How to access surgical treatment?

theguzman

Firstly I am uninsured, and as this is an underlying condition would not be covered for 5 years anyway, I am very early thirties, Male. I am sorry for the long story here but I think it is important to understand the story and context of my very rare case.

Patient Background
I have been suffering with chronic Nasal congestion since I was 12 years old, it happens all year round but it is far worse is summer. It has been linked to Hayfever Allergic Rhinitis and this was true earlier on in my life, however it is all year round now https://en.wikipedia.org/wiki/Nonallergic_rhinitis I have only got relief from this whilst I was based near the Equator in South East Asia, devoid from the allergens in Ireland and in a permanently hot climate, Ireland's damp and horrible climate plays a huge part also. Relocation is not an option but I have geared my entire life towards trying to save and make investments for an eventual relocation.

Firstly I am not looking for any medical advice, I am diagnosed and I know what is wrong with me lol. This is rather asking peoples opinions of how to best access surgery. I will give a brief description of the medical management history of this debilitating condition.

Ten years ago after dozens of trips to my GP, umpteen nasal sprays and meds I was eventually sent to the public HSE ENT Consultant, I was given a nasal septoplasty but this ultimately did not alleviate the condition. In the intervening years it has gotten progressively worse, I am constantly a mouth breather, I can sleep for 12 hours straight since I am getting no quality of sleep, I could wake up tired after 12 hours, I often sleep 10 hours wake up tired and snooze for another 2 hrs. It is placing enormous strain on my heart and I have limited taste and sense of smell. It has also started to cause gum disease due to my mouth being dry half the time and this will eventually shorten my life and kill me due to its associated side effects unless I can get surgery soon.

In 2017 I went to Private Consultant in Ireland since there is a 4 year waiting list for a public ENT Consultant, this private ENT consultant prescribed me a new Drug called Montelukast Singular, it worked very well for around 9 months to one year cutting down my congestion by 33% to 50%, its efficiency wore off and eventually I stopped taking it since it stopped working.

in 2018 my GP refused on several times to forward me to the public waiting list for this, telling me that there is no solution to it other than to live with it and would I consider antidepressants, naturally I declined.

2019: This year I learned of the Cross Border Initiative, I went back to my GP for a referral letter and she refused to give me the referral, I fired her over this and instead took my healthcare to another younger more obliging Doctor. Within a few weeks I was on my way to the Kingsbridge Private Hospital in Belfast where I met a fantastic ENT Consultant and he performed a simple 20 minutes Endoscopy and told me what I had always known myself, I have significantly enlarged Turbinate and need to get Turbinate Reduction surgery and second septoplasty since the 2009 HSE Septoplasty was not a success and he thinks they even made the airway worse.

Now here is my conundrum there is three types of Turbinate Surgery that I know of, there is more than one way to crack an egg as they say.

Type one is a simple resection, whereby the enlarged Turbinates are simply cut down to a smaller size, this for me is the highest risk as the turbinate is spongy flesh similar to the Penis in that blood swells it, in my case I have almost constant swollen turbinates. This carries a risk of Empty Nose Syndrome and permanent loss of smell, I will not under go this surgery unless all other types fail first.

Type two is similar to the above but where electro cautery is used to burn the turbinate which causes it to shrink down in size, achieving volume reduction opening the airway inside the nose, to allow for nasal breathing again.

Type three is different and a newer technique called Submucosal Inferior Turbinate Reduction surgery whereby they perform effective liposuction on the Turbinate and reduce its mass by shrinking it down from the inside. I want to get this surgery first and if it is not a success I can try one of the other more extreme methods afterwards.

Unfortunately for me the Private Hospital in Belfast only performs the turbinate resection surgery (Type 1) and it is too risky for me to chance it, it is permanent and non reversible, Empty Nose Syndrome has caused a very high percentage of sufferers to eventually commit suicide, I'd rather suffer on as I am than risk this.

END

So now I am back to effectively square one and since there is a 4 year wait for a Public HSE ENT Consultant appointment, and that is just the consultation and you would be waiting even longer for surgery for sure.

Since I am only willing to get the Submucosal Inferior Turbinate Reduction surgery performed this is proving incredibly difficult since I can't find any hospital that performs it, hospitals and clinics are incredibly secretive of what procedures they perform. If I could find a Private Hospital outside of Ireland in the EU, ideally UK (pre-Brexit) then I could access this surgery under the cross border initiative. I have even contacted Medtronic the manufacturer of the surgical tools used in this procedure and they couldn't help me.

I contacted http://www.trasna.com/ and they informed me that this type of surgery the "Submucosal Inferior Turbinate Reduction surgery" is not performed within Ireland through the HSE and that I should instead go through the treatment abroad scheme.

The problem with the Treatment Abroad Scheme is you must be referred by a Public Consultant and there is a 4 year wait just to see the public consultant.

The "Submucosal Inferior Turbinate Reduction surgery" is however performed privately in Ireland within the Bon Secours system and I have a referral now to that consultant which will cost me €250 - €300 and then I can find out what the procedure would cost. However since it is privately in Ireland I will have to pay but if it was Privately in Belfast (or anywhere in the EU) the state would pay under the Cross Border Directive.

Sorry for such a long post but I am fuming at the absolute disgrace our healthcare system is, the bureaucracy of trying to access such a simple procedure is mind boggling but it would have an enormous effect on my quality of life if I could access it.

In contrast to the American situation I know of several clinics which will perform this across America and from reading online it seems to cost between $10,000 - $15,000 for the uninsured and foreign patients like myself. The Americans are very forthcoming with all this info as healthcare is a consumer choice there. In comparsion to the EU situation where everything here seems to be a closely guarded secret. I'm sure there is other places across Europe also but I can't find anything due to the language barriers. I could fly to England or Germany tomorrow under the cross border directive for a consultation and claim it back but it could be another wild goose chase like my earlier trip to Belfast only to be told we don't perform this particular type of surgery you are looking for.

Gael23

Could you take out a credit union loan and go private here?

Either that or take out health insurance now and suffer on for 5 more years.

skooterblue2

Gael23 wrote: »

Could you take out a credit union loan and go private here?

Either that or take out health insurance now and suffer on for 5 more years.

Horrible truth: If you want good treatment in this country, you have to go private.

Gael23

skooterblue2 wrote: »

Horrible truth: If you want good treatment in this country, you have to go private.

Unfortunately yes. But if he takes out a loan then it’s effectively the same as paying a health insurance premium every month.

JustAThought

I am.not necassarily recommending this BUT my old workcolleague(s) in 2 different jobs were from Poland and Lithuania. Both used talk about going home for surgeries on various ailments they had diagnosed here on the public health system in Dublin. They contacted the consultants,organised cat scans/diagnostics tests and consultations and returned later for the surgeries which cost a.pittance. Apparently it is standard practice in ex communist hospitals where it pays to pay. Interestingly a talk on studying medicine in Poland renently promoted this practice where 12 public hospitals in Poland operate in english to facilitate training doctors in english and their patients are returning Poles returning for cheap private treatment in public hospitals from their countries they have emmigrated to. Might be worth a google.

Regarding all your research and investigating it seems you are quite clear on what you want. You have put up with it for over 12 years. Is it not time you decided you were worth it and got the loan and paid for it privately with the recommended procedure and hospital of your choice in a language and in a system.you understand and have some comeback on. Cos you're worth it.