Posted on 01/22/2005 4:16:37 PM PST by neverdem
Edited on 10/21/2005 4:59:15 PM PDT by Admin Moderator. [history]
For a brief moment, Dr. Thomas Giannulli, a Seattle internist, thought he was getting in at the start of an exciting new area of medicine. He was opening a company to offer CT scans to the public - no doctor's referral necessary. The scans, he said, could find diseases like cancer or heart disease early, long before there were symptoms. And, for the scan centers, there was money to be made.
(Excerpt) Read more at nytimes.com ...
When I first heard about this 6-7 years ago, I thought this was a fad. How many healthy people have few thousands dollars to blow?
Professional ethics versus money making.
I would have paid for a body scan .. why not?
My husband and I both had one in one of those portable units a few years ago. I must say I was quite impressed with the results. It showed some lung scarring on mine and said it may have resulted in my childhood from a fungus known to grow near rivers. I did grow up on the Missouri River. My husband's showed some minor heart blockage that had also shown up in a hospital treadmill and dye test a few weeks before. Oh, yes, we both have arthritis starting to show up in our lower back.
The horrible thing is waiting for the test results although they will call if something is spotted and needs immediate attention. The cost was around $800 for both of us.
High radiation alert
FYI on ct coronary artery calcium score:
Small point about coronary artery calcium scoring. The test does not claim to localized specific sites of stenosis/narrowing. Conventional coronary angiography and possibly ct coronary angiography actually demonstrate regions of stenosis.
The coronary artery calcium score is a test measuring "plaque burden" and therefore is a marker of disease and indicates that further treatment or tests are warranted.
Also, it is estimated that over half of myocardial infarctions arise in arteries that are not critically narrowed. The current theory suggests an abrupt thrombosis (clot) within a diseased but not narrowed artery that develops when fatty/lipid plaque erodes and is directly exposed to the blood. The lipid incites a clotting cascade which clogs the artery and then kills the downstream heart muscle.
That's one reason why a baby aspirin every other day helps prevent heart attacks and strokes.
I don't doubt the medical profession put the kabash on this scan because it takes a lot of it out of their hands. I just went for 99 test for NOTHING ..All these doctors kne weachother. A misread cardiogram sent me on a VERY expensive wild goose chase . I dont totally trust the medical profession .They have their own scams going as well.
Yeah, like you wouldn't like to get your hands on her CD.
They sure do, it's all about money. Many of them own the labs and other clinics.
So Couric and the colonoscopy is a chicken and the egg kind of thing?
Well, I can't do the research. . .too late. . .have to pack. . .etc. but. . .my point is that the excuse is no more or no less than, the same reason; people undergo tests to begin with. if only starting with a suspicion or a doubt.
More to the point; the excuse belies what I think is the real reason for the failure of these whole-body/scan clinics; the Medical profession; already beset by malpractice insurance . . .lowered incomes as cost paid for surgeries are preset etc. . .
and these Doctors are not in any frameof mind, to deal with or cooperate with another industry that they see 'taking their turf. . .and their patients; while ursurping some of their 'specialities' of diagnostics. Even though, these people- and a whole lot more. . .would need the 'traditional services' anyway.
But then. . .there are those; particularly younger people; who would go the 'intern/whole physical; who would not move beyond the 'scan clinic' when their tests show up as a clean scan. . .as is more the probabiliy with a younger population. . .and they do not want to have to wait. . .for these folks to age; and show up, just much later in life; on their doorstep, as new patients.
Of course, mine is only speculation. . .but I think we are on the same page. . .and I think I am repeating myself. . . ;^)
BUMP
Where did you find that practice guideline?
Low-Dose Aspirin Therapy
References
Citations
Awtry EH, Loscalzo J (2000). Aspirin. Circulation, 101: 12061218.
Danchin N, et al. (2002). Acute myocardial infarction. Clinical Evidence (7): 1135.
