View Full Version : How do I go about seeing Dr's along the trail
Afternoon all,
I was originally planning my thru hike for this year, but due to medical problems I had to postpone it.
I am now trying to figure out if it's possible for me to do it in 2009, and I would be grateful if I could pick some of your brains for some info.
I am suffering from 2 auto-immune diseases which require me to have monthly blood tests, and I then adjust my medication accordingly.
As I am in the UK, I have very little kniwledge of the American Health system apart from it being heart bleeding expensive.
Do GP's in USA do blood tests in their clinics or would I need to go to a hospital to have them done ? (which would be a major inconvenience)
I was thinking the best way to do it, would be to try and see a doctor in towns where I would resupply but do they see "drop-in" patients or only their own registered patients?
Has anyone any sort of idea how much I would have to expect to pay to see a doctor for a simple blood test and then get the results?
Is this feasible at all, or am I just kidding myself
Frolicking Dinosaurs
05-21-2008, 08:32
Virtually all doctors in the US have the ability to take a blood sample in their office and to do routine lab tests there. Some have in-office labs to do more extensive testing and others send the blood to an outside lab for testing.
I have free long-distance service in the US and can't hike right now due to medical problems myself. If you wouldn't mine sending me a private message about what blood testing you need, I will call the clinics listed in the guidebooks and see if they could provide this service and what the costs would be (in US dollars).
Oh that would be great, thanks so much !
Ehm how do I go about sending a PM? Cant seem to locate the PM facility
auburnbreeze
05-21-2008, 09:10
Its really gonna depend on the lab test. I work in a major hospital lab. I'll be glad to see what I can find out for you too! If its an esoteric that is a send out for most labs you maybe able to set up testing with one of the reference labs.
Good Luck! I think its still doable!
I need to have blood tests for Secondary Adrenal Insuffiency (Addison's) - normally test ACTH and cortisol levels. For Graves Disease they normally test T3, T4 FT41, and TSH I think (need to look at one of the blood testings bags I normally take to the hospital)
Thanks everyone - would be grateful if I can still do a Thru despite being at a disadvantage medical vise.
click on the username in the thread, it is highlighted. Up opens a window and there is an option to "send a Private Mesaage (PM) to user". Some will also allow "send an EMAIL". But FD said to PM.
good luck
Oh that would be great, thanks so much !
Ehm how do I go about sending a PM? Cant seem to locate the PM facility
budforester
05-21-2008, 10:52
I need to have blood tests for Secondary Adrenal Insuffiency (Addison's) - normally test ACTH and cortisol levels. For Graves Disease they normally test T3, T4 FT41, and TSH I think (need to look at one of the blood testings bags I normally take to the hospital)
Thanks everyone - would be grateful if I can still do a Thru despite being at a disadvantage medical vise.
If approved practices and drugs differ between US and UK, could that interfere with continuing your usual treatment? Maybe your doctor would have suggestions for meeting your medical needs during your adventure.
I suspect that those T- cell analyses are too specialized for small clinics. A larger medical center may be required, or a sample sent away and wait for the local physician to obtain results. Telephone and internet should make monitoring and treatment easy to coordinate with your personal physician.
orangebug
05-21-2008, 11:34
Uh, he isn't testing T-cells.
He has two endocrine problems (adrenal and thyroid). No doctor's office will be likely to have on site testing for that, and you will either have to have blood drawn and wait a day or two for results and adjustments. Another issue will be how to assure that meds used in the UK are similar in strength and response to what you would get here.
I'd expect most docs along your route will be happy with the TSH, ACTH and cortisol levels (depending on time of day when drawn.) You will need to carry more medical documentation to help a doc agree to providing the tests and prescriptions. Just thinking it thru, I'd expect stops at Erwin,TN or Hot Springs (Asheville, NC); Harper's Ferry, WV; NYC; Burlington, VT or Dartmouth and then back home for you.
YOu also need to be prepared not so much for the cost of the doctor visit, but for the lab tests.
Maybe someone on here can give you the prices theirs labs charge for these tests. I predict several hundred dollars each time.
