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#health care – @sarahthecoat on Tumblr
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SarahTheCoat

@sarahthecoat

mostly Sherlock. The New Semester my dreamwidth
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lordnot

If you want to get angry with every American politician who railed against socialized medicine, try making an appointment with a specialist with private health insurance.

Recall their warnings about rationing of care as you're told that the first available appointment is a Thursday afternoon four months away.

Think about the fearmongering about how the quality of care would drop as your doctor meets with you for all of fifteen minutes, half of which is asking you questions you answered on a survey before you came in, the other half doing the minimum amount of tests of your breathing, blood pressure and the like necessary to bill your insurance.

Recall the hysteria around 'death panels' as your doctor goes over the long-term risks of not having your condition treated, and then tells you to call a number to actually get tested for the condition that has another two month waiting list.

And keep in mind how many privileges you possess that others do not that prevented this whole process from being even more difficult. Privileges like living close enough to a major city that the specialist is only 40 minutes away by car and not two hours. The fact that you own your own vehicle. How you are able to take time off of work without worrying about a supervisor calling you last minute to say you need to come in. The fact that you can afford the copays, can afford to miss a half day of work, don't have to worry about whether you'll be home in time before kids get back from school, etc.

In short: it was all a crock of shit.

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cocklessboy

The biggest male privilege I have so far encountered is going to the doctor.

I lived as a woman for 35 years. I have a lifetime of chronic health issues including chronic pain, chronic fatigue, respiratory issues, and neurodivergence (autistic + ADHD). There's so much wrong with my body and brain that I have never dared to make a single list of it to show a doctor because I was so sure I would be sent directly to a psychologist specializing in hypochondria (sorry, "anxiety") without getting a single test done.

And I was right. Anytime I ever tried to bring up even one of my health issues, every doctor's initial reaction was, at best, to look at me with doubt. A raised eyebrow. A seemingly casual, offhand question about whether I'd ever been diagnosed with an anxiety disorder. Even female doctors!

We're not talking about super rare symptoms here either. Joint pain. Chronic joint pain since I was about 19 years old. Back pain. Trouble breathing. Allergy-like reactions to things that aren't typically allergens. Headaches. Brain fog. Severe insomnia. Sensitivity to cold and heat.

There's a lot more going on than that, but those were the things I thought I might be able to at least get some acknowledgement of. Some tests, at least. But 90% of the time I was told to go home, rest, take a few days off work, take some benzos (which they'd throw at me without hesitation), just chill out a bit, you'll be fine. Anxiety can cause all kinds of odd symptoms.

Anyone female-presenting reading this is surely nodding along. Yup, that's just how doctors are.

Except...

I started transitioning about 2.5 years ago. At this point I have a beard, male pattern baldness, a deep voice, and a flat chest. All of my doctors know that I'm trans because I still haven't managed to get all the paperwork legally changed, but when they look at me, even if they knew me as female at first, they see a man.

I knew men didn't face the same hurdles when it came to health care, but I had no idea it was this different.

The last time I saw my GP (a man, fairly young, 30s or so), I mentioned chronic pain, and he was concerned to see that it wasn't represented in my file. Previous doctors hadn't even bothered to write it down. He pushed his next appointment back to spend nearly an hour with me going through my entire body while I described every type of chronic pain I had, how long I'd had it, what causes I was aware of. He asked me if I had any theories as to why I had so much pain and looked at me with concerned expectation, hoping I might have a starting point for him. He immediately drew up referrals for pain specialists (a profession I didn't even know existed till that moment) and physical therapy. He said depending on how it goes, he may need to help me get on some degree of disability assistance from the government, since I obviously shouldn't be trying to work full-time under these circumstances.

Never a glimmer of doubt in his eye. Never did he so much as mention the word "anxiety".

There's also my psychiatrist. He diagnosed me with ADHD last year (meeting me as a man from the start, though he knew I was trans). He never doubted my symptoms or medical history. He also took my pain and sleep issues seriously from the start and has been trying to help me find medications to help both those things while I go through the long process of seeing other specialists. I've had bad reactions to almost everything I've tried, because that's what always happens. Sometimes it seems like I'm allergic to the whole world.

