Friday, August 24, 2012

UCLA is a long way away

My insurance plan authorized me to see a Neurotologist at UCLA.  I looked up Dr Gopen, both his website at UCLA and on Healthgrades.  He gets high marks.  A young guy who somewhat resembles Dr Hegarty.  This will probably be ok but it is nearly 4 hrs away.  I have a 9am appt so I will either have to get up really early or drive down the night before. My hearing has been down.  I  had a little improvement with the steroid blast/taper but the last couple of days have been poor.   I went to Costco to get my HA adjusted.  Added a program with just a little more volume.  I'm having trouble hearing a few people at work.    This is frustrating.



Tuesday, August 14, 2012

Dr Sajjjadi-Neurotologist

From: Hamed Sajjadi [mailto:drsajjadi@earandsinus.com]
Sent: Saturday, August 04, 2012 5:50 PM
To: Muratet, Alan - AGCH
Cc: Leslie Gutierrez; Vanessa Castro; Azar Sajjadi; Ali Sajjadi
Subject: Re: Urgent

Dear Alan,

I'm a Board Certified Neurotologist with special interest in Meniere's Disease and over 20 years of experience. I do give Intratympanic high dose steroid perfusion for Meniere's Disease. Our office is located in San Jose, near the city of Los Gatos. You could call our office and make an urgent appointment to see me this week.

However, as you may have been told in the past, there is no guarantee that steroid perfusion will restore hearing in Meniere's patients. I offer this method frequently to our patients, but data on it's efficacy is not conclusive and experts differ on it's value. Even though it seemed to have helped you in the past, it may not work for you this time around.

Meniere's disease is a very unpredictable disease, with natural fluctuations in hearing. Often times, one treatment or another may "coincide" with a hearing gain or drop, even though it may not have been a cause and effect relationship.

Having said that, you could receive ITT Dexamethasone at my office this week if needed. You would have to do the following:
1. Call 408-358-8507, after 9 am on Monday and ask for an urgent appointment with Dr. Sajjadi
2. Bring all your old records dealing with Meniere's Disease, i.e., any Hearing tests, CT or MRI's, ENT/Otologist office notes, etc.
3. Purchase high concentration Dexamethasone at our compound pharmacy, Silicon Valley Pharmacy on Winchester Ave, in Los Gatos. The pharmacy would charge you about $200 for a multidose vial, which would be good for at least 6 injections.
4. If you have no insurance, then be prepared to pay cash for the office visit and any perfusion sessions.Please discuss the cash price with my office when you call on Monday. You would need to ask the cost of a new patient Consultation, Audiogram and Middle ear perfusion. The first visit would take you 2.5 hours. Follow up visits are shorter and less expensive. Each follow up perfusion session lasts 45" or more.

I hope this information helps. Please let us know what we can do to help you.

Best wishes,

Hamed Sajjadi, MD, FACS
Clinical Associate Professor,
Otology / Neurotology - Skull Base Surgery
Stanford University School of Medicine
President, San Jose Ear & Sinus Medical Center
408-358-8507
Fax: 408-358-8506
hsajjadi@ohns.stanford.edu
www.earandsinus.com
On Fri, Aug 3, 2012 at 2:46 PM, Muratet, Alan - AGCH <Alan.Muratet@dignityhealth.org> wrote:
I am recently relocated to the San Luis Obispo area.  I have had intratymp injections of dexamethasone from my former Neurotologist and I had improvement in my hearing.  I saw a local ENT on my insurance this week and my audiogram is way down from the last time.  The physician I saw does not do IT injections and I have not been able to find one in the area or on my health plan that does. 
I was receiving great care and preserved my hearing up to this point.  I am only 52 and still need to be able to hear.   I called my former physician in Colorado and he agreed to order a Prednisone blast/taper over the phone.    He has had me on Diamox and Lasix for 6 months. 
Can you provide IT steroids and care for my Menieres?   I am willing to be a cash pt initially. 
Please get back to me as soon as possible.  I fear that if my Menieres is left untreated, I will certainly go deaf in that ear. 

Alan Muratet
RN, Clinical Documentation Specialist
Arroyo Grande Community Hospital

Dr Stewart

    Went to seean ENT on my health plan.  I had my doubts going in.  Dr Stewart said plainly on his website that his interest was neck surgery.  I called every ENT doc on the central coast, including some that were not on my health plan, to verify if they offered the services I was receiving from Dr Hegarty.  None of them did.   But, I gave my insurance plan a shot.

Dr Stewart didn't even look at my audio until I brought it up near the end of the visit.  He had his agenda and it didn't include treating me with an  aggressive bent towards preserving what function I had.  In fact, he suggested we go ahead and do the Gent injection to kill the ear.  He focused on my least problematic symptom, the vertigo.  He said that IT steroid injections are not proven to work (inconclusive results
on that one.  It did work for me so that is 100% success rate).