December 2011 Surgeries - want to wait together?

fitzdc

VENTING -- bill in amount of  $22,191 for stage II freaking denied by my insurance!!!!!  I changed insurance providers in April as I was on COBRA (expensive!!!!!) and switched to my husband's insurance.  What a minute, they say - this cancer is a pre-existing condition and we don't have to pay.  I know the HIPPA laws on this and I know they have to pay - just so pissed that yet another thing to go through in this journey.  So mad.   I am going to drink a cup of warm milk to see if that calms me down.

CookieMonster

HUGS Fitz, I'm sorry insurance companines are idiots. I hope that things get straightened out.

The last two times my MO's office drew blood I got a bill for it and had to call and say - it says all labs are covered - and they agree and take it off. I'm waiting for this most recent time to hit and if they want to charge me, I just might hit the roof! I'll call and yell at someone, that's for sure.

Moonflwr912

Fitz, you are right you should be covered, you never had a lapse of insurance. Hope they get it straightened out.

Ginger48

Fitz- that is just wrong; such a pain to deal with all that.

spunkyboobster

Fitz-sorry you have to go through the unnecessary stress of dealing with insurance crud.  Do you mind telling us what insurance company is putting you through this?  I think people should be aware of what companies are trying to dupe us. Grrr...

QuinnCat

fitz - I'm curious. When you say you switched to your husband's insurance, is this a group plan, an employer's plan?  If so, do those sorts of plans even have pre-existing condition limitations?  In federal employment, you get hired, you get insurance and that insurance covers any and everything, no limitations.  I thought that is how all group/employment plans worked?  Maybes yours is private insurance, though.

fitzdc

Ah federal gov plans.... if only.  Most Group Plans though employers do not cover everything (which is why many people get heated in the insurance debate).  And of course there is the issue with high out of pocket limits, too. Group plans have pre-esisting condition limitations which is where the ensuring you can show past coverage with a 'letter of creditable coverage'  which is a letter that states you were covered for X amount of time and the pre-existing condition was covered during that time.  Well, it all is sorted out. My previous insurance - United, through my previous employer, was very good.  But I quit my job and went onto the same policy but through COBRA, which was very expensive.  I could have switched to my husband's inurance, a group policy - Blue Cross/Blue Shield but it was easier to stay on COBRA for a few months to ensure for continous coverage.  When I switched to the new policy, I sent in that letter of creditable coverage.  The kink in the system was that the letter had no start date for my previous insurace, thus the new insurance provider  had no way of verifying for how long I had had the insurance.  Sure, I should have caught the fact that there was no date but I was so worried about so many other things that I missed it and Blue Cross had to deny based on that. Bottom line is that it will be sorted with a new DATED letter and the bills will be paid by Blue Cross/Blue Sheild

My fun for the day was bra shopping.  I went in January after the UMX and was measured as a 38B.  NO WAY !! I had been wearing a 36 B or C for years.  Yes, the fitter said and for years I bet those bras fit poorly.  So after the revision I went bra shopping again (I admit I just went up to Target and found them) and bought some fun bras - 38B.  Got them home and they did not fit.  Today went to Nordstroms and had a fitter, who must have been all of 25, tell me I was a 38D.  NO WAY!!!! But damn if that 38D didn't fit nicely.  No weird bulge under the arm (and after the LD there is a slight bulge), the sides fill the cup and don't spill out the edges.  Still trying to wrap my head around it. 

CookieMonster

So glad to hear things are getting straightened out for you Fitz. Still, the stress of dealing with it can be a pain and it's being studied whether or not stress can cause BC too. I'm actually participating in such a study through UCLA. I'm curious to see how it goes because they're supposedly going to ask about your life the year previous to the BC diagnosis, but my MO says my BC (slow growing and not terribly aggressive) was probably around for 5 years before we discovered it during my very first mammogram. We'll see how this goes.

I want to go bra shopping too, but I have to wait, I'm only 3 weeks post op so the swelling is still there. I got approval from the PS to take the steristrips off so did so last night, lots of peeling skin underneath, but no open wounds or anything - one would hope not after 3 weeks. My arealas are not terribly round right now, wonder if that will improve too. Pre BC I was a 34/36 G/F, but asked to be reduced to a C, I suspect the end result is somewhere in the middle. I'm looking forward to wearing real bras again and not just big sports bras. We have a place out here that all they do is fit bras properly, I'll go there when it's time.