And then, just a few days ago, the most shocking thing happened. I'd been wondering for a while if I might have a mast cell condition like MCAS, having read a lot of informative posts by @thebibliosphere which sounded a little too relatable. Another friend suggested it might explain some of my problems, so I decided to mention it to the psychiatrist, fully prepared to laugh it off. Yeah, a friend thinks I might have it, I'm not convinced though.

His response? That's an interesting theory. It would be difficult to test for especially in this country, but that's no reason not to try treatments and see if they are helpful. He adjusted his medication recommendations immediately based on this suggestion. He's researching an elimination diet to diagnose my food sensitivities.

I casually mentioned MCAS, something routinely dismissed by doctors with female patients, and he instantly took the possibility seriously.

That's it. I've reached peak male privilege. There is nothing else that could happen that could be more insane than that.

I literally keep having to hold myself back from apologizing or hedging or trying to frame my theories as someone else's idea lest I be dismissed as a hypochondriac. I told the doctor I'd like to make a big list of every health issue I have, diagnosed and undiagnosed, every theory I've been given or come up with myself, and every medication I've tried and my reactions to it - something I've never done because I knew for a fact no doctor would take me seriously if they saw such a list all at once. He said it was a good idea and could be very helpful.

Female-presenting people are of course not going to be surprised by any of this, but in my experience, male-presenting people often are. When you've never had a doctor scoff at you, laugh at you, literally say "I won't consider that possibility until you've been cleared by a psychologist" for the most mundane of health problems, it might be hard to imagine just how demoralizing it is. How scary it becomes going to the doctor. How you can internalize the idea that you're just imagining things, making a big deal out of nothing.

Now that I'm visibly a man, all of my doctors are suddenly very concerned about the fact that I've been simply living like this for nearly four decades with no help. And I know how many women will have to go their whole lives never getting that help simply because of sexism in the medical field.

If you know a doctor, show them this story. Even if they are female. Even if they consider themselves leftists and feminists and allies. Ask them to really, truly, deep down, consider whether they really treat their male and female patients the same. Suggest that the next time they hear a valid complaint from a male patient, imagine they were a woman and consider whether you'd take it seriously. The next time they hear a frivolous-sounding complaint from a female patient, imagine they were a man and consider whether it would sound more credible.

It's hard to unlearn these biases. But it simply has to be done. I've lived both sides of this issue. And every doctor insists they treat their male and female patients the same. But some of the doctors astonished that I didn't get better care in the past are the same doctors who dismissed me before.

I'm glad I'm getting the care I need, even if it is several decades late. And I'm angry that it took so long. And I'm furious that most female-presenting people will never have this chance.

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queenlua

i never do these PSA posts because most PSA stuff isn’t actually actionable, but, uh, this one is:

tl;dr: there are now a bunch of drugs that are really damn good at treating COVID.  if you or a loved one get COVID, especially if you have extra risk factors, you should ask your health provider about them (and, if you’re in the US, you can even use this handy dandy website to see what’s in stock near you).  also, consider telling people (esp. older people) about this, i guess?  so that they know too?

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sarasa-cat

Important US specific info:

As of March 7, 2022 The US “Test to Treat” program allows you to get a covid test and, if it is positive, you will be met by a trained medical practitioner at that same location who can give you a prescription for a covid anti-viral drug. This new program allows you to directly bypass the normal medical nonsense that is part and parcel of life in the US.

Here is the map of american locations for Test to Treat (test + medical professional) plus additional locations to fill your prescription of Lagevrio (molnupiravir) or Paxlovid (nirmatrelvir / ritonavir) if they cannot fill your prescription at the same site.

When visiting a Test to Treat location, bring a list of your current drugs with you. Both of these medications can interact with some drugs. The medical staff and pharmacist at Test to Treat locations will be able to select the best course of treatment for you if you have your complete list of prescription drugs (or just bring the drug bottles) with you.

