March 2014 Surgery
Comments
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Got a 150 cc fill in each foob on Monday and no discomfort at all. My foobs now fill my old bras - the ones without underwires - and they are comfortable in them. I still have 175 CC left - I wonder if that is gonna be too much?
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Remember, the implants will look about half the size of the TE's, even if they have the same cc's. So if you like where you are now, keep going the extra 175cc's.
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Oh thanks sandra, I wondered about how much smaller they would be so that is helpful. I was going to ask either in the 101 forum or ask my PS next visit but now I can just go forward. My PS is impressed with my supple skin and ease of taking fills. I am happy that I really don't have any discomfort with them - I mean I feel them and know they are there but no pain and I can still sleep on my sides. I am currently at 375
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Linda - my implants (currently implant, lol!) are definitely more than half the size that my TE were. Implant appearance and cup size is dependent on anatomy, height, weight, implant type, and the pocket work done at the time of exchange.
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Has anyone else's insurance denied payment for Femara and your monthly labs? Mind did today. Funny thing that they will pay for surgery, reconstruction, chemo, and all kinds of other things but not the drugs that could prevent a reocurrence? I don't understand. I have a great oncologist who is going to bat for me on this one but he said he has other patients that are having the same problems with their insurance. I wonder now if they will approve my bone scan? I think the insurance fun has just begun! -
klj - what monthly labs are you having? Usually drugs are reimbursed differently from treatment - did your insurance indicate why they denied for Femara?
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SpecialK, they said it is not a covered drug. The monthly labs are the bloodwork that the oncologist wants to monitor how Femara is reacting with me. It won't be every month forever, just in the beginning. They drew blood yesterday and will do it again in 4 weeks providing I start taking the Femara. My insurance also says they don't need pre-auth for procedures such as bone scans but they are getting one anyway because he just had a pt. that had a bone scan and they payment was denied. She had the same insurance (Aetna) but not through the same company as mine. Just a precaution for me. He also said there is an injection given every 6 months when you are on Femara if you experience bone pain that probably won't be covered but they will pre-auth that if necessary too. I expect to hear from someone today about the Femara. Either way I am picking it up and will just pay for it for this month to get things going.
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klj - that Femara is not covered is bizarre. Is your prescription written for the generic letrozole or Femara brand name with no substitution? I am on it and have never had any bloodwork done to see how it is working. I don't even know which lab that would be. Is there any question about your menopausal status? I also get an injection of Prolia every 6 months - it is covered by my insurance, but I will warm you it is very expensive. Like $2k.i would get a pretreatment auth if I were you. It is treating a side effect of Femara so if they won't cover that they might not cover the injection either.
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SpecialK. yes it was written for the generic. I found it bizarre as well. Prolia is exactly the injection he was talking about. I will be sure that it is pre-auth'd as well. He didn't say that was a question about menopause for me but maybe there is. I had a partial hysterectomy in 96. Still have ovaries. I am going back to the pharmacy today since they had to order the med for me and I will make sure it was written for a generic. And 2K for an injection??? Won't be happening in my lifetime if my insurance won't cover it. I will keep you posted! Thanks for the help and advice!
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No problem! Prolia is made by Amgen and I believe they have a program for people who need the drug but for whom it is not covered. The financial folks at your MO should have the info. Have you had a bone density done? Do you have bone issues now, or is your onc acting preventively? Some can't get Prolia covered if their insurance will cover bisphosphanates like Actonel, Boniva, or intravenous Reclast.
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SpecialK, he is acting preventively. I am being scheduled for my first bone density test but have had no issues that I know of. Off to the PS now for my first fill in 2 weeks thanks to the allergic reaction to adhesive. Hope this part is done soon too!
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klj - your insurance may deny the Prolia based on no demonstrated need if your bone density is ok. Mine was approved because I was already osteopenic prior to chemo and hormonal therapy, and after both I worsened markedly, bordering on osteoporotic.
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Hey Special K and KLJ.
was just reading on the femara issue and I have Aetna also - I am not at point to be prescribed anything yet but I decided to go online to Aetna to see if I could price it out - it appears that it MAY not be covered by my aetna plan either - even the generic.
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linda505, I picked up my generic for Femara today (Letrozole) and was only charged $14.50. It was through a plan called Free Drug USA and would have been $548 but apparently my oncologists office had something to do with this. They left me a voicemail telling me to go to the pharmacy and get it and that they are still dealing with my insurance but until that is either resolved or they decide to never pay for it that my generic would be through Free Drug USA. Until I talk to their office I won't know more about how they did it but I'm glad they did!
