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Would you self-pay for an operation?

  • 02-11-2021 2:32pm
    #1
    Registered Users, Registered Users 2 Posts: 392 ✭✭Fionne


    I'm 46 and have spinal stenosis, diagnosed after an MRI by a consultant in the Mater Private, Cork. Got a caudal epidural about a month ago now, it has helped a bit but I still absolutely cannot sit down - have now not been able to sit since early July, so can't drive, have to stand at work (office job), can't even sit long enough to eat.

    Turns out my VHI policy doesn't cover me for any private hospitals so I had to pay €900 for the epidural injection. I rang my GP yesterday, asking to be referred to someone in a hospital I am covered for and he said he doesn't believe there is anyone else in this part of the country (County Cork) that could do a good job of operating on my back. The orthopaedic surgeons in the public system he says are up to their eyeballs in knees and hips and just don't have the expertise for the kind of surgery (spinal fusion) I need.

    So what am I to do? I know that the 5-6 day stay in the Mater costs €1,000 per day so adding the cost of the actual operation onto that - I don't have that kind of money - I'm guessing but I reckon the whole thing could cost upwards of €10,000, maybe much more.

    If I increase my health insurance cover when it's renewed next month so that I am covered for private hospitals, then there's a 2 year waiting period.

    I can't bear the thought of having to wait 2 years with constant pain and being unable to sit down.

    My GP says he's not even sure he can get me in to see a pain management doctor to get another of the epidural injections to keep me going, he said I'd be lucky to see anyone this side of Easter.

    I understand the hospitals are busy, I get that there are people worse off and in more urgent need than me.....but.....PAIN!

    Has anybody got any advice on what to do or where to go next? At the rate I'm going, I won't be able to continue working as it's just becoming so much of a struggle to stand all day, most of it on one leg as I can't bear the pain of putting my right leg on the floor.

    Should I take a loan out for the operation? Would you do that if it was you? I'd sell my car, since I can't drive it anyway but it's still got 2 years of HP left.

    Is it worth going for physio? I've been reluctant to as I can't cope with much more pain. I'm on pain meds but the GP won't increase them as he says it's amazing I've not already got stomach trouble from being on them since July.



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Comments

  • Registered Users, Registered Users 2 Posts: 7,860 ✭✭✭SuperBowserWorld


    At least pay for an appointment to see the best consultant you can for your condition. Maybe their are other options, stop gaps, treatments until your health cover covers it.

    And ask them what the best thing to do is.

    And get a realistic idea of the cost. Etc etc etc

    Also, it might be possible to travel abroad for cheaper/better treatment.



  • Registered Users, Registered Users 2 Posts: 392 ✭✭Fionne


    Yes, I have wondered if I should do that, go and see him again and get more information. My problem with travelling for treatment is that because I can't sit down (it is agonisingly painful) I can't travel far - I only manage as a passenger in the car if I recline the seat back. Apparently most people with my condition get relief from sitting but I would be the one to have it the other way around. 🙄



  • Registered Users, Registered Users 2 Posts: 7,860 ✭✭✭SuperBowserWorld


    Train to Dublin. Stand when you need to. And same on Dublin bus ?



  • Registered Users, Registered Users 2 Posts: 392 ✭✭Fionne


    Oh, I'd definitely get as far as Dublin if needs be and I've told my GP that. He still didn't seem hopeful of me getting an appointment with anyone though. Maybe I need a GP who will work harder for me.



  • Registered Users, Registered Users 2 Posts: 706 ✭✭✭SATSUMA


    I've done this before. Find a consultant, ring the secretary for an appointment. The Mater Private is v expensive (the care was poor in my experience also) . Usually a consultant works in various hospitals and all will charge different prices. You can also negotiate with the hospital believe it or not! I think you should look into it for sure. You might actually be surprised at the varying costs. Best of luck



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  • Registered Users, Registered Users 2 Posts: 2,108 ✭✭✭boombang


    If the HSE can't do it you may be eligible for the treatment abroad scheme. It might not be fast to process, but could be worth considering. There's a clause about care being delivered in a timely manner. I hate to say it, but talking to your TD might help this along.



  • Registered Users, Registered Users 2 Posts: 392 ✭✭Fionne


    I did look into that, I'll need to have been through the public system first (you can't get referred for treatment abroad as a private patient) and my whole problem is not being able to get an appointment to see anybody in a public hospital. If I could just ring someone up that would be great but everything has to be done as a referral from the GP and to be honest, I've no idea if he's even tried.



