Still waiting

4 weeks to go. I'm still waiting on hearing about the insurance issues. I did do more research on "their" doc. first he doesn't even have an affiliation with the hospital of my choice. "They" want me to switch teams. NOT going to happen at this point. I spoke a little with this doctor when I was trying to find out what procedures he preforms. He does do the free Tram but does not to the DIEP. He was even trying to talk me out of the procedure since I would not find a doctor "in network" that would preform it. That should work to my advantage because if there is no one in my network that performs the procedure they should ok my PS. My BS's office has taken it up with the hospitals highest people and hopefully I should have an answer soon.

In the meantime, My PS and GYN surgeon have finally come to an agreement as to when the ooph should be preformed. It has been decided that it would be best to have the ooph done at a later date than the BMX. It all came down to the PS and I guess he knows the GYN and is ok with him going in afterwords.

I have only 1 1/2 weeks left of work. I took off two weeks before the surgery so I can get things at the house cleaned up and organized. It still seems so far away but I know it will be here before I realize it.

At least one thing can move forward

I couldn't get the MRI scheduled until my period started as it is time sensitive to my cycle. Well I started today so around May 4th or so i should have the MRI.

A day's worth of thought.

This whole insurance thing is really bothering me. I figured since I might have a fight on my hands I have been educating my self on the specifics of the procedures (DIEP, SGAP) I want and how they are different than the free TRAM that I'm sure "their" doctor can do. I will probably have to call and ask some questions. I really want to talk to Marybeth and try to figure out the best way to move forward.

Arguments for my PS

1. He works as a team with my chosen BS.
2. He has done hundreds of the muscle sparing procedures. (Important as there are muscular issues as a result of a previous triplet pg.
   
3. He offers the nipple sparing procedure (If I'm a candidate)
4. Timing.... I'm one month into this, surgery date scheduled, family plans made and in progress. Cancer is stressful enough I really don't need to spend my energy on them.
5. Dr. Misner incident. - Unauthorized doctor calling for information. (Where did it come from?) HIPPA Violation.

I'm going to go into work late. I need to make some phone calls and try to get this settled so I can relax.

And two steps back

I should have known it was not that easy. My insurance is denying my PS because there is one that preforms the free trans flap "in network" well that's all and good but I chose "a team." I am so ready to move forward on this. Dates are set, lots of docs have already put in a lot of time. Of course this all comes up on a Fri afternoon, to late to make many phone calls on this. There is a difference between the trans flap and the DIEP. Insurance providers don't quite get the difference. Heck I didn't even understand the difference until I started reading about them. The basic difference is one takes muscle and one does not. I said it before I want a surgeon that can offer me ALL my options and has done hundreds of these procedures. I chose my doctors carefully. My insurance company should not chose them for me. I made sure that the BS was in network before I went any further. I asked about insurance at the PS's office and they said they can work with the insurance co since they are one of the few that do the procedure I want and they aren't on any one's insurance. So I can't check out this new doctor as its now the weekend. I can' t talk to the BS's office about it because its the weekend. I just have to try not to let it eat at me. Much easier said than done.

Fighting this Cancer is hard enough, I really don't want to have to fight the insurance company as well. I just want to be able to relax and get things prepared for the surgery. I want to be on the road to recovery and not have this sitting in front of me. I want it behind me!

So things are moving

I now have an appointment with the GYN Surgeon. It is looking like the oopherectomy will be moved up a bit. The PS wants to have more time. Hopefully I will have a date for that soon. Once that last piece is put into place I can work around the rest of my stuff that needs to be done.

Update: I just spoke with my BS's office. They spoke with the insurance co about the doctor incident. They also pointed out the HIPPA violation that was made. Needless to say my insurance co was a bit nervous about the way it was handled. Bottom line, my PS has to submit a letter explaining why the methods of reconstruction offered by this guy are not in my best interest. So now that that hurtle is crosses, I am waiting for my period so I can schedule the MRI, waiting for the PS and GYN surg. to decide if the oopherectomy will be at an earlier date or not. (PS has lots of say about how the GYN can go in because he wants to be able to use as much as possible and not have it destroyed). Once I have all my final surgery dates I can also schedule my pre certification check up with my PCP. So I guess I am looking at a few busy weeks in the near future.

Making the Decision.

Ever since my mothers experience with breast cancer I have always told myself that if they ever find anything then they could just take them. I have my children and for the most part I guess I could say I was done with them. With that said its a whole new ball game when you are actually faced with the choice. After my meeting with Dr G. I basically had two main options: Lumpectomy with radiation or Mastectomy with no radiation. He was very nice and explained everything very thoroughly. He also took some blood and sent it off for the BRCA testing. I was told that if that came back positive he would advise to have both breasts removed as well as the ovaries. I have to say I did give lots of thought into what I was told. I also did lots of reading and learning what I could of my choices. So many women that I was reading about would have the lumpectomy and then 5, 10 years later were back and were now doing the mastectomy. After doing lots of sole searching I made the decision to do the BMX. For me its not if the cancer came back but when. I only want to have to go through this once!.

So one week after my meeting with Dr G. I then meet with Dr. Klien. I have to say that I really liked both doctors very much. Both were very informative and listened to my concerns. After that meeting I had the name of the PS that my BS recommend and I called and made an appointment for a consultation. I also make an appointment with the PS recommended by Dr. G. It was a hard choice but I ended up choosing Dr Klien at Valley. I'm more familiar with that hospital and decided that was where I was going to be.

The only thing left out to be decided on was the ovaries. I had to wait for the BRCA results to come in to make the final call on that. As my luck would have it those results came in on April 15th and of course I was positive for BRCA 1. Ovaries come out.

Interesting Phone Call

So I run some errands today and get home and their is a message from MaryBeth, (BS office). She has a question about another doctor (PS) that my insurance co asked about. Then she got a phone call from that PS's office asking about a "patient of theirs", (me). I never heard of this doc but apparently because he is my "in network" doc I "have" to use him. First. I did not give my insurance co authorization to give my medical info to this doctor. Second I don't think this doctor performs the type of Reconstruction (DIEP) that I want. This one only does implants or Lat Flaps, neither of which I want. Marybeth said to sit tight, she would talk with the docs and figure out the best way to approach the insurance co. Of course this was the first time in her 17 years she's had this happen. Typical me.