>
>
> Jenny,
>
> I think BCPs in general usually can help with heavy bleeding in most
> cases. Fibroids grow with estrogen, which is why they tend to shrink
> after menapause, so you might want to ask your doc about the est. in
> the BCP. My mother, my sister and I have all had fibroids AND have
> symptoms (even if not diagnosed)of PCOS.
>
> For the past three weeks I've been on Yasmin with the following results:
>
> 1)skin has improved dramatically(I'm 43 and have been on acutane 2x!)
> 2)no nausea, bloating, mood swings, yeast infections (like other BCPs)
> 3)ovarian pain (which was constant) has greatly improved
> 4)I still have a goatee and a bald spot but I'm willing to give that
> another 3 weeks to correct!
>
> I should start my period soon, it should be light.
>
> good luck!
>
> At Mon, 9 Jul 2001, Jenny wrote:
> >
> >I haven't read these boards in a long while. Three + weeks ago I was
> >hospitalized with major menstrual bleeding (I always said that I was one
> >of the "lucky" ones with PCOS who bled). I ended up getting 4 units of
> >blood which didn't help much but they kept me from bleeding to death.
> >
> >Now I find out I have 4 fibroid tumors ranging in size from 0.5-2.0
> >inches in diameter (that is, up to 5 cm). And my GYN has put me on
> >Yasmin to help control the bleeding. When I got it, I checked here to
> >see if anyone was taking it. All I found were some posts from January,
> >2001, asking if it was available in the USA. Well, it's here and my
> >insurance doesn't cover it. Fortunately it cost $30 and I could afford
> >it.
> >
> >Now for my question...Are fibroids common in PCOS? I know from the lists
> >of symptoms I've read that some women rarely have periods and some
> >hemorrage every month and everything in between.
> >
> >I see my GYN on Thursday and we decide what to do.
> >
> >--
> >Jenny
> >
>
> ------------------------------
>
> ------------------------------
> Date: Mon, 9 Jul 2001 20:58:06 -0500 (CDT)
> ------------------------------
> From: fvelles@yahoo.com
> To: PCOS-MEDICATION@OBGYN.NET
> Subject: PCOS
> Message-ID: <200107100158.UAA27990@mail.medispecialty.com>
>
> It is a good idea to take an SSRI such as Celexa if you have PCOS?- to
> help with mood swings and PMS
>
> ------------------------------
>
> ------------------------------
> Date: Mon, 9 Jul 2001 21:13:08 -0500 (CDT)
> ------------------------------
> From: anonymous@medispecialty.com (michelle)
> To: PCOS-MEDICATION@OBGYN.NET
> Subject: Re: Glucophage XR dose?
> Message-ID: <200107100213.VAA04153@mail.medispecialty.com>
>
> This is my concern with the XR version. I haven't heard of many people
> who feel they are getting good results with it - only less G.I.upset. I,
> too, may go back to the "regular" version.
>
> At Sun, 8 Jul 2001, Vanessa wrote:
> >
> >At Fri, 6 Jul 2001, anonymous@obgyn.net wrote:
> >>
> >>Does anyone know what the "limits" are for taking the XR version of
> >>glucophage? I take 500mg. twice a day and don't feel it working.
> >
> >I just had a discussion with my sister about this. I took Glucophage
> >500 mg. t.i.d. for 18 months and in June went to Glucophage XR, 1000
> >mg. q.d. I don't feel as good as I did when I took the regular
> >Glucophage. The doctor's staff said the lower dose of XR was because it
> >is time release and the levels are more constant, but still I feel my
> >sugar floating up and down during the day. Any suggestions? I may have
> >to ask to be changed back to the other RX, but hate to waste the rest of
> >the 3-month supply I have now.
> >
> >--
> >Vanessa Beam
> >Mineral Wells, West Virginia
> >
>
> ------------------------------
>
> ------------------------------
> Date: Mon, 09 Jul 2001 20:08:35 -0700
> ------------------------------
> From: Renee <rcordrey@earthlink.net>
> To: pcos-medication@obgyn.net
> Subject: Re: Venting on perscription costs (long)
> Message-ID: <3B4A71AC.861D0F15@earthlink.net>
> MIME-Version: 1.0
> Content-Type: text/plain; charset=us-ascii
> Content-Transfer-Encoding: 7bit
>
> I don't mean to start a flame war, but I have to disagree.
>
> Without federal regs, your insurance company would be able to drop you because
> you are too expensive (especially if only one med costs $700/month). Also,
> you could get a plan that was essentially a catastrophic, high cost, plan.