  • Registered Users, Registered Users 2 Posts: 2,108 ✭✭✭boombang


    What a crazy system. The Treatment Abroad Scheme is meant to give faster access, but if you can't even get a public appointment you can't avail of the benefits?! I feel sick on your behalf. Maybe see if you can get the ball rolling on that process as it might be possible to get it going in parallel. I hope something sorts itself out soon.



  • Registered Users, Registered Users 2 Posts: 26,219 ✭✭✭✭Strumms


    Ultimately if it gets anymore out of hand and even if it doesn’t I’d present myself in a&e....you can sleep, appetite diminished, pain unbearable and can’t sit...



  • Registered Users, Registered Users 2 Posts: 2,495 ✭✭✭apache


    If it has to come to that do present yourself in A&E. That's terrible.



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  • Registered Users, Registered Users 2 Posts: 48 Fazorb


    Have you read, The Wim Hof Method?



  • Registered Users, Registered Users 2 Posts: 392 ✭✭Fionne


    That tactic doesn't work I'm afraid, you still get sent home and told to make an appointment with a consultant. I know because my brother ended up in A&E with agonising pain in his leg because he'd been waiting so long to be seen for a cruciate ligament problem but he still got sent away from A&E and told to wait for his consultant appointment. He ended up self-paying for his operation to get it done.

    A&E are busy enough without having to deal with non-life threatening issues coming in so I wouldn't really even consider doing that, as bad as I may feel. It just wouldn't be fair (and yes, I know, the whole system seems unfair). It's hard to fight my corner and kick up a fuss when there are people at risk of dying because of waiting lists or young children waiting for scoliosis operations.



  • Registered Users, Registered Users 2 Posts: 392 ✭✭Fionne


    I haven't but I am familiar with belly-breathing as I suffer with anxiety and panic attacks occasionally.



  • Registered Users, Registered Users 2 Posts: 48 Fazorb




  • Registered Users, Registered Users 2 Posts: 2,495 ✭✭✭apache


    I thought you were in agonising pain. Are you still working?



  • Registered Users, Registered Users 2 Posts: 61 ✭✭MissGriff


    Hi OP, Has your GP even mentioned any neurosurgeons who he could refer you too? Neurosurgeons do spinal surgery, discectomies,fusions. Pretty much same training as orthopaedics but they do brains/ neuro all nerve system obviously too.

    I say this as I had my back done by a neuro in CUH but by a private neurosurgeon with his rooms behind the hospital but who does his surgeries in CUH.

    My health insurance was limited also but I was given the option by my great GP of an Ortho in a Dublin private hospital or the Neuro in Cork( I'm in Limerick). The appointment for Cork came thru within 3 days so went with him. Emergency situation started losing use of my leg ontop of severe pain for yrs.

    Great surgeon, and lovely man to deal with.

    I hope this might help.



  • Registered Users, Registered Users 2 Posts: 26,219 ✭✭✭✭Strumms


    A&E though are not just for life threatening or seriously ill people...

    about 5-10 % of people there are junkies for example who’ve been in a minor scrap, scrape or entanglement ...

    go there.



  • Registered Users, Registered Users 2 Posts: 1,722 ✭✭✭PoisonIvyBelle


    I have and did, don't regret it at all.



  • Registered Users, Registered Users 2 Posts: 1,228 ✭✭✭The Mighty Quinn


    Personally I'd take the 10K loan. Repayments over 5 years are 199 a month with Bank of Ireland.

    The financial pain would be more than worth it to have your health back. You can't live in that kind of pain for years.



  • Registered Users, Registered Users 2 Posts: 392 ✭✭Fionne


    I am in pain, though the caudal epidural has helped. I have no choice but to go to work, there is no sick pay in my job. I've had to switch to a standing desk which is utterly exhausting. I struggle, especially towards the end of the week because the pain gets worse. I arrived in this morning and spent the first 10 minutes crying because I was that sore from the 5 minute drive into work. If I lived any further away, I would absolutely have to give up work as I can barely tolerate sitting for that 5 minute journey.



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  • Registered Users, Registered Users 2 Posts: 392 ✭✭Fionne


    My GP sent me to the guy in Mater Private as that was gonna mean I'd get seen sooner which was probably correct. I had the MRI and consultation and paid for the epidural injection. As I'm not covered by VHI for Mater Private, I rang the GP back and asked if he could refer me to someone in CUH or any other public hospital. He said there are two problems 1- getting an appointment as they are all so busy and 2- he said the guys doing back surgery in CUH are also doing hips and knees, etc so don't have the expertise to do the type of surgery I need.

    I had an operation done 10 years ago by a guy in CUH as a private patient but it was a different issue (ruptured disc).

