NOLA in September?
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Hang in there Dianne. I'm sure it will work out in the end. It sounds like you've got a good attitude about it.
I received a letter that the Center had appealed my insurance companies denial of Dr. D's portion. Strangely they covered everything else, but not Dr. D. I've got stage 2 next week and like you am just trying not to worry about it. I've had issues with insurance before (once they tried to say my cancer was pre-exisitng, a second time they tried to say my policy benefits had changed)....it's never ending it seems....but so far it's all worked out. Just keeping faith this time will be no different!
As if we don't already have enough stress, insurance companies seem to want to pile even more on, don't they?
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I don't know who your carrier is, but I have Aetna, and they have paid the doctors and hospital something like 600k so far (before this surgery), so I keep waiting for them to reject me, but so far they have paid and authorized the procedures. I am actually trying to get IN Network coverage for this one... I find it hard to understand how they say they cover the procedure, but NO DOCTOR is in network, not one for DIEP. So who would they have expected me to go to?? Of course this last surgery was revisional and a rotaional flap... so I would need to see if there are any doctors in network for that. And if not, then I will petition. I don't want to overstep and screw myself, but I will proceed cautiously. Its astounding the amount it costs to have this surgery. Thank goodness for my insurance.
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I'm still confused by all the insurance and payment stuff. I'm not exactly sure how much this will cost me in the end... It's totally uneasy to think there could be any insurance issues.... NOLA has full time pros going after the companies so I would "try" to relax... I know I have BC/BS and Vickie told me they have a full time person dedicated to pursue just Blue Cross insurances.
Betsy...
Still didn't get a chance to call you but I remember you are returning back to work tomorrow.... Hoping you have a wonderful day!
Take care.
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Oh can I say.... also... I picked the tentative date of April 17!
and Southwest had direct flights for $89. I went to book my flights the next day and they had started their "Southwest Nationwide Sale".... I was psyched until I saw my flights went to $166. WTH? I'm annoyed that this "sale" has doubled my dang price to NOLA.0 -
I have Blue Cross/Blue Shield of NY and they paid an outrageously hefty sum for Stage 1. This is the same insurance co. that put us through hell, and delay in treatment with worsening weakness in my husband who was asking for something that cost 15% of what they paid for me. Go figure. It is criminal the way the insurance companies play with our lives and well being. Did anyone ever see the documentary "Sicko"?
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Maybe it was 89 each way?? and now 166 RT?
You can call me any evening... will be home at 7 or so tomorrow and 8 or so on Tuesday... much earlier on Wednesday.
And do relax about the insurance. It will work out. Some of my bills have already been paid by Aetna for my surgery that was less than 2 weeks ago.
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I have always thought all insurances deny a certain percentage of claims that come across the desk every day, regardless of merit, just to delay payout as long as possible. Anything to slow the money machine down !
....It is really comforting to know NOLA docs and staff know how to play the insurance companies silly games and get the job done. Dr M mentioned to me that once nipple work is done, many insurances don't want to pay for anything else, so she tries to leave that for last. Guess Aetna figures the sundae is ready to serve if the cherry is on top 
.Diane - Hope you have good news with your very next phone call and are able to take insurance off your list of things to think about.
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I have two questions for you ladies. Did you apply the Kelocote twice a day as recommended? I am having a hard time doing it twice a day as it needs to be dry before dressing. I usally hang out in a bathrobe until it dries. Maybe I'm applying too much, as it seems to take a while to dry. I thought it had dried one morning before going to work, finally treated myself with a new bra, and managed to get the ointment on it. Not a big deal but would have preferred for it not to happen.
How long did you wait to exercise post Stage 2? I asked Laura twice and re-read my paperwork about going back to regular exercise being okay at 4 weeks. I questioned it as I didn't feel quite ready. When I had my seroma concerned Dr. Cohen (that turned out to be all okay- no seroma) advised that they don't recommend resuming regular exercise routine until 12 weeks out. I really notice my overall mood improves when I exercised...its the endorphins I'm sure. I went to Zumba today, took it slow, but it felt great! I could tell it made a different in my mood today. I surely don't want seroma and/other concerns but I was suprised when Dr. Cohen had mentioned 12 weeks. I was not even advised of that timeline for Stage 1...went back to running at 6 1/2 weeks. Any input would be great.