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Forgot to mention that PS said two more fills. That will put me at 600 cc's and my exchange is tentatively scheduled for Sept 2! The light at the end of the expander/exchange tunnel is shining!
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KLJ - Yay on the surgery date!! I was so excited to get mine. Also great to hear you got the Femara. I hope you can continue to get it at that price. Weird that Aetna didn't cover it.
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Thanks Julie! I am not the only one on here that Aetna has denied. My oncologist said he has been having a lot of trouble with Aetna lately. Let's hope everything else gets approved! Can't wait for Sept. 2nd! We need to have exchange party!
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Oh great news KLJ!!! Aetna is really a mess right now - I have had to battle many things. Here is what I have been told by someone on the inside at Aetna. The CEO HATES Obama and obamacare and has directed claim adjusters to find any way to deny claims on all policies and blame it on following obamacare rules and new medicare rules which were put in place to be obamacare compliant. You can google aetna CEO and obamacare and find many many articles dealing with things he has said and done in the last couple of years. The most recent thing I could find was "oh low and behold" rates will most likely not increase much in 2015 and their first quarters earning for 2014 were up - hmmmmm. Anyway - in my case - we have a small group rate through work and since it is a small group rate it is identical to one of the exchange plans - so it is basically an obamacare policy. It started in April of this year. Aetna no longer offers the plan we had prior to that to anyone - hmmm. ANYWAY - here is the kicker - here is it June - and AETNA still does not have the plan policy written in total. You know what I mean the detailed plan - it doesn't exist yet - they said they will send it to the company as soon as it is done but they aren't sure when that will be LOL. Makes it very difficult to contest claim denials without the whole policy. My understanding from my insider at AETNA is that the CEO was SO CONVINCED that obamacare was never going to go into existence that he directed the policy writers to wait to write the new obamacare compliant plans and they waited so long that they are trying to play catch up. Up until about March of this year - AETNA was saying they were most likely going to have to pull out of the open market and therefore withdrawal from obamacare - now they are whistling a different tune as profits are up. Such crazy world.
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Us March gals are moving along! I have a tentative date of September 9th. My last fill to 650cc (of course my hubby thinks I might want to go a little bigger) will be July 9. PS said I could have the surgery in August, but after this long, horrible winter we had, I didn't want to give up my summertime! So opted for the week after Labor Day. Plus the nurse said that would be good to wait a couple of months.
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Frostecat, we are right on track with each other. My last fill is July 2nd and I will be at 660. He added the last fill appt. after he saw me yesterday. I would have been happy to stop at 600 but I'm going with what he says.
Linda505, that really makes me sick about Aetna and after talking with my oncologist I believe every word of what your insider is telling you. This will be an interesting ride. Prior to these most recent denials everything couldn't have been easier. I just want to get through this and get the care that Aetna promised in the beginning! Don't need this added stress
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Frostcat and KLJ, so happy for you both! I'm actually an April sister, but was watching the March thread when I first found these boards.
I just had my last fill and I'm at 660cc. I'm also hoping to schedule for the first week of September. I could have it sooner, but want to enjoy my summer too and have some pool time.
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Frostecat, KLJ, and Scubalady you're all getting bigger boobs than me! I hope I'll be happy with my smaller ones. I'm filled to 450cc and she is going to bring in Allergan style 20 in 450, 475, and 500. My surgery date is 8/8. I'm going to try to lose a few pounds by then. I gained 10 pounds since diagnosis in February :-p I put pictures on the picture forum. Yeah my summer won't be pool side! I am also getting fat grafting for a dent and will have to wear a compression thing for who knows how many weeks. I'll be happy to get it over with, though.
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Julie, you are right on top of things as usual. I have no idea what my PS plans on inserting, I'm just going with the flow. You are much smaller than I am as a person on the whole, so don't feel that way. I also gained 10 pounds during all of this eating processed/sympathy foods. I said the heck with it, I'm eating mac and cheese. Obviously a wrong move, but ya know with all we had to deal with I guess I was just in a "the hell with it " mode. Yes now paying the price, but I don't think I would have changed things.
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Yes I was definitely into comfort food. Now I need to get back to eating better.
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I'm right there with you Julie and Frostecat. Except I beat you, I gained 15 lbs. And I have no idea what my PS plans on using but I trust him. He is quite the meticulous guy. My daughter says he is very "starched"! We have a good time getting him to laugh
which we have managed to do a few times. My daughter has been to every single appt. I have had but will miss the next few. If she doesn't go into labor on her own by Tues. they will be inducing her! So by Tues. for sure I will have a new grandson! I'm going to miss my sidekick at my appts though!
I'm going to work hard at losing these pounds by Oct. We have a family reunion at the beach and I want to look good!