I hope everyone is doing well. HUGS!!

spunkyboobster

Fitz-glad that insurance thing is getting straightened out.  I had to switch insurance after my dx.  Managed to get bmx in under old insurance (UHC) then employer transferred to Aetna.  Aetna stinks.

Regarding bra shopping.  My PS told me no underwires-which greatly limits the selection.  Are any of you who've had MX/BMX wearing underwires?

Moonflwr912

Still not wearing bras. Still using my camisol. Getting my TE replaced in a couple weeks so didn't want to bother.

QuinnCat

Spunky and Moonflwr...I could have sworn I saw in one of the Bras 101 or TE Exchange thread, that we are suppose to wear underwire bras 24/7 for months on end to keep the implants in place.  Geez...why are the protocols so different?

Moonflwr912

My ps never said what to wear after TE placement. After the big Exchange to squishies, I think that is another story.

Bogie

Hello sisters I'm reading and catching up, sounds like most of you have completed your exchange and congratulations!



My TE ruptured, how who knows and the replacement did too. I have capsular contracture and old deflated tissue expanders inside me driving me crazy! Itches..



Has anyone gone the DIEP rout when expanders failed.

spunkyboobster

Bogie-I am so sorry you are having such difficulties.  I went directly to implants, but check on the Illinois Ladies thread-I think someone there had DIEP.  Sending you positive vibes~~

fitzdc

As for what type of bra to wear - when I asked my PS she told me to wear whatever felt comfortable.  And to keep massaging the breast so the implant 'settles'.

goldlining

Bogie, you may also find TE to DIEP experiences on the DIEP topic. DIEP has been working out great for me.

Cookie, I totally buy the stress connection. I was so stressed that I almost welcomed the surgery as a pause button. Little did I know that they had ways of stressing me over that too.

Fitz I'm sorry to hear about the insurance gauntlet you have to run.  We have it so lucky here. 

QuinnCat

Goldlining - certainly you don't have to figure out the bills bills bills! Between surgery, chemo and the general folderol of BC, I've just been letting the bills pile up (no partner to handle).   As I get the "pink" copies, I just pay. I've so lost track of what I've spent, what bills are paid, which aren't.  I just couldn't handle all of this and chemo too.  I just know I will have spent atleast $5,350, this calendar year, if I pay all of my 2012 bills, cause that is what my insurance requires me to spend out of pocket until they kick in at 100%.  Today I called one hospital in another town that is the mother hospital of the hospital in my town (where I'd get my biweekly chemo bloodwork).  Last Friday I thought I paid one $10.13 charge and then was told I owed another $10.13, for what and why I have no idea.  I have no idea how I"m going to get this under control, into a spreadsheet, so I can properly do my taxes next year.  There is one reason to love Universal Health Insurance!

Bogie

Thanks Spunky



Gold, I have been checking those sites. no complications from your Diep? I would love to hear about your experience. I'm looking at University of Chicago or Charleston, SC if I decide to have it, another long surgery..yuck!

goldlining

Bogie, there are surely some people whose DIEP went sideways, just like with the other options, but with a very experienced surgeon, it has a lot of positives. My foobs are natural tissue and move and shape that way. My surgeon is the superhero of flaps (not just breast recon but faces after oral cancer) with a lot of experience with the microsurgery technique, and at least four "ducklings" dedicated to making a positive impression on him, so I had a lot of attention. The length of the surgery was nothing to me. All I had to do was show up on time and go back to sleep :-D It totally fixed backpain that I had been seeing chiro/physio/massage weekly or more often for 8 months as well. The relaxation from the anaesthesia was long enough to relax what was messing me up! I was barely awake that evening and stayed the next day in the step-down unit and had the flaps Dopplered hourly to confirm good blood flow, then they relocated me to the surgery ward where I had a private room. I stayed I think five days. I had a clinical trial painkilling drip (or placebo) self-administering itself in the abdominal incision and a morphine clicker controlled by me. I tried that but it didn't really do anything for the pain that really bothered me which was the damned headache from the germicide in the hospital (virox, which contains formaldehyde, and I am sensitized to it). I had all but one drain removed before going home and the remaining one was not draining anything so it was gone in the minimum 48 hours.

