NOLA in September?
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Hey Betsy... tattoo time very soon!!! You ready? V
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Hey all, need some advice. I was told no more mammograms and to do annual breast MRI's as a followup to my DIEP. I had my first MRI post DIEP in December and Blue Cross is refusing to pay for it. They keep telling me that I need to be doing mammograms! I'm about to be sent to bill collectors but I really don't want to pay another $4,000! Health care got enough of my money last year since I have a high deductible. What have the rest of you done for followup care and have you had any problems with insurance paying for it?
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I was told to do clinical breast exams in the office and on my own monthly. But, my cancer was aggressive-multifocal - but it wasn't invasive. I am comfortable with that. My mammogram and my mind had not picked up my cancer- I picked it up through an aggressive breast exam.
Usually the facility tells you if your insurance company will or will not pay for it b4 you go. Did they not tell you that? If not- then I would blame the facility
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Klanders, I would certainly file an appeal. Is it something your oncologist might be able to help you with? My MO told me after I had a mastectomy, he was recommending MRI every year because, other than the skin, the only place BC could potentially show up is the chest wall. Really. Someone needs to educate these insurance companies.
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I've been through one appeal process so far where the doctor submitted additional information. From what I can tell, Blue Cross says it boils down to nowhere in the records does it indicate the reason WHY my tissue is different and can't be mammogrammed. I just spoke at length to Blue Cross and they've suggested another letter from the doctor and a level 2 appeal. The MRI was ordered through my medical oncologist. I also just called and spoke to her nurse and the billing manager so hopefully I will get a better letter. I think my next step is to call NOLA and ask them to submit a letter also, since my oncologist was going on their recommendations and doesn't see many DIEP patients. Somewhere along the way someone suggested that instead of mammograms OR MRI's I should be doing annual ultrasounds. Surely with as many of us DIEP ladies as there are there should be some standard of followup care published. I've talked to the MRI billers and I think I'm okay for now as long as they know it is in appeals.
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Dr M gave me a letter for BCBS and it states that mammogram can cause failure to the flap and ONLY MRI may be done on the breast from now on. It worked and they paid for the MRI. I did find a lump in the newbie so maybe that was why they approved it. Hope you get it taken care of Klanders. Just something that you should not have to be worrying about that is for sure. Insurance companies SUCK!
Maggie
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good luck Klanders. There is nothing worse, IMO, than seedling with insurance companies. Except maybe car dealers, where I am sitting right now.
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oh Zenful, I can give you a boatload of advice on car buying. If you didn't buy yet send me a pm and I will pass along the things ice learned over the years.
Pat
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Klanders... Mine was denied as well, and I called NOLA to see if Dr Stolier (who gave me the order at my request) would write an appeal, but he didn't think the MRI was necessary, but had agreed to give me the script. So I wrote an appeal myself and won. I still have a copy of it if you're interested in using it.
Vinnie... YES. We are indeed getting close. And remember we have a dinner plan for that evening. Can't wait!!
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I am confused--what screening should be done after a DIEP? I had stage 2 surgery/revision 6 months ago--now what? What does Dr. Stollier recommend after a pbm? How often do you have a check-up with your gyne? Thanks for your help!
Klanders--I have BCBS too. How should the MRI be coded so it can be covered?
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Betsy,
I am not going to eat for two days just to save up the cholesterol for that meal... it sure adds up when I'm down there...yummy! See you in a few... V
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Bailey.. That is the big debate. Some doctors say MRI, others say manual exam only. For me, all of my doctors say that if I see the breast surgeon once a year and a gyn once a year (alternate parts of the year) and they do a breast exam, that is all that's needed. Plus I get blood drawn from my MO who also does a breast exam. Of course, I always ask how this monitors my chest wall, which is inches below my skin. All I get is that its very unlikely to recur on the chest wall. So how does this sit with me? Not well. I would prefer an MRI yearly or at least every other year just in case something is brewing and can't be felt.
Hey Vinnie... maybe you should make a reservation somewhere cause its the French Quarter Festival that week... Your choice! I hear you are quite the foodie... At least that's what Dr DellaCroce says.
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As always you all are a great help. Thanks! I will pursue seeing if Dr. Sullivan will write a letter like Dr. M did for you, Maggie. Betsy, I would LOVE to see the letter you wrote. If you could PM it to me I'd appreciate it. Thanks!
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klanders... I have it on another computer... Just remind me.
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Bets... I good for whatever you want... it's the end of your journey... your celebration day...
I didn't know that is was French Quarter fest that week...AWESOME!
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You said your favorite is Revolution, yes? I've never been. If that's your favorite, let's do that. I am good with anything. Love it all!
