Obama's Affordable Care insurance and Remicade payments.

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cra43
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Date Joined May 2008
Total Posts : 154
   Posted 11/21/2012 5:39 PM (GMT -6)   
Ok,,,It's been a while, but I have a question... My son has colitis and has been on Remicade 4 years now..When he developed a perianal abscess,,,then later a fistula,,the doctor had him do the infusions every 6 weeks instead of 8 weeks.... I was just wondering,,,just how long can he be on this Remicade before it no longer works.... and if it does quit working,,,what would be his recourse? What would be left.
He has no insurance yet..but we are now going to apply for the Obama insurance, "Affordable Care" does anyone here have that insurance,,and does it pay for Remicade infusions?
Thanks for any info on this Obama insurance...

garylouisville
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   Posted 11/21/2012 6:07 PM (GMT -6)   
Can't answer your questions about the Remicade. As far as the insurance goes, I think you are totally confused about Obamacare. There is no such thing as Obama insurance or "Affordable Care" insurance. The affordable care act that is commonly called Obamacare is nothing but a bunch of different laws regulating health insurance companies and mandating that everyone have insurance or pay a penalty. Most of this doesn't even go into effect until 2014 and is not even fully implemented until a few years after that. Some minor aspects have gone into effect already. One of them is you can add children 26 and under on to your insurance policy and children can't be denied coverage due to pre-existing health conditions. Do you have a health insurance policy you can ad your child to?
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hineycase
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   Posted 11/21/2012 6:29 PM (GMT -6)   
Please don't wait for Obama to take care of you.
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Richard in NY
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   Posted 11/21/2012 7:13 PM (GMT -6)   
The only government medical insurance you might be able to get for your son would be Medicaid. If he's young enough he might qualify for CHIP:

http://www.chipmedicaid.org/

Otherwise he'll have to see if he qualifies for regular Medicaid. Your county department of social services should be able to help you find out.

Noah_Bodie
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Date Joined Nov 2010
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   Posted 11/21/2012 11:38 PM (GMT -6)   
Several provisions of the Affordable Care Act (ACA) have already gone into effect.
http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act#Provisions
 
Here is a link to all things related to ACA.
http://www.healthcare.gov/
 
One of the provisions of ACA which is already law is Pre-Existing Condition Insurance Plan (PCIP). This will be replaced with the Health Benefit Exchanges (HBE) by 2014, but it remains the law and available to you.
https://www.pcip.gov/

Ken
Age 45
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notsosicklygirl
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   Posted 11/21/2012 11:46 PM (GMT -6)   
What state are you in? Definitely visit healthcare.gov and see if you can get him into your states high risk pool. Currently, people with preexisting conditions are not able to purchase private health insurance.
Co-moderator: Ulcerative Colitis
Diagnosed with Pancolitis, Laryngopharyngeal Reflux & Migraines. Battling Extreme Exhaustion.
Currently: 6mp (25mg) + Lialda (2400mg) + Canasa (1g PM)

garylouisville
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Date Joined Aug 2012
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   Posted 11/22/2012 9:03 AM (GMT -6)   
Unfortunately high risk pool means high prices. As much as I hate Obamacare for the country as a whole I voted for Obama solely on this reason for my own personal selfishness. In 2014 nobody can be denied coverage and nobody has to pay higher prices just because they have health issues. That will probably bring my rates down while everyone else's go up. I get the feeling that the OP doesn't have much money to go to a high risk pool.
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jse
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Date Joined Sep 2009
Total Posts : 198
   Posted 11/22/2012 10:24 AM (GMT -6)   
There is an insurance through the gov't that you can apply for if you have been denied by an insurance company and they will cover you........
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Judy2
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   Posted 11/22/2012 11:28 AM (GMT -6)   
As for Remicade, like everything else in the UC world there's no one answer for all. I've been on it since early 2006 and in remission since my second dose. I've never had a problem and can't see any decrease in its effectiveness for me. I've always taken an antihistamine (Zyrtec in my case) and tylenol before my infusions to help prevent development of antibodies or adverse reactions.
Ulcerative colitis diagnosed in 2001; symptoms as early as 1992. In remission since 2006 with Remicade.
Inflammatory osteoarthritis; osteonecrosis from steroids
Grave's disease successfully treated with radioactive iodine and now on Levothyroxine.
Type II diabetes induced by steroids.
Meds: Remicade, Colazal, Levothyroxine, Mobic, Metformin

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Noah_Bodie
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Date Joined Nov 2010
Total Posts : 164
   Posted 11/22/2012 7:04 PM (GMT -6)   
garylouisville,

Expanding the risk pool benefits everyone. It is estimated that at least half of all personal bankruptcies are medical, so the economic benefit of fewer personal bankruptcies helps everyone.