I couldn't lift more than 10 lb for six weeks or do ab exercises but I had no other restrictions. I had no dietary limits or special garments to wear. I was able to wash my own hair unassisted the day the drain was gone. I bought a recliner but soon abandoned it for the bed and pillows. I started on the treadmill at 2 weeks, for an hour at 4mph and worked my way up to weekly sessions of 90 minutes +, then ran in a 5K at 6 weeks and did a half marathon 2 days later in 3:07. Work, however, would not let me come back for another four weeks because they did not have the paperwork from the surgeon. Notwithstanding that, I actually was working, and did work starting from about 10 days post op, in a very feeble hobbling-around way, but it was good to get out, too.

The flat tummy is a great bonus. Knowing in my head that there is stooping and actually experiencing it are two different things. I really did not do the math that they are taking out, I don't know - 6 inches? - of vertical height on the front, but not of the spine, and it takes time for the skin to stretch out. I was more or less upright, albeit tight, by the time I did the 5K but I was noticeably stooped at 5 weeks. I still am tight but I have been skimping on strength and conditioning in order to catch up on missed work. 

I have enough asymmetry that I have a good excuse for a touch-up later and perhaps recycle a little hip fat for that purpose, but I doubt you would notice asymmetry in my everyday attire. My surgeon doesn't go in assuming there will be a "Stage 2" the way DIEPs are described on the forums here. The incisions don't require any revision and the shape is pretty good. Not at all the "hamburger bun" shape. One has a bit of a dent and the other has a bit of an overhang, largely because the flaps were not precisely divided in half the way you would do if it was dough for two bread loaves. Also, one was delayed and the other was immediate, so the delayed side uses ab skin and just patches it in, whereas the delayed had the flap skinned and stuffed through the porthole with just a circle of ab skin where the areola would be. The shaping and positioning stitches, I imagine, would be different for the two cases.  

My only "complication" is not from the DIEP but from the hack mastectomy that I had the previous year and the two nodes. Just on the trunk and mild/moderate. That and the stressful work relationships. The surgery was the best part of my whole year, more or less. Your mileage may vary but that was my journey in a large nutshell.

Blessings2011

Hello, December Sisters!

Fitz - so glad you got things worked out with the insurance company!

I think my whole breast cancer experience (seven diagnostic procedures, a BMX, two surgeons, TEs, fills, an LE PT, and drugs) has come to a little over $200 out of my pocket. My Kaiser premium for me and my husband is $40 a month. A physician's visit is $15. There is no cost for diagnostic procedures, labs, Xrays, Ultrasounds, MRIs etc. The $50 inpatient fee was waived because I was a breast cancer patient. Drugs are either $5, $10, or $15 depending on the formulary.

My exchange surgery is August 22nd. There will probably be a $15 co-pay. That's it.

There were many times in the past when I thought about leaving my job, but it was a university position and we had a strong union. They bargained for our benefits every two years. For years, the university paid all our premiums; it's only been in the past few years that the amount has come out of my paycheck, and now my retirement check.

My heart breaks for those whose bills are not covered, or are covered so poorly that the deductibles take every last penny they have.