Sudlow C, et al. (2003). Stroke prevention. Clinical Evidence (9): 221243.
Kurth T, et al. (2003). Inhibition of clinical benefits of aspirin on first myocardial infarction by nonsteroidal antiinflammatory drugs. Circulation, 108: 11911195.
When my doctor ordered me to have one, I went in half an hour early with a mile long list of questions and demands. I wanted to know what assurance they could give me the same equipment hadn't just been used on an AIDS patient, and wanted to see the equipment, and how it was sterilized. They took me around the corner and into a little room where a pimply-faced kid sat with one of the long tubes in a pan of something green. He didn't look like he knew how to wash himself, let alone something as vital as that thing. Since that was flexible tubing like a hand-held shower water hose, I still felt the flexible bending joints could easily have held bacterial or infection from the guy it was used on before.
Then the "Pay-for-your-own" CT scans came out, I gladly opted for that, and much preferred it! At least there's no AIDS contamination to worry about. Also, you sit and chat with the doctor afterward, know the results instantly (he points out everything right in front of you, plus they also tell you about every other organ that shows in the scan. I got mine on a $499 "special" and felt it was well worth it for the peace of mind, if nothing else.
Also, you're dead right about the Illegals sucking up all our medical resources. We all pay thru the nose so they can waltz in and get taken care of free. THAT nonsense MUST stop! The Canadians already all come down to the US for their medical care. When our system goes broke because of the Illegals, where are we supposed to go?
"160 to 325 mg for acute treatment of cardiovascular events and 75 to 160 mg/day for primary and secondary prevention" (By which mg/d means milligrams per day. Scroll down the link halfway, just before the references.)
Primary prevention means before you have the first acute myocardial infarction or ischemic stroke. Secondary prevention's intention is aimed at preventing a recurrence.
You wrote a baby aspirin every other day in your previous comment. Your second reference, "Danchin N, et al. (2002). Acute myocardial infarction. Clinical Evidence (7): 1135.", has nothing to do with the prevention of acute myocardial infarction or ischemic strokes. That citation was obtained from this link's URL. It describes treatment after it happened, not prevention.
I was unable to find the article referenced in your next reference, "Sudlow C, et al. (2003). Stroke prevention. Clinical Evidence (9): 221243", but in the search I found this recommendation, The optimal aspirin dosage for use in the prevention of stroke or TIA remains controversial, but a range of 50 to 325 mg per day has been recommended which comes from the 3rd reference of Transient Ischemic Attacks: Part II. Treatment
Does your last reference to Kurth T, et al. have anything to do with daily dosing versus every other day dosing? I am aware that other NSAIDs can interfere with the irreversible inhibition of platelet aggregation by aspirin in 75 - 80 percent of patients.
Limiting the search to practice guidelines, the only article that I could find was Antithrombotic therapy for coronary artery disease: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy., which recommended "For primary prevention in patients with at least moderate risk for a coronary event, we recommend aspirin, 75 to 162 mg/day".
There is always a price to pay for good health care. Pay 'for' health care. . .;or with your health; in too many instances.
I do think these clinics will be back; but sorry for the losses so far generated and the closings. If the Medical establishment had supported them. . .then the Insurance Companies would have as well, I think.
But given the now territorial battles going on for the 'patient' and the 'patient dollar'. . as well as the exclusivity of the medical 'establishment'. . ..not sure they had a chance.
Although, I really thought they did have one. Too bad.
That is really reasonable for the peace of mind.
How often do we hear 'if they had caught it earlier '
It is well worth it
And I don't trust a hospital scan reader. They have a vested interest in getting you to take more tests, etc. I would prefer to pay for it myself and receive the results myself having seen to it that the scanner has no alliances to certain doctors or hospitals. I also want, in case of positive readings to have access to the results to be read by my own chosen reader.
Do you suppose that I haven't had experiences making me wary of "the system"? Any system.
Try England. Maybe the Arabs won't have taken over yet.
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