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Kerry... I think its 4 weeks, but I waited 6 after my stage II. I have never heard 12 weeks. And about kelokote, it should only take a couple of minutes to dry... just use a little. And its expensive, so you don't want to blow through it.
Maxine... I had nipples at stage II, and yet surgery after that is being covered. Just because nipples are done doesn't mean there is symmetry and no other issues. In my mind it is unrelated. I could have had tattoos and still been covered. For me, I am waiting for tats until I am 100% sure I have seen the last of the scalpel. But I had necrosis and symmetry issues due to the necrosis, and so having the nipple didn't matter. BUT there may be a general rule about nipples and completion. Not sure.
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Where do u get kelocote from? Is that the best scar cream?
I already have my return to tennis date set up exactly at 4 weeks. ( stage 2) Right now the problem is to not overeat, which I did tonight, while I wait out the 4 wks.0 -
Thank you Betsy. Pamela the center provided he kelocote and will mail out one tube after that. Not sure of the results I'm almost seven weeks post stage 2 and started using around three weeks ago. They didn't address at stage 1 because they are going into the same incisions at stage 2.
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Hi ladies,
Is there someone you all recommend that I talk to at NOLA (about the DIEP surgery)if I have questions? I have basically just realized that I decided I wanted this procedure but haven't spoken to anyone... I mean no one. I haven't even gone to a local PS. I spoke with Lilie Shockney from Hopkins a few times and she told me this was the way to go for PBM so I just haven't really questioned it a whole lot. I know I really don't want implants. I honestly haven't had anyone walk me thru the process of what to expect, recovery, or anything. I've got to think NOLA has someone I can talk to.
I also just got access to the photo site... I'm still having a little trouble navigating it. The very few after pictures I have seen have been amazing... the before... kind of scare me. That's a really big belly incision... If I'm having prophylactic surgery I won't have flaps on my breast, correct? Just my normal breast skin? If I have too much breast skin where is the incision made to reduce that?
Still considering going down to talk to them ahead of time for a consult just for peace of mind. Had Southwest not started their nationwide sale and my one way tickets gone from $89 to $166 each way... it would have been a definite. I just don't understand how that worked...
Thank you Ladies.
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gmorning lovely gals....happy new day!.....cider and 4mybabies, great replies you gave a lil back to motherof5...:)).....pamela, thanks for the good wishes....back to playing tennis at 4 weeks?....that sounds so great....is it ok for us to be exercising at 4 weeks?....my stage 2 is 1 week away and getting the nerves a lil bit...not wanting to be off work and exercise etc....stage 1 was really hard for me, not painwise at all, but emotionally....i had my drains for 8 weeks, didnt drive for at least a month....just felt a lil isolated and when the drains were out i felt reborn......
....how long are the restrictions for stage 2, activity wise, and weight restrictions, sleeping on back, etc?....how long til i will be able to easily handle alone getting the kids ready for school, etc?.....i know some said they went back to work soon, betsy, back today?....hope it is good for you.....i have a very active retail job....how soon to go back to work and be on my feet all day, lifting things, etc?....arent we supposed to take it easy for awhile if there is fat grafting?....nipples?....
....i know dr d replied something about not intimate activities(as far as "massaging" the newly fat grafted breasts 6-8 weeks?....anyone have any comments/experiences with that?.....
...thanks for adding my date spring...and keeping us all connected...:)
i would have to say some of the hardest part of this is the unknown, so any shared experiences are so great, giving some idea of what to expect.....thank you to all....
....anita and kerry....the private messages you sent are so awesome....thank you so much for sharing your experiences and for the comforting reassurances.....it really means so much to me, and helps to bring some calmness and strength that ok i can do this.....
....hope all can find some enjoyment and smiles in their day.....like i tell my kids....yesterday is history, tomorrow is a mystery....and today is the present...like a gift....open and enjoy........
