So I haven't been around OH during my cancer process so I'll get you caught up in a few short sentences.
Nikki gets breast cancer. Nikki elects to have bilateral mastectomy as treatment. Nikki has mastectomy/partial reconstruction, but finds out that despite the "authorization letter" she got, her reconstructive surgeon was not in-network. Nikki manages to work out payment plan for first surgery and follow-up. Nikki was happy.
Until I went in last Friday for my final pre-op appointment.
I'd made a payment arrangement through my nurse advocate with his office that brought my out of pocket cost pretty much down to what my deductible is. Well, seeing as last year not asking enough questions got me into ho****er, I decided at this appointment I was gonna get stuff in writing.
Yeah. So let's talk about that.
Surgeon: Was not aware of payment arrangement. (That's not unusual as very few surgeons are even aware of their billing.) BUT surgeon was also not aware that ANYTHING weird had happened with my insurance which I do find strange because my first surgery got DEEPLY discounted (like 90%) and I find it awe-inducing that his staff would do that without asking him.
Office staff: When the surgeon confronted them, had a bunch of BS and excuses and downright UNTRUTHS about what I know, don't know, should know and have agreed to do. Bottom line: they claim I knew what the situation was (I obviously didn't if I asked) and then tap danced HARD around saying that they, in fact, ONCE AGAIN were about to let me go into surgery under sketchy cir****tances. The surgeon was not happy with his staff.
So long-story short: I'm changing surgeons. I LOVE my surgeon. He's very kind and understanding and an overall good surgeon but bottom line, he's not in-network and he'll cost me a fortune to stick with. With the payment plan it would have been do-able but it's obvious that ain't gonna happen. So now instead of getting my surgery tomorrow I will be going to another surgeon on May 24 in HOPES that he'll take my case.
Meanwhile I swear to BEANS if I could take this stupid effing tissue expander out myself I would! Just imagine having the most over-inflated Nerf ball EVER tacked to your chest wall and that's what this thing feels like. Sleep is a joke. My back constantly hurts because of lack of a comfortable sleeping situation and, dangit, it's ruining my otherwise delightful disposition!!!
All of which makes me wonder if it's worth it? I have a boyfriend. He actually says he could care less if I have boobs. But at the end of the day I'm doing this for me. I'm already bald (I have alopecia totalis) and so losing all my hair and my boobs in the span of five years is just a bit much for my self-image to take. So...here I go...fighting for my boobs.
RNY Gastric Bypass 1-8-08 350/327/200 (HW/SW/CW). I spend most of my time playing with my food over at Bariatric Foodie - check me out!
Nikki so sorry for all your pain and all you been through. You put everything into perspective for me as I am sitting here job hunting on indeed.
Blessings to you. I will pray that your surgery gets approved for May 24.
Have a nice evening
Going to be super honest, I'm not sure if I understood all of your post because I'm super high on hospital meds. But man the stuff I did read was heartbreaking. So sorry you had to go through this.
i feel like if someone loses their breast to cancer they should be able to get a reconstructions/implants at a super affordable rate with or without insurance. I don't know how that would happen evonomically, I just feel lie that's how it should be.
way to be a fighter, survivor, and enpower-er. You go!
Nikki, I'm so sorry to learn you're going through all this. Clearly, you're an incredibly strong woman, and I thank you for sharing your story.
My mom went through difficulties with reconstruction as well. She had her nipple sewn to her stomach for many many years as they were going to re-attach it, but when the reconstruction failed, no one ever dealt with her nipple. (I don't think they do that anymore... I hope not anyway. It was in the 80s and awful). It was very difficult for her, so I understand closely the pain you're going through, physically, emotionally and psychologically.
Nikki, I hope your May 24 appointment goes very smoothly and the doctor is able to help you in the way you want.
Love and prayers.
Just a post to say I'm sending you the best cosmic vibes possible.
As someone who is boobless because of double mastectomy, I totally get wanting to normalize what you can. And, it should be covered without such angst and hassle. I'm glad you are switching surgeons, that out of network thing tends to haunt under the best of cir****tances. You don't need that.
Peace, joy and good boobs to you,
HW:361 SW:304 (VSG 12/04/2014)Mo 1:-32 Mo 2:-13.5 Mo 3: -13.5 Mo 4 -9.5 Mo 5: -15 Mo 6: -15 Mo 7: -13.5 Mo 8: -17 Mo 9: -13 Mo 10: -12.5 11/3/2015 Healthy BMI Reached! Mo 11: -9 Mo 12: -8 12/27/2015 Goal Weight Reached!
Hang in there Nik. You are incredibly strong. Thankfully, you had the forethought to get details in writing or you would be "up the creek" after your surgery and be responsible for paying.
I can't imagine the discomfort and sorry you must endure it for a while longer.
Sending prayers and good vibes your way.
I'm sorry you're going through this. I had the tissue expanders in and they're horrible. My body rejected the implants (encapsulated them) so I had a revision with a free-flap transplant. Wouldn't you know it, the first place my post RNY body decides to burn fat? Yep.
The reason I wanted reconstruction was simply that it allowed me to wear off the rack clothing. But a few years out, I've become pretty attached to them :)
5'4" 49yrs at surgery date
SW - 206 CW - 128
M1 - 20lb M2 - 9 lb M3 - 7 lb M4 - 7 lb M5 - 7 lb M6 - 6 lb M7 - 4 lb M8 - 1 lb M9 - 2 lb M10 - 4 lb M11 - 0lb M12 - 3lb M13 - 0 lb M14 - 2 lb M15 - 0 lb M16 - 3 lb