On April 19, 2016, my wife, former Minneapolis City Council Member Doré Mead, and I drove to Abbott Northwestern Hospital for a “minimally invasive endovascular coiling” procedure to treat two volatile aneurysms in her brain. Our expectation was a couple of days in the hospital to monitor the coils, 10 days to full recovery from the incision to insert the catheter and onward for the year of traveling we had scheduled. The sword of the aneurysms would no longer be hanging over her head. I described what actually happened, in more or less real time, on a blog at https://sdoremead.wordpress.com.

We read with great interest, and some distress, the lead article in the Sunday Business section about endovascular procedures for addressing malformations and other problems in the brain (“Going deep to repair the brain,” June 25). Dr. Josser Delgado, featured in the article, was one of Doré’s doctors. Our distress was from the focus of the Business section article, compared with what the focus might have been had the article run in Science and Health instead.

The fourth paragraph of the article points out that the market for the equipment (just the equipment, not the procedure) is now $500 million, expected to reach $1 billion by 2025. The phrase “minimally invasive” is used at least four times on the first page. Terms like “risks,” “complications” or “side effects” do not appear anywhere in the article.

Anyone who worked with Doré on developing affordable and special-needs housing, on creating viable options for public transit, and on mitigating the effects of stormwater runoff, etc., knows she is a numbers wonk. Going in for the procedure, she knew and understood the numbers better than anyone: roughly, 90 percent success rate. Put another way: a 10 percent failure rate, with failure being anything from unable to fix the aneurysms (i.e., try something else) to clotting to hemorrhaging to death. For Doré, failure meant a hemorrhage, a trip back to the operating room to save her life, a clot, two weeks in intensive care, ongoing physical therapy for weakness in the left leg from the hemorrhagic stroke on the right side of the brain, and ongoing speech therapy for Wernicke’s aphasia from the ischemic stroke on the left side.

There is no doubt in our minds that this procedure was her best option, or rather least bad; we have not second-guessed the doctors or our decision. The fact of life in the U.S. is that medicine is big business. Equipment manufacturers have to make a profit; doctors, hospital administrators, insurance company executives have to make a living. Financially, we did fine. Doré’s Medicare supplement paid, or discounted, almost all of the half million or so dollars that we were billed. Our share was about $3,500. Medicare and supplemental insurance cost only about $200 a month. With drugs, dental, eye care and long-term care, our insurance costs total about $500 a month each. Everyone should be so lucky to afford and have our coverage.

The comment about second-guessing is not totally true. There have been many dark nights when we thought that the aneurysms that started all this might never have ruptured if left untreated.

For an update on the status of our travel plans, see our other blog at https://tandemonia.com. And, by the way, the treatment of the aneurysms was a success.

 

Ronald and Doré Mead live in Minneapolis. Doré Mead was a member of the Minneapolis City Council from 1994 to 2002.