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bailey2, I also had DIEP and was instructed by my Breast Specialist before my surgeries that I would no longer get mammograms that I would get ultrasounds. I'm on a 6 month with the Breast Specialist, 4 month with the MO, 6 months with the OB/GYN, and 6 month with my dermatologist (since I had a mole come back atypical, first time ever, and I've been seeing a dermatologist since I was 15).
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That's a lot!!! I see the Breast specialist yearly, although she just sent me a notice that I'm a graduate, and no longer need to see her. Not sure how I feel about that. I see my MO every 6 months, OB/GYN once a year. And I also had an atypical mole removed (first time ever) during my November 2011 recon revision. I am actually going there tomorrow as my second follow up appt.
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The most difficult about the post-chem, post-radiation, post-mastectomy, post-recon process is separating from the doctors. Personally. They are part of your safety net. It is very normal for the BS and PS to discharge you when their part of the process is over. The good thing is that, hopefully, you won't need to ever see them again for this particular "problem". Letting go is very hard to do. Vigilance is good, over vigilance is an easy habit to adopt though not necessarily healthy for our minds.
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Been MIA for a while....but I'm happy to be back
Hope you are continuing to do well wvborledon and gram!
That is very insightful, Marty. It's hard to get to a place where breast cancer is a thing of the past. When you get hit with something like that, it's very hard not to feel like you're just waiting for the other shoe to drop. And the gratitude we feel towards our docs is incredibly difficult to let go of. These docs are a VERY important part of our lives, but we are just another patient to them at the end of the day.
I've been gone recently because in these past few months because my hubby and I have literally watched our business fade away. It's what he's done for the past 13 years and it's very sad to see it literally disappear. Another case of the little guy being swallowed up by the big guys
But, he's found another path to pursue, so keeping fingers crossed it works out in the end. I was hoping to get my last little tweak and tattoos in April or May, but finances aren't going to let that happen. Perhaps in the fall.0 -
As long as you keep waiting for that other shoe to drop, I guarantee it will. I was hospitalized for 6 weeks when I was 20 (not cancer, an infection). One of the biggest challenges was to reduce the dependency on the hospital schedule, routine, doctors dropping in, nurses bringing me everything, strangers dropping in to visit (this was in the old days with 4 bed wards). You want very much to cling to that routine as it is comforting, but not very independent. Back to my husband's fav saying: your mind can be your best friend or worst enemy and you get to choose which.
Audrella - so sorry about your DH's business. We, too, are experiencing something similar. Going to sell the house, downsize and get on with things. Determined!
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Yes Marty... It is bad for the mind if we sit waiting for the next shoe to drop so to speak. Unfortunately, its a lot easier said than done to put it all behind us. I really don't worry about it myself, and that could come back to bite me someday too. I do like getting annual exams since its the one thing I can do, since no one seems to think an MRI is a good tool for us DIEP gals.
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I really want to get to that place where it's a thing of the past. I think once the reconstruction and tattoos are all done, it will be easier. I want to be confident in my health again and not worry about every little thing.
I'm sorry Marty you're going through something similar. It's an uncomfortable adjustment to be sure, but hoping things turn out better for us in the end. That's what keeps me going these days!
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Daylekbraca2, I added your stage 2 surgery on Apr 7 to the list above....
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I keep asking every time I go to my oncologist when can I go to 6 months visit, (I saw him in Jan) he said not for a while it was to soon that I was only 2 years from last chemo. I'll ask again in May when I see the MO and the breast specialist.
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Thanks so much for all your responses regarding follow-up after the Diep. I will ask my gyne what she thinks about follow-up, too. I just want to do the right thing regarding doctor visits and screenings--whether it is an exam, MRI or ultrasound. I have read/heard that some BRCA women get a CA-125 even after a BSO and others do not.
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BAiley... The CA125 is not a dependable test. It gives false negatives and false positives. I had one, but my doctor doesn't trust them. An intravaginal US is one way to monitor the ovaries and look for suspicious things.
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I am hoping someone can answer my questions. I just had a LMX with ALND and a temporary implant put in with Dr S. and Dr T 10 days ago. I feel well, drains out, still some swelling. I still need to do rads then recon. It looks like I will have GAP flap done bilaterally (RMX) when I do the surgery. I never really had much pain just uncomfortable, how hard is the recovery from GAP flap and how long did it take you to recover? I'm 57 and kind of worried about down time,anyone?
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Gram... I had zero issues with the GAP donor site... no pain. Recovery was quick, and stopped pain meds after like 2 days. I did have revisions (butt lifts) at stage II, and the butt lift was sore for about a week, and then fine. I requested a second lift at stage IIb, and it was much better. And then had a minor revision removing a pseudobursa at stage IIc, but again all good.
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I have a revision and reduction on May 8th, leave for NOLA on May 6th. Can't wait!!!
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