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Annie20

Ulcer and Calcinosis

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Hi Everyone,

 

I have an ulcer on my right hand, index finger on knuckle which has lead to a calcinosis, (same finger), which has become abscessed on pad, it's becoming bigger. I went to see my internist today which I had scheduled to see her a couple months ago. She prescribed an antibiotic hoping the calcinosis will shrink and go away. I need to call this Friday. She said if the antibiotics do not work, the calcinosis will need to be cut.

 

She said if it's done in the office, even having it froze, it will hurt like the dickens! Not sure what hurts more the ulcer or the calcinosis! :wacko: Well..... even if I slightly bump the calcinosis, or touch it, it hurts!!!!!! And then she suggested that I could have it surgically opened and be under anesthesia.

 

I hate to pay a lot more money if I have it surgically opened having to pay for the surgeon and anesthesiologist, but then I do not want to be in so much pain that I cannot tolerate it. My husband Mike said it would be covered under insurance, but not sure how much. My husband and internist were very understanding with how much pain I'm already in and they both said it was up to me.

 

My question is, should I endure the excruciating pain, save money, have it done in a doctor's office or should I have it surgically opened and be under so I don't feel any pain?

 

I even told Mike that I will be willing to pay him $500 in cash and not be in such unbearable pain to help pay for the surgeon and anesthesiologist.

 

I'm hoping the antibiotics will do the job, then I won't need to worry about this.

 

 

Annie :emoticon-insomnia:


Diffuse Systemic Sclerosis, (Scleroderma). Lung, skin and gastrointestinal involvement.

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Hi Annie,

 

I'm sorry you have an infected ulcer and calcinosis.

 

Are you sure you would have to pay more to have it surgically removed? Many insurance plans would very likely cover it completely (especially Medicare and most Medicare gap policies). Read your insurance policy and if necessary call them to clarify your coverage so you know exactly what the trade-off is, because it may be that you would owe nothing or much less than you think. Then again if you have rotten coverage, it could be way out of the ballpark, so you'd want to make sure your $500 offer would cover it.

 

Obviously, it sounds like your choice is to avoid as much pain as possible. That's a reasonable option and it's rather doubtful anyone would thus be able to convince you to go through the merciless infliction of unnecessary pain.

 

Here's a hug for you, along with hopes it will clear up on its own.

 

:emoticons-group-hug:


Warm Hugs,

 

Shelley Ensz

Founder and President

International Scleroderma Network (ISN)

Hotline and Donations: 1-800-564-7099

 

The most important thing in the world to know about scleroderma is sclero.org.

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Hi Annie,

 

I am so sorry to hear that your ulcer and calcinosis are still giving you such a lot of pain.

 

We have a different system in the UK, but the same dilemma would occur if I wanted to have something done privately, as opposed to under the NHS (National Health Service).

 

I don't have any more advice to offer, but I do hope that the anti-biotics clear it up and you start to feel better very soon. :emoticons-group-hug:


Jo Frowde

ISN Assistant Webmaster

SD World Webmaster

ISN Sclero Forums Manager

ISN News Manager

ISN Hotline Support Specialist

International Scleroderma Network (ISN)

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Hi Annie, sorry you're suffering so, I'll hope too, that the antibiotics will do the job and you won't have to decide which route to go surgically.

 

I do understand your dilemma, it's very difficult that some insurance company plans are arbitrary as to what and how much they cover. I agree with Shelley, a call to your insurance carrier, to get an exact $ amount as to your cost, is in order. Then you can make a more informed decision. Although if I were in your shoes, I'd opt for the less pain method, even if that meant I needed to give up some things and be extra frugal for awhile to pay for it.

 

It was great chatting with you last week, am looking forward to this Friday so we can connect again! :emoticons-group-hug:

 

Red

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Hi Annie

 

I too am sorry to hear you are still in so much pain, fingers, eyes, and toes crossed that the antibiotics work and things start getting better.

 

Are there no other types of local anesthetic that they could use in place of the full anesthetic and surgery? I had my carpal tunnel surgery done years ago and was given a twighlight (not sure on spelling) sleep and it didn't cost that much as you are never under completly. They then injected me with lots of numbing stuff in my wrist, and because of the twighlight sleep, I only felt a slight pinch from the first needle. I had this done as well when I had my wisdom teeth out. Im not sure if it is an option for you, but it did make my procedures easy and pain free. Of course until all the numb juice wears off!

 

Sending you some soft hugs, and hoping things go much better for you.

 

:emoticon-hug:

 

Cheers

Jean

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Thank you very much Shelley, Jo, Jean and Red for your responses. :thank-you-2:

 

Mike will be looking into how much our insurance will cover, but he said it doesn't matter what the coverage would be. He does not want me to be in any unnecessary pain. The $500 I mentioned was just a ball park figure. My guess without insurance would be around $1,500 - 2,000, surgeon and anesthesiologist. My husband said, do not worry about the money, I will take care of you. Well, he has proven that to me in the 30 years I've known him. :happy1-by-lisa-volz: I do have a gem of a husband, that's for sure.

 

Take care and :emoticon-hug: ,

 

 

Annie


Diffuse Systemic Sclerosis, (Scleroderma). Lung, skin and gastrointestinal involvement.

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I've had surgery for calcinoses on the fingers.

I can't imagine thst they would even consider doing it without anesthesia. That would be monstrous.

 

Mine were done by a family practice physician (not even a surgeon or rheumatologist). He anesthetized the finger with lidocaine injection, then cut it out with an instrument with a tiny scissors-like jaw. Nothing more than an extended regular doctor visit. Most dental work is much more complicated, and doesn't require a separate anesthesiologist! Why an anesthesiologist? The doctor can't give a couple of lidocaine injections, like dentists (and many non-anesthesiologist doctors) do all the time?