    The public hospitals are so under pressure because of Covid, I think the GP is probably right in saying I'd be lucky to see anyone this side of Easter, let alone have any procedure done.



  • Registered Users, Registered Users 2 Posts: 392 ✭✭Fionne


    I may well have to do that if it comes to it, at the very least I'll have to find out the exact cost. A friend thinks I'd be mad though as if there was a complication I could end up owing a fortune if I had to stay in longer, etc. There's also an issue with not being paid while I'd be off work, when I had an operation 10 years ago I had to take my entire holidays for the year and then go back to work after 3 weeks when I'd been told to stay out at least 3 months. This operation is a much bigger deal so I could be out of work for much longer. I'd have to factor how I'd survive on the social welfare for that length of time and obviously wouldn't be able to afford loan repayments out of that either, I already have a car loan.



  • Registered Users, Registered Users 2 Posts: 335 ✭✭Redlim


    I'd second what MissGriff said above and check out the neurosurgeon route. There are a few in CUH which you could call to check what their waiting times might be. Your condition may also mean you might get priority. Then just get your GP to refer you. Contact details listed in the link bit I think Prof O Sullivan is retired: https://cuhcpc.ie/services/neurological-surgery/

    Was your previous disc surgery done by a neurosurgeon?



  • Registered Users, Registered Users 2 Posts: 392 ✭✭Fionne


    Yes, my previous surgery was done by George Kaar who I believe has also retired since.



  • Registered Users, Registered Users 2 Posts: 335 ✭✭Redlim


    Ok, might be no harm checking with one of the others. For example Chris Lim and Mahmoud Kamel are definitely still active.



  • Registered Users, Registered Users 2 Posts: 61 ✭✭MissGriff


    Your GP doesn't seem to pushed to advocate for you by sounds of it in the 2 points you made.

    Of course they are all busy and especially now with Covid and cancellations of elective surgeries, but he and you should be exhausting all options no matter. And it sounds odd to me he says the surgeons in CUH don't have the expertise. People have stenosis and get fusions done all the time by these surgeons, unless your diagnosis is particularly unusual.

    I completely understand the pain and how it can negatively affect how you perceive things and causes more worries, negativity etc but my advice is get on the phone, as Redlim said, check out the others, call directly,do your research, contact your health insurance provider and find out in detail what you are covered for specifically and where... sometimes just reading the the policy yourself is confusing and you can miss things.

    Also re finances, if you have a mortgage, you will most likely have mortgage protection which will cover payments while out sick/recovering and with your situation ie.back surgery you just provide MRI evidence and surgeon sends a report.

    Try not to panic,write notes and start making calls. Forget the GP not even trying to refer you to others, you need to insist he tries all options.

    Mind yourself.



  • Registered Users, Registered Users 2 Posts: 788 ✭✭✭useless


    Re the comment on mortgage protection above, unfortunately this isn't true. The vast majority of people have mortgage protection, which pays back the bank if you die before the mortgage is paid off. A much smaller number of people have mortgage repayment protection as well as mortgage protection- this makes your repayments if you're ill or out of work. MRP is not standard and is expensive, hence most people don't have it. Even for those that do, the insurers go to great lengths to avoid paying out- if you do have MRP read the policy document to make sure elective surgery is covered.

    OP, I would investigate the cost of private treatment and phone around some of the consultants offices to establish what their waiting lists are like. If it means borrowing the cost, surely its worth it if the pain you're experiencing is alleviated. Best of luck.



  • Registered Users, Registered Users 2 Posts: 61 ✭✭MissGriff


    No need to explain thanks, I know exactly what they are and the differences.I didn't say everyone has it and only basing my info on my own situation. I have one policy that covers both aspects and it's not very expensive. Yes they can be difficult to pay out however if covered for illness, evidence eg.mri and report they generally don't refute. Mine was paid with no question.

    Anyway, it was a simple suggestion to help guide the OP to check out all the options they may have access too,medically or financially. I'm not here to dissect the ins and outs of mortgage protection.

    Good luck OP?,



  • Registered Users, Registered Users 2 Posts: 12,127 ✭✭✭✭Gael23


    Strongly advise against going abroad. What if there are complications along the way?

    You can either upgrade your health insurance and wait or take out a loan and do it now. But I’d take this as a lesson and upgrade your VHI either way



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  • Registered Users, Registered Users 2 Posts: 392 ✭✭Fionne


    I got my renewal from VHI yesterday so have been weighing up my options. It's going to add a lot of cost onto my policy to upgrade and there's the 2 year wait then to avail of it but I will definitely upgrade to at least be covered by private hospitals. Irish Life seem to include the Mater as a private hospital whereas VHI categorise them as High-Tech so I might even switch companies. It doesn't help my current problem as a 2 year wait just feels like a life sentence but at least if I ever need anything else from 2024 onwards, I'll be covered. I think it was because I had my last surgery done in CUH that I felt I was covered by just having the Private patient in public hospital box ticked, if only I'd known then what I know now.



