PRMA or NOLA? Needing Info From Experienced Ladies

TruffleShuffle · July 2017

Hello ladies,

First I have to say I'm so impressed with the support system you all have going here.

I'll get right to it. This is looooong and I'm sorry!!

I have decided to have a prophylactic blmx done soon due to a number of factors. I have a genetic mutation (NBN), my family hx of cancers (mostly breast) is extremely extensive, and my mammograms are "problematic" (every six months, dense breast tissue, anxiety & call-backs etc).

I wanted to go with the skin and nipple sparing blmx with immediate reconstruction using the diep method. I am closer to the PRMA and NOLA groups than any of the other known surgeons who are well versed in this technique.

NOLA:

I have seen many before and afters of the NOLA patients. I have looked at their website and talked to their advocates. They seem great. Many women on this site sing their praises. The problem is I have also talked to their financial person and the price quote for my out of network insurance is amazingly high... like, high enough to put a down payment on a house and buy a new car all at once. I have BCBS of IL through my husband's work. Also, I live 7 hours away, and have no family there. So that's another expense tagged on due to the amount of days I would have to stay post op. Has anyone been in my situation financially and still been able to work things out with NOLA? I understand they have a 60 month payment plan. And I know they have a financial aid type form one could fill out- but I haven't been diagnosed with bc and certainly wouldn't dream of taking aid when there are people out there needing it more than I do.

PRMA:

I have also talked to advocates at PRMA but haven't heard back from their insurance person. I have family in San Antonio, (six hours from where I live), which is convenient. I have read about a lot of ladies loving the PRMA docs and facilities and their results. And the few pictures they have online are nice looking. But I have so many questions. I would really love to hear from some ladies who have gone with PRMA. Another person said that they weren't proficient at doing nipple sparing flaps, but that was a thread from several years ago. And there have been a few members on this site who have copied and pasted numerous "rave reviews" of PRMA onto several different threads. Which is annoying because I can't tell if they're just enthusiastic about their doctors and results, or if it's someone working for their group.

Thank you for taking the time to read this. I apologize for how long it is. And please know that I am just seeking answers- I'm not trying to put down anyone's choice of surgeons or hospital. I just don't know what to do and I need guidance.

Thank you!!!!

Lula73 · July 2017

I sent you a pm

TruffleShuffle · July 2017

Lula, thank you so much for taking the time. My inbox says it's empty. Am I doing something wrong?

Lula73 · July 2017

try again- it had an issue submitting but now it says it went thru :-)

TruffleShuffle · July 2017

gotcha! Replied

JWoo · July 2017

I'd opt for PRMA if I were you, especially if your insurance coverage is better there.

fredntan · July 2017

I went to PRMA- I wouldnt go anywhere else. nipple sparing wasnt option for me. Methodist hospital was amazing. I am or was a nurse. They are top notch. I had a TE-torture expander. all the local docs in VA wanted me to keep it year after rads. It had been in there 9 months. PRMA can do rads people 3 months out. they use 2 docs in procedure. the garmets you have to wear after are tight..If this is optional for you..time it for colder months. I had DR A and Dr L

TruffleShuffle · July 2017

Thank you everyone who replied to my rambling post. You all have helped make my researching easier!

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FLBuckeye93 · July 2017

I had Aetna and just went to NOLA. The experience was wonderful and I received great care. I didn't have the insurance issue you do, but have heard of some ladies that have. There are some foundations that help with payments. http://airsfoundation.org/community/financial-assistance-options-reconstructive-surgery/

TruffleShuffle · July 2017

Buckeye, Thank you for this info You've all been so helpful. Can't wait to get this all behind me so I can move on.

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gardendesignr · July 2017

I had considered NOLA & PRMA but travel is out for me. One thing I did see on the PRMA website was that they DO NOT balance bill, my experience w medical things in FL has taught me that never happens here. That could be a major financial advantage to go to TX. Good Luck!

ChiSandy · July 2017

The NorthShore system has a breast cancer surgeon, Katharine Yao (she did my lumpectomy) who helped pioneer skin-and-nipple-sparing mastectomies, and an oncoplastics team skilled in DIEP and TRAM flaps. The surgeries are done at both Evanston and Glenbrook Hospitals in Chicago’s northern suburbs. Maybe BCBS of IL will cover them even though you live in TX?

TruffleShuffle · July 2017

I did see that they don't balance bill. That's very helpful of them for doing that. Thank you for your feedback Gardendesignr- I wish that the travel part of all of this wasn't so inconvenient. Wishing you luck and peace on your journey. Hugs!

TruffleShuffle · July 2017

ChiSandy, thanks so much for your input. I will be sure to look into them. It's a possibility that they would take my insurance. The insurance/financial issues puts tons of stress on an already stressful situation, so I do appreciate all of you truly lovely people taking the time to help a stranger. It's touching, really.

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ChiSandy · July 2017

I was not yet on Medicare, but instead on my DH’s office’s United Choice Plus PPO insurance, when my bc journey started with an abnormal mammo, and all the way through biopsy, surgery, and radiation. NorthShore Evanston Hospital didn’t balance-bill me. (And in 2013 when I had my L knee replacement, neither did NorthShore Skokie Hospital). Am now on BCBS IL’s Medicare Part B Plan F supplement, and neither hospital (nor its sister Highland Park, where I was to have trigger-thumb surgery) has balance-billed me either.

dixiechick442 · July 2017

I just had my first surgery at NOLA and it was amazing for surgery. The Doctors and staff have been very kind and helpful. I have felt very confident in my decision.

I'm from New Orleans and was blown away that a hospital like this was in my city. I'm in my early 30's and this was my first surgery/hospital stay ever so I was terrified. The facility was like a 5 star hotel. The rooms had pull down bed in the room which my Husband spelt on while we stayed in the hospital. Also my family was able to wait in my room during surgery. They have a snack area on each floor with an icee machine. I must have had 10 after surgery.

I was told majority of patients are from out of state. I was told it rare they get locals.

My first stage of my surgery was a month ago. The next stage will be in the fall.

My insurance cost for out-of-network hospital was lower than I expected. It varies on insurance I was told. The staff did work really hard to make sure we got everything covered by insurance.

DiepGal · July 2017

Needing guidance is completely understandable in this difficult decision time. I know several plastic surgeons across the United States and some in other countries because of the nature of my work. There are many fine ones and we can only share our own personal success stories. I went to PRMA and had a very successful delayed DIEP flap surgery after a second breast cancer diagnosis. As far as checking insurance the best course of action is to contact their patient liaison named, Brittany, at their office. She walks patients through the process and can answer many of your questions. I hope this helps and I wish you all the best. Asking questions is certainly what you need to do in this process to put your mind at ease. Happy to answer more questions if you have them.