DIEP Surgery in Seattle

I cannot imagine a waiting list being that far out! make sure your surgeon has been the primary on TONS of these. I only had to wait about two months for my S-GAP--most of that was my own scheduling conflict, not the surgeon or the insurance. I do not understand, not would I accept, that long a wait for this surgery.

Anne

Ladies - this is a pretty up to date website that lists all the free flap surgeons by state and tells which procedures they perform. I hope this will help in your quest. Dragonfly, I am going to post to your other message board in regard to expenses.

www.breastrecon.com/id10.html

Nancy who was the surgeon that did your DIEP? How happy were you with the overall treatment you recieved at UW. I have heard mixed reviews. I'm not sure what to do now as my other stread stated the skin sparing mastectomy was told is a possibility when I checked with one breast center, that does the DIEP. However since there are no DIEP surgeons in my town, can a local ps put the expanders in? My breast surgeon doing the mastectomy can't, right?

Seeing most of you c/o of the time frame for DIEP procedure, namely 1 yr out. I hate to say this, but get use to this if the healthcare reform bill goes in. Actually, I predict it'll be worse, especially if we're all on the same plan. So scarey!! Try to get your procedures done prior to all this. I know the medical codes for the system change is mandated for 2013. Good luck to us all!

J.Seda

I am not sure I understand your post.  What do you mean by "c/o of the time frame for DIEP procedure"?  I have understood that a DIEP procedure can be performed whether immediate or several years out.  Please clarify.   

I think the poster is talking about waiting times to get your reconstructive surgery. Scare tactics. As in don't ask for health reform because it will be bad for you and your personal needs.

I'm sorry. Didn't mean to continue the hijack of the thread. We have separate threads for gripes and fears and hopes for our health insurance/care systems.

Anne

I just met with my breast surgeon today, and we were talking about Virginia Mason because I had originally expressed interest in going there. My surgeon called and talked to Beshilan's nurse (not sure I'm spelling that right) who was great she said.I guess his nurse was very informative, and offered all kinds of information to my surgeon. HOWEVER, he is supposedly booked for surgery for ALL of 2010. So if I chose to go to him, I couldn't even get in next year!

Hi Katie: Depending on your insurance and whether or not you have the freedom to go to any facility for the procedure, DIEP's can be done immediate or delayed. In my case, U of Wa was out of network, therefore, my ins GH NW options, requested I go to Virg. Mason in Seattle, As some of you know, they're scheduled 1 yr for the procedure, meaning you are not able to have an immediate done. This to me was unacceptable, therefore, I and my surgeons appealed their decision and were able to overturn the appeal, therefore, allowing me to have my procedure where I want and with the doc I choose. As per Anne W's comment that I, the poster, am using scare tactics to make women feel like they better get this done before healthcare reform. Well, after being in the medical field 35 yrs as a nurse and married to a physician, I am worried. I've seen enough that I'm praying people keep revolting and standing up for their freedom of choice. I've experienced lack of choice with my insurance company and managed care and if the gov. runs healthcare and limits their plans, we are all in for a big surprise. Kind of like how surprised america is with how our president is leading vs what he promised during the big campaign. Enough said.  I'm a realist and believe in what I see, not what I hear. Take it for what its worth!

J. Seda

Just got off the phone to my breast oncology surgeon who just got back from doing research in Chile. He tells me their government is trying to figure out how to set up standards for treating breast cancer in women. Ladies, this country is on socialized medicine. My concern is that If socialized medicine ran by the government is so wonderful, why hasn't this been addressed before now. This is what our healthcare will become if we allow the gov to take it over. Instead of having the best healthcare in the world, we will become like the other socialized med countries; behind the times. Think of how many women have died because of lack of care. Do your homework and educate yourselves. Read up on socialized med in other countries and how they address their issues. Don't just listen to the talk. No more politics. I can't stand back when I'm seeing what's going on. We are important and need to stand our ground in being treated.

J.Seda

Hi all - I know this is a thread about DIEP in Seattle, but can I add a point about health care in Canada? I live here and we do not have socialized medicine. This is a single payer system, the doctors are all independent and are paid by the govenment for their services like the way Medicare works in the US. The government does not run the health care - they do not dictate care nor do they proscribe care. I am sorry to hear your friends' brother died waiting for surgery, Nordy. I hope you do not assume this is a universal experience however - I have had cancer here in Canada and my care has been exemplary from beginning to end - I had surgery 2 weeks after diagnosis, it could have been 2 days after but I needed time to process the whole business  so the 2 week wait was my choice. I was able to schedule my DIEP, an elective surgery remember, 5 months after I requested it. This is alot sooner than others I hear about on this forum. And my care was all free, no co-pays, no deductables, I had a private room and I was hospitalized for 5 days. I had a nurse visit me at home for the 3 weeks afterward. I have had as a support and resource a specialist Breast Nurse Navigator work with me the whole breast cancer journey. I work as a nurse here in Canada and the care is excellent. Urgent surgeries never wait - they really don't. There are problems, yes, but please don't generalize about a system Canadians overwhelmingly love and would never change.

Choice is a good thing. Some people in our country, in fact MANY of them, have no choice. They can't afford a choice. Or they have no choice to choose from. Why can't there be an option for them? think of all the women who can't even get a mammogram here, much less a quarter-million dollar surgery simply because they have no health insurance? Or that their insurance requires $30K up front for the surgery?

Our country has a moral issue here...

And I think waiting a year for an elective microsurgical reconstruction stinks.

Anne

Dear Katie:

Look at this site. There is an appeals letter that addresses the issue about DIEP not turning into a Tram procedure....

 http://www.breastcenter.com/support/insurance_letter.php

j.seda

As a followup to my previous post, I met with Dr. Isik yesterday regarding a possible unilateral DIEP.  (He is extremely experienced in doing DIEP's and was the first and only doc doing them on the West Coast for a number of years.)  I was astounded to hear that after hundreds of successful procedures, he has recently decided that the much longer and more complicated surgery, increased risks and increased cost of doing a DIEP is not warranted in most cases.  His conclusions are based on a new long term study that found that the TRAM flap results in "no significant difference in postoperative outcomes or in the subjective ability to perform activities of daily living compared with the DIEP flap."  He acknowledges that there are bad outcomes and outright horror stories for all of these procedures, but many bad outcomes can be related to the skill of the surgeon and/or poor patient selection (smokers, too obese, etc. etc.)  He also told me that he almost never does a unilateral DIEP and recommended that I undergo a TRAM.  I am now rethinking the entire TRAM vs. DIEP thing, but plan to see Dr. Said at the UWMC for a second/third opinion.  He has an awesome CV including a 7 year Integrated Plastic Surgery residency at Northwestern and a 1 year fellowship in Reconstructive Microsurgery at MD Anderson.  We will see what he says.

As an aside, both of the highly qualified and frequently recommend Plastic Surgeons I have seen to date refuse to do immediate reconstructions (both TRAM and DIEP) stating that the complication rate (ranging from minimal to total flap failure) is 50% higher with immediate reconstructions.  One wants to wait a week and one would require a month. I'm not sure I can survive a week, but know that a  month would be impossible for me. Has anyone else been refused immediate TRAM or DIEP reconstruction?