The USA is extremely backwards and behind on dealing with incontinence.

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My (partial) story:

I do have a serious mental illness that I take a lot of different medication for. I also have accident problems. When I told my pdoc about it he recommended that I go to the doctor to seek help. I was worried that I might have some kind of cancer (prostate or colon).

First I went to a specialist to have a colonoscopy done and everything was fine. On my next appointment the doctor talked about changing my diet on wanted to put me on some kind of medication. There was no talk on how to manage my incontinence he just wanted to try medication. I do not want to take more medication I am already taking enough believe me.

Then I went to another specialist to exam my anatomy because I was scared I might have prostate cancer or something. By then I was doubling and tripling regular underwear and wearing Dickies pants so nothing would show. When he examined me my underpants were soaked. Why was I not offered some kind of absorbent product at the doctor's office or even given me advice on how to manage this? All they did was give me Flomax and then something else. More medication. That's it.

If you look at the internet in the UK and Australia people are given a lot better help for these issues. I have had to learn how to manage this all on my own even though I have gone to the doctor. The U.S. needs to catch up on helping people with incontinence issues. I guess doctors are either afraid to bring up the subject of using absorbent products or because they can't make more money off of you for wearing something for management they don't offer any help at all. I have had to learn about all of this on my own, no help from the doctors.

 

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My best source of help for me has been from the nurses who run the continence service and my own GP. The urology team only seem to be interested in surgical procedures. Phil

 

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Right, that's the UK. We don't have a "continence service". We don't have anything.

 

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It does seem odd that a population as large as the US doesn't have a continence service. Does it vary from state to state? Phil

 

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Hello and I’m sorry your having such a hard time with this all!! This is been the typical response for most of us from doctors or other medical staff!! They love the push pills and procedures but not very often do they mention products for management I’ve learned all of my tricks on the go Lol

 

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No there is nothing like that here. You have to go out cover your eyes and pick a Urologist specialist and a GI doctor. "Cover your eyes" because you don't have any idea what the doctor is going to be like.

Also I think there has to be a revenue stream attached to your condition. So all they are doing is trying to get you to have surgery or take more medication so you are spending money on healthcare end everyone makes more money for the condition that you have. That is the type of "help" we get in the U.S.

 

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@Coolwinter123 our system is paid for by taxes, it is slow, but everyone gets a chance for treatment. I am pleased with the system apart from the waiting time, typically 2-3 months for a hospital appointment, Phil

 

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I have the same view Coolwinter, a jaundiced view of the shift from NOT treating the person, but the patient, its about the insurance, what it will pay. A compassionate doctor could at least explain products that are available through medical supply companies and a site like this one by googling it while you are at the office, knowing you need rx for mental stability, they could go that extra humanizing mile.

 

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physlink I'm sorry I think because of the way I wrote that you thought I was addressing you and your countries health system. When I said "your" I was referring to "me". I should have read that and worded that differently.

You're very lucky to live in a place where there isn't a "revenue stream" attached to you and your care is not based upon how much money they can make off of your condition. I wish our health system here is more like yours.

 

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@Coolwinter123 no need to say sorry, I hadn't noticed.

It would be interesting to compare the finances of the two systems. It is all a bit unclear, but I think I pay about 12% of my earnings for our system.

 

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Phil, make no mistake. We are always glad to have the point of view from across the pond and would gladly accept input from Russia too if Alas south can see it from his front porch, semaphore that!) In other words, all are welcome as we struggle here.

 

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@Maymay941 I don't have any idea how health care works in the US. Does everyone need to have insurance? Do you pay for what you use? Is it different in each state? Just curious, Phil

 

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Unless you are poor or rich you are on your own. There is nothing. American is every man for Him or herself, which is fine in some cases but does not work for healthcare.

In my situation, I am very lucky, especially with my mental health issues, to have a decent job in which I am provided with good insurance. But just having insurance isn't enough. As I said these doctors are only in it for the money they can make. Doctors are among the most wealthy people here. Your treatment has to be something from which they can make money on. (surgery etc)

I am very lucky to have the insurance I have. In many jobs because health insurance has become so expensive, people have money taken out of their paycheck into a "medical savings account" with which they can use to pay their expenses until they reach their deductible which is usually $2,000 - $3,000

This means it costs them $100 - $150 just to visit a family doctor with which they pay with the money that is taken from their paycheck. And it costs more to go to a specialist.

In my case I have a really good job with "real" insurance. When I go to the doctor it is only $25. My medications are also covered by my insurance. When I am put in the hospital I have to pay 20% of the cost. My insurance covers the other 80%.

