Medical Stuff

william webster

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Jan 16, 2009
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I had reason recently to need medical attention.

At my annual skin checkup, they tested two spots that were found :
One was basal cell cancer, the other was melanoma..... small scrapes off my back for biopsy.

The melanoma rule is that over 1mm is considered dangerous
Don't ask me why .9999mm and 1.00001mm differ.... an arbitrary number, I suppose.
Mine was 1.22mm


This happened in the US...... I was already here (RD) when the results came.
I hemmed and hawed about seeing the doctor in May when i return.
He blasted me (known him for years) and said - NOW!!

You need a surgical oncologist and a sentinel node biopsy.

Sentinel node biopsy involves injecting a dye and tracking it to the nearest lymph node.
Then remove and biopsy that node.
If malignant - follow to the next and repeat- and so on.

Through DR1 , I was referred to a dermatologist to remove the affected skin and biopsy it further.
Six stitches for each removal and a negative biopsy report..... nada, zero cancer.

Of course, I'm ready to walk at this point.

I call back to my US doctor and back him up with my Cdn one.
Both yell back about the sentinel node biopsy.

OK,
My dermatologist forwards me to the surg/oncol guy.

He sees me and sends me for a 'gamagraphia'..... like immediately....
Point here is that all this happens so smoothly & quickly in RD.....
Canada? Never fast.

Gamagraphia is nuclear.... radioactive dye and a full body scan.... not invasive and not costly.
A $5million machine....... The imaging center i used was CIMEN in STI

The scan covers every organ in your body.

Clean , I am ......... and all done in a flash.
Not to say the waiting period isn't fraught with demons (my brother died of Lymphoma) but all in all, relatively painless.

RD has some excellent doctors, facilities and equipment.
I strongly doubt that my Cdn hospital has a Gamma Scanner.... I will check.

For anyone interested, the dermatologist is listed in the residents' forum.... Dra Yunen.

If I can steer anybody to help..... I'm happy to help.......... as i was helped.
Thank you HB.
 

Chirimoya

Moderator - East Coast & Headline News
Dec 9, 2002
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I had a basal cell carcinoma removed from my chest about five years ago. My skin is very badly sun damaged due to excessive tanning up until my early 30s and that was a wake-up call. I live near some of the world's best beaches but rarely go to the beach now. :(
 

dv8

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Sep 27, 2006
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this is the best thing about dominican health insurance: immediate access to any specialist and any diagnostic. few months ago i felt a lump on my breast. went to see my doctor, he immediately sent me for mammography, ultrasound and a battery of tests. all covered by insurance, even the mammography which in europe is a problem for women my age.
 

william webster

Platinum
Jan 16, 2009
24,780
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I'm busy now but will report the insurance side of the story later.

Agreed dv8..... smooth as silk... the whole thing.

In other countries you sweat it out waiting for attention.... never here

Smooth as silk.......... glad your breast is better..... lol
 
May 5, 2007
9,246
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I had reason recently to need medical attention.

At my annual skin checkup, they tested two spots that were found :
One was basal cell cancer, the other was melanoma..... small scrapes off my back for biopsy.

The melanoma rule is that over 1mm is considered dangerous
Don't ask me why .9999mm and 1.00001mm differ.... an arbitrary number, I suppose.
Mine was 1.22mm


This happened in the US...... I was already here (RD) when the results came.
I hemmed and hawed about seeing the doctor in May when i return.
He blasted me (known him for years) and said - NOW!!

You need a surgical oncologist and a sentinel node biopsy.

Sentinel node biopsy involves injecting a dye and tracking it to the nearest lymph node.
Then remove and biopsy that node.
If malignant - follow to the next and repeat- and so on.

Through DR1 , I was referred to a dermatologist to remove the affected skin and biopsy it further.
Six stitches for each removal and a negative biopsy report..... nada, zero cancer.

Of course, I'm ready to walk at this point.

I call back to my US doctor and back him up with my Cdn one.
Both yell back about the sentinel node biopsy.

OK,
My dermatologist forwards me to the surg/oncol guy.

He sees me and sends me for a 'gamagraphia'..... like immediately....
Point here is that all this happens so smoothly & quickly in RD.....
Canada? Never fast.

Gamagraphia is nuclear.... radioactive dye and a full body scan.... not invasive and not costly.
A $5million machine....... The imaging center i used was CIMEN in STI

The scan covers every organ in your body.

Clean , I am ......... and all done in a flash.
Not to say the waiting period isn't fraught with demons (my brother died of Lymphoma) but all in all, relatively painless.

RD has some excellent doctors, facilities and equipment.
I strongly doubt that my Cdn hospital has a Gamma Scanner.... I will check.

For anyone interested, the dermatologist is listed in the residents' forum.... Dra Yunen.

If I can steer anybody to help..... I'm happy to help.......... as i was helped.
Thank you HB.

Ironic, cousin had same procedures done past week In Boston with exception it took ten days from excision to getting final result Man, it's great to know all is clear but they sure want to use every single machine available Though he was “clean” the following information is disheartening The annual incidence rate of melanoma is 1 per 100,000 in blacks, 4 per 100,000 in Hispanics, and 25 per 100,000 in non-Hispanic whites.

The overall average 5-year melanoma survival rate for African Americans is only 70 percent, versus 93 percent for Caucasians.

Kind of like your chances of getting it if you are black are much lower but if you do, pretty good chance of dying Not sure if this is better or not (If you are AA)

In any event, happy for you WW
 

twhitehead

Bronze
Nov 1, 2003
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I am very happy for you William and agree on the med system here - trust me you dont want melanoma....tom
 

william webster

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Jan 16, 2009
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40-50% of the population over 65 gets melanoma.

Learning that was a comfort..... I was not a 'rare 'case.