.............~peace n' smiles~.....brenda...:))
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Motherandhild5, the insurance stuff is all handled upfront as far as the surgeons and the hospital bills are concerned. There may be some smallish lingering charges for anesthesia and/or some pre-op testing at SCHS, but apart from that there won't be any additional bills you're expected to pay. Has Vickie told you your co-pay amount for the Center yet? You will of course have travel and lodging expenses, which aren't insignificant but you will absolutely know exactly how much you will be paying the Center and SCSH. My only advice is to be sure you know your own policy benefits and that it matches up to what Vickie is telling you. My insurance has played a few games and had I not known my own policy, it would have cost me quite a bit of money. Vickie can only go by what she is told from the insurance company....and that isn't always right as I have experienced.
Do you think it would ease your mind if you consulted a local dr. or two? I can see now why you are quite a bit anxious....you haven't had a single consult anywhere. I'd be anxious, too! Liz at the Center is the one who discussed with me all of my initial questions. She'd be a good person to talk to, I think.
If you have a skin sparing mastectomy, you will not have abdominal skin flaps transferred along with the fat. That right there is one of the reasons I chose to go to NOLA rather than stay locally. The one Dr. in my state that does DIEP only does the football shaped flaps with abdominal skin and fat, meaning she transfers both the fat and the skin to the chest. After having a 10 pound baby, no way did I want those massive stretch marks carried up to my chest! I believe this is done because it's a bit easier to make certain the flap survives since there isn't a separation of the fat from the skin.
Betsy....I hope your first day back at work goes well! I'm thinking of you today!
Harmony....looks like you and I are up next! Best wishes to you next week!
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I too, was put off by the abdominal skin on the breasts for a PBM. I was told by Dr. Sullivan that the abdominal skin left to "monitor" the flap is an old method. The PS who do that sometimes still remove them at stage 2, sometimes not. At NOLA that was not needed to be done because the flaps are monitored by a small dopper wire that is taken out before you leave New Orleans. That is the state of the art as far as I know.
I imagine if you want to go smaller, they reduce the breast skin at stage 1 but I am not sure. I wanted to go bigger. I am thrilled with my new size. From the front I don't look that big, but I do from the side. I was an A growing up, a partial B after kids and menopause- though a thin, volume loss B, and then a beautiful full C after stage 1. At stage 2 I told him I loved how I was when I was "swollen" and still loved it after the swelling went down but would have liked to have stayed larger. Iwas probably an almost full C at that point. So Dr. S. did fat grafting and now two weeks out I definitely look like a full C. (?maybe more- time will tell.)
mother- I gave you my contact info. I would be happy to walk you through it on the phone if you would like. If you call and I am not home, let me know when would be a good time to call you back. I did go to 3 PS's outside of NOLA. One local for DEIP, he said I was not a candidate and he most likely couldn't spare my nipples- NOT. He recommended lat flap which I did not want because I swim and play tennis. The second was for implants only, he was great, did beautiful work,said he could spare my nipples, but ultimately I decided I didn't want implants. The third was Joshua Levine in NYC for DEIP. He was a strong contender, right where I lived. He was a moderator at the FORCE conference I attended and I believe does only or mainly flaps. He was not confident he could do DEIP on me because of my prior intraabdominal chemotherapy, though he didn't say he couldn't. He recommended PAP flap (from thigh) which I definitely did not want. He said he could spare my nipples. He uses the abd. skin to monitor but said he could take it out at stage 2. Due to his lack of confidence- when I met Dr. S. at the FORCE conference- he said "no problem", and I didn't like his after pictures as much, and I didn't want to be in Manhattan Eye and Ear, I went to NOLA. How fortunate I was to be able to go there.
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Brenda, Anita & Cherrie - Can't believe y'all are right around the corner. Especially Cherrie - we began together. A quick question - are you doing a pre-op consult with Dr M the day before or morning of surgery? Just trying to wrap my head around the schedule.
I have been away without access to email for since Thursday. It is amazing what gets talked about and how much conversation happens here on bco.
I, too, have a large hard area at the bottom of one breast. Dr. M saw it 3 weeks post op and told me not to worry. Some of it might soften properly, but some may not. She assured me she could deal with it during Stage 2. If it was an area of necrosis that would cause a void, she could do a smaller flap procedure right here in Charleston (no return to NOLA necessary). I have absolutely no idea what she has planned.
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Marty I had a pre op the day before for 2a. I have not heard yet about pre op for 2b. Labs are done, blood work and UA. I am ready and excited to finish up.
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Oh, other part of the question for the Mermaids - did you take a laundry list with you of requests or are you just leaving it up to Dr. M?