Of course, universal would have been my preference, and we would have joined the rest of the civilized world. Give it time. Within 10 years perhaps.
Ken
Age 45
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garylouisville
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   Posted 11/22/2012 10:46 PM (GMT -6)   
Interesting angle regarding the bankruptcy thing. I have never heard that arguement before but it actually has some logic to it. I totally disagree with you on the universal coverage though. I'm assuming you mean a single payer system like Canada, UK, Australia and many other countries. I certainly don't want their healthcare. Even though it is "free" I have heard way to many horror stories over the long waits, limited choices, and shoddy care. And, when you are having problems and you really need to see your specialist, they just tell you to forget about it and go to the emergency room where you will be seen by someone who doesn't even really know the details of your particular case. No thanks.
Asacol 400mgs 2 pillsX4; VSL#3 112.5mgs 2 pillsX4; DGL 400mgs 2 pillsX3; Monolaurin 300mgs 2 pillsX3; Vitamin D 5000 ius 1 pillX2, Thorne SF722 10pills/day, garlic 3 pills/day

Discontinued: Prescription - Glycopyrrolate; Natural - peppermint oil, Inflaguard (Boswellia), Pepto Bismol, Omega 3 fish oil, Imodium, Beano, Zymactive, Renew Life Probiotic 80 billion, Florastor, Slippery Elm

Post Edited (garylouisville) : 11/22/2012 8:53:21 PM (GMT-7)


Noah_Bodie
Regular Member


Date Joined Nov 2010
Total Posts : 164
   Posted 11/23/2012 4:40 AM (GMT -6)   
Universal healthcare isn't free, but the data shows it's cheaper and the outcomes are better.

OECD has a wealth of info on many subjects, including health.

www.oecd.org/els/healthpoliciesanddata/oecdhealthdata2012-frequentlyrequesteddata.htm
Ken
Age 45
1200 mg generic Asacol twice a day
20 mg Omeprazole (generic Prilosec) once a day

Penngurl75
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Date Joined Nov 2011
Total Posts : 266
   Posted 11/23/2012 7:10 AM (GMT -6)   
the healthcare b4 obamacare is sucky that's why it's regulating insurance companies from unfair money making practices, it does not take full effect til 2014. if private practices and hospitals are threatening to stop obamacare, it's because they can't overcharge u now. America is the only developed democracy with money making medical field, even India is better. and it's a third world country. it's a safety net, basically anyone can lose their life's earnings this will ensure medical coverage for any unforeseen problems.

Judy2
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Date Joined Mar 2003
Total Posts : 9293
   Posted 11/23/2012 8:57 AM (GMT -6)   
I do believe the US has the best healthcare available in the world. For those who can afford it. For those who have no insurance or poor insurance and can't afford to pay themselves, it's often substandard and sometimes life-threatening. We end up paying far more for these unfortunate individuals to be seen in emergency rooms than it would cost for care in a medical office.

I hope we can find some system that affords universal access to excellent health care without the "rationing" that becomes necessary in some systems.
Ulcerative colitis diagnosed in 2001; symptoms as early as 1992. In remission since 2006 with Remicade.
Inflammatory osteoarthritis; osteonecrosis from steroids
Grave's disease successfully treated with radioactive iodine and now on Levothyroxine.
Type II diabetes induced by steroids.
Meds: Remicade, Colazal, Levothyroxine, Mobic, Metformin