> The feds regulate Medicare (they do fund and administer it, after all), but
> have few rules for commercial plans, except for what Medicare HMO's must cover
> (at least what Medicare covers), the recent Healthcare Portability Act (which
> we should all be grateful for since we have a chronic, pre-existing
> condition), the recent mandate for coverage of birth control pills (actually,
> a Supreme Court ruling), and a few others. Mostly, it's state regulatory
> agencies mandating what types of services must be covered in certain
> conditions. However, for most of us, it still comes down to what our employers
> choose to offer. An employer can decide what level of insurance to offer, and
> often determines the co-pays, since the higher the co-pay, the lower their premiums.
>
> Plus, there are several other major reasons health care costs have
> skyrocketed. First, care is more expensive. It used to be you went to your
> doctor, had a personal visit, maybe a couple blood tests, and that was it.
> Now, we have CT scans, MRIs, arthrograms, angiograms, bone scans, etc. Those
> tests are extremely helpful, but very expensive. Secondly, in the 1960s
> medications were few and rarely used. That's why Medicare doesn't cover
> drugs; when the plan was developed, it wasn't an issue. The drug industry has
> blossomed, as is evident from the posts displayed here. There are meds for
> everything, and R&D is constantly going on. That's one reason for the high
> price of drugs, which leads to the higher insurance prices--they need to pay
> for the drugs somehow. (I know, drugs are often much less expensive after
> exportation. The drug companies follow the laws of supply-and-demand: they
> have willing customers in the US, and other countries won't put up with it.)
> 15 years ago, you didn't see ads for drugs everywhere you turned. Marketing
> was aimed at physicians, who prescribed meds that were needed, in their
> judgement. While this shift in marketing is sometimes beneficial (many of us
> have asked for meds that have been needed and were not offered by the
> physician initially), it also leads to misuse. A person sees an ad for a med
> and thinks, "I should have that." The American culture is a quick-fix, pill
> popping culture, and would often rather take a pill than do a behavior
> modification, or live with something. So, in order to please the patient (if
> they're not happy, they'll give their money to someone else--many of us have
> done that), they give the pill-of-the-month, even though it may be
> unnecessary, or more expensive than another equally effective med. Lastly,
> there's the good old "L" word: Litigation. 30 years ago, people accepted that
> no one was perfect, and with the limited technology, there were fewer
> opportunities for malpractice. Now, with lawyers on TV begging you to call
> them if anything has ever been gone wrong in any way from anybody (doctors to
> other drivers), lawsuits are extremely common. Malpractice insurance rates
> are very high. Granted, some people do make VERY BIG mistakes, and should pay
> the price, in more than one way. However, people do need to take some
> responsibility for themselves. I spilled coffee on my bare legs once. It was
> my fault. I wouldn't even think of suing McDonalds because they didn't tell
> me coffee was hot. Doctors aren't perfect, though people expect them to be.
> How many mistakes do other people make on their jobs. Unfortunately, doctor's
> mistakes do affect a person's health. However, things will happen. Some
> people will be allergic to a medication. No surgery is risk free. Sometimes,
> people don't respond as expected. That is why informed consent is needed
> before operations and procedures are done. (In case you're wondering, no,
> I've never been sued. And, I have seen situations where I have suggested to a
> patient that they may want to see an attorney. But, I have seen insane cases.
> ie: a woman sueing a surgeon because the scar from her gallbladder surgery
> was too "ugly." Even if the provider wins, or it gets settled or thrown out,
> it's a lot of time away from work, and a lot of costs for the physician and
> his insurance company.)
>
> Sorry for the rant. I just had to respond. No health care system is perfect.
> Each has it's strengths, and it's weaknesses. But, we each have one we have
> to deal with (depending on which country you're in). So, write your
> congressman about the problems you see (eg: drug prices), and try to change it
> for the better. Our modern society and culture has produced the health care
> delivery system we're in. It's up to us to change it if we see there is a way
> to improve it.
>
> Renee
>
> Sue wrote:
> Then there's another part of me that
> > remembers when doctor's office visits, prescriptions, and other medical
> > needs weren't so expensive. I remember when it became expensive--it's
> > when the Federal gov't stuck its big nose in and started telling these
> > companies what they HAD to cover and what they could and couldn't do.
> --
> Renee Cordrey, MSPT, MPH, CWS
> ---
>
> Don't follow in the footsteps of the masters. Seek what they sought.