 

In my case, the surgery did not completely eradicate the calcinoses, but removed most of it. Most importantly, it removed all of the pain.

 

I'm astonished that these doctors make such a big, expensive deal out of something that is simpler than filling a cavity, or suturing a small wound.

 

Just my 2 cents. Good luck,

 

Craig

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Hi Craig,

 

Thank you for replying.

 

I chose not to have the procedure done in the doctor's office. The internist said it would be numb, but I still would be in extreme pain. My pain tolerance is very low. If I bump or press on the calcinosis, it hurts tremendously. (It has become bigger.) I do not want to subject myself to anymore pain than is necessary.

 

I'm under my husband's insurance which will cover some of the cost of surgeon & anesthesiologist. Thank goodness!

 

I'm happy you're not in any pain. You must have a high tolerance for pain. Take care :)

 

Annie


Diffuse Systemic Sclerosis, (Scleroderma). Lung, skin and gastrointestinal involvement.

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I don't understand why you would feel pain. With the finger anesthetized with lidocaine, there is no pain during the procedure.

 

Craig

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Hi Annie,

 

Craig mentioned that with the finger anesthetized, there is no pain during the procedure. I have to agree with this, as I've had all sorts of work done in office with no pain whatsoever at the time. Afterwards, well, that is a different story entirely when the meds wear off.

 

But, and here is a big BUT, there is absolutely no pain at all involved in getting an MRI, either. I merrily have them with no worries at all, in fact, nearly falling asleep. But I know people who totally freak out over them and need to be sedated -- even though, mind you, they aren't even being physically hurt at all. And I think this is where you're coming from; you don't want to be awake while they do whatever they do, and you don't want to endure even the slightest pain, even if it is accurately couched in terms like "pressure" or "this is just a pinch."

 

Since anxious people are rightfully sedated for MRI's, which inflict no physical pain at all, there are certainly grounds to choose to be out when you know you may not be up to enduring the psychological effects of even remotely possible pain (or the sight of blood) during the procedure. I say, if it is an option for you, medically and financially, then hold your head high and insist upon it. It doesn't make you a "baby" in any way, it just means you are drawing the line where it feels comfortable and safe, for you.

 

:emoticons-group-hug:


Warm Hugs,

 

Shelley Ensz

Founder and President

International Scleroderma Network (ISN)

Hotline and Donations: 1-800-564-7099

 

The most important thing in the world to know about scleroderma is sclero.org.

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One other thought might be an anti-anxiety drug, if the idea of the surgery bothers you even when anesthetized.

 

I mention this because I have had several bronchioscopies, where they put tubes down your nose while conscious. When it was first described, my attitude was "I don't think so!", but with the anti-anxiety drug, it didn't bother me at all. Even though awake, I was too dopey to be bothered.

 

Craig

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Hi Annie,

 

Please know that I must agree with Craig, especially since he has first-hand knowledge about these procedures, so he's not talking out of school.

 

I DO appreciate how you must feel ie: Low pain tolerance, likely fear of the "unknown" and basing your decision on the fear the lady doctor (apparently) instilled in you :o during your visit with her.

 

My husband doesn't do very well, when it comes to some procedures. Therefore, he is given a medication that relaxes him to the point they could do whatever they wanted and it would be fine with him!

 

Please rest assured that you aren't the FIRST person to feel this way and I'm POSITIVE you won't be the LAST, either.

 

So, my friend, know that :emoticons-i-care: and hope that all of this will ease your mind.


Special Hugs,

 

Susie Kraft

ISN Support Specialist

ISN Chat Host

International Scleroderma Network (ISN)

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Hi Craig, Shelley & Susie,

 

Thank you very much for your reassurance. It means so much!!!

 

On Monday, I will be having a consult with the hand surgeon. He may just as well advise me to have it done in the doctor's office. However, I need to know that I would be in no pain whatsoever.

 

When it comes to non-invasive procedures such as m.r.i.'s, cat scans, x-rays,seeing blood, etc....I have no anxiety. But when it comes to blood draws which I have a great fear of because I've had such horrible experiences and pain related, then I begin to feel worried and beside myself-not a good thing. Craig, I was not aware there was such a med for anti-anxiety. I may need to check into it. Thank you! The internist said it would be numb, but I would still feel pain, I'm happy she was forthcoming, not sure why it wouldn't be totaly anesthetized with the lidocaine. hmmmmm?

 

Will update you all after talking to the hand surgeon on Monday. :thank-you: means a lot.

 

Annie


Diffuse Systemic Sclerosis, (Scleroderma). Lung, skin and gastrointestinal involvement.

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I had one removed from the fold under a knuckle. It was done in the hand surgeon's office with a local. The surgeon said it was tricky due to a nerve that ran right next to the spot but it was totally pain free. I wasn't even aware of when the doctor finished til he showed me the thing. I even sneaked a peek (very briefly) while he was working.

I have also had another one taken out with a general anesthesia and I can honestly say it was not worth the bother.

Both ways had some pain when the meds wore off but even that was not as bad as I was expecting.

Whatever you choose to do, I wish you every success.

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Hi Enjoytheride,

 

Thank you for the reassurance, means so much!

 

It'll be interesting to see what route the hand surgeon will take.

 

Craig, I forgot to mention in my last post, I love your profile pic of your puppies, they are so cute!!!! What breed are they and what are their names. I have a 10 yr. old female Yellow Lab, named Sunny.

 

Take care :VeryHappy:

 

Annie


Diffuse Systemic Sclerosis, (Scleroderma). Lung, skin and gastrointestinal involvement.

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