Moderator, thyroid forum

beatUC
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Date Joined Mar 2010
Total Posts : 1124
   Posted 11/23/2012 8:57 AM (GMT -6)   
Universal healthcare is a no brainer. The USA is the only industrialized country in the world that does not offer it's citizens universal healthcare.
Can someone explain to me why, in the richest country in the world this is even an issue?
Nothing is free, but no one should have to lose their house and life savings because they got sick.
The people of this forum, we with UC/CD know all too well the financial devastation that disease can bring. it shocks me that people who are sick even argue the need for medical insurance reform -it's here -be happy!
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garylouisville
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Date Joined Aug 2012
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   Posted 11/23/2012 9:24 AM (GMT -6)   
There are a lot of faults with the US healthcare system. Whether Obamacare will have any effect on that remains to be seen. It will obviously help some, including me, but how many and how much will it help and how many and how much will it hurt everyone else? Many people here see things through the eyes of the not well off and the eyes of sick people. Most of those it will help but we are actually in the minority. There are a lot of people who post here due to the bad points of the current US system but those people fail to see all of the many posts here which highlight the bad points of the single payer systems, which I have pointed out in the previous post. Often you have to wait for long periods to get to see a specialist for the very first time, many doctors and providers have very long wait times, if you need surgery you often have to wait months before you can have it, options are limited including drugs - causing you to have less choices or a voice in your own care, if you are having troubles and need to get in to see your specialist ASAP you can't do it and are told to go to the emergency room for quicker care where you will be seen by someone who doesn't know the details of your case, and many times the care is just shoddier. Can these things happen in the US? Of course they can in some instances but in almost all of those cases we can tell the doctor's office to shove it and go find a different doctor. That usually can't be done in the single payer system. I know someone in the UK who's brother died due to the waiting involved in a fairly minor operation which shouldn't have been life threatening but he was not in an emergency situtation so he had to wait and wait and wait to have the surgery. He wound up dying from complications due to the long wait. Someone just recently posted here about the absolutely atrocious care they received from some country using the single payer system. From everything I have heard and seen I do not want a life like that, particularly with UC. I'll be darned if I have to wait months to see my GI and then wait for two hours in his office to see the doctor, only to have limited options and not much choice in the treatment plan. I'll take what I've got now even if I had to file for medical bankruptcy.
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killcolitis
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Date Joined Dec 2009
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   Posted 11/23/2012 2:04 PM (GMT -6)   
I'm not going to get into this too much but I really don't think you should base your opinion of a healthcare system on online anecdotes and halftruths trotted around during an election. One of my daughters was born in England on the NHS, the other one in the US (we had a good policy apparently and co pays resulting in a us spending a few thousand out of pocket for her birth). When my daughter was diagnosed with UC we made the decision to stay in Canada solely based on our fears of the American health system and the insurance issue. I do not want her care dependent in any way on our financial status (which is solid but you can not predict the future). I do not want drs pushing treatments on her due to financial incentives and kick backs. And I do not want to risk bankruptcy. She receives the best quality of care (and I have had second, third and fourth opinions in Europe and the US and have been told that by all of the drs we have consulted) at a top IBD clinic. It is free. If she needs to see a GI she's in within a day or two if not the same day (has happened unfortunately) if necessary. She's been hospitalized three times unfortunately and the hospital we attend has private rooms for all of the children (thousands). I've experienced several health care systems and there was no doubt in my mind that despite it's faults and frustrations (which all systems have) this is the best. Also, my brother had a stroke in his early 20s and required two brain surgeries, radio therapy, 6 months of inpatient care and extensive physio and rehab, many follow ups with top specialists etc and ALL of it was free and world class, my uncle had years of hospital based dialysis, a failed kidney transplant, and now dialysis at home for free, my cousin had a brain tumour removed at 17 and has regular monitoring to check it's regrowth. She will require many surgeries and extensive monitoring throughout her life unfortunately. "Free". Of course, none of this is free, and we happily have always paid for it and are thankful to be able to do so. If you look at cancer care for example, there is absolutely no difference in outcomes between the US and Canada - yes some test may take longer if they are not necessary but emergency care is a different issue. I wish people would stop repeating the garbage they see on CNN when it comes to this issue, but really it's your loss.

Post Edited (killcolitis) : 11/23/2012 12:51:42 PM (GMT-7)


garylouisville
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   Posted 11/23/2012 2:35 PM (GMT -6)   
I don't understand why people keep on accusing me of basing my feelings out of the election hoopla. There are posts right here on this forum, almost every day, regarding all of the bad things I mentioned about other country's health systems. The care and wait times are often horrible.
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Discontinued: Prescription - Glycopyrrolate; Natural - peppermint oil, Inflaguard (Boswellia), Pepto Bismol, Omega 3 fish oil, Imodium, Beano, Zymactive, Renew Life Probiotic 80 billion, Florastor, Slippery Elm

killcolitis
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Date Joined Dec 2009
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   Posted 11/23/2012 2:48 PM (GMT -6)   
Gary, look at the stats. They outcomes are the same, even if it seems like they are not when you're in the system. It is frustrating but priority is given to the most emergent cases. You keep saying things which have no basis in actual reality, so I assumed that this was the result of the political garbage we all witnessed recently. Maybe I'm wrong and you got it elsewhere? Apologies if that's the case.

