It's ironic that more than 1 thread on Optimal right now is expressing concerns
of the increase of NaFl costs & you guys are suggesting 3 or 4 vials for oral
FA's. That's more than whats being reimbursed right there!!
Also, Akorn & the other FORMER dye companies have done the math for you. 1 vial
(2cc) of 25% is EXACTLY the same as 1 vial of (5cc) 10%
i.e. 2ml x 25% = 50, 5ml x 10% =50
So it doesn't matter if you use 3 vials of 25% or 3 vials of 10%, It's the same.
Paul Paquette
-----Original Message-----
From: Sandor Ferenczy <sandorferenczy@xxxxxxxxx>
To: optimal <optimal@xxxxxxxxxxxxx>
Sent: Wed, Mar 8, 2017 9:13 am
Subject: [optimal] Re: Denice's cocktail for oral administration of sodium
fluorescein
25% concentration sodium fluorescein is a 2.5x higher concentration that 10%
concentration sodium fluorescein.
so to get the same dose, 25% would be a volume 2.5x less than 5 cc.
5/2.5 = 2 cc
the actual dose you find appropriate for your camera can differ from there.
-sandor
On Wed, Mar 8, 2017 at 6:03 AM, Patti Kish <photohomer@xxxxxxxxxxx> wrote:
Thank you for response. We have a Optos California and I use 2.5cc of 10%, up
the contrast and have excellent results.
If we would convert to 25%, how many cc's would be standard? We also have an
old Topcon.
Respectfully submitted,
Patti Kish, COT
From: optimal-bounce@xxxxxxxxxxxxx <optimal-bounce@xxxxxxxxxxxxx> on behalf of
CPMC Ophthalmic Diagnostic Center <cpmceyelab@xxxxxxxxxxxxxxxx>
Sent: Tuesday, March 7, 2017 7:23 PM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: Denice's cocktail for oral administration of sodium
fluorescein
You can read the literature
Personally, I haven’t used 10% in two decades
I prefer the higher concentrate 25% and lesser volume
I believe amongst imagers, this is the concensus
From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx]On ;
Behalf Of Patti Kish
Sent: Tuesday, March 07, 2017 4:03 PM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: Denice's cocktail for oral administration of sodium
fluorescein
Sorry 10% and definitely a "heavy" patient. Do you suggest that we use 25%
instead?
Sincerely,
Patti Kish, COT
From:optimal-bounce@xxxxxxxxxxxxx <optimal-bounce@xxxxxxxxxxxxx> on behalf of
CPMC Ophthalmic Diagnostic Center <cpmceyelab@xxxxxxxxxxxxxxxx>
Sent: Tuesday, March 7, 2017 6:59 PM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: Denice's cocktail for oral administration of sodium
fluorescein
Two or three vials! That must be a very heavy patient
Particularly if you are using 25%
I had my FIRST case of oral FA, impossible venipuncture, with 5 ML of 25% ,
well over the dosage required with a cSLO.
However, given her severe diabetes and no doubt compromised absorption and/or
blood barriers absolutely no dye at 45 minutes or even out to one hour!
D.
From:optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx]On ;
Behalf Of Patti Kish
Sent: Tuesday, March 07, 2017 3:52 PM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: Denice's cocktail for oral administration of sodium
fluorescein
Greetings,
In our office we put two or three vials of sodium fluorescein in Pepsi or diet
Pepsi and shoot at about 15 minutes. Definitely would use a straw or two to
make the experience a better one.
Sincerely,
Patti Kish, COT
From:optimal-bounce@xxxxxxxxxxxxx <optimal-bounce@xxxxxxxxxxxxx> on behalf
oflguerette@xxxxxxxxxxxxxxxxx <lguerette@xxxxxxxxxxxxxxxxx>
Sent: Wednesday, March 1, 2017 4:32 PM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: Denice's cocktail for oral administration of sodium
fluorescein
Don't recommend orange juice - looks really bad in that.
what else is anyone using?
