That would explain it!
Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS
Ophthalmic Diagnostic Center
CPMC Department of Ophthalmology
2100 Webster Street Suite 212
San Francisco CA 94115
(415) 600-3937 FAX (415) 600-6563
From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On ;
Behalf Of Krista Peters
Sent: Friday, March 11, 2016 9:22 AM
To: optimal@xxxxxxxxxxxxx
Subject: [optimal] Re: FA dye dosage
We have 6 OCT's between 4 satellite offices and 5 retina specialists. A huge
diabetic population and common practice to do angiograms on every new
WetAMD/RVO patient.
Krista
On Mar 11, 2016, at 8:30 AM, CPMC Ophthalmic Diagnostic Center
<cpmceyelab@xxxxxxxxxxxxxxxx<mailto:cpmceyelab@xxxxxxxxxxxxxxxx>> wrote:
Wow! 100 angiograms a week! Sounds like the old days. Either you have a
huge diabetic population or don’t own an OCT?
Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS
Ophthalmic Diagnostic Center
CPMC Department of Ophthalmology
2100 Webster Street Suite 212
San Francisco CA 94115
(415) 600-3937 FAX (415) 600-6563
From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Krista Peters
Sent: Thursday, March 10, 2016 5:43 PM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: FA dye dosage
Thanks for your input Denise et al
I'm not involved in the purchasing of the dye (although maybe I need to be) but
our accountant is saying we're spending close to 25k every 3 months. We do
about 75-100 angiograms per week. We're in Vancouver Canada and I hear it's
been difficult for us to find a company to ship to Canada. Then there's added
custom charges etc...
I'm thinking we need to investigate a cheaper company that ships to Canada
instead of compromising quality images.
Krista
On Mar 10, 2016, at 4:45 PM, CPMC Ophthalmic Diagnostic Center
<cpmceyelab@xxxxxxxxxxxxxxxx<mailto:cpmceyelab@xxxxxxxxxxxxxxxx>> wrote:
Costs? I think a vial is up to a whopping 8.00 at the present time
Isn’t that splitting hairs a bit? Like shorting on the GenTeal when doing a
biometry
Cost of doing business
I cannot see the point of cutting anything in half to save money
The term “Allergic” reaction is sure thrown around lightly. You have to
really ratchet up a normal reaction to the procedure ( vasovagal) or even mild
hives to begin to fill the criteria of a compromised airway, aka “Allergic”
One hears that term thrown around from everything from gluten to the color
pink. Check out the references and you will see that the peer reviewed
literature on reactions to sodium fluorescein for ophthalmic use are mighty
Slim indeed. Nausea is not an allergic reaction. It’s a contraction of the
large smooth muscle of the stomach more often or not caused by nerves,
clenching, lack of breathing.
Ana, do a literature search on the OPS Website. You will see a number of
articles discussing these issues that have been discussed for four decades now.
AAO’s OMIC group also has a few well worded missives on the subject.
Us old dogs in the field will tell you that PATIENT MANAGEMENT goes a long way
to lessening reactions, not cutting your vial in half.
Respectfully,
Denice
Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS
Ophthalmic Diagnostic Center
CPMC Department of Ophthalmology
2100 Webster Street Suite 212
San Francisco CA 94115
(415) 600-3937 FAX (415) 600-6563
From: optimal-bounce@xxxxxxxxxxxxx<mailto:optimal-bounce@xxxxxxxxxxxxx>
[mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of Ana Mills
Sent: Thursday, March 10, 2016 2:40 PM
To: optimal@xxxxxxxxxxxxx<mailto:optimal@xxxxxxxxxxxxx>
Subject: [optimal] Re: FA dye dosage
Hi Krista,
Ana here, how does your office manager feel about using the 10% fluorescein? I
use the 10% and I always only use 2.5cc for every patient, to cut costs, and to
cut down on the likelihood of an allergic reaction for the patient. With that
combo, I've noticed that it is very rare that I have patients with
nausea/vomiting or itching, etc., which is nice for everyone. My images very
typically still end up being of very high quality, and we don't blow through
our fluorescein supply too quickly. I'm not sure what the price difference is
between the 5% and 10%, but I think you should try to get your office to start
just buying the 10% and always only using 2.5cc per patient. I've been in the
field for five years now, and so far this is definitely my preferred way of
administering the fluorescein injections. I'm curious to see if they let you
switch!
Ana A. Mills
Ophthalmic Photographer/Technician
DC Retina, Dr. Neal Adams, M.D.
2101 Medical Park Drive, Suite 303
Silver Spring, MD 20902
Business phone: (301) 754-1200
On Mar 10, 2016, at 5:27 PM, Krista Peters
<krista_81@xxxxxxxxxxx<mailto:krista_81@xxxxxxxxxxx>> wrote:
My office manager is wanting to cut costs by lowering the dosage of FA dye from
5cc to 2.5cc. We are using a 5% dye and currently cut the dosage for people
with renal issues and those images are rarely as good as when using the full
5cc. My manager is claiming that lots of clinics are doing this. Do any of you
only use 2.5cc with 5%?? I'd be curious to know your thoughts so I can try to
convince the doctors otherwise.
Krista