garylouisville
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Date Joined Aug 2012
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   Posted 11/23/2012 4:55 PM (GMT -6)   
My thoughts on the subject are not from stats but from real people, many of whom post on this site and some I have known personally. I don't listen to political garbage or skewed stats from either side . There have been many, many posts on this site who talk about long waits just to see the GI for the first time, long waits while at the doctor's office, less care options, having to go to the ER when you should have gone to the GI just because the wait time was too long, people having to wait months for surgeries, people having to stick with incompetent doctors because no others are readily available, etc. Many of these people are seeing primaries or ER doctors when they should be seeing speicalists but can't get in for months, and are suffering from sub standard care, mostly because primary care doctors and emergency doctors are too often having to treat specialties and they don't know what they are doing.

The one case in my previous post was from the UK. I knew this girl and her brother died from complications waiting for a common surgery for months. By the time he was bad enough to be admitted to the hospital due to the complications it was already too late. Even though there are many, many faults with the US system, especially for the poor and the sick, I certainly don't want a universal single payer system where if I need my tonsils out I have to wait for 8 months. That's ridiculous. Maybe I am mistaken but it seems like people here who are in a single payer system are more apt to just have to follow a doctor's treatment plan because they don't have any other options whereas here in the US, if you have good health insurance, you can be more involved in the decision making process, have more treatment options available, and if you aren't happy you are more apt to tell your doctor to go take a hike. I had another autoimmune disease in the past which is not an issue now. I was not happy with my first specialist so I fired him and went to a different doctors office. Even though I liked the next doctor his office was totally incompetent so I fired him too and went to third specialist's office. I was happy with him and his office. In a single payer system your options are more limited and it is harder to do something like this. You get what you get and if it is a bad doctor or a bad office you are pretty much stuck having to accept that. Of course if you are poor in the US or don't have insurance then you can get the same but why should everyone else have to suffer by forcing EVERYONE into a single payer system? The best option would be to find a way to cover only the poor and lower income better than we are doing now and finding ways to decrease health care costs for all. Middle to upper income people and those with good health insurance shouldn't have to suffer with worse healthcare just for the benefit of those who would benefit from a universal single payer system.
Asacol 400mgs 2 pillsX4; VSL#3 112.5mgs 2 pillsX4; DGL 400mgs 2 pillsX3; Monolaurin 300mgs 2 pillsX3; Vitamin D 5000 ius 1 pillX2, Thorne SF722 10pills/day, garlic 3 pills/day

Discontinued: Prescription - Glycopyrrolate; Natural - peppermint oil, Inflaguard (Boswellia), Pepto Bismol, Omega 3 fish oil, Imodium, Beano, Zymactive, Renew Life Probiotic 80 billion, Florastor, Slippery Elm

killcolitis
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   Posted 11/23/2012 6:12 PM (GMT -6)   
We don't suffer with poorer health care, that's why the stats don't reflect any difference. There is no treatment you can access in the US for IBD which can not be accessed here. Canada and other social democratic countries consistently rank higher than the US in terms in large part because of the access to good health care. I've heard horror stories about Americans having their surgeries put off and botched, having biologics pushed on them due to their docs being in the pockets of drug reps, and having had pretty terrible care and I've been on these boards for four years. I don't assume as a result that the quality of the entire American healthcare system is reflected in their experiences. I'm just letting you know from my experience and the experiences of millions of others and by the stats, what you're saying is not correct. Of course, if you live in a small town or rural area, you're not going to be able to access specialists as easily and your wait time will be longer. That's the case in the US and elsewhere as well. If you're in a city like the one I live in, you pretty much have access to the best healthcare in the world. I don't believe in a two tier system like Italy's or England's as the public system becomes a ghetto for the poor/middle class and the private is for the elite. Having said that, I would take it over the American system and I've had good care in both the UK and Italy on the public system though in the UK it is more of a lottery . I just can't understand how most of the American public can forgo facts and stats and repeatedly vote against their own interests when it comes to this issue (I guess until this time but it's far from a state run healthcare). We have a right wing government in power right now yet health care is not up for discussion - the reason is that people do not want anyone messing with the system as it is, though, as I've said, there's always room for improvement in any system.

