meld score

December 1, 2008

hello everyone,havent been to see my new hepatologist yet but really

wanting to know my meld score,my family dr.gave me a copy of my

bilirubin (2.6) & creatinine(0.7) & then I had him do a seperate one for

my INR well,went and picked that up and it says diagnosis code

571.2,456.0 I went to the mayo clinic site to put my figures in and

something is wrong it says my meld is 87 teeheehee I'm talking from the

grave,can someone tell me what I'm doing wrong.I don't understand the

INR,still NEW AT ALL THIS.....thanks & god bless,

December 4, 2008

What transplant center was she referred to for evaluation? Just curious?

MaC

jason wrote: Hi all, my name is

jason. my mother has cirrhosis and i am her

caretaker during the day. we are both confused and have a question for

you. a few weeks ago her gastro said her numbers were high and he

reffered her to a transplant doc. she saw the transplant doc who told

her that she didn't need a transplant because only her creatinine was

high, her bilirubin is at 0.5, her INR is at 1.0 and her creatinine was

automatically set to 4.0 because she is on dialysis. these numbers gave

her a high MELD (20) but the doc says it is only high because of her

kidney failure. i thought that the MELD calculation accounted for

kidney problems and even with these lab values, her MELD of 20 was

accurate and she does need a transplant. ever heard of this, is this

doc. wrong? please help, they won't put her on the list untill the doc.

says to. thanks in advance!!

December 4, 2008

She went to a kiaser permenente facility in los angeles.

Hi all, my

name is jason. my mother has cirrhosis and i am her

> caretaker during the day. we are both confused and have a question

for

> you. a few weeks ago her gastro said her numbers were high and he

> reffered her to a transplant doc. she saw the transplant doc who

told

> her that she didn't need a transplant because only her creatinine

was

> high, her bilirubin is at 0.5, her INR is at 1.0 and her

creatinine was

> automatically set to 4.0 because she is on dialysis. these numbers

gave

> her a high MELD (20) but the doc says it is only high because of

her

> kidney failure. i thought that the MELD calculation accounted for

> kidney problems and even with these lab values, her MELD of 20 was

> accurate and she does need a transplant. ever heard of this, is

this

> doc. wrong? please help, they won't put her on the list untill the

doc.

> says to. thanks in advance!!

>

December 5, 2008

Then I would bring up the question about her being referred to a transplant team

at a transplant hospital for an evaluation to be put on the transplant list.

Only the transplant team can say no. Not the gastro doc. He isn't the deciding

authority and doesn't make those decisions. he only makes the referral for the

evaluation. It's only HIS opinion that she's not a candidate and he may be right

and he may be wrong, but he's not the final say.

The squeaky wheel gets the oil.

MaC

jason wrote: i guess it wasn't

a transplant center, it was a kiaser facility that

has a gastroenterologist/transplant specialist in staff. i think his

name was Dr. Jim Tung, or something like that.

>

> Do you know the name of the medical center? There are hundreds of

Kaiser facilities in LA, and none that I know are transplant centers

but I could be wrong. Below are the list of Liver Transplant Centers

in California. Was she referred to one of these for a transplant

evaluation? If not, then I would have to question the doctor who said

she wasn't a candidate.

>

> California Liver Transplant Centers (No particular order):

> California Pacific Medical Center, San Francisco

> Cedars-Sinai Medical Center, Los Angeles

> Childrens Hospital Los Angeles, Los Angeles

> Loma University Medical Center, Loma

> Rady Children's Hospital and Health Center, San Diego

> Scripps Green Hospital, La Jolla,

> St. Medical Center, Los Angeles

> Stanford University Medical Center, Stanford

> University of California at Los Angeles Medical Center, Los Angeles

> University of California Medical Center, Sacramento

> University of California Irvine Medical Center, Orange

> University of California San Diego Medical Center, San Diego

> University of California San Francisco Medical Center, San Francisco

> University of Southern California University Hospital, Los Angeles,

>

> This listing was provided by UNOS.

>

> MaC

>

December 5, 2008

Kaiser Permanente, the largest Health Maintenance Organization (HMO) in

the world, suspended its Northern California kidney transplant program

after a Los Angeles Times article disclosed the HMO had badly

mismanaged the program, which may have caused the deaths of some

patients on the waiting list for a donor. The problems began in

mid-2003 when more than 1,500 Kaiser patients on waiting lists at two

institutions (University of California San Francisco, University of

California ) were informed by Kaiser that it was establishing its

own kidney transplant program in the area and would not longer pay for

their transplants at outside hospitals.

