Exchange City
Comments
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Jan: Oh my, oh my. Staggering! I have an HMO which in and of itself contains its own little shop of horrors, but I just feel SOOO very much for you'all who have such exhorbitant out of pocket costs. You have to go over the bills with a fine tooth comb! I know in this troubled economy, hospitals are willing to "settle" accounts with any reasonable offer. When a hospital like Johns Hopkins is notorious for excess billing procedures, I would not hesitate to try to reduce the bill - especially if there is some way to do so in one lump payment. They would jump on such an offer.
I am glad you vented about this. I know we are just hit with the mack truck of being diagnosed with breast cancer and then having these medical bills in the dreadful wake...it is mind boggling.
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Ladies,
Have any of you had a lot of scar tissue to remove at exchange and had a capsulectomy ( ps) to clean it all out. If so... did it come back to your implants?
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Jan1 - I feel your pain ... Last night I started working on an appeal letter to my insurance company because they've DENIED over $20,000 of charges resulting from my BLM. they've also denied all of my fills (6 of them at $540 a pop) - at first, they asked for additional supporting documentation related to my diagnosis for the fills. My dr's office complied back in April sending them all kinds of documentation. Well, it is now late June (officially July!), and I have received more EOBs telling me that they've denied the claims because they never received the supporting docs. Which isn't true, because I spoke to them twice in June and they admitted that they did receive the faxes, but haven't finished going through the material. What?!?!? So now I'm resorting to filing an appeal, sending in documentation that my PS sent me explaining the benefits of using AlloDerm for breast recons, and I'll also be copying my senators and representatives so they're aware of the hassle I am going through. I'm fortunate that I am not undergoing rads or chemo right now and feel good, although I get so angry about it all that I could just scream. I'm not a doctor, for pete's sake ... how was I supposed to know they were going to use AlloDerm to anchor my TEs? My ins co is telling me using AlloDerm is not the "standard" practice in health care, thus the denial of charges.
Sorry for the long post - I had to vent though ... my DH is tired of hearing it!
Less than two weeks until my exchange - can't wait to receive those bills! sue 0 -
Deborah, Johns Hopkins is the best hospital and charges the least. My local hospital who did the MX and exhange charged 480% MORE than Johns Hopkins posted charges. Hospitals in CA have so many write off charges from the uninsured that they stick it to private pay patients with resources.
((Suegmomof3)) I had the same problems in the past. I ended up keeping all of the supporting data, mailing them myself to the insurance, certified mail with a signature. There was no doubt that they got them. The other thing is hand carrying them and to the insurance office and getting a signature. I did get the Dept of consumers affairs involved regarding insurance reimbursement many years ago, The bill got paid within a week after they got into the frey. What is sad is if you do not know your rights, you get screwed. How many know that there is a law in CA where I live that Hospitals cannot charge a private pay patient more than the medicare reimbursement rate if they are under the median income? For a family of four, that income amount would be $78,000. It isn't right that after fighting an illness, you have to fight the insurance companies. Off to work!
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Oh duhhhh...Jan....you are in California. So isn't it just par for the course that services at the least known California hospital might be vastly more expensive than the best known hospital in another state?
For everyone: In the event you have not read the laws pertaining to your own state re: coverage of mastectomies and reconstructive surgery, here is the link:
http://www.breastreconstruction.org/breast_reconstruction_insurance_coverage.html
It is interesting to see the verbiage for various states referable to reconstruction.
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I see Colorado is absent from that list. Maybe that's why I've had insurance nightmares. They pay, but it's been a fight the whole way.
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Unfortunately, some states do not have issued mandates referable to reconstruction after mastectomy:
http://www.insure.com/articles/healthinsurance/mastectomy.html
Firni: I am sorry you are having such a difficult time with insurance...keep fighting...
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Sue, OMG that is an unbelievable amount of money. I thought I was dealing with an awful lot of denied payments, that beats it. So sorry you're going through it. You know its just beyond ridiculous when they can challenge your fills, what did they think you were going to do, somehow get your head down there and blow air into them to blow them up?
