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Kim Stagliano

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How Does It Feel To Be Told You Can't Have A Test?

Posted: 11/20/09 04:27 PM ET

America, how does it feel to wake up and learn that you can't have healthcare tests that you think you or your loved one needs? Welcome to the autism treatment world. Kinda sucks, doesn't it?

This week we learned that neither mammograms nor pap tests are as necessary as previously recommended. So there will be less testing.

I didn't know that the pap smear (scrape?) could lead to procedures that could injure the cervix. But I recall being a young woman and having my gynecologist perform a procedure that hurt like hell - "cauterization," he called it. That's Latin for "insert a small blow torch and press the on button." I was such a poor healthcare consumer it never occurred to me to ask what he was doing or why. The New York Times writes (HERE):

Dr. Iglesia said the argument for changing Pap screening was more compelling than that for cutting back on mammography -- which the obstetricians' group has staunchly opposed -- because there is more potential for harm from the overuse of Pap tests. The reason is that young women are especially prone to develop abnormalities in the cervix that appear to be precancerous, but that will go away if left alone. But when Pap tests find the growths, doctors often remove them, with procedures that can injure the cervix and lead to problems later when a woman becomes pregnant, including premature birth and an increased risk of needing a Caesarean.

Was I one of those women for whom the cauterization was unnecessary, or did that doctor save me from cervical cancer? I have no idea. If you know a woman who died of cervical cancer, these new guidelines will set your hair on fire. If your breast cancer was found on a yearly mammogram I'm sure you're angry too. Understandably so. We each bring our own perspective and needs to this healthcare equation.

In the autism world, there are myriad tests and treatments that are helping ameliorate behaviors and boost progress by addressing the medical conditions that can cause pain, confusion and poor brain functioning. Think of how you feel when you have PMS or a migraine. Could you sit in school all day or take the LSAT's or make a presentation at work if you felt very sick? Of course not. Now try to do it when you have little or no speech to convey how you're feeling. You might scream, or kick or scratch or bang your head.

Some of us know families whose kids have lost their diagnosis and are mainstreamed in school and headed toward full, independent living because of these tests and treatments. For others, this treatment can mean the difference between life in an institution, sedated on powerful medications and life in a group home, among peers and within the community.

And yet - the vast majority of us have no access to this autism medical world because the "powers that be" who control what's recommended and covered tell us the tests fall into the category that is the insurance kiss of death, "not medically necessary." For every Dr. Tim Buie at Mass General Hospital treating the GI problems associated with autism, there are a hundred GI docs and pediatricians who will laugh you out of their office for suggesting that food can affect functioning and behavior. Even the one treatment that is considered scientific, ABA therapy, is often off the table for us when it comes to insurance.

This weekend, The Chicago Tribune will run an article about autism treatments from skeptical point of view. Even after interviewing parents who have changed their children's lives for the better, they'll focus on the few controversial treatments that always get media attention and ignore the real progress. I'm not sure what their agenda is, and why learning that some kids are improving and even losing their autism diagnosis isn't considered worthy of a ticker tape parade on Michigan Avenue.

When you read that article (assuming anyone reads The Trib any longer) think of how you feel knowing that you, your wife, daughter, sister is also losing medical care that could help ensure a healthier, safer life.

By the way, I can help those of you wondering about your next mammogram or pap test. There are three magic words that we in the autism world know all too well: Out of pocket.


 

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02:30 PM on 11/22/2009
The whole thing with pap exams is maddening. Women need to be checked regularly. If the doctor finds an issue, perhaps they can watch it - instead of acting immediately or aggressively. But, to delay testing...that really is unsettling.

If there was no Gardasil vaccine - I would likely feel differently. I guess I just fear the time when women start dying from cervical cancer at rising rates...and we start hearing about how "the vaccine could have prevented all of these unnecessary deaths".

