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Germany and Payment Choices
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03/10/2011 04:33
Cyclist 
03/10/2011 04:33
Cyclist 

Re: Germany and Payment Choices

Chobe2:
Thank you all!

LubaM - Thanks for the Capitol One credit card tip. I just applied, got approved, and now will keep my fingers crossed that I get the card before we leave. Otherwise, I guess I'll be using a debit card. But even if I don't get the Capitol One card in time, it will come in handy in the future - so thanks again.

Maddie - Sorry that we will miss each other! It would have been fun to meet for lunch or something. Have a very safe and enjoyable trip. Just curious...which hotel are you staying at? I just went with the Courtyard Marriott but it's a little pricey at $129 a night. We can cancel with no penalty so I'm still looking at other options.

Diane

Hi Diane
Good to hear your news!

I'm using a Travelex Visa Debit card - the card version of the previous Travelers cheques that you use exactly like a Visa debit card.

It's basically a pre-paid currency exchange card that you can set up instantly at any Travelex agency (includes many travel agencies). You can also purchase your card online, but it takes a few working days to receive your card in the post.

Once you get your card and set up your account, you can top it up online from anywhere in the world using your bank's BPay facility and there are banks everywhere in Hamburg that you can withdraw money from using the teller machines.

The only cost is the initial set up administration fee of about $10 (from memory) and a small fee when you withdraw funds (for Australians, it's about $2, but it varies across different currencies). If use it like a Visa card, the cost is the same as your Visa card. You can use this to pay at the clinic.

Shop around, each agency has a different exchange rate, and the Travelex online exchange rate is often better.

More for your trip!

All the best
Di

PS Some banks have a better exchange rate so you might want to exchange some cash there to take with you. Airports give the lowest exchange rates, so be prepare in advance!

03/10/2011 13:08
Chobe2 
03/10/2011 13:08
Chobe2 
Re: Germany and Payment Choices

LubaM.:
To those of you who have been to German for the RT treatments in Hamburg....

would you mind posting what the total expense of the trip was for each of the two sessions (including Dr. fees for the RT, flights, plus hotel expenses, maybe food?), and indicate what part of the US you live in (the cost would be different for flights from the East or West coasts).

It would be helpful in comparing to the cost in the US, especially for those of us who have Medicare if they stop paying for these treatments and we have to consider paying out of pocket in the future...

Thank you

When I return, I'll post all the costs. My husband and I are going to spend an extra few days but I'll take that in consideration and just break out the cost for the 6-7 days of travel and treatment. My airfare from Montana is $996.33 on Delta and 6 nights at the Courtyard by Marriott Hamburg for 2 is $830.88. I priced the Mercure Hotel and it was even a little higher.

I am planning on asking the Dr. if the second series of treatments can be done here in the states with the guidance of the information from the first round. Earlier when I spoke to University of Oklahoma they actually suggested that instead of coming to them, they could send the protocol to a radiation center closer to my home - maybe this would be a more affordable option for some of you??? Has anybody ever suggested this to Dr. S?

Diane

03/10/2011 18:10
Cyclist 
03/10/2011 18:10
Cyclist 

Re: Germany and Payment Choices

Chobe2:

When I return, I'll post all the costs. My husband and I are going to spend an extra few days but I'll take that in consideration and just break out the cost for the 6-7 days of travel and treatment. My airfare from Montana is $996.33 on Delta and 6 nights at the Courtyard by Marriott Hamburg for 2 is $830.88. I priced the Mercure Hotel and it was even a little higher.

I am planning on asking the Dr. if the second series of treatments can be done here in the states with the guidance of the information from the first round. Earlier when I spoke to University of Oklahoma they actually suggested that instead of coming to them, they could send the protocol to a radiation center closer to my home - maybe this would be a more affordable option for some of you??? Has anybody ever suggested this to Dr. S?

Diane

Hi Diane
I would make sure the other layers of treatment such as differences in delivery of the RT (e.g. equipment) and experience (i.e. less practise with this particular condition) don't make a contribution to the effectiveness.

I asked Prof S about having treatment here in Australia by a radiation oncologist taking an interest in this condition, and he said he wouldn't trust anyone else as he has developed his protocol and method and has had over a decade of experience and practise. However, he may have been mostly concerned about the different protocol. If you could find someone to follow his protocol exactly, you might just have to look at comparing the equipment and delivery as I believe radiation oncologists are very highly trained medical professionals - highly capable.

All the best
Di

03/10/2011 18:37
marjorieb 
03/10/2011 18:37
marjorieb 
Re: Germany and Payment Choices

I spoke with my Orthopedist about them doing the R.T.. He said they had tried it in the past and the results were bittersweet. They didn't want to try it again. He said I should either have it done in Germany, or see if my Hand MD and the Xiaflex rep wanted to do research with my feet. I'm sure he only suggested the last part, becuase I have worked with that group as a therapist, and he knows I can mae medically based judgements.
The reason I say this, is that I have high regard for this group of physicians. The fact they don't want to keep trying the RT, makes me feel that much more certain that the place to have it is Hamburg.
Beth

03/10/2011 19:11
Larry 
03/10/2011 19:11
Larry 
Good point of discussion ! Are the treatments competitive ? Or do they cooperate ?

Good point of discussion ! Are the treatments competitive ? Or do they cooperate ?

It is interesting, that I have never heard a critical word about surgery from my radiation therapist. Prof. Seegenschmiedt has compiled the literature data on the published reports about surgery effects and side-effects in his book chapter.