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Laura - I had alot of scar tissue at my exchange. It wasn't fully removed until my second revision (still had scar tissue after the exchange and the first revision).
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Suegmomof3 - I had a tissue graft on my last revision. The insurance company covered some of it, but I was left with a $1500 co-pay. I was unaware of the cost of the tissue graft. I asked my PS if it was covered by insurance and he sadi Yes. Well, I wasn't really given the full story!
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Thanks Robin... why did your PS leave any scar tissue in the 1st place at 1st exchange???
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Since my dh is self employed, we have a high deductable insurance plan. However, we do have maximum out of pocket expense, ($10,000). I have to go over my EOB's with a fine tooth comb. What kills me is I get anestheologists bills that are completely denied as they are not in my network. It's not like you can pick your anestheologist. urg!!! I feel for all of you girls battling insurance issues. It's exhausting. Also, my insurance company told me that there is a maximum that these providers can charge. For instance my ps charged $12,000 for the tissue expander placement. My insurance said the maximum he could charge me was $980. That's a huge difference. I am in New York, but it may be worth looking into no matter where you live. Good luck to all.
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Oh ladies - As if bc, mastectomies, tissue expanders, implants, surgery, chemotherapy and radiation therapy are not enough. I feel for all of you battling your insurance payments. Hugs!!!
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Hi Everyone!
I would like to wish all those south of the border a great big Happy 4th of July.
Today is Canada Day July 1. Our weather today is cloudy, on the cool side, (my kind of weather) can't stand the heat.
Hugs and Prayers to all those recovering, waiting for srugeries and those having them today. Hope all goes well.
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Sonia from what I got your TE are apox 13 by 12 by 5.6
your being over filled so it should be a little bigger than that...
style 20 550 would be 13.5 by 5.6
with a rib cage of 36' I almost wonder if you'd want a wider implant
Do you feel your TE look wide enough?
you might want style 15 (natrelle) or mod plus profile (mentor)
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wow things have been busy on this thread
Monday my friend Debbie also got her 2nd exchange
our new PS said her implants were like little chicklets in there
they were only 280cc style 45. these were only like 10cm wide, her rib cage is about 30-32 inches
she went with mod plus profile 400cc since she only wanted to be a B and didn't want the step off
we both flashed eachother in the hospital when I went to visit her Monday night
she looks so much better : )
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Hi all,
Absolutely pooped from work - back to my 9:30-8pm schedule - but only 4 days a week. It is 5 weeks from my surgery as of today and I'm feeling sore, but OK.
Question (and I think I'll put this in a separate thread too): Has anyone had odd "cording" or a tight string extending from where the alloderm was stitched to the breast down into the ribs? On mty left side I can literally see a chord of tissue that goes from under my breast near the fold all the way down to my lowest rib and beyond. It is the oddest thing and it HURTS! I'm seeing my doc next week for a first fill (although the incision on my other breast still hasn't healed) and I'll show it to her then -- but just wondering if this strikes a "cord" with anyone?
Geena
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Sonia: I agree....550 cc's is just not going to be wide enough or have sufficient volume to get you to a C or D in a high profile. You could use the moderate plus styles Sandy mentioned above and get sufficient width. You would not have as much projection, but the width would enable to you fill out a larger bra cup size. I personally think at least 600 cc's would be better for your frame - again - in Allergan or Mentor's moderate plus styles - 650 cc's even better. If you want the HP style implant, you would need at least 650 cc's - better with 700 cc's.
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That is great about your friend Sandy! Why sooooo many 2nd exchanges is what has my panties in a tangle.. I think it is ridiculous for most. Our PS should get it right the 1st time. If we express what we really want.. they should be able to do that the 1st time. I personally know I might have to have another implant in my rads side if scar tissue misbehaves... but if my BOOBS are too small or wide or narrow.. after all my discussions with my PS about my feelings... I will BE MADDDDDDDDDDDDDDDDDDDDDDDDDDDD....LOL
I am so sorry for any of us.. who DO express our desire.. only to find out AFTER we drop and fluff.. that our size is smaller.. that, to me, is unacceptable.
Eeekkkkkk. off my soap box... I just feel so bad for ANY of you ladies having to do all this time after time.. I just wanna HUG you all to death!
