Surviving

 I fired my plastic surgeon on Friday. It was my third post-op appointment and everything continues to be healing just fine. I learned (only after my sixth surgery) that the first three follow up appointments are free if completed within 90 days. It was said as an aside, not a statement of policy. I've paid a lot of money to this doctor because this wasn't made clear earlier. I insisted that this last appointment occur before the 90 days expired. Sorry to be a pain in the ass, but y'all have been a pain in my boob. And my wallet.

He wants to do more. He is, after all, a plastic surgeon. He reminded me, as he does at every meeting, that it's a woman's prerogative to change her mind and asked if I had changed my mind about additional plastic surgery. I declined saying it (the results) were good enough and I wanted to be done. 

He seemed to understand and acknowledged that it had been a long road for me. He wished me well and told me to say hello to Hubby and then asked his assistant to book another follow appointment for six months from now.

I told him no, this was the end of the road for me. He didn't try to talk me out of it. If he had any concerns that I needed continued monitoring, he did not express them other than an recommendation to follow up with an oncologist. (I tried but getting medical records proved to be such a hassle that I'm putting it off until the new year. However, I have made an appointment with my GP and we will make a plan for follow up care for the rest of this year: either a mammogram or an MRI.)

I have come to like this man but it hasn't erased everything I've been through. Just in my time with this doctor, I've had three surgeries, miscommunications, appointments when I've been kept waiting for over an hour, billing errors (still unresolved), debt collection - and all of it during COVID when Hubby couldn't always be at my side.

I'm 2.5 years cancer free. I'm not a survivor, I'm surviving as best I can. And that's all any of us can do.

Pink

 

Cancer is Big Business

That was the opinion of a woman on Facebook who vented that anyone who wanted to pay $35 for a pink t-shirt just to parade around for cancer awareness was just wasting her money. (I refer to any number of organized events during the month of October designed to raise breast cancer awareness and, more importantly, money.) It would be more useful, she opined, to drive a woman to chemotherapy if one really wanted to help. She went on to say these fund raising organizations were not entirely what they said they were and didn't offer the services they really said they offer.

She wasn't necessarily wrong. I would have re-posted her comments here except they've been taken down either by the author herself or the Facebook group's organizer (organizing a team of walkers for such a fundraising walk.)

Cancer is a big business. Surgeons, hospitals, medical equipment companies and their sales reps, pharmaceutical companies and reps, etc., There's a whole non-medical world seeking to profit as well (well intentioned or not). Some would call them wholistic healers; others would call them reckless scam artists. Some are legitimate; some are not. The problem is, the patient has to sort all this out in a pretty short period of time right after she hears the word "cancer."

I don't know the woman who posted this but maybe she was hurting. Maybe she was still near to her breast cancer experience. Maybe she got burned. Her post wasn't hostile but it was angry. 

I feel for her but I bought the $35 t-shirt anyway. I also checked out the organization for this particular fundraising walk and felt comfortable enough to donate more. I haven't volunteered to drive anyone to chemo yet but I did download the application to donate time to said fundraising organization.

It's not much but maybe someday we can accomplish two things with all this awareness. Eradicate cancer and the big business that goes with it. 

It can make you wonder if one group is working against the other.

Vitality

I read an affirmation suggesting that I imagine my cells as warriors that nothing could penetrate. Well, I know that's not true. I came across this card much earlier in my journey, maybe even before my mastectomy. I loved the idea of warrior cells doing battle against the cancer in my body. I tried to visualize  it and thereby make it so.

The warriors didn't get the message.

The subject of the affirmation was really about vitality. Verve. The energy to live. Manifesting that energy, if you will, into healthy cells. A healthy mind and body.

That's where I find myself today. I'm done with this cancer bullshit. I'm done griping about my insurance company. It's time to let go and get on with it. It's time to be grateful for the rest of me, the healthy, un-diseased vital parts. I'm even grateful for my frankenboob. It's been a long journey but a marvelous and beautiful testament to science and to healers. I wouldn't wish it on anyone but I can be grateful that I made it this far. I have to acknowledge it could have been much, much worse.

As for the warrior cells, I am imaging them in my niece, praying that these miraculous cells do indeed exist, that her surgery will not result in amputation. Fight, cells, fight! (Different cancer, different body amputation.)

In the meantime, I'm signed up for one of those cancer walks that are promoted every October. I did one a couple of years ago and was congratulated on being a survivor. I was three months post-surgery at the time and didn't feel like a survivor. I wasn't ready to celebrate survivorship. I was still getting used to my form, my new self image, the idea that I had cancer in the first place.