Covid anti-viral drugs need to be started during the first 5 days of symptoms so if you or someone in your life has symptoms, look into this. Especially do not delay of you/the person has one or more high risk factors for covid.

Test to Treat

The Biden-Harris Administration launched a new nationwide Test to Treat initiative in March to give individuals an important way to quickly access free lifesaving treatment for COVID-19. Through this program, people are able to get tested and – if they are positive and treatments are appropriate for them – receive a prescription from a health care provider, and have their prescription filled all at one location. These “One-Stop Test to Treat” sites are available at hundreds of locations nationwide, including pharmacy-based clinics, Health Resources Services Administration (HRSA)-supported federally-qualified health centers (FQHCs), and long-term care facilities. People can continue to be tested and treated by their own health care providers who can appropriately prescribe these oral antivirals at locations where the medicines are distributed. 
A Test to Treat lo​c​ato​​r is available to help find participating sites. A call center is also available at 1-800-232-0233 (TTY 1-888-720-7489) to get help in English, Spanish, and more than 150 other languages – 8:00 am to midnight ET, 7 days a week. The Disability Information and Access Line (DIAL) is also available to specifically help people with disabilities access services. To get help, call 1-888-677-1199, Monday-Friday from 9:00 am to 8:00 pm ET or email [email protected].

If you’re a whippersnapper keep this in your back pocket for your parents etc

If you or someone you live with is at high risk from covid, you ESPECIALLY should use this resource. If you’re not sure what constitutes “high risk”, here’s a (non comprehensive) helpful list from the CDC: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html Your doctor may know more about whether one of your conditions makes you high risk. These treatments aren’t only available to high risk individuals, but they’re especially important for those people to know about and use. Please make sure your friends and family know about this option, and help them figure out if they are high risk.

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kaelio

The Mark Cuban Cost Plus Drugs Company (MCCPDC) is a registered pharmaceutical wholesaler and purchases drugs directly from manufacturers, bypassing middlemen to lower the price of more than 100 medications, it said in a statement.

For example, the leukemia drug imatinib is priced at $47 a month on MCCPDC compared to the $9,657 retail price.

MCCPDC CEO Alex Oshmyansky reached out to Cuban with an idea for a low-cost generic drug company in a cold email. It was launched in January last year. They were motivated in part by “Pharma Bro” Martin Shrkeli’s outrage-producing price hike of the lifesaving drug Daraprim from $13.50 to $750 per tablet while Shrkeli was CEO of Turing Pharmaceuticals. Cuban told Forbes last year the pricing for generic drugs was “ridiculous.” He said he decided to put his name on the company to “show capitalism can be compassionate and to send the message I am all in.” It’s not clear how much he had invested in the company.

Reblog to save someone an entire paycheck, or more, on the pharmaceuticals they need.

Gods, I want this to be true so badly.

It is true. Mark Cuban is doing this in part because he wants to run for President in 2024 if Biden doesn’t run again (Mark ran in 2020). He’s a Democrat and “I personally made medication affordable” will give him an immense edge. He’s far from perfect but this is a good thing he’s doing. Also he seems to genuinely believe this stuff, but either way, site’s up and operational and you can start any time.

just so people understand what a big deal this is, i ran some fast price comparisons. goodrx is an app that offers discounts on medications for which you have to pay out of pocket, whether because your insurance doesn’t cover them or because you don’t have insurance. if you don’t have insurance, goodrx is often about as good as it gets, so i’m using their prices for my comparison.

please note that prices are location dependent on goodrx—it shows you the options at pharmacies near your location. i’m in pittsburgh, pa; if you’re in a different part of the country and you try this, you may get slightly (or wildly) different numbers. 

fluoxetine is generic prozac. thirty 20mg capsules costs $12.80 at my cheapest local pharmacy. costplus has it for $3.90.

atorvastatin is generic lipitor. thirty 40mg tablets is $10.95 at my cheapest local pharmacy. costplus has it for $4.20.

omeprazole is generic prilosec. thirty 20mg capsules is $13.90 at the cheapest local pharmacy; $4.20 at costplus.