I'm sick of posting on other sites where the pro-vaccinators are excitedly talking about when their sons will also be able to get the cervical cancer vaccine. What is wrong with us? Boys getting vaccinated to prevent a disease they lack the body parts to contract?!? This is all so frustrating. Maddening!!!
04:38 PM on 11/24/2009
I completely agree with you -- I think with proper explanation and *TIME* spent with the patient, women would understand that the pap is a screeing test, not diagnostic and so should be done to determine if something needs to be watched. I had an abnormal pap this year and was so freaked out that I immediately went with my doctor's prescribed protocol of cutting out the abnormal cells pronto. Of course, she didn't get it all and so now is pushing me to get the same surgery again to get the rest. I am pushing back and asking why can't we try some alternative treatments (as there are well-documented, scientifically proven alternative treatments to cervical dysplasia, which I found out about in my own research after the first surgery and subsequent tests showed she didn't get it all). Now she is irritated with me because I am not following the protocol. Why is the protocal to immediately go to cutting (same question with the mammos and the biopsies)?! I think it is part CYA, part financial incentive, and part ignorance/lack of experience with alternative therapies. Now, I am left with a damaged cervix from the first surgery that makes getting a Pap test a MISERABLE, PAINFUL experience and that is how I am suppossed to be montioring myself to see the status of the abnormal cells.
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wxw101
livs (low information voters)
03:43 PM on 11/25/2009
Doctors are essentially required to perform these procedures in almost a methodical and predictable fashion. CYA? You bet - anything to mitigate risk, mitigate the chance for malpractice, and mitigate having to deal with the insurance carriers. Risk costs money, and it eventually will catch up with you. Show me a successful doctor, and I will show you someone who is an expert in mitigating risk. So to ask a doctor in good standing (meaning properly licensed and insured) to go outside that box is asking them to put their livelihood on the line.

I remember when my brother was diagnosed with cancer in the 70's. Since the outcome according to his doctors was pretty much a forgone conclusion, my parents took him down to Jamaica for an alternate approach. The focus they provided was a bit of both worlds, but the most significant portion of it was focused on diet, on well-being, etc..

Our approach to medicine is so mechanical, and many times so devoid of humanity. I read these stories with Kim, and some of the others here, and they are painful, but I differ with almost everyone here. Not only have we become slaves to the out of control costs imposed on us by health insurance and medicare/aid, but so many feel government is our solution. You think our health care is devoid of humanity now? Wait till it becomes a managed by Washington operation.

Just my 2, and sorry for your medical difficulties.
02:24 PM on 11/22/2009
Great article Kim!

It's frustrating having two vaccine damaged kids and lacking the finances to treat them as aggressively as they really should be treated!

We're doing biomed and my kids have improved significantly - but, we just don't have the money to do all of the needed tests and interventions. Instead of returning for a 1-3 month follow up, we usually wait 6-9 months because we just can't afford to go back when we "should". Instead of ordering all available tests, the doctors pour over charts with us to determine the "best bang for our buck". While we've been lucky to have some testing (bloodwork) and medication (anti-fungals) covered by insurance...it's still maddening because so little is paid for. Now, I'm scared - as I sit on a mountain of debt and begin to receive notices of rising interest rates - even though I'm never late on a payment. We just can't get ahead.I know my kids could be doing better - but, we can't afford the things that would make this a reality.

I wish society would see that we're all going to pay for these kids - in one way or another. It makes much more sense to care for them now and work to ameliorate symptoms than to imagine the social security, medicare and other costs that'll be paid out on their behalf if they don't "recover".

Keep fighting for your girls - and for all of our families - we are grateful!
05:07 AM on 11/22/2009
Too true.
You said it all Kim. I'll just add that even for those who can pay out of pocket for the special test you described there are tests available in other states that are not available to me because we live in NY. Just not available? What about that OATs test we took in 2006? Couldn't get it in 2007. Fortunately we can also travel to see docs in other states. All of this takes an incredible amount of time, fortitude and money. It's galling.
11:16 PM on 11/21/2009
"How does it feel to be told you can't have a surgery ? " that three doctors have told you is needed ? Not exactly on point, but related. My wife was bleeding heavily EVERY day....she went to her OB/GYN who did tests and told her she needed a hysterectomy. She didn't want one, so went to another doctor ( same opinion) and then a third. She finally agreed, only to be told by her insurance company that the surgery was " not indicated"....Three doctors had told her it was! I asked the insurance co. what their guidelines were..."we cant tell you "...I told the insurance co. that my wife is bleeding heavily every day...they said "take her to an emergency room!" I asked for a review, and it was denied ! The doctor asked for a review and it was denied ! I called my congressman, who called the insurance co. Within an hour I received a phone call for the insurance co...."were so sorry, it was just a mistake...of course your wife can have surgery ..." What about the people who can't call their congressman ? And should we really need to call a politician to get surgery approved ? And, by the way, I'm a surgeon !
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MomOf3AU
07:37 AM on 11/21/2009
For autism coverage, the basic problem is there are only a couple handfuls of doctors in this country who understand the myriad of possible underlying medical issues. And it's grossly unjust that few families of the over 1 million people with autism have access to these treatment options.