http://www.dailypress.com/news/local/la-me-kaiser13may13,0,5289978.story?page=2

http://www.latimes.com/news/local/la-me-kaiser13may13,1,7824088.story?page=2 & tra\

ck=rss

http://www.allbusiness.com/health-care-social-assistance/ambulatory-health-servi\

ces/4005635-1.html

http://www.latimes.com/features/health/la-me-newtransplant13jul13,0,2774759.stor\

y

http://findarticles.com/p/articles/mi_m0YUG/is_2007_Jan/ai_n17215747/pg_4

MaC was the first one here to bring this to every one's attention, and

from what I can tell in reading these articles, Kaiser is sending

transplant patients out side hospitals to get organ transplants because they

were

failing to provide adequate care to the patients. It seems very ominous

to me. If I had a loved one with Kaiser who had any kind of end st5age

organic disease such as cirrhosis, I would scream to member services,

or the receptionist to get my loved one outside to a reputable

hospital. What follows is the story of the tendon in my left hand.

At one point back in 1995 Sharon and I choose Kiaser in order to save money on

health insurance. I cut my middle finger on my left hand at band practice on a

Friday night. In the ER, the doc told me that I had nearly cut all the way

through the extensor tendeon in the middle finger, and that a good hand surgeon

was going to need to fix it. He said he would give it a go, but that he was

swamped, and that I really deserved a better chance at not ending up with a

useless digit, and that all I would need to do is go see my regular doctor and

they would refer me to an orthopedic surgeon who would fix it. On Monday, at

Kaiser, a " half-a-doctor " as chief used to call them saw me (physician's

ughsistant) and he said " you already have stitches, we won't want to open your

finger back up under any circumstances. I demanded to see a surgeon. We went

upstairs to the office of orthopedics. They whispered into a room, and a doctor

came out in to the hall, and quietly

told me " I have read many medical journals that these things heal all by

themselves " . " our hand surgeon is on maternity leave " . I said what??? Sharon

said what the f----??? Then I said " I think you are lying to me, I want a

second opinion " . They just looked at each other, turning pale, asking me to

lower my voice, and I just got louder, demanding a second opinion. They said "

our other hand surgeon is on maternity leave " I kept demanding a second opinion,

not knowing what else to do. Then I said " you have to give me an outside second

opinion, because your hand surgeon isn't available, don't you? They admitted

that by law, they had to give me a second opinion, and gave me a name of a

prominent Denver boob man, and I went to see him. He is well known here for

boobs, but he does hands too. Dr Brown called Kaiser from his office, said " I

have mister Aragon here in my office, he needs some sutures in his extensor,

and next Thursday I am going to need

OR 4 and surgical team, and you are going to pay for it, right? . He came back

into the exam room and said " next Thursday, Bobby. " He fixed my tendon without

any further crap from Kaiser, and the following October, we dumped them and

never went back. My sympathy to any one with Kaiser, I do not know how anyone

gets medical treatment with them. Bobby

________________________________

To: livercirrhosissupport

Sent: Friday, December 5, 2008 8:44:35 PM

Subject: Re: Re: MELD score

Then I would bring up the question about her being referred to a transplant team

at a transplant hospital for an evaluation to be put on the transplant list.

Only the transplant team can say no. Not the gastro doc. He isn't the deciding

authority and doesn't make those decisions. he only makes the referral for the

evaluation. It's only HIS opinion that she's not a candidate and he may be right

and he may be wrong, but he's not the final say.

The squeaky wheel gets the oil.

MaC

jason <pcexetrayahoo (DOT) com> wrote: i guess it wasn't

a transplant center, it was a kiaser facility that

has a gastroenterologist/ transplant specialist in staff. i think his

name was Dr. Jim Tung, or something like that.

>

> Do you know the name of the medical center? There are hundreds of

Kaiser facilities in LA, and none that I know are transplant centers

but I could be wrong. Below are the list of Liver Transplant Centers

in California. Was she referred to one of these for a transplant

evaluation? If not, then I would have to question the doctor who said

she wasn't a candidate.

>

> California Liver Transplant Centers (No particular order):

> California Pacific Medical Center, San Francisco

> Cedars-Sinai Medical Center, Los Angeles

> Childrens Hospital Los Angeles, Los Angeles

> Loma University Medical Center, Loma

> Rady Children's Hospital and Health Center, San Diego

> Scripps Green Hospital, La Jolla,

> St. Medical Center, Los Angeles

> Stanford University Medical Center, Stanford

> University of California at Los Angeles Medical Center, Los Angeles

> University of California Medical Center, Sacramento

> University of California Irvine Medical Center, Orange

> University of California San Diego Medical Center, San Diego

> University of California San Francisco Medical Center, San Francisco

> University of Southern California University Hospital, Los Angeles,

>

> This listing was provided by UNOS.