Lori
-----Original Message-----
From: "Michael Turano" <turano@xxxxxxxxx>
Sent: Wednesday, March 1, 2017 4:27pm
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: Denice's cocktail for oral administration of sodium
fluorescein
Sprite is the best tasting soda mixed with NaFL.
Mike
__
Michael Turano
c. 917.826.9506
f. 917.591.1841
e. turano@xxxxxxxxx
Sent from my iPhone
On Mar 1, 2017, at 4:12 PM, Sara Morales <sjmorales13@xxxxxxxxx> wrote:
Lori,
Two straws? We're a one straw office. 😊
Sara
On Wed, Mar 1, 2017 at 4:04 PM,lguerette@xxxxxxxxxxxxxxxxx
<lguerette@xxxxxxxxxxxxxxxxx> wrote:
There's a great dosing guide for the 10% in Marshall's book - but most
generally my docs have me mix four vials into juice (somewhat disguises the
color & taste) and two straws to really drink down fast.
Most times I'll try taking a base at 10 minutes (some of the young ones have
showing that early), but generally not until after 15 minutes.
Oral FAs are fine for the diabetics/AMD/..., but not for occlusions (no earlies)
disco time!!!
Lori
-----Original Message-----
From: "Sara Morales" <sjmorales13@xxxxxxxxx>
Sent: Wednesday, March 1, 2017 3:13pm
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: Denice's cocktail for oral administration of sodium
fluorescein
Denice,
Thanks for the cocktail recipe, I'll try it with fireball at my next black
light party. We have been using 4ml of 25% Fluorescein for oral FA on the
Optos. I like the idea of using only 2ml. Any other opinions out there?
Sara Freeman Morales
On Wed, Mar 1, 2017 at 1:01 PM, CPMC Ophthalmic Diagnostic Center
<cpmceyelab@xxxxxxxxxxxxxxxx> wrote:
I have been using oral FA for years- so many of our patients have impossible
venipuncture
Particularly, with the new cSLO instruments, the oral works particularly well
25% 2cc ( or more, or less per weight of patient) into diet coke ( diabetics)
or root beer ( non diabetics) hides the taste very well
Use a straw- the dye stains the teeth. Better yet, chug it like a shot of
whiskey. Hey, perhaps mixing it with Fireball is the answer!
Wait about 15 minutes ( less if younger, more if older) and you can get very
decent information.
Denice
From:optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx]On ;
Behalf Of wgraham6@xxxxxxxxxxxx
Sent: Wednesday, March 01, 2017 9:53 AM
To: optimal@xxxxxxxxxxxxx
Subject: [**External**] [optimal] Re: [optimal] AccuVein
WARNING:This email originated outside of the Sutter Health email system!
DO NOT CLICK links if the sender is unknown and never provide your User ID or
Password.
We have a few patients a year that are extremely hard or impossible to stick.
We will get out the vein finder but usually not very helpful. So not to torture
these diabetic patients with more than my limit of sticks oral FA is a great
option. We use the Optos California and get amazing images.
BJ Graham, CRA
Bjgrahamphoto@xxxxxxxxx
336-469-4951
Sent from my Verizon HTC Smartphone
----- Reply message -----
From: "Sara Morales" <sjmorales13@xxxxxxxxx>
To: <optimal@xxxxxxxxxxxxx>
Subject: [optimal] AccuVein
Date: Wed, Mar 1, 2017 12:00 PM
Our department is looking to purchase a vein finder for those seemingly
impossible patients. I can't believe how expensive they are and need to make
sure that they actually work on the difficult patients. Easy patients are easy
and I don't need a $5,000 device for them.. Do these devices work well for the
obese, dialysis patients, severe diabetics etc.
Sara Freeman Morales, CRA, OCT C
Scheie Eye Institute
Philadelphia, PA