Bogie -  So sorry you are having issues with the TEs!!! I have heard of many success stories of ladies with DIEP procedures.

~~~~~~~~

Well, two things are official: my exchange surgery has officially been scheduled for August 22nd, but I won't know the time until they call me the day before.

The second thing is that tonight was Optifast weigh-in, and I have officially lost 50 pounds!!! WooHOO! Now just ten more pounds to get to my goal.

Wishing all you December ladies a good night and a great rest of the week.

spunkyboobster

Blessings- 50lbs!  you rock!!! congrats

Bogie

Gold, you shed some important light on the DIEP surgery and recovery.  Can I ask who did your surgery?

 As much as I'm tired of having ruptured tissue expanders inside me, I don't want to get them removed if I'm going to end up going with the DIEP flap rout.  I admit everything I've been through I like the idea of having an iron flat stomach with natural breasts again   that would be my incentive to do it all over again. 

 I know how you feel about the work stress, mine is getting to me big time lately but need to stay for now and suck it up.  I want to take a few months break, get into shape and optimal health before makng a decision to move forward with yet another major surgery.

Last dav of vacation for me and I finally have time to get back on here for a real conversation.  I'm so happy for my December sisters at the end of this difficult journey or close to the end.  For those like me with surgeries ahead and complications remember we are women and will be as strong as we need to be to move forward!

QuinnCat

And Blessings - I have that "wonderful government insurance," the same one that Congressmen and Congresswomen get.  I'm so sick of hearing that phrase.....$5350 out of pocket before things are "free", laughable dental ($18 for a teeth cleaning, $25 for a filling, etc.), and absolute ZERO for optometric.  My glasses and exams were well over $600 this year...that's not included in my $5350.  Atleast we got the "free" diagnostic tests before everyone else were required to give as of 2 days ago.  Kaiser is good, but I see my new neighbor, who is on disability, who is tied to, yet had to move from the expensive Bay Area so he could afford to live, but has to drive 240 miles back to the Bay Area to get treatment...and he has a lot of medical issues going on. It's not good if you are forced to move away. Ofcoures, the elimination of pre-existing conditions in 2014 should help him get into another plan, but at what cost, not sure?

My brother designed the Kaiser EMRS, btw!

QuinnCat

Bogie - why did your TE's rupture? How long did you have them in before this happen.  I keep wondering if this is something that is preventable, or a matter of time.  I so careful to shield my breasts from my cats and other living matter.  I even sort of halfway sleep on my sides so I don't press on them too hard.  I know they are only guaranteed for 6 months, and I will have them in for 6 months and 10 days before their removal, but maybe "time in" is not the problem.  Ofcoure, if I had actually gone into that MRI machine last week,  i had a vision of the magnet pulling them out of my chest, as in the first Alien movie!  I'm so sorry you have to deal with this.

Since your dx is very similar to mine, yesterday my MO asked if I would be interested in a new BC Vaccine clinical trial.  Ofcourse, there is a risk for getting a placebo, but no risk no reward.  She couldn't give me any more information than that except we had to be "disease free," and since she is saying that to a BC patient, I'm thinking it is the one the Mayo Clinic is sponsering where the vaccine is designed to prevent a relapse in early stage dx BC.  My only problem is that I have to drive 85 miles to my MO and if I get the placebo - boo hoo.  Then again, one would probably get free checkups, etc., which in my case would be a huge help.  The ACS gives me $300 a year for gas, as I'm in a rural zipcode, so that helps too.

goldlining

Bogie, sent you a PM.

Bogie

Thanks Gold, got it.



Kam- As for failed TE my PS doesn't have an answer. It is extremely rare so I wouldn't worry if I were you. I have both lymphadema and capsular contracture with slow open wound so I had many complications that could have attributed to it. It could be my compression garment but he doubts it, faulty expander, surgeon error causing pin hole if not directed correctly during a fill. PS will never admit that so I'll never know.

QuinnCat

What's everyone doing?

Blessings...I know your surgery is a week before mine and mine is in about 2 weeks.  Is that correct?

Faith - how's the Brava going??

Bogie - saw you on the Aromisin thread...I just started those yesterday.  A few things are happening, but it could just be normal stuff.

Sending hugs to the rest of you December sisters.  I love this group, btw.  I hope everyone's pain has gotten better, hopefully? 

I finished chemo last week!! Didn't qualify for vaccine trial (it was being run my original MO, but only for node positive).

Moonflwr912

Hey, Kam, glad you popped in. I had my TE replaced today and am taking my Vicodin, so pardon typos! LOL now the only surgeries I have left will be exchange and then my knees when.I can take.off again. Always something. Much love

Ginger48

Hi kam- congratulations on finishing chemo! Good luck with surgery.

I have been off the computer for a few days. I went to my 31st high school reunion. I had a blast and completely put breast cancer out of my mInd for a short time. It felt so good and gave me some hope that one day this will be my norm.

Hugs to all my December surgery sisters.

QuinnCat

Moon- "TE replaced?"  What does that involve??  Replaced with another TE or are you talking implants? Outpatient?  Anesthesia?  I guess I'm confused by the word "replaced" rather than "exchanged."