> --Zen saying
>
> ------------------------------
>
> ------------------------------
> Date: Mon, 9 Jul 2001 21:50:36 -0500
> ------------------------------
> From: "Bronwyn" <spryte@dnsonline.net>
> To: <pcos-medication@obgyn.net>
> Subject: Re: Venting on perscription costs (long)
> Message-ID: <002f01c108eb$1ce21580$fb0322d0@default>
> MIME-Version: 1.0
> Content-Type: text/plain;
> charset="iso-8859-1"
> Content-Transfer-Encoding: 7bit
>
> Renee,
>
> So....is it a federal law that birth control pills be covered now? I knew
> it was up for vote or something, but I wasn't sure if it was just Indiana or
> what. And, I had thought I heard it was turned down in Indiana....in
> essence, I'll be needing another note from my doctor to explain I take them
> for PCOS and to avoid another burst ovarian cyst requiring surgery to stop
> the internal bleeding.
> I'm confused about this now.
> Thanks for your help on this one!!!
>
> Oh....I'm just finishing up a "Legal Environment in Business" class. One of
> the other students wrote her paper about the McDonald's Coffee case. She
> said that once she got digging into the background information that wasn't
> brought into the highlight of the news, that it was much more than just a
> mere "ooops". I think she said that McDonalds had received many previous
> complaints about the coffee being too hot, the cups not sturdy enough, etc.
> I didn't read her paper but I thought it was interesting that maybe
> something most of us thought was a bit "much" could have had some solid
> basis for the action that was taken. Unfortunately,
> businesses....especially big corporations....are also guilty of not owning
> up to their responsibility to others until it's forced upon them by a
> lawsuit. Not taking a stand for or against anyone on this case, just
> mentioning that there are often things not stressed by the media that could
> have been strong reasons for results that we feel are a bit extreme.
>
> I do agree with you, though, about some of the stupidity on things people
> feel they must sue for!!! Sheesh....."the scar is too ugly"......What ever
> happened to laughing at things and going on with your life? (I have a
> "square" belly button due to all the surgeries I've had thru or running past
> it.......I think it's kinda funny.)
>
> Have a great day!
>
> Hugs,
>
> Shelley
>
> Renee wrote:
>
> ... the recent mandate for coverage of birth control pills (actually,
> > a Supreme Court ruling), and a few others. Mostly, it's state regulatory
> > agencies mandating what types of services must be covered in certain
> > conditions
> ******portions deleted to shorten original*****
> However, people do need to take some
> > responsibility for themselves. I spilled coffee on my bare legs once. It
> was
> > my fault. I wouldn't even think of suing McDonalds because they didn't
> tell
> > me coffee was hot. Doctors aren't perfect, though people expect them to
> be.
> > How many mistakes do other people make on their jobs. Unfortunately,
> doctor's
> > mistakes do affect a person's health. However, things will happen. Some
> > people will be allergic to a medication. No surgery is risk free.
> Sometimes,
> > people don't respond as expected. That is why informed consent is needed
> > before operations and procedures are done. (In case you're wondering, no,
> > I've never been sued. And, I have seen situations where I have suggested
> to a
> > patient that they may want to see an attorney. But, I have seen insane
> cases.
> > ie: a woman sueing a surgeon because the scar from her gallbladder
> surgery
> > was too "ugly." Even if the provider wins, or it gets settled or thrown
> out,
> > it's a lot of time away from work, and a lot of costs for the physician
> and
> > his insurance company.)
>
> ------------------------------
>
> ------------------------------
> Date: Mon, 9 Jul 2001 20:54:01 -0700 (PDT)
> ------------------------------
> From: Kristy <sokokl@yahoo.com>
> To: pcos-medication@obgyn.net
> Subject: Re: Venting on perscription costs (long)
> Message-ID: <20010710035401.94162.qmail@web13304.mail.yahoo.com>
> MIME-Version: 1.0
> Content-Type: text/plain; charset=us-ascii
>
> Shelley,
>
> The case went all the way to the Supreme Court about
> whether ins co should cover birth control pills and the
> ruling from the Supreme Court says that yes the ins co have
> to cover birth control pills.
>
> I will see if I can find more on the story for you if you
> would like me to do that.
>
> =====
> Kristy :)
>
> http://www.geocities.com/sokokl/kristyspersonalpage.html
>
> Owner:
> http://groups.yahoo.com/group/Endo_Vulvodynia_PCOS
> http://groups.yahoo.com/group/Zoladexforendometriosis
>
> Get personalized email addresses from Yahoo! Mail
>
> ------------------------------
>
> ------------------------------
> End of PCOS-MEDICATION Digest 504
> ------------------------------
> *********************************
>
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