Good luck.
Frau
I forgot to post that our very small towns (2) send nearly everything to the lab in Lexington for analysis, AND most usually for the blood draw as well.
Fr.
budforester
05-21-2008, 13:20
Uh, he isn't testing T-cells.
Thanks for the correction; please excuse my ignorance, Conster
mkmangold
05-21-2008, 13:46
Conster: or you could head right into a hospital lab with prescriptions already written for the tests. Send me more info PM and I'll see what I can do to help.
auburnbreeze
05-21-2008, 15:03
Conster, a lot of this will depend on the comfort level of your individual physician. I talked to folks here in the lab where I work. Probably what would be easiest is to have your MD prepare orders for your lab work. Most of the clinics, doctor's offices and especially hospitals will be able to draw the sample and send it to a reference lab, if they do not perform the testing themselves. The results would be sent to your physician for his interpretation. (Personally, I would not be comfortably with physicians who may or may not be familiar with autoimmune disorders adjusting meds!) Hopefully, by the time you hike, you maybe better regulated so the testing is not as often.
The cost will depend. Some places may only charge a fee for drawing the sample. Others may include all charges.
orangebug
05-21-2008, 15:12
I don't think that he is going to get lab drawn (or Rx's filled) with a UK order. It is probably correct that the biggest expense will be the lab work.
I'd encourage a contact with hospitals in the towns I previously mentioned to arrange referral - letting them know that an AT hiker is involved as well as a Brit guest to our fair land. Some sort of letter from your attending physician will help treatment planning.
take-a-knee
05-21-2008, 15:31
I would scan my med records and a letter from my doc and store it on a thumb drive if I were you.
Frolicking Dinosaurs
05-21-2008, 17:13
After a bit of searching, it is apparent that the doctors and clinics along the AT are not going to be able to do Conster's testing in their offices. All I have called thus far have said they would have to send it to a lab. Orangebug may well have the answer - going into a large city with a hospital monthly for these tests. It is possible a central lab could preform the tests.
Getting the tests ordered will likely not pose difficulty. Since Conster's doctor is not licensed to practice medicine in the USA, I'm sure a US physician would order the necessary testing with proper documentation from his doctor.
orangebug
05-21-2008, 19:30
A central lab will do the tests, as the industry has changed to using peripheral sites to draw blood, then transporting it to a central lab for processing. There are fewer companies providing the service (Quest and Labcorp) so little downward pressure on the price.
I won't get into the politics and economics that have led to this additional fiasco in what we call a healthcare system.
Of course, if he were American and going to England or Europe with the problem, I doubt he would be charged for any of it.
A big thank you to everyone who's taken the time and effort to find out information for me.
Oh and just to clarify, I am a girl not a guy :eek:. Maybe the name was confusing, but Connie was already taken, so I went for my nickname which is Conster (the Monster) I am Danish, but have been living in England for some 8 years now.
I read through all the replies and I think what I might do, is getting my own Doctor to prescribe me enough meds to last me for 12 months and take those drugs with me. If during the hike following blood tests, I need to adjust my dose and take a higher quantity of drugs, I can dip into the excess months worth of drugs. This should hopefully save me hassle and also considerable costs, as I am positive the drugs is much much more expensive than they are here in the UK where I pay a one of yearly charge of $150 for unlimited prescription drugs.
I reckon if I go into a doctor in the cities recommened and get a blood test done, they can in turn send the blood off for testing, and I could call the doctor back from the next town to get the results and then e-mail those to my own GP who can then tell me how I should adjust my dose.
Does that sounds feasible?
Is it legal to send drugs from one State to another in a bouncebox, or is that opening another whole can of worms
I am VERY shocked to hear that it might cost several hundred dollars to get just one blood test done and then results, surely this can't be right. :eek: PLEASE TELL ME THIS IS NOT RIGHT!!!
AI reckon if I go into a doctor in the cities recommened and get a blood test done, they can in turn send the blood off for testing, and I could call the doctor back from the next town to get the results and then e-mail those to my own GP who can then tell me how I should adjust my dose.