>

> MaC

>

December 5, 2008

6 years ago a gastro told me I had 2 to 3 years to live. ooooops he was

wrong. I am still living. Jan H

> Then I would bring up the question about her being referred to a

> transplant team at a transplant hospital for an evaluation to be put on the

> transplant list. Only the transplant team can say no. Not the gastro doc. He

> isn't the deciding authority and doesn't make those decisions. he only makes

> the referral for the evaluation. It's only HIS opinion that she's not a

> candidate and he may be right and he may be wrong, but he's not the final

> say.

>

> The squeaky wheel gets the oil.

> MaC

>

> jason <pcexetra@... <pcexetra%40yahoo.com>> wrote: i guess it wasn't

> a transplant center, it was a kiaser facility that

> has a gastroenterologist/transplant specialist in staff. i think his

> name was Dr. Jim Tung, or something like that.

>

> >

> > Do you know the name of the medical center? There are hundreds of

> Kaiser facilities in LA, and none that I know are transplant centers

> but I could be wrong. Below are the list of Liver Transplant Centers

> in California. Was she referred to one of these for a transplant

> evaluation? If not, then I would have to question the doctor who said

> she wasn't a candidate.

> >

> > California Liver Transplant Centers (No particular order):

> > California Pacific Medical Center, San Francisco

> > Cedars-Sinai Medical Center, Los Angeles

> > Childrens Hospital Los Angeles, Los Angeles

> > Loma University Medical Center, Loma

> > Rady Children's Hospital and Health Center, San Diego

> > Scripps Green Hospital, La Jolla,

> > St. Medical Center, Los Angeles

> > Stanford University Medical Center, Stanford

> > University of California at Los Angeles Medical Center, Los Angeles

> > University of California Medical Center, Sacramento

> > University of California Irvine Medical Center, Orange

> > University of California San Diego Medical Center, San Diego

> > University of California San Francisco Medical Center, San Francisco

> > University of Southern California University Hospital, Los Angeles,

> >

> > This listing was provided by UNOS.

> >

> > MaC

> >

>

December 5, 2008

yeah, Dr. Tung did say he would reffer her to a transplant team, but

they would almost definatelly tell her the same thing, so he didn't

reffer her. i don't know, my mom swears by kiaser, " been there for

years " yada yada, but i am trying desperately to get her to drop them

and try something different. it is so frustrating watching all this

happen to a loved one and being so helpless. thanks again all!!

> >

> > Do you know the name of the medical center? There are hundreds of

> Kaiser facilities in LA, and none that I know are transplant

centers

> but I could be wrong. Below are the list of Liver Transplant

Centers

> in California. Was she referred to one of these for a transplant

> evaluation? If not, then I would have to question the doctor who

said

> she wasn't a candidate.

> >

> > California Liver Transplant Centers (No particular order):

> > California Pacific Medical Center, San Francisco

> > Cedars-Sinai Medical Center, Los Angeles

> > Childrens Hospital Los Angeles, Los Angeles

> > Loma University Medical Center, Loma

> > Rady Children's Hospital and Health Center, San Diego

> > Scripps Green Hospital, La Jolla,

> > St. Medical Center, Los Angeles

> > Stanford University Medical Center, Stanford

> > University of California at Los Angeles Medical Center, Los

Angeles

> > University of California Medical Center, Sacramento

> > University of California Irvine Medical Center, Orange

> > University of California San Diego Medical Center, San Diego

> > University of California San Francisco Medical Center, San

Francisco

> > University of Southern California University Hospital, Los

Angeles,

> >

> > This listing was provided by UNOS.

> >

> > MaC

> >

>

December 5, 2008

Just talk to your Mom and ask that Dr. Tung follow up with his/her initial

referral. What would it hurt? Just because he thinks one thing doesn't mean

another doctor will not think something different. That's why there are so many

different doctors. :-) I can only assume Dr. Tung is imposing his

values/beliefs and not thinking objectively, nor looking for the long term well

being of his/her patient.

Ok, this may be a separate issue, but I bet, he is making referrals to co

workers for tests, exams, etc. See, they will keep treating her, referring her,

to other doctors within the hospital without really furthering her care. That

way, they keep charging the insurance.

My wife was charged for an office visit and treatment for a hemotologist (blood

doctor) while she was in a coma. I saw him come in, he looked at the chart,

shook his head and left. My insurance paid him $169 for an office visit because

he was referred by her doctor. Why would she need a hemotologist at that point?

She didn't but even if she did, he didn't do anything. But they got $169 out of

the insurance company and all he did was walk in shake his head and leave.

Didn't even acknoweledge me and I was 2 feet away. I bet hospitals scam

insurance all over the US doing this. Especially to critically ill and dying

paitents when family are too distraught to make heads from tales. When bills

come in months later they can't remember and assume it was legitimate.

I have even had the a bill collector come after me for money because the doctor

was charging my wife for an office visit three days after she died. I didn't pay

by the way. I won that one.