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Brenda... Yes I am back to work today... The rule of thumb that I was told is no lifting more than 10 pounds for one month. No major activities for one month (no workouts at gym), back sleeping for 3-4 weeks, no massaging fat grafted areas for awhile (I would say 2 months at least).
Stage II is a hard one to gauge as everyone and everyone's procedure is different. I had a fair amount of work done at both stage IIs. Since I am a GAP and DIEP gal, I have had revisions front and back and up top in both. This last surgery was 6.5 hours long... and yet here I am drug free at work less than 2 weeks later. Childcare? Well... as long as you don't lift anything or get jostled around, then whatever it feels like to you. You don't want a roughhousing kid accidentliy hitting you in a fat grafted breast. If its less hands on, then right away you can parent.
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Wow Betsy, I am impressed that you are drug free and back to work. Good for you! Stage 2 really knocked me down for awhile, I just didn't bounce back as soon as I would have liked. Question: My next surgery I will be hopefully be having a second round of fat transfer and nipples...would you call this Stage 2b, or Stage 3? It should be my last surgery.
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Mother&Child5,
Good advice from other patients to call Liz to talk with questions you have prepared.
I went to a different center; however, I consulted/talked on phone for one hour first with the PA, next day one hour with OR nurse/RN, emailed my med records and pictures, and two days later talked for 90 minutes with microsurgeon. All were very friendly and professional with answering my questions, but me being me, still was nervous meeting all of them for the first time in person at the pre-op the day before surgery!
I would start with Liz and she can either answer all your questions or find the appropriate staff at NOLA. For your consult, Southwest still sounds like a deal, especially if you can get a room at Hope Lodge for one night, which is free, and center pays for ground transportation as well.
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Hey Gals,
This is late notice but I just got off the phone with Vinnie Myers the tattoo guy. He said he and Dr. D were interviewed today by Erin Burrnett CNN team. They should be featured sometime between 7pm-8pm THIS evening on CNN. Vinnie said that he hated being interviewed after Dr. D since he is so smooth...LOL... That made me laugh.
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Marty-I can't believe I am going back in 11 days. My bloodwork and UA is done. It looks like my pre-op is the morning of. With Betsy's push I am sending in pictures this weekend with a list. I will bring my list with me to go over.
Anita- Did you go in with a list? What did she do for you in stage 2a and what will she be doing in 2b?
I am expecting a lift, fat grafting, lypo, scar revision, one rabbit ear...... Have I missed anything? I am an outpatient and that scares me. Our hotel is right across the street. I think i can stay at Magna for 23 hours.
Mother- you have been given great advice. Most of my questions were answered right here on this site. It has been invaluable to me. I had a PBM, DIEP with skin and nipple sparing. PM me if you have any questions.
There are a lot of us having a stage 2 next week. You are all such strong amazing women. We will do great!!0 -
Cherrie - thanks, really helps. My pre-op is morning of as well and I have no idea what to expect. I guess I should ask Becky if I should plan on 23 hour or what.
I forgot you were skin & nipple sparing. So fortunate! I am assuming they still resemble what was removed? Mine currently look like hamburger buns plopped onto my chest. 23 hour is not too bad. Better than same day and they will keep you if you really need to stay. I know you will do well! Can't wait to hear.
Mother - thanks for the tip about Vinnie on CNN. I am now watching Erin Burnett for the very first time.
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Marty- Mine are definitely hamburger buns with my nipples pointed south. However, my same scars and everything are still there from before surgery. It seems like they are the same except shape and I can't feel them.
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Oh no... missed CNN. If someone finds a link, please pass it along.
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Betsy, it was all Vinnie, no Dr. D. Nice little segment and Vinnie looks nothing like I expected!
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Still love to see it. I will be meeting Vinnie one day soon.
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Oh my goodness I just saw the CNN clip. I was exercising at the gym and saw it!! I got all teary eyed. Pretty sure a girl saw me getting emotional as I was climbing on the eliptical but oh well. The lady from the clip is the Patient Advocate for the Center..couldn't remember her name but remember her coming in to visit me for both surgies. Very nice lady!
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I have Dish and I'm hoping it's the same episode of Erin Burnett comes on later at 10 central time with Vinnie. I'm going to record it.
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