  • Registered Users, Registered Users 2 Posts: 12,127 ✭✭✭✭Gael23


    Depends on the specific policy. I’m with Irish life too and I’m covered for 50% of the cost in the Mater Private but there are loads of other options. You’ll also notice that certain policies have a co payment for some orthopaedic procedures but you’d need to give them the specific details to be sure.

    I see my health insurance as one of the essential bills I have every month



  • Registered Users, Registered Users 2 Posts: 6,344 ✭✭✭Thoie


    Check to see if your consultant from the Mater has rooms anywhere else, for example in CUH. Many of them practice in multiple locations. If (s)he has a private practice in CUH, you could see them there, and you might find that your VHI covers you for being a private patient in a public hospital.

    I can't remember the exact details now, but I had a fairly large surgery a few years back (not spinal), which was mostly covered by my health insurance. I was in hospital about a week, and I remember that the "amount due" (of which I only paid a fraction) was in the region of €30-40k - I was gobsmacked by the cost of it. There was a nightly rate for the bed, separate costs for the use of the operating theatre, costs for everyone who saw me (surgeon, anesthetist, random bloke passing down the hall), every drop of blood they took, and processed. It all added up rapidly.

    I also needed to go back to outpatients regularly for a few weeks afterwards, and it turns out my health insurance didn't cover that, and that came to about €100 a pop each time as well.



  • Registered Users, Registered Users 2 Posts: 392 ✭✭Fionne


    The guy I saw in the Mater doesn't work anywhere else unfortunately, that's why it was possible to get an appointment to see him and not the ones also working in other hospitals.

    The Mater is €1,000 per day just for a bed so yeah, I'm terrified of what the whole operation might cost as it's a 5-6 day stay even if all goes well. If I was unlucky enough to have complications and have to stay longer or need further treatment...god knows. All quite depressing.



  • Registered Users, Registered Users 2 Posts: 2,495 ✭✭✭apache


    My insurance only covers 70% I think of the Mater Private. It must be expensive.



  • Registered Users, Registered Users 2 Posts: 4 Jessieb99


    Hi I’m just wondering how you are getting on and if you have gotten to see anyone since ? I’m waiting on a call to cork myself to see a consultant as I have a spinal stenosis now also , hope your ok , Joanne



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  • Registered Users, Registered Users 2 Posts: 7 sharon.1969


    Hi i dont have the same problem but i appreciate any feedback on my problem. I keep hitting a wall when being referred to a consultant for review on what I need going forward for my knee injury (operation or just physiotherapy) all the consultants so far need health insurance which unfortunately I don't have but I am willing to pay myself for the 1st step, to get a consultation on what I need. Can anyone point me in the right direction to a consultant who takes direct payment for same. Thanks



  • Registered Users, Registered Users 2 Posts: 392 ✭✭Fionne


    I still haven't seen anyone. I asked my GP in October to refer me to someone my health insurance would cover me for. Finally, 4 months later, and after me having to ring, email and even go into the surgery, they tell me the letter was sent 2 weeks ago now. I was ready to go and stage a protest by that point because a letter takes a minute to do and they took months to get around to it. Until I hear from the consultant I won't even fully believe that they've sent it as they seem to be incompetent, almost every time they send my prescription to the chemist it is missing items or has items on it I didn't even ask for. I've no faith in them anymore.



  • Registered Users, Registered Users 2 Posts: 27,051 ✭✭✭✭Dempo1


    Have you had an MRI scan done 🤔 I've quite the experience of a knee issue, I'm happy to share.

    Is maith an scáthán súil charad.




  • Registered Users, Registered Users 2 Posts: 2,495 ✭✭✭apache


    Could you change GP?

    Although I don't know how easy that is. Looking in to it myself.



  • Registered Users, Registered Users 2 Posts: 27,051 ✭✭✭✭Dempo1


    Very difficult at the moment , few GP’S taking on new patients and if a medical card holder all the more difficult, involving a protracted administrative process.

    Is maith an scáthán súil charad.




