Wednesday, September 23, 2009

Are young people today angry about being handed a despoiled planet?

According to "Power Shift O9" they are, as in this quote from Power Shift:

Thousands of young people will rally across the United States this Fall for the Power Shift '09 Regional Summits: 11 massive gatherings to exercise the political power of young voters and ask President Obama and Congress to pass a clean energy jobs plan by December to rebuild our economy, end our dependence on dirty energy, and bring America lasting security.

It's a wonderful image...

Saturday, September 12, 2009

Boston has the best fertility centers in the world -- why go to Turkey and Cyprus?

The summer of my medical tourism, Part II

In discussing the book and film Money Driven Medicine, Bill Moyers put it this way: America excels at rescue medicine, but it it not clear it if does more standard care as well as other countries.

Agreed. If I was in a near-fatal accident or developed an unknown form of cancer or a puzzling disease, yes, I want Dr. Gregory House's cutting-edge innovation to save me. Sure, I'd want to benefit all the high technology the richest country on earth can buy.

But if I need a procedure that takes less than 10 minutes of operating room time and no anesthesia AND is labor intensive in terms of doctor visits and monitoring AND is expensive because its elective and still relatively new -- like IVF with egg donation -- America medicine has only the following to recommend it:

Three weeks to get an appointment

Waits of 15 minutes to 2 hours to see your doctor

Huge amounts of paper work, dozens of required tests that are not actually necessary for your procedure but are there because of over-regulation and because hospitals/doctors get paid per procedure they perform.

What about costs?

The financial consideration can't be ignored: IVF with egg donation top out at $30,000 for everything, and includes me doing the hard work of finding a donor (at least for the clinics I contacted). In Turkey, they find the donor for you, and the whole thing is $10,000.

$30,000 and hours waiting to see your doctor, vs. $10,000, and you call and chat with your doctor any time, same-day appts...? Its not a hard decision.

I wrote the following to a friend who couldn't understand why I would voluntarily travel to what he considers a third-world country for a medical procedure.

Dear W,

My experience with the hospital in Istanbul and Cyprus was very positive. The treatment is *better* here than in the U.S. In the U.S., they don't want you as a patient. They are too busy and to concerned with making a profit. To make a profit, they have to keep patient volume high and minimize labor costs, meaning minimize time customers spend with medical personnel. It took me 4 days and 4 messages left at Boston IVF for them to finally call me when I was at home. Why? They refused to answer their phone because that is too costly. Their operating procedure is that they only call you, so you have to be at home or by your cell phone when they call. Would you voluntarily opt for that treatment if there was something better around?

In the U.S. hospitals, each hospital visit is many hours because you can wait 2 hours to see your doctor. Doctors in the U.S. use psychological propaganda to convince US consumers to expect this. I was so used to this treatment that I was shocked to get to Jinemed and our doctor met with us at exactly the appointed time. I wondered, why bother to haul books to read in the waiting room if they meet with you right away?

Whenever I had a question about what I was going thru, my Turkish friend would say, just call Munip, and she'd bring out her cell phone to call him on his cell phone. She would actually have a conversation with him right then! I was shocked. You can't call your doctor in the U.S. and expect to get him/her on the phone.

The day after my transplant treatment, I was obsessed by finding all the web pages I could to compare what I went through for the prior two weeks and what the best practices are at the leading medical fertility centers in the U.S. My doctors did everything that the U.S. centers brag that the do. Except one thing -- at Chicago Advanced Fertility center, they require that you rest on your back for 1 hour after transplantation so that eggs are not dislodged. In Cyprus, they made me not move for 3 hours, and gave me and H our private recovery room.

Question for readers: Why does Chicago Advanced Fertility allow/require women to vacate after 1 hour of bed rest?

The transplant itself is very simple. They only have to do a few things: grade the embryos, pick the best ones, and deposit them under ultrasound guidance in the uterus. Skill is required to know how to do this, but the Cyprus and Istanbul doctors may do this several times a day for a decade. If they make a mistake, no pregnancy. That is the worse that can happen.

[I wrote this last sentence to W because one of his concerns was: in a foreign country, what if they "mess you up" -- how could you sue and expect compensation?]

The procedure is as easy for the woman as an examination of the uterus with ultrasound. I was not given any anesthetic because it is uncomfortable, not painful. It is barely more complicated than a pap smear.

Final reason to go overseas: Its just easier. Here's how easy: I got a next-day appt. at Jinemed for my first consultation.

July 20 -- first consultation at Jinemed August 4 -- H gives sperm and they mix it up with the Cypriot Beauty August 7 -- embryo transfer August 8 -- I'm free to fly home or do whatever

Length of entire process: 20 days

What about payment? There was no 30 minute consultation with a finance officer. I began taking medicine and had 3 doctor visits before I ever paid a penny (via wire transfer from the U.S.). I never showed a single piece of identification, not a passport, nothing. I never filled out a single form until I signed a consent form for the transplant 5 minutes before the transplant.

During the 2 weeks before the transfer while my doctor was monitoring me with ultrasound every 4 days for the thickness of the edometrial lining, my Turkish friend wanted me and H to go sight-seeing with her in Didem, a 10-hour bus ride from Istanbul. My doctor said we could go for 5 days and I could be checked by his doctor in near-by Izmir! Amazing.