Tom, my process was slowed only by the Christmas/New Years season.

My derma appt was within 2 days of contacting her.
The excision was that same day........ 8,000 pesos each and 3,000 for the biopsy...= 19,000 total.

Results came a day ahead of Christmas and I was scanned Jan 13th.... Doctor's appt the afternoon before.

Very efficient - in all ways.

Imagine the cost of a traditional sentinel node biopsy....
Surgeon operating, in an operating theater with biopsy equipment at hand and a possible overnight stay.

Scan was faster, and more thorough.........IMO
 

zoey_kat

Member
Feb 2, 2007
108
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Glad to know that everything worked out okay and thank you for posting your experience. Could you provide contact details for
Dra Yunen. Thanks!
 

william webster

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Jan 16, 2009
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Dra. Mar?a C. Yun?n
Cutis Dermo-Estetica
Calle Puerto Rico (off Juan Pablo Duarte in front of the Uni?n M?dica)
809 581 9797

Santiago.
Google her but use a 'HotMail' e-mail not her G-Mail acct.... that cost me 2 days.

Dra Solange Reynoso is in the office too..... she did my work
Not much English
 

william webster

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Jan 16, 2009
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INSURANCE

mine is ARS Palic.

The imaging center started the process - gave me an invoice and the req'd forms.
You need to get insurance approval before the procedure.

All insurance companies have small offices at Union Medica in STI.
The bldgs are next door to each other, so very easy.

Take the forms for approval.
Girl writes it all up & calls the prescribing doctor (just down the hall)
She takes the forms for his approval/signature and then authorizes the payment.

You take all the approvals to the imaging center and you're done.

The company knows the cost in advance so there is no argument.
Any issues are cleared before a procedure.

I thought it was a good system.

Whole thing took less than an hour to authorize.
 

zoomzx11

Gold
Jan 21, 2006
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I have had four of them. I go every three months for a head to toe check. Quality and completeness of the checkup is vital. The md needs to look "everywhere" including your booty. If it spreads its one of the most deadly cancers. Good news is with a thorough0 deramatologist you will never die from a skin cancer. Highly treatable if caught early and removed. My experience has been its suspicios, its removed, sample goes to pathology, its malignant they phone me, I go bach for a more in depth removal and its charted and the area is watched. My first malignant melanoma was 1988 and I am doing fine. Quality of dermatologist is important. Good luck. There are far worse things
 

william webster

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Jan 16, 2009
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Yes, I am advised now - after this episode- to check every 3 months instead of my annual.

Just a follow-up...... really important to be vigilant

The dermatologist is the key - agreed
 

william webster

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Jan 16, 2009
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Zoomer, thanks for your input.
I was hoping this would be an informative thread... considering 40-50% of the over 65's will be affected.

I have had 2 basal cell problems removed before.... pre basal cell cancers.... nada.

This summer, I was enduring the humiliation of having several 'senile moles' removed from my back.
The aesthetician spotted 2 things she would not to touch without a medical opinion.
They were my 2 issues... one basal and one melanoma.

She is the heroine .
I drew those to the attention of my steady dermatologist and he scraped them off.

Like a case study..... she was going over me like fine toothed comb.

As you say, it VERY important to get on it and stay on it.

For those who think these things are strictly sun related.... think again.
You can get melanoma on your palm or on the sole of your foot..... anywhere.

Sh!t happens............ be on guard.

A good skin clinician (as was my case) is a resource.

She enjoyed a nice bottle of champagne..........as a reward.
 

twhitehead

Bronze
Nov 1, 2003
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I have now been 2 years with Stage 4 melanoma - I have never had anything show on the outside and primary tumor has never been discovered. A dermatologist will not always find melanoma as sometimes (like my case) there are never any signs of it on the skin. I was never a sun guy so I do not believe my melanoma was caused by the sun....tom
 

twhitehead

Bronze
Nov 1, 2003
618
14
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How did you find it Tom?
without any outward signs.

I had a tumor in my groin - assumed it was a hernia for the longest time. Went to the doc to get it looked at. Did surgery and turned out to be Stage 3c mastatized malignant melanoma. Since that tumor have had them in head, both lungs, both lungs again, liver and colon. Last scan showed signs of entering bones as well. 5 surgeries, tons of radiation and 6 month of heavy heavy chemo and still kicking. Way outlived my life expectancy - still fighting hard, still golfing, and still helping the animals here through DCDR....tom
 

zoomzx11

Gold
Jan 21, 2006
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two year survival is great. If the melanoma begins on the skin then mestacizes the chances of living one year are slim. I asked my dermatologist if I get regular skin checkups can I rule out dying from a skin malignant melanoma? He said absolutely. I have had many many of the two other skin cancer types removed. MM is the big risk. The other forms of skin cancers are slow growing and do not mestasticize to vital orgas as fast. Go frequently to a good dermatologist you will be fine. Sadly the DR is not the best spot for skin cancer patients. Hats, long sleeves, and sunscreen are in your future. One reason I like Sosua Beach is the shade trees. 9
 

william webster

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Jan 16, 2009
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Tom & Zoom

Why not try the gamagraphia in STI or elsewhere?

Full scope of all organs, body... the works.

I think I'll do that for a couple of years.... just to be sure.

Tom,
My brother had the groin thing.... non Hodgkins Lymphoma..... lived 8 yrs or so.
Chemo, MDAnderson... lots of $$$$.....
That one is fight you will lose..... with certainty....just a matter of when

Happy you're well
 

william webster

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Jan 16, 2009
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My Cdn doctor suggests the following protocol for a melanoma issue located on a back:

Chest CAT scan a year later + blood work.

If all clear, just annual chest x-rays for 5 yrs. not scans

I'll get more opinions .........