HUG HUG HUGSSSSSSSSSSSSSSS...... Me.
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Genia.. yes.. I had this.. and it is normal.. MAN.. I cannot think of what it is called.. it is NOT cording though... it went away, like my PS said it should after the fills were done....Ask around.. SOMEONE here should remember the name of this... if it does not resolve.. I think they release it at exchange....
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I think some doctors are taking advantage of the law and have us go under more surgeries to make them money!!!! Since the law allows us to have as many surgeries as necessary to get it right- we are ripe for the picking!
wabiarts- yes- I can see what looks like a string from my breast under my armpit and yes it hurts- it gets better (or maybe you get used to it) after a while- My mastectomy was March 17 and I have had all my fills (I think) and now it doesn't really bother me too much and I can even sleep on my side for about 30 minutes at a time! So don't worry "this too shall pass"!
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Yippeee! I went for my post -op follow up appt today....and my foob is still really sore and swollen, but at least this time looks like it might heal......my PS put lots of extra sutures in the area that kept opening before......and he laughed and said he may never take them out. I hope I am not jinxing myself but I was so happy that had to share. PS said there were lots of adhessions and he did place the implant up higher but that it should "settle" and be even with the left.........no swimming and that is bummer but if that is what I have to do......I'll just watch lots movies. It is very hot here in summer......Everyone happy 4th July.
To all you gals having procedures this week......my prayers are with you......
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Wonderful Elaine.. Wonderful!
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I had my exchange on 5/29......On 6/9 my left breast was swollen, hot, & red. Phoned the PS and he called in a prescription for doxycycline. Took that for unti 6/24. On 6/27 left breast again swollen, hot, & red again. At the beach, phoned PS, he called in Bactrim, I drove home early and went to hospital on 6/29 as an add on surgery at 5:30 pm where the PS opened up the left breast, took cultures, sterilized the implant, & put the implant back in, & closed back the original incision, but now with a drain for 8 days. Just phoned the PS office and said I have to have the lab results back this am because we are going into the holiday weekend and I still feel like I have the flu. I will go see an infectious dr today if the report is inconclusive. Now I am taking levaquin, but I need to be on the right antibiotic to get rid of this. I think I picked up some kind of staph infection at my exchange surgery. I just don't feel right.
For a while you just go along and then I am mad, we have to be our own advocates! Has this happened to anyone else? I am not crazy, but think I am never going to feel better!!! Help!!
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I just had my exchange with the Allergan 410 560g, FX three days ago, and LOVE them. I cannot believe how natural the shape is. Good luck. The implants are much softer than the expanders, not cold at all, my post op pain is already better at three days.
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Jackie Tiger: Congratulations! It would be so very helpful and encouraging if you would post your pictures on the pictures forum. We would all like to see more 410's represented in your size range.
Deborah
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Hello ladies,
I want to check in with you about my update, I had exchange surgery on 6/4, it's almost 1 month out. New boobies look great, smaller than I had imagined. My expanders were filled to 300cc on left side and 350cc on the right. PS put in 400cc style 20 both sides. I've been wearing surgical bras for 4 weeks 24/7. finally went to Macy's to get some 'real' wireless bras, the only one that is not padded is by Calvin Klein, the size I ended up buying was 34B. I'll try to figure out the picture forum and post some pictures.
Have a nice long weekend!
Cil.
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We look forward to your photos Cil!
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Is it normal to have muscle pain at the top of your breasts after exchange surgery? (NOT bad, just annoying) Overall, I'm doing well, but the past 2 days I'm sore at the top. I try NOT to take my vicodin, but last Fri - exchange day, I was given 60. Am I expecting too much too soon?
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Geena, It sounds like what you are describing is a mondors cord. I had it after my lumpectomy, and now I have two, one on each side after my bm. When I raise my arms, they are more pronounced. They extend from under the braline and down my ribs and they can really hurt. I find that the heating pad works well for them, and they should resolve over time. They are completely different from the underarm cording. (axillary web syndrome) I had that, too!! I hope that heat brings you some relief, as it did for me.
Denise
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