 

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@Coolwinter123 thanks for the summary, I didn't realise that it is so complex, cheers Phil

 

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Yep good explanation. And if you don’t have health coverage we are fined on our taxes we pay each year...and the coverage still keeps getting lower and lower for less actual care. I found out I can use the GoodRx app and get most of my lower price scripts there for less than my health insurance that tries to make us use OptumRx.

 

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I didn't know that. Thanks for the info! I'm going to def look into that.

 

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Phil i might not be totally accurate in my representation of this but heres a try.
People of very low income at poverty level can apply to the government for a national basic assistance program called medicaid it provides a low but basic coverage for everything. It can cover some portion of prescription drugs of the most generic type. It will not provide options when an operation is necessary, for instance when a tooth has a cavity it will pull the tooth rather than fill it. It can be accessed for children whose parents cannot afford insurance. One must apply to the office of Welfare that oversees poverty stricken and unemployed
People and every asset and savings or income that you have is calculated to see if the individual is poor enough. Many people make just a little over the poverty line so are denied and even though employed or between jobs but with assets are denied thus creating a large pool of heslth uninsured "scrapping by" pay check to pay check praying they dont need to see a doctor.
Then for people 65 or older there is medicare which again is a minimal level of insurance to reduce prescription costs and hospitalized costs but does not cover all an elders medical bill, it just insures the medical facilities and pharmaceutical
Companies get paid a portion of their bills should the elder reneg on the remainder of the bill or die and have no assets to seize.
Most working people take insurance through their work place at a monthly cost out of the paycheck and they decide how fancy an insurance they want to pay for. Depending on each employer, the insurance quality and cost to employees varies greatly. Some companies have in house matching savings plans for a medical emergency savings account, some not, but the number of family members covered and the quality of the treatments available vary by insurance company the workplace contracts with and the amount of money the employee is willing to forgo to treat their medical issues. So a good insurance plan is a part of the idea of an employee paycheck. You might make a bigger salary but have a larger insurance payment than some one paid less in a different company who has a better insurance! There was a nationwide national health care program set up a few years ago by President Obama that forced every uninsured American to pay a monthly premium to private insurance companies and get the level of health care according to the level they paid for. This was a debacle as poor working people had to pay monthly money they did not have and got no better service than if they had no insurance but needed a fairly routine assist at a doctors office. Prior to the Healthcare marketplace a sick poor person had access to a walk in clinic pay as you go type place for minor stitches to an injury or a child with an earache or a visit to an emergency room, which could be paid in tiny monthly installments if it had come to that.
I myself bought into this national health care and paid for the most expensive program because i was told it would pay for a needed surgery. I was told by the general physician of my choice they did not accept the national version of the private Insurance company. They accepted only the employee employer version. I went back to my low cost state subsidized clinic Doctor who was otherwise a snid patronizing individual but I got a referral for a specialist from them. The day before my consult with the specialist i was called and they also said they did not accept the national healthcare arm of the insurance company.
So. Clear as mud, right?

 

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Wouldn’t it be great if the healthcare prices all dropped so people could actually afford the care they need. I would love to see that day happen for everyone on a global scale. Too much suffering and needs locally and everywhere else. There has to be some way to let folks get decent care without them deciding do I buy insulin or be able to eat. Crazy and unfair world.

 

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@Maymay941 wow, even more complicated than I thought.

On reflection, our system isn't quite as simple as the government would have us believe. We pay a bit towards drugs unless we have an exception certificate. The same applies to dental care, optical care and hearing care. Some services like our continence service is covered by taxes but is only available to people like me who have a condition confirmed by a hospital. waiting lists vary from hospital to hospital. Some treatments like the Botox I had recently is only available at certain hospitals who bid for money to provide the treatment. Some services like end of life care is partly paid for by charities. Something like the air ambulance service is totally covered by charity.

I could go on, but I think this is enough to show that our system has its complications too.

Cheers Phil

 

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Flomax

was useless for me, probably because according to my urologist my prostate is fine (thankfully).

Doctors here are programmed to give you drugs when you present with a problem. Sometimes I would just like to here that "Nothing serious is wrong" and be sent on my way. Or be offered non-pharmaceutical treatments such as diapers. That's not the way they do things though.

My doctor had given me a drug, duloxetine, that was supposed to help with depression and back pain, or so my doctor said. It's didn't help with either. I had to fight to get off it (I could have just stopped it, but I try to do things the right way). I personally don't want to take anything I don't need or that doesn't work. Sometimes I think my doctor likes to pull a placebo effect on me by telling me something will work better than it really will. In any case when the patient says "it's not working" the pill should stop unless there is a measurable reason (blood pressure, cholesterol, etc) not to.

@Coolwinter123 fight for what you need, even if you shouldn't have to.