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  • Personally speaking, I would sell car and anything else to find surgery in the Mater Private, where a legendary spinal surgeon operates. Can’t recall his name, but I was in a rehab centre recovering from a knee replacement where I shared a room with a lady who had recently undergone surgery for a very complicated neck spine issue. She was jubilant in that she woke up free from the website intolerable type of nerve pain that had been affecting her. Now I know with lower spinal surgery you have to wait to find that improvement as the weight of your body is upon recovering inflamed tissues.

    Aldo, be careful which surgeon you choose when it comes to spinal surgery. I worked with someone who had spinal fusion, and it turned out a disaster as the wrong size screws were used which pressed into his spinal cord, causing great pain and compromise. This was discovered when instead of improving in the rehab facility he got much worse, and it was discovered a screw was pressed on spinal cord, and in spite of emergency surgery he never properly recovered, and one leg was both agonising and wouldn’t reliably hold him up. Other aspects were affected, as can happen in lower spinal issues. The surgeon had been more practised in operating on children, it seemed. It was through the public system, where another surgeon had refused to touch him because of his complexity, and he sought a second opinion and that surgeon was willing to try and help him. It might have worked except that inappropriate screw size was used for him.





  • Your GP practice sounds exactly like mine! I’ve been quite cross with them on occasion and have been told “NO need to get like that!” They would drive you insane at times, especially the admin staff and the two female doctors who seemed to come from a mould of what I can only describe as “fussy indifference”. They seem to hate being GPs, as another patient in the surgery said to me “a pair who went into medicine purely for social status, no people skills”. However the original senior partner is a really nice and helpful man when he is on duty, but he seems less and less so in recent years.



  • Registered Users, Registered Users 2 Posts: 253 ✭✭mct1


    I've needed several (private) referrals in the past few years and I always ring the consultant's secretary to check they've received my GP's referral and enquire when my appointment might be, similarly for scans, Xrays. I'd do that if I were you - it would put your mind at rest anyway. I do trust my doctor but as a retired GP I know how referrals - which are almost always done electronically now - can sometimes get overlooked or buried. Practices have been up to their eyes with Covid, vaccines and backlogs and unfortunately this means that sometimes a patient just needs to stay on their case.

    You can ring the hospital switchboard and ask for the consultant's secretary or find their number on the hospital website. I hope you get some relief soon.



  • Registered Users, Registered Users 2 Posts: 2,495 ✭✭✭apache


    What's the reason why it is so hard to change GP?



  • Registered Users, Registered Users 2 Posts: 27,051 ✭✭✭✭Dempo1


    Numerous

    Firstly the lack of GP's

    Secondly, most practices full

    Thirdly, all extremely busy.

    In relation to Medical Card Holders.

    Generally Medical card holder are assigned a GP or GP has assisted in applying for the MC.

    To Change existing GP whilst a MC holder , the process involves applying for a move through the HSE and there is no guarantees there's another GP either willing to take on a new MC patient or indeed there's even one available on the panel within a geographical location of the patient. Whilst the MC can in certain circumstances be used in out of hour services , Hospital visits etc, they are generally assigned for usage by a nominated GP, indeed MC have the name of the GP assigned on them.

    This is the simplified version but if your a MC Holder (I am) it is not straightforward moving to a new GP , thankfully my own, generally excellent.

    Is maith an scáthán súil charad.




  • Registered Users, Registered Users 2 Posts: 2,495 ✭✭✭apache


    I see. I think it's hard enough to change GPs also if you're paying. They are all overstretched.



  • Registered Users, Registered Users 2 Posts: 29,088 ✭✭✭✭_Kaiser_


    Got a cataract removed up North at the start of last year under the Cross Border scheme (got in just before the effects of Brexit took that option out) having been told it could be 6 years on the waiting list (no insurance) and having already waited 3 of those.

    Cost me about €500 net by the time I was done. Very efficient and helpful team that run that section. Had the money back in about a month after the operation.



  • Registered Users, Registered Users 2 Posts: 15 Mynydd2


    I've self-payed for an operation for my daughter. Not sure how feasible for you, but some corporate policies waive the waiting time. Mine at least does, not sure if it's company-related (multinationals tend to have this) or not. Maybe enquire about corporate policies, they are available to the general public.



  • Registered Users, Registered Users 2 Posts: 27,051 ✭✭✭✭Dempo1


    It really is and the old saying , Private is faster is really no longer the case in certain disciplines. I think the shortage of GP's and indeed specialist consultants, coupled with increased workload is having a real impact on both private and public patients.

    Is maith an scáthán súil charad.




  • Registered Users, Registered Users 2 Posts: 4 Jessieb99


    Hi just to let ye know Pr o Sullivan is not retired thank god as he’s operating on my tomorrow morning, please get this person to get her GP to send her referral to him as she is in a bad state with pain,



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