medical care in Moscow

[mervin]

Hello everyone. I'm new to this forum (as a registered member), but been a long time reader. I've been a member on rwguide for a while but I decided to get involved here too.

I'm looking for someone who can elucidate on the state of health care in the city of Moscow. A very close friend of mine has been diagnosed with wet AMD. That is, wet macular degeneration. She's 28 and she was diagnosed with this about a year ago. To say that she has a rare disease is an understatement. Normally, people don't get AMD until they're in their 50's at the least. It's gotten steadily worse over the last year, even though she's undergone laser surgery a few times. She's now being told that she should take invalid pay, which means she'll have to quit her job. She works for Megafon, and most of her job requires her to sit in front of a computer all the time - which is a big hazard if you've got macular degeneration. Moreover, there is not cure for macular degeneration, so she's in a serious state of depression with the recent changes in her life.

First, I'm curious as to what it means when a person accepts invalid pay? I personally don't think it's a good idea for her to take it, but I'm certainly no expert on the situation.

Second, what is the level of competence of the average physicial in Moscow? Guzel tells me that the specialist she's seeing was recommended by a few people. I've been to Moscow before, though I can't say I've experienced their level of medical care. Personally, I don't have much faith in it, regardless of the fact that it's Moscow. I'm hoping someone can tell me that I'm wrong, and that she's getting good, competent medical attention.

[Lily]

Terrible story 

First and foremost your friend have to seek legal advice.

I doubt it that she HAS to quit her job. Her employer is definitely interested to get rid of such employee asap, but for her accepting invalid pay and quitting job would mean starvation.

Probably there are ways for her to get her sickness certified as not prohibitive for work, and that Megafon is likely to have another position for her to continue working. Megafon is a well known telecommunication company, perhaps she could work using telephone and not the computer?

I think a lawyer should be able to guide her in her rights and options.

On the medical care in Moscow - I have experienced this in a few Western countries, and IMHO I like the Moscow medicine best. There are various clinics and hospitals, and qualification of surgeons and physicians may vary to a big extent.  Often the employer provides medical insurance to the employees as part of the employment package.

[mervin]

Thanks for your opinion Lily! I feel a bit comforted by your advice. Megafon isn't trying to get rid of her though, the doctors are just advising her that she needs to take a job in which she is not staring at a computer all day.

Thanks again

[Lily]

Depending on the doctors opinion, she may even be legally eligible to get a position within the same employer, a job where she may still be able to perform without damaging her health.

Just remember, invalid pay is her worst option.

[mervin]

Well I'd love to give her this advice, but she doesn't seem to be answering her phone. Whenever I call her cell phone (when she's outside her coverage area) she wants to end the call quickly because it's expensive. I've been trying to call her frantically over the past 24 hours but she's not been picking up or answering sms messages.

I think she's convinced that invalid pay is her only option. She's never been very good about thinking things like this through, or getting a second opinion, so I want to get in touch with her before she decides to do something rash, like quit her job, or worse. She was very upset last time I was talking to her, and she was crying all the time. I'd call her parents but they don't speak English at all. Anyone on this board who lives in Russia want to make a phone call to Yoshkar-Ola?

[jb]

Yo~! mervin,,,  Did you say you had met this girl in person?  I didn't see that.

I hate to sound like an a$$,,, but are you looking for a wife and family,,, or a charity case to send money to forever?

I'm sorry to hear about this gals problems,,, if in fact they are real,,,but solving her stuff will not fix your needs.

I think you need to re-examine where you are and where you think you are going. 

Trust  me on this,,, most of these sob stories are scams to milk a few dollors from the stupid westerners.  Don't send money to someone you don't know well.

[I/O]

Yet again, JB's mind and keyboard skills are quicker than mine.  Twas thinkin' zackly the same thing and then I saw Yoshkar Ola. :hairraising: :hairraising:  Mervin, unless you have met this woman personally, preferrably more than once, I'd be taking steps if I was you, BIG LONG steps in the other direction.

I/O

[mervin]

I've known the girl for years. This isn't a MOB story I'm telling you here and it's not a money issue either. This is someone I've known for years and spent lots of time with in person. I'm not some noob who comes her asking for advice because in the back of my mind I'm contemplating sending money to some stranger I've never met. I know this girl, her family and all of her friends.

[I/O]

I've known the girl for years. This isn't a MOB story I'm telling you here and it's not a money issue either. This is someone I've known for years and spent lots of time with in person. I'm not some noob who comes her asking for advice because in the back of my mind I'm contemplating sending money to some stranger I've never met. I know this girl, her family and all of her friends.

Good oh..!!  Well that thows a whole 'nother light on the subject.

I/O

[Lily]

Money is not the issue so far. All the girl needs now is advice and guidance.

Just FYI - all incoming calls to Russian mobiles are free since 2007, also from abroad. It's a little strange that a Megafon employee does not know this yet...

The most important thing for her to know is not to resign on her own initiative. As soon as she writes her resignation, everything is finished for her. Let her know this please.

[mervin]

Well I thought that incoming calls were free too! I know it's that way in Ukraine. I think it's because her phone is always roaming when she's in Moscow. Either way, she doesn't have her telephone on so I can't reach her at all.