Does that sounds feasible?
Is it legal to send drugs from one State to another in a bouncebox, or is that opening another whole can of worms
I am VERY shocked to hear that it might cost several hundred dollars to get just one blood test done and then results, surely this can't be right. :eek: PLEASE TELL ME THIS IS NOT RIGHT!!!
Clear it with "adjusting your meds" with your current doctor.
Sending drugs in the original container, to yourself, is not problem. I'd suggest you get TWO bottles from your current doctor. I do this. I get some mail-order drugs, which come in a 90 day supply (big bottle). I have a small bottle, which is also my perscription, and just put in a weeks or two's worth in that to take along. That way, you have your perscriptions, in a labeled bottle, with your name and dosage on it.
I have clorestoral problems and dr did blood work 2 weeks back. Cost was about $125! (draw fee, handleing, lab work, etc).
Remember, look up how your countries subsidise your medical care with taxes! Here in the US, it is almost a pay-as-you-need/go.
mkmangold
05-23-2008, 01:13
Miss Connie: you'll still need a prescription for each lab drawn and for each time. Is your GP handling all of the endocrine issues? We usually refer to a specialist. Logistically, I think this can be handled with the help of people at this site. Perhaps a list of independent labs and hospitals close to the trail can be made for you. A "GP" here in the states can write the prescriptions for the labwork and send the results on to your GP or specialist. It can be done! Please send me a note if you want more details.
Frolicking Dinosaurs
05-23-2008, 06:11
A big thank you to everyone who's taken the time and effort to find out information for me.
Oh and just to clarify, I am a girl not a guy :eek:. Maybe the name was confusing, but Connie was already taken, so I went for my nickname which is Conster (the Monster) I am Danish, but have been living in England for some 8 years now.
I read through all the replies and I think what I might do, is getting my own Doctor to prescribe me enough meds to last me for 12 months and take those drugs with me. If during the hike following blood tests, I need to adjust my dose and take a higher quantity of drugs, I can dip into the excess months worth of drugs. This should hopefully save me hassle and also considerable costs, as I am positive the drugs is much much more expensive than they are here in the UK where I pay a one of yearly charge of $150 for unlimited prescription drugs.
I reckon if I go into a doctor in the cities recommened and get a blood test done, they can in turn send the blood off for testing, and I could call the doctor back from the next town to get the results and then e-mail those to my own GP who can then tell me how I should adjust my dose.
Does that sounds feasible?
Is it legal to send drugs from one State to another in a bouncebox, or is that opening another whole can of worms
I am VERY shocked to hear that it might cost several hundred dollars to get just one blood test done and then results, surely this can't be right. :eek: PLEASE TELL ME THIS IS NOT RIGHT!!!Don't want to open a political can of worms here, but the US medical service delivery system is so messed up that it does indeed cost as much as is being quoted without health insurance. However, there are several ways to make the system more affordable legally and I'm currently looking into those for you. This may become a moot point if the US puts in a system similar to the one in place in your country - something that both of the current front runners for our presidency favor. However, this will definitely not be in place in 2009.
On your end, you may want to look into how students from your country who receive education in the US handle this problem. The solution they use may well work for you.
WalkingStick75
05-23-2008, 07:27
Just a couple ideas to throw out. Anyone know if it is possible to get these tests through a county Health Department? or, do they have to be a resident of that county?
Another thought is about travel insurance? I have DAN (Divers Alert Network) which covers medical expenses when I am out of the country but is not limited to when I am diving.
Good luck Connie, I'm sure there is a way I have met a lot of people from other countries while hiking but never thought to inquire how they handled medical issues.
orangebug
05-23-2008, 08:15
There is travel insurance, but I'd be concerned with price for pre-existing conditions.
Welcome on your visit to the pinnacle of capitalism. We must fund overhead of advertising, administration and stockholders. The waste is horrendous.