I'm ready now.

The purpose of the walk is to raise funds for the Desert Care Foundation which does not conduct or fund cancer research. Their mission is "to help pay for cancer care for local residents who need financial assistance." I think that's worth supporting. I don't want anyone, regardless of their ability to pay, to have to fight to get coverage from their healthcare provider for breast cancer treatment and related services. I want to help those who need help paying for what insurance doesn't cover. I hate hitting up family and friends for fundraising (which makes me a terrible fundraiser) but if you're interested, this is the place to donate.

By the way, my niece has a Go Fund Me page. She elected to get some treatment in Mexico which is not covered by insurance but she will also have care in the United States which will undoubtedly come with a sizable deductible.

I give up

I'm tired of fighting with my insurance company. Maybe it's time to throw in the towel. Surrender. After all, I have my life. I have a bionic boob. I have all my limbs (a relative is facing potential amputation in the face of cancer). I have all my hair. I only owe roughly $200 at this point.

The hospital had lost, then found, $2,000 that I paid so that battle is over. There was no acknowledgement of their error. Certainly no apology for the aggravation it caused.

I have a while before my account goes to collections. That was another headache: I waited so long for a claim to be paid that my account went to collections. I paid the outstanding $113 but - long story short - I continued to be harassed for money, again, I no longer owed. That's been cleared up now.

I have a couple of appeals still out there for the remaining $200. I doubt things will change. I'll wait just to see but I might not have any fight left. They win.

I have some forms to submit a grievance with the state. I'll review those and consider making a complaint at the very least. I won't expect any financial recovery. Last year I paid about $1,400 over my maximum out-of-pocket of $6,900. I don't think I'll get any of that back even though those services were medically necessary and should be covered by my insurance, imo.

I learned from last year. So far this year, I'm only $200 over my out-of-pocket maximum (of $7k). The hospital found the money they lost. The collections company has recorded the money I paid and closed that account. Theoretically, I only have two more follow-up appointments with my doctor that are theoretically covered.

It's not so much about the money. It's the principle. No cancer patient should have to fight their insurance company to cover legitimate claims. Cancer patients are already fighting a battle. 

No patient should have to fight to have their claims paid. I can't imagine what it's like for people who have no insurance, no education, no means to absorb what insurance doesn't cover. It makes me sad. And mad. Hours of phone calls. Literally, hundreds of pages of paper. (I'm looking at them right now. There's at least 500 pages there.) 

I have to remember to be grateful because, in the end, I'm one of the lucky ones.

Time will tell

 So far, healing well. 

Survival

I don't think of myself as a cancer survivor. I rather think I'm surviving my healthcare system which has been far more difficult than my experience with cancer. I joke that I have spent more time on the phone with my heath insurance provider than I have with all my doctors in the last two and a half years combined. (For reference, I've had six surgeries so that's saying something.)

My brush with cancer was so brief it's as if I never had it which is a good thing. It means it was discovered in its earliest stages, before it even became invasive. It was, in fact, categorized as Stage 0 or as a pre-cancer: cancer cells that were growing in the milk ducts of my right breast (where most breast cancers begin) but hadn't yet ventured into the breast tissue. 

A lumpectomy was not possible because there was no lump, yet it was recommended that I have a mastectomy. Even though the breast tissue was, at that point, fine there wasn't all that much breast tissue to begin with, meaning the cancer cells, on a relative basis, occupied most of what little space there was. Ergo, it all had to go.

I have survived six surgeries: mastectomy, emergency drainage of hematoma, implant, removal of implant, insertion of tissue expander, final implant. In the span of two and a half years, I feel as though I've aged 10. It will take a long while for my body to recover from the effect of so many surgeries, or not being able to be active during six post-surgery recoveries.

Cancer survivor? More like cancer avoider. I was very lucky in that regard. Warrior? Maybe. But I didn't so much beat cancer as ran the other way. Yes, I survived but we're all surviving something.

Nearing the end, I hope.

My sixth, and hopefully last, surgery was August 10. They tell me it went well but I don't remember. 

I haven't looked at it yet. Not that I'm afraid to look, I just have been sleeping mostly since the tissue expander came out and the implant went in. 

I'm doing okay. Very little pain but some discomfort especially getting in and out of bed. My job is to just take it easy until my first follow up appointment.

Near the end? Not likely.