[Yulz]

I hate to sound like an a$$,,, but are you looking for a wife and family,,, or a charity case to send money to forever?

I'm glad someone brought it up first.
Mervin, could it be that she's just trying to prep you for sending her financial funds for a surgery? She seems to be in a hurry to quit her job; I think the first thing a typical RW would do is look for any other option, but quitting..
Now, of course, I'm not aware of the specifics of your relationship, but this would be a red flag to me personally if I didn't know the person very well.

[Yulz]

Good oh..!!  Well that thows a whole 'nother light on the subject.

I guess next time I'll finish reading the thread before responding
I would still be suspicious

[Turboguy]

I am not sure what your relationship or interests are but is there any chance of getting her somewhere with more modern methods of diagnosis and treatment.   There is a medication called LUCENTIS that will arrest it or partially cure it in the majority of the cases.

I question myself if that is really her problem.  I have never heard of a case of AMD in someone that age.  Wet AMD is considered treatable and reversable to a degree.   Dry AMD has no cure or treatment at the moment but in 5 years there may well be.  At least they have been able to reverse it in rats.

I am not meaning to sound cold hearted but the reality of what she would get to live on in Russia is that she should take her first payment and use it to buy a tin cup.   This is one area that Russia has a long way to go in human rights.

[ScottinCrimea]

You can't just assume that all doctors in Russia are less competent than those in the US.  For example, vision correction surgery was developed in Russia and they were doing it years before anyone in the US.

[Turboguy]

Scott,

I am not saying that the doctors are inept.  I do think there are more modern facilities with more extensive diagnostic equipment elsewhere.   I would also think with the shorter life span in Russia and the poor financial condition of some of the pensioners that the doctors would have less experience there. 

The information provided is not that detailed.  There was mention of laser surgery.   I believe that is pretty standard treatment and proper treatment.  If I recall correctly the condition is caused by excessive growth of blood vessels in the back of the eye and I am sure one of the best treatments is laser surgery.  There is no mention of if the pharmaceutical route was tried or not.  I believe it is effective enough that it should be.  I believe in a majority of cases the problem is arrested and often people gain 1-3 lines on an eye chart.

It still seems highly unusual for someone that age to have the problem.  It is not something I have researched to any degree.   You would know more about that than I do, what do you think?

[mervin]

Thanks for the replies all.

Turbo: you are right, the disease is very rare for a woman of her age! She's had a thin retina her who life though - call it a genetic defect or whatever, but about a year and a half ago it degenerated into full blown AMD. I've never heard of a woman her age with this disease but evidently there are cases. Wet AMD is treatable, but to be perfectly honest, there are not reversible treatments, and all that laser surgery does is prevent further deterioration of the disease or slow its progression.  I'd say that "slow" its progression is a more accurate representation of what laser surgery does because a person with wet AMD will have to get laser surgery every few years from what I understand. And even with laser surgery the disease can still cause a persons vision to deteriorate. The other treatment you're referring to is with the use of vitamin supplements? She's been taking vitamins too over the past few years, and I know that this is a form of treatment that many doctors recommend. There is also a form of treatment in which a fluid is injected directly into the eye. I'm not real familiar with this methodology of treatment, but I know it's an option. Evidently, Guzel is getting good treatment at a renowned medical facility in Moscow. I fairly confident now that she's getting good, competent attention there.  I think that Scott is probably right to the degree that he says not all medical care in Moscow/Russia is bad.

Anyway... I am certainly no expert on this disease, and I'd love to believe a person can regain some of their vision with a successful treatment, but all that I have read about this disease tells me that reversing its effects is all but impossible.

As far as sending her money, yeah, I would send her money if she asked me. But she would never ask. I've even offered up the idea and she's refused. I think her problem is that she would feel as though she would owe me something. She's a rather complicated girl.

[mervin]

I guess next time I'll finish reading the thread before responding
I would still be suspicious

No problem Yulz   She's not looking to quit her job at all. That is the last thing she wants to do. She doesn't want to sit on her parents "neck" (as she calls it) her whole life and not be able to work. She was earning decent money working at megafon and she'd never allow me to send her money, unless I went to Russia personally do shove it down her pocket. Believe me, she's a proud woman who does not feel comfortable accepting monetary help, even though I've offered it to her. With Guzel, there is no such thing as a red flag, I can assure you. Yoshkar-Ola may have a bad reputation, but it's not because of good people like her.

[Turboguy]

Do an internet search for LUCENTIS.   It is medication that in many cases arrests the AMD and often allows them to regain some of their vision.   Most always at least one line on the eye chart and sometimes as many as three.  It doesn't sound like they have tried it and what do they have to loose.

[mervin]

Come to think of it Turbo, she's already getting injections, but I'm not sure what medication they're giving her. Last year she was asking me about Visudyne, and she was asking me to look up information on this drug. I think maybe that's what they're giving her.

[Turboguy]

Thanks Mervin,  I know little more about medical capabilities there than what I read here and I can't say it is too impressive.

I had my first hospital stay since I was 8 last year and I have to say the things they can do and the equipment they have was awsome. 

I hope they are able to help her.