As far as I understood he was never "pushing" his approach using radiotherapy, but only stated in my case "... you have to await the right moment of "activity" ... but if the disease has progressed too far, the window for the use of radiotherapy may close rapidly. So stay alert !" In medicine we call this selection process of choosing the best treatment "the correct indication" which means the appropriate action in a pre-defined clinical situation.

So unappropriate use would be: to treat TOO EARLY , i.e. with no active cells in the plantar region, or to treat TOO LATE when the active cells have already gone and only scars remain, or treat TOO SMALL or TOO LARGE REGIONS of the foot because palpation or imaging was not well done or by unexperienced "hands" or "eyes" or with insufficient knowledge.

I clearly have seen my physician in radiotherapy to provide me an OPEN OFFER, but never as someone who has aggressively PUSHED THE METHOD of radiotherapy. I remember when I left the last time counselling about my newly affected hand he stated "When the window for radiotherapy closes, the door for surgery opens ... !" which did sound very kind an collegial to me !

I honestly hope that at a certain point within the next years the different disciplines in medicine have discovered the chance of "cooperation",even for Ledderhose and Dupuytren's Disease!

Larry

Edited 03/10/11 21:15

03/10/2011 21:26
Cyclist 
03/10/2011 21:26
Cyclist 

Re: Germany and Payment Choices

Hi Larry, Diane and Beth
I didn't get the impression that Prof S was pushing his own agenda either. He advised me in Jan that I will need to seek RT in the next few months, to avoid painful surgery as the nodules were quite large and progressing quickly. It was my decision to weigh up the pros and cons of RT and surgery (and of course the cons of surgery definitely outweigh the pros).

Australia and some other countries are reforming their health systems in ways that will gradually bring a more collegial approach to the health professions. Unfortunately it will probably take a whole generation for health consumers like us to start to see the changes as the various health disciplines like to hang on to their health territory.

Apparently in the US the IT developments in health are showing huge potential in making a difference in terms of how health professionals are communicating and collaborating. Right here in front of us, we see how we are benefiting from this website, one example of how technology can bring positive changes to our health. It'll be interesting to see how things shape up over the next 20 years.

A few musings from a very over-tired LD sufferer (working in the health field) ... hopefully getting better soon.

All the best
Di

Larry:
Good point of discussion ! Are the treatments competitive ? Or do they cooperate ?

It is interesting, that I have never heard a critical word about surgery from my radiation therapist. Prof. Seegenschmiedt has compiled the literature data on the published reports about surgery effects and side-effects in his book chapter.

As far as I understood he was never "pushing" his approach using radiotherapy, but only stated in my case "... you have to await the right moment of "activity" ... but if the disease has progressed too far, the window for the use of radiotherapy may close rapidly. So stay alert !" In medicine we call this selection process of choosing the best treatment "the correct indication" which means the appropriate action in a pre-defined clinical situation.

So unappropriate use would be: to treat TOO EARLY , i.e. with no active cells in the plantar region, or to treat TOO LATE when the active cells have already gone and only scars remain, or treat TOO SMALL or TOO LARGE REGIONS of the foot because palpation or imaging was not well done or by unexperienced "hands" or "eyes" or with insufficient knowledge.

I clearly have seen my physician in radiotherapy to provide me an OPEN OFFER, but never as someone who has aggressively PUSHED THE METHOD of radiotherapy. I remember when I left the last time counselling about my newly affected hand he stated "When the window for radiotherapy closes, the door for surgery opens ... !" which did sound very kind an collegial to me !

I honestly hope that at a certain point within the next years the different disciplines in medicine have discovered the chance of "cooperation",even for Ledderhose and Dupuytren's Disease!

Larry

03/11/2011 02:44
marjorieb 
03/11/2011 02:44
marjorieb 
Re: Germany and Payment Choices

I was not intending to sound as if my orthopedic MD was against R.T.. He was only saying they didn't succeed in his group. He did not say I shouldn't go to Germany.

I'm sure they would love to try Xiaflex on feet. Since I have a relationship with them, and predominantly have cords, and very small nodules it makes me look like a good prospect for that.

I still want to think the best of the medical folks, that they do want to work together for the best of the patients. That has always been my experience.

Of course, it is human anture to think that our chosen path is the best answer.

My 'surgeon' was very upfront about telling me that he would not choose surgery for his own feet, unless it was impossibble to walk otherwise. He's a very trustworthy man. (Has operated on my daughter, and just operated on my son today).

Beth

03/11/2011 12:23
David26

not registered

03/11/2011 12:23
David26

not registered

Re: Germany and Payment Choices



I am planning on asking the Dr. if the second series of treatments can be done here in the states with the guidance of the information from the first round. Earlier when I spoke to University of Oklahoma they actually suggested that instead of coming to them, they could send the protocol to a radiation center closer to my home - maybe this would be a more affordable option for some of you??? Has anybody ever suggested this to Dr. S?

Diane

Diane,

I think that is a really good idea and something that should be explored. I know my treating radiologist reviewed some of Prof S's publications before treating my hands the first time. She was very open to his ideas and protocols and would be happy to retreat the second round based on what information was brought back as you described above.

Yes, of course, there are other issues and it isn't as cut and dry as replicating the first treatment but it is a far more convenient and affordable option for those of us who have insurance that will cover RT.

I am interested to see what he says about this. Thanks for bringing it up.

David

03/19/2011 09:25
Larry 
03/19/2011 09:25
Larry 
Re: Germany and Payment Choices

Hi David26,

The RT protocol is ONE ASPECT, the SKILLS TO EXAMINE and choose the right areas to treat is another aspect, but probbaly the MOST IMPORTANT one, as it will finally decide whether your treatment is successful or not.

So find the THE MOST EXPERIENCED DOCTOR !

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