The final surgery has been scheduled for August 10. Meanwhile, there is the seemingly unending battle with my insurance company to pay for all of this. Plus, my surgeon's office sent me to collections because the battle with the insurance company was taking too long. So I paid the doctor off and now the battle includes trying to get a reimbursement for a claim that was processed incorrectly.

The hospital where I had my surgery lost my last two payments totaling $2,000 so they sent me to collections as well. It apparently makes no difference that I have sent them copies of the canceled checks. I don't deny that I owe them the money but I'm not going to pay them twice. It gives me a great deal of stress and opening the mail brings me no joy.

On the other hand, I'm blessed to have $2,000. I could make all this stress go away by giving them the money and then just hope that some day they'll figure it out and send me a refund with a sincere apology. BWAH HA HA.

I just hope they don't plan to blackmail me into giving them more money by holding up my next surgery. I want to get this over with.

Participation

I don't talk about my cancer for a few reasons but the main reason, at it's core, is that I'm ashamed of it. It wasn't awful enough. I still feel like I got a "participation medal for cancer." I wasn't outstanding in my field, but at least I played.

But then someone spelled my name wrong on the medal and I have to play again. It's not any more awful. It's just a redo like being picked last for a team. Again.

I'm waiting for the last inning so I can go home, if I may continue the analogy. One more surgery to go. 

Hopefully, my last.

And, by the way, I don't want to play this game ever again.

Otherwise, I'm good. 

The cost of healthcare.

 

There are billboards along the freeway announcing, "breast augmentation from $3,500."

This is a long way from $3,500.

Follow up #2

Drain came out and I took a nice long shower. Washed my hair and shaved my legs. I was also relieved of the restriction to not lift anything heavier than a gallon of milk. (I am still to avoid baths, swimming, and physical activities.)

There are still some mobility issues which will remain for several months. Namely, I can't lift my elbow above my shoulder. Pullover shirts are tricky but not impossible. Sports bras, if I'm going to wear one, are donned bottom up, pulled up my legs and over my hips before pulling the straps over my shoulders. Reaching for things with my left arm rather than my right.

I was also inflated at my last doctor visit. The tissue expander was installed with 150 cc of saline. He pumped me up to 200 on Monday. Baddah bing baddah boom! That, for reference, was the size of the implant he took out. Still, he wants to add another 25 cc next week. He's all about going bigger but I think he's only putting in enough for aesthetics and symmetry. Anyway, the final size is is yet to be determined.

After next week's appointment, we're back to waiting, three months, before my final surgery which should be sometime near the end of June. Just healing and getting stronger. And, getting ready for another surgery.

My sixth.

Follow up #1

6 days after surgery and feeling fine. Mobility is getting better, pain is receding more and more.

Saw my surgeon and he thinks things are going fine but not well enough to remove my surgical drain. That and two prescriptions for antibiotics remain for another week. This (the drain) makes bathing difficult not to mention getting dressed, especially in this climate. When one doesn't wear much in the way of clothing (as in, layers and/or loose clothing), it's difficult to be discreet about medical devices.

Next checkup is in a week. Until then, carry on.

Bionic Boob

The surgery for February 9 was postponed. This time because the ECG was irregular so the surgeon referred me to my primary care physician. I would need to obtain clearance from her in order for him to proceed. I saw her on February 1. The ECG taken in her office also came back as irregular so she referred me to a cardiologist.

Since I couldn't get in to see a Cardiologist until the 17th, the February 9 surgery date got pushed back again. 

The short story is my heart is fine and the Cardiologist approved my moving forward with surgery which got scheduled for March 2. This time, it stuck. 

I had a tissue expander placed in my right breast with 150cc of saline. For reference, the one that was removed was 200cc. The tissue expander has the capacity for 300cc which the surgeon thought I might take advantage of if I want larger boobs at this time.

Fat chance, I say. 

Surgery rescheduled

Surgery is currently scheduled for February 9, assuming we don't have another surge in COVID cases. While I'm not entirely enthusiastic about having surgery, I am looking forward to getting this behind me.

Or in front of me, as you might say.

View from the top

 

Location services... even here.

Grounded

All non-essential surgeries are hereby postponed due to COVID. Not surprising, I think that was the case last spring as well. At earliest, I might be re-scheduled for the first week in February. If that doesn't work, I don't know if I'll push to have it done before the middle of April.

I'm only a little disappointed. On the one hand, I'd like to get this over with. It would be nice to wake up with two boobs. It'd be nice to not have to stuff my bra every day - or to not wear a bra, even. On the other hand, I've had four surgeries already. I'm in no rush to have another one.

We'll get there when we get there.