aripiprazole is generic abilify. thirty 10mg tablets is $17.73 at the cheapest local pharmacy (and $260.60 at the most expensive—and that’s with a discount, still, yikes); $6.00 at costplus. 

lamotrigine xr is generic lamictal xr. thirty 25mg tablets is $36.59 at the cheapest local pharmacy; $8.40 at costplus. 

maybe that doesn’t seem like a huge discount, but the goodrx prices change *all the time*—last time i used it to buy fluoxetine, which was in the last couple of years, it was $31. also, many people are on multiple medications, or have multiple people in a household taking multiple medications, and $5 off every prescription adds up real fast. 

this is an objectively fantastic thing and a huge deal, and i hope they’re wildly successful.

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guccixcucci

My mom taught me to exaggerate my pain so that doctors would take me seriously and all I'm saying is that it hasn't failed me yet

Listen. If you're a Black Woman you absolutely should exaggerate your pain.

We're dying because these doctors refuse to take us seriously. If you feel like something is off exaggerate it until they test for it. We've gotta advocate for ourselves

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sinfulnoodle

Seriously yall. Doctors would rather you be in pain than have to actually diagnose you. Some doctor stans gon be mad but damn if it took 10 years for them to successfully diagnose my mom after she was telling them textbook recounts of what she was experiencing and if it took 8 years for my aunt experiencing terrible indescribable pain in her stomach that they could have EASILY xrayed her for to which they actually did after literal fuckin years of her crying they found that the last operator on her left shit in her stomach. Then yes doctors don't fucking care aboht patients anymore. Its a money business and you're a dollar sign to them. May be some legit ones out there but in my experience its been "you're fine, heres some shit that won't help." Because nothing fuckin changes.

So many stories of people having to see 3,4 different doctors with the same symptoms just to get someone that'll run all the tests so they can get a diagnosis

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afronerdism

I had all the classic symptoms of Multiple sclerosis 4 years ago. I mean textbook symptons. A disease which has no cure and which best hope is to get on treatment as soon as you see symptoms to delay or stop disease progression.

I went to my doctor after the er discharged me with “stress” and said “help my face is numb and I’m scared. He looked at me in my face and said “well what do you want me to do about it?” I had to beg to see a neurologist. The neurologist refused to let me speak and told me I was just stressed and refused to schedule me for an mri. Had she done that they would have found lesion on my brain.

4 years later I have now 2 lesions on my brain consistent with MS. I only found a doctor willing to take me seriously by happenstance after being hospitalized and refused a surgery that I would need anyway a few short months later. While on the hospital I was dismissed and refused pain medication unless I was literally screaming.

Fuck these doctors. Advocate for yourself hard.

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cwicseolfor

“I want to copies of your documentation in my records of the symptoms I have reported and what actions were taken to respond to them.”

LISTEN ALL OF YOU BUT BLACK WOMEN ESPECIALLY

If a doctor refuses treatment or tests, say “I would like your refusal to treat documented in my chart.”

Then wait about 24 hours. (Partly for computer processing time, partly so if they think they’re being smart and saying yes but not actually doing it they’ll think they’re in the clear.)

Then call the doctor’s office AND SAY YOU WANT A COPY OF YOUR MEDICAL RECORDS.

If the refusal to treat isn’t in your records, you now have a malpractice suit.

Very, very few doctors are going to risk that possibility. They’ll bitch and moan when you ask for documentation, but they’ll run your tests.

As a comparison, by the way, here’s a doctor who had nothing to hide: my mom’s eye doctor when her eye started getting to the “It’s going to have to be physically removed” stage. He met us at the office at 9pm, long after close, with his date, to give my mom an injection to try to relieve the pressure in the eye. (Luckily said date also worked at the clinic and completely understood why he was doing this. He’s a great guy, he deserves a great lady.) I asked if he could note the exact time in her records, because the time needed between these injections was speeding up immensely. His reply:

“Actually that could give us an idea how fast this is progressing. Yes. What time is it? I’ll look up her earlier visit when I’m done.”

If your doctor isn’t that eager to make these notes, demand documentation and try to find a new doctor ASAP. It will save your life.

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