Julie I know I am older than you which is I guess why I am taking Femara instead of Tamoxifen. Did either of you have a bone scan? I am scheduled for that on June 30th. I wonder if Aetna is going to cover that?
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Hi Everyone --
Back from a daughter college graduation and a step daughter marriage! Catching up on everyone is fun. It seems as though everyone is getting their exchange long before I am. Not sure why my PS wants to wait so so long.-- early October -- but I am honoring it -- plus I get my summer that way too. Surgery 2/24 - finished fills in mid April -- then wait 6 months -- it's his way. It's funny the longer I wait the smaller my "Mounds" look. I am at 500cc -- and I go into see the PS on July 1st to pick out implants and I am going to ask him if I need to be filled any further -- to have what I think I want. I think as you say Special K the end product all depends on body type, elasticity of skin, weight, etc…. the optical illusion of my mounds getting smaller is just me getting used to them.
Comfort food is the enemy -- I am trying not to bring it into the house. Or I will eat it. reducing sugar intake which is my #1 goal in terms of a healthy preventative step of my own -- makes mac and cheese -- my favorite too -- off limits. Usually I have it once a year when I see my mom and she makes a homemade casserole. but she did visit me post surgery and made it when she was out here from Michigan.
Anyhow -- it sounds like everyone is progressing fairly well! Yeah! I am having a bone density test on July 9th -- having started Arimidex in mid March -- they want to get a baseline -- given it is a 5 year deal. My bones/muscles systemically do ache -- but not so much I need any treatment. If I move and walk and stay somewhat active -- the ache is only when I go to sleep and wake up. I can handle it at this point just fine.
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KLJ, you must be so excited about a new grandbaby coming! Tamxifen is supposed to improve bone strength while AIs do the opposite. I had a bone density scan about 4 years ago and it showed osteopenia. I haven't had it checked since. I was also low in D3 with a score of 19 so I am being diligent about taking D3 and calcium.
If you meant a regular bone scan looking for cancer, I did have one after diagnosis and it was clear. They only ordered one because I have a long history of back pain and sciatica due to having spondylolisthesis. I never had an MRI or chest xray or anything even though I told the doc that I get a pain in my back lung area when I take a deep breath. I've had that for years, though.
Being at grade 1, stage 1, with negative notes, there will be no future scans or blood tests looking for metastasis unless I were to have symptoms. My Onc said that early detection of metastasis through scans did not improve quality of life or length of survival. That's rather unsettling. I've read that with ER+ cancer, there is a continued risk of recurrence after 10 years. I guess we'll always have that hanging over our heads.
Sailon, it's funny that you said that your mounds look smaller to you as time passes. I had my final fill and I'm at 450cc. When I first had that fill, I thought I looked so busty! Now not so much. I looked at a lot of pics on the picture forum, though, and I still think 450-500 implants will be a good size for my frame. I think I'm more nervous about the fat grafting than anythig else. I'll be wearing a compression garmet for weeks after so poolside in a bikini and swimming won't happen. Even now, I'm afraid to go into a pool or jacuzzi because my scars are still red and annoyed looking. I don't want to risk messing them up!
I went back to my low carb eating on Thursday. I'm already down 3 pounds and feeling better. I'm angry at myself for eating so much sugar in the last 5 months knowing that it is not good for breast cancer.
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Julie - while refined sugar has no redeeming quality other than tasting good, your body will convert many foods into sugar for cellular use. The whole sugar-cancer thing is a myth, so don't feel bad. Every cell in your body needs sugar to function, not just cancer cells. I wore compression for 8 weeks after fat grafting. My donor site was abdominal so I wore a high waisted Spanx thing - not bathing suit friendly, but keep your eye on the prize. If you don't wear the compression you may end up with fluid-filled tunnels at the donor site made by the cannula. These can also form seromas so the compression is really important.
On looking smaller after being done with fills remember that you had swelling after surgery that can take months to dissipate. This will happen again after exchange, so how you look right after that surgery will change also with time. Just remember that a 500cc implant will not look as large as a 500cc expander, it is good to have looked at the photos but these things look different on everyone.
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Thought I would try and give everyone a good laugh on a Saturday afternoon. Just went out to get the mail and had a big envelope from Aetna our insurance company. They have denied all medications including generic for Femara. Their decision was based on "the member does not have a documented diagnosis of breast cancer". I wonder why they covered the DMX and all of the diagnostics I had as well as the PS and placement of expanders? I suppose next they will try to get out of paying to have the implants placed! Geez! Can't wait until I can start making some phone calls on Monday. They were kind enough however, to give me a list of Assistance Programs! I'm still in shock!
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KLJ, that's ridiculous!
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