My three boys received a grant from NAA for biomedical treatment. It was wonderful, and they have improved. How can a family like mine continue to pay out-of-pocket? This is very disheartening, but we decided to continue somehow.
11:04 PM on 11/20/2009
Thanks as always for your thoughtfulness and insight, Kim. You have a gift for making connections.
I'm not sure what to make of this new rule on mammograms because the radiation issue has always bothered me. I think the pap smear change is ludicrous-- they're going to do less of them simply because some docs are too handy with the laser? Why not set regulations on the risky procedures? I agree it's because the more cervical cancer there is, the more women will be cornered into thinking they need the vaccine. This makes me wonder if they're about to launch a breast cancer vaccine in the near future.
We're all meat and the world is a giant CAFO, basically. We pay between $20,000 and $30,000 a year to keep our vaccine injured kids out of the looming institutional "feedlot"-- where they'd be headed and profitably drugged to oblivion after my husband and I are gone if we didn't try to recover them.
05:48 PM on 11/20/2009
Honestly, how is it you can go see a doctor for a headache, certain it's just a sinus problem that maybe a couple of dollars of antibiotics will help, and he orders a $1,200 CAT scan? Why is it that ANYTHING related to autism is rejected? Why is it insurance will pay for a shot that can cause a brain injury and not get any help because of it? I mean if someone were to hit Ben in the head with a baseball bat he would be covered, give him a vaccine and it's all "out of pocket."

How do I feel? I feel like I'm watching my son struggling to stay afloat in the rough waters off the beach of I Don't Give A Crap Island and the 12 lifeguards standing around are either deaf or choose not to hear me. How do I feel? I feel like swimming out there to save him or to sink right along his side. However, if I am able to drag my son out of the water, to breathe life back into him, then by God, the entire island of I Don't Give A Crap will end up a lot like Atlantis.

Which reminds me, a little while ago we drove past a pasture with horses in it, and my son Ben said, "Horses are a lot like cows daddy."

The disparity against kids with autism is a lot like a crime against humanity.

Ain't that right Ben?
05:26 PM on 11/20/2009
I was listening to Talk Radio this afternoon and heard a "Medical Professional" claim that, due to our wonderful HPPV vax, these frequent Pap Tests won' t be necessary. Right, because that Pap test which catches the multitude of causes for cancer isn't better than the vax that "might" prevent a few.
05:00 PM on 11/20/2009
"Out of pocket" - I know this all too well. Having a child who can talk to me, can be assimilated in his Kindergarten class, and the only issue his teacher knows is he has food allergies, it's worth every penny. My little angel's issues are medical, not psychological, and by educating myself I've learned so much about diet/food, medicines and vaccinations, the immune system and how it affects the brain.

You know, the messed up decisions and messages being given to the public might cause them to look into other ways to heal their body. Maybe this is a blessing in disguise. Too many rely only on a mainstream doctor for their care. There are other practitioners out there with equal or better success rates with their patients. They don't have Big Pharma's money backing them up and taking them on golf vacation trips, so no main-stream-media press for them.
06:33 PM on 11/20/2009
I hear you . . . out of all the things that have actually helped my child - very few came from our mainstream ped (so we've become very familiar with "out-of-pocket" costs ourselves).

This child is functioning so well - above grade level and an amazing athlete. It's hard to believe where we were three years ago. I'm incredibly grateful that we didn't wait for mainstream medicine to do it for us - we'd still be waiting I suspect.
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Barbara Fischkin
Author of Muddy Cup, Confidential Sources and Exc
07:27 PM on 11/20/2009
Age-wise I come from the other side of the autism spectrum. Our affected son is 22. And we, too, know out-of-pocket well. It was money well spent on bio-medical interventions which helped him to enter a group home without any real behavioral issues. (And he went off an anti-psychotic drug months earlier).
I am adding my voice to those demanding coverage for these interventions that work and wind up costing society much less in the long run.

Tests for breast and cervical cancer - if conducted correctly - are like that too.
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jwebs94
04:49 PM on 11/20/2009
Amen Kim!

One time I asked my pediatrician if I could have both my ASD and "typical" child tested for parasites and yeast. She said, very dismissively, "Oh, I wouldn't even know how to order that one... I don't know anything about that." --and then never ordered the tests. She went on to tell me that my kids don't have those problems (a psychic doctor?). (Never went back to her)

We have these "people" who tell us that we are making this stuff up... that our kids do not have GI issues and Heavy Metal issues... but then we try to get tests to prove it ---and we have to drive or fly 5 hours to find a doc who doesn't say, "Oh your kid doesn't have that problem."