Needless to say, I don't trust " corporate " doctors.

MaC

jason wrote: yeah, Dr. Tung did

say he would reffer her to a transplant team, but

they would almost definatelly tell her the same thing, so he didn't

reffer her. i don't know, my mom swears by kiaser, " been there for

years " yada yada, but i am trying desperately to get her to drop them

and try something different. it is so frustrating watching all this

happen to a loved one and being so helpless. thanks again all!!

> >

> > Do you know the name of the medical center? There are hundreds of

> Kaiser facilities in LA, and none that I know are transplant

centers

> but I could be wrong. Below are the list of Liver Transplant

Centers

> in California. Was she referred to one of these for a transplant

> evaluation? If not, then I would have to question the doctor who

said

> she wasn't a candidate.

> >

> > California Liver Transplant Centers (No particular order):

> > California Pacific Medical Center, San Francisco

> > Cedars-Sinai Medical Center, Los Angeles

> > Childrens Hospital Los Angeles, Los Angeles

> > Loma University Medical Center, Loma

> > Rady Children's Hospital and Health Center, San Diego

> > Scripps Green Hospital, La Jolla,

> > St. Medical Center, Los Angeles

> > Stanford University Medical Center, Stanford

> > University of California at Los Angeles Medical Center, Los

Angeles

> > University of California Medical Center, Sacramento

> > University of California Irvine Medical Center, Orange

> > University of California San Diego Medical Center, San Diego

> > University of California San Francisco Medical Center, San

Francisco

> > University of Southern California University Hospital, Los

Angeles,

> >

> > This listing was provided by UNOS.

> >

> > MaC

> >

>

December 6, 2008

Well, he didn't take into account what a scrapper you are, and doesn't know you

are stubborn, so here you are, and I'm glad he was wrong! Love, Bobby

Sent via BlackBerry from T-Mobile

Re: Re: MELD score

6 years ago a gastro told me I had 2 to 3 years to live. ooooops he was

wrong. I am still living. Jan H

> Then I would bring up the question about her being referred to a

> transplant team at a transplant hospital for an evaluation to be put on the

> transplant list. Only the transplant team can say no. Not the gastro doc. He

> isn't the deciding authority and doesn't make those decisions. he only makes

> the referral for the evaluation. It's only HIS opinion that she's not a

> candidate and he may be right and he may be wrong, but he's not the final

> say.

>

> The squeaky wheel gets the oil.

> MaC

>

> jason <pcexetra@... <pcexetra%40yahoo.com>> wrote: i guess it wasn't

> a transplant center, it was a kiaser facility that

> has a gastroenterologist/transplant specialist in staff. i think his

> name was Dr. Jim Tung, or something like that.

>

> >

> > Do you know the name of the medical center? There are hundreds of

> Kaiser facilities in LA, and none that I know are transplant centers

> but I could be wrong. Below are the list of Liver Transplant Centers

> in California. Was she referred to one of these for a transplant

> evaluation? If not, then I would have to question the doctor who said

> she wasn't a candidate.

> >

> > California Liver Transplant Centers (No particular order):

> > California Pacific Medical Center, San Francisco

> > Cedars-Sinai Medical Center, Los Angeles

> > Childrens Hospital Los Angeles, Los Angeles

> > Loma University Medical Center, Loma

> > Rady Children's Hospital and Health Center, San Diego

> > Scripps Green Hospital, La Jolla,

> > St. Medical Center, Los Angeles

> > Stanford University Medical Center, Stanford

> > University of California at Los Angeles Medical Center, Los Angeles

> > University of California Medical Center, Sacramento

> > University of California Irvine Medical Center, Orange

> > University of California San Diego Medical Center, San Diego

> > University of California San Francisco Medical Center, San Francisco

> > University of Southern California University Hospital, Los Angeles,

> >

> > This listing was provided by UNOS.

> >

> > MaC

> >

>

December 6, 2008

OMG, they did this to me, too!! I got a call from the doctor who " sees " the

patients at poplar grove nursing home (now defunct) and they asked if I would be

paying the bill for ms ? I said " sorry, ms is with Jesus, but I

guess you could try her there if you really want- " hah. Then I said, " by the

way, since the fine doctor never actually " saw " her, and I found out later that

chole styramine has to be used with great caution in patients with hepato-renal

syndrome, and he didn't even have them check her hydration, I think I might add

the doctor to my complaint to the state of Colorado which was doing an

investigation into allegations that they had continually fed her gluten, despite

my providing them with strict and specific instructions, AND all of her gluten

free pasta, and quinoa flour, and rice flour,rice and potato flour pancake mix,

that came from her apartment etc. They got real quiet on the phone, and I never

heard from them again, but the state of Colorado dept of health complaint went

in their file as a citation. So she did get Justice in the end. B.