Putting together a string of docs for obtaining labs, reporting labs and adjusting drugs may be a challenge. I think you may be better off with anticipating a couple of zero days in city/town while you do this chore.
deeddawg
05-23-2008, 11:00
Welcome on your visit to the pinnacle of capitalism. We must fund overhead of advertising, administration and stockholders. The waste is horrendous.
As someone who has worked for companies providing claims and payment processing services to doctors and hospitals, I can tell you that the waste has far more to do with excessive government regulation and the myriad of bizarre different rules/regs/procedures than it has to do with any of the above. The red tape is the primary issue here.
But that discussion is off topic for this thread and best left to the politics area. Just pointing out that Evil Capitalism isn't always the easy scapegoat.
I have about as many tests done once a year as you have done once a month. It came to $365, last year. I didn't have the blood work done this year because I couldn't afford it, and I have medical insurance.
Frau
I have about as many tests done once a year as you have done once a month. It came to $365, last year. I didn't have the blood work done this year because I couldn't afford it, and I have medical insurance.
Frau
How depressing, if that's really how much the bloods is going to cost me then there is no way I can remain on schedule for my Thru in 2009, I simply would not be able to save up enough money in time. Especially considering I would have to save up enough money for any unexpected medical expenses related to said conditions.
I will take out travel insurance from the UK, but they will not pay out for any pre-excisitng conditions. However they would pay out in if I fractured my leg or got munched on by a bear LOL.
Feel very down now, guess I need to look at 2010 now, and then save like mad in between
SawnieRobertson
05-23-2008, 16:17
Absolutely, that is about what seeing a doc and having lab work plus filling a prescription will possibly cost. Sorry. {Perhaps though your insurance over there will reimbuse you when you send them your bill.
My solution would be to have an prearranged, well ahead in time consultation with one friendly doc who will order all of the tests, evaluate the results, and arrange for the scripts to be filled and sent to you if need be from a pharmacy in her/his area.
Yes, the blood drawn would go out to a lab such as LabCorp, whichever the doc uses. You simply need to do some creative planning ahead.
One thought is that the level of physical activity you will engage in could result in different results with each or some of the tests as you move up/down the trail. You are showing notable wisdom in planning for this in advance.
As for the levels of expertise you will encounter as you hike, I believe you can count on doing very well in that regard. My physician is board certified internal medicine at the Troutdale, Virginia, Clinic. (Note: TroutDALE, not Troutville.) He too is a hiker and enjoys AT hikers who need his help.--Kinnickinic:welcome
If your Dr. can limit the number of tests you need to monitor your conditions and they are listed below, and if waiting up to 2 weeks is not a problem, maybe.....this will help.
From the Life Extension Foundation:
When you place your order, you will be sent by mail a list of blood drawing stations in your area along with a requisition form. NY, NJ and RI residents will receive a blood draw kit due to state law (additional local draw fee may be incurred). After your blood is drawn, the test results will be mailed to you.
Call 1-800-208-3444 or place your order online (http://www.lef.org/newshop/cgi-shop/showCategory.cgi?catid=23000), and we'll send you a requisition form. (NY, NJ and RI residents see disclaimer at end of this page)
Visit one of the LabCorp draw stations closest to you to have your blood drawn. (You will receive a list of the 3 labs closest to you via mail).
Blood test results may take up to two weeks to be completed. Results will be mailed upon completion of all tests.Lab Corp blood draw stations
http://www.labcorp.com/psc/index.html
Cortisol
http://www.lef.org/newshop/items/itemLC004051.html
Cortisol AM and PM
http://www.lef.org/newshop/items/itemLC104000.html
FSH
http://www.lef.org/newshop/items/itemLC028480.html
T3 Uptake
http://www.lef.org/newshop/items/itemLC001156.html
Thyroid Panel
http://www.lef.org/newshop/items/itemLC304131.html
TSH
http://www.lef.org/newshop/items/itemLC004259.html
THYROXINE (T4)
http://www.lef.org/newshop/items/itemLC001149.html
Thyroxine (T4) Free, Direct
http://www.lef.org/newshop/items/itemLC001974.html
Tri-iodothyronine (T3) Free
http://www.lef.org/newshop/items/itemLC010389.html