Judy2
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Date Joined Mar 2003
Total Posts : 9293
   Posted 11/23/2012 6:41 PM (GMT -6)   
Just want to point out that there are many places in the US where doctor choices are limited unless you are willing to travel a long way. Many rural areas, underserved areas have a limited number of doctors or the ones who are left after the best fill spaces elsewhere. I understand health care accessibility in Canada varies according to province and area also. Some of the inequities relate to this most places, I would guess.
Ulcerative colitis diagnosed in 2001; symptoms as early as 1992. In remission since 2006 with Remicade.
Inflammatory osteoarthritis; osteonecrosis from steroids
Grave's disease successfully treated with radioactive iodine and now on Levothyroxine.
Type II diabetes induced by steroids.
Meds: Remicade, Colazal, Levothyroxine, Mobic, Metformin

Moderator, thyroid forum

Noah_Bodie
Regular Member


Date Joined Nov 2010
Total Posts : 164
   Posted 11/23/2012 7:16 PM (GMT -6)   

Wiki has quite a bit about Canadian healthcare, including criticisms.

http://en.wikipedia.org/wiki/Health_care_in_Canada#Criticisms

State HBEs (Health Benefit Exchanges) and the Federal HBE are going to serve as a "proving ground" over the next decade plus to see who does it better. This will be something of a test between something close to the UK NHS model and the Swiss model, from the little I know of their two universal systems.

One aspect of the rationing of care, under any system, is the number of doctors, nurses, etc. The primary factor determining whether one gets into college in the U.S. is the ability to pay. If only the wealthy are becoming doctors and nurses, we're in a lot of trouble.

Cuba has an abundance of doctors, and as such they trade their services for other goods and services. Despite Cuba's third world status, largely imposed by an embargo, they have an infant mortality rate that is about the same as our's here in the U.S.

I'm not saying marxism is the answer. I'm saying that if we socialize the safety net of healthcare, and all safety nets are socialism, then we create stability and support the economy. The mythology of having been born in log cabin one built themselves needs to wither and fade.



Ken
Age 45
1200 mg generic Asacol twice a day
20 mg Omeprazole (generic Prilosec) once a day

DBwithUC
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Date Joined Feb 2011
Total Posts : 1556
   Posted 11/23/2012 7:18 PM (GMT -6)   
I thought the wiki article was balanced: en.wikipedia.org/wiki/Health_care_in_Canada

I sometimes wait 8 to 12 weeks for an endocrinologist appointment - especially new patient visit. GI can be 3-5 weeks sometimes. ... and I live in a city. Rural would be worse. Judy2 has good points.

I do think some of the reports about deficiencies of Canada are hyped up a bit in US because of partisan politics.
11/08: ischemic colitis and scope perf colon. 12cm colon/ileocecal resected. IV antib:sepsis.
01/10: Dx: Mod. UC pancolitis. Rx: Lialda 3x.
02/11: Major flare w/antib:sinus. Rx: 40mg Pred taper. 6mp.
07/11: Histol remiss rt/trans; worse sigmoid. Rx: Rowasa & hydrocort
---
Curr: 3-6 loose stool w/ blood, limited urgency: Lialda, 10mg Pred (dependent), sf-Rowasa, VSL DS, Vit-D/C, Omg3

garylouisville
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Date Joined Aug 2012
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   Posted 11/24/2012 10:35 AM (GMT -6)   
I agree that there can be a lot of problems with any system. I think that's why the US has lagged other countries in nationalized healthcare because we want a better system than we see in other places and that is one of the reasons why we went down the Obamacare route instead of nationalized healthcare. There are obviously numerous problems with the old US system including medical bankruptcies and persons with pre-existing conditions getting the shaft, and there are and will be many problems with Obamacare as well. Maybe the true answer is that there is no such thing as a perfect system.
Asacol 400mgs 2 pillsX4; VSL#3 112.5mgs 2 pillsX4; DGL 400mgs 2 pillsX3; Monolaurin 300mgs 2 pillsX3; Vitamin D 5000 ius 1 pillX2, Thorne SF722 10pills/day, garlic 3 pills/day

Discontinued: Prescription - Glycopyrrolate; Natural - peppermint oil, Inflaguard (Boswellia), Pepto Bismol, Omega 3 fish oil, Imodium, Beano, Zymactive, Renew Life Probiotic 80 billion, Florastor, Slippery Elm
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