My bellybutton is too high??? First Plastic Surgery Consult

02/08/17
9 days after my surgical oncology consultation, I went to the Plastic Surgery office for my first meeting with Dr. O and his nurse.  

Another pink gown

This was my first time in a plastic surgery office...and very unlike any doctor's office I've been in before!  It is a nice facility and every time I go, there is some little take-home "gift". This first visit I was given paperwork to fill out (just keep your insurance cards in the front of your wallet and a pen handy...there is always paperwork!) along with a pink pen and a pink chapstick (both with their logo).  

Shortly after arriving, I was escorted back to an exam room to wait.  They gave me a soft, knit patient gown to wear....pink, of course.  I was told to keep my jeans on and just take off my top and bra.  

The room looked like any other exam room except one entire wall was a mirror. A big wall mirror...like in a gym.  It also came with the standard fluorescent lighting....not exactly flattering!  Considering all of the reasons folks come to a plastic surgeon, a big mirror makes sense, but it certainly wasn't appealing to see myself in it.  

Once Dr. O arrived, he began the visit just by going over my recent history to find out what I already knew and what I didn't.  I knew he was an expert with the natural tissue reconstruction and I was hoping that he would tell me that I had enough belly fat to make a DIEP Flap procedure possible.  Something I did not know from my reading and was pleasantly surprised to hear:  During Stage 2, the scar revision and "make it pretty" phase, there is the opportunity for fat grafting...which could add an additional half-cup size if needed!  This was reassuring to me because I was worried about being too small with the natural tissue versus implants.  I am currently a big B-small C.  I definitely don't want to be much smaller.

After going over the DIEP Flap procedure, Dr. O had me stand at an angle in front of the wall mirror while he sat on a rolling stool in front of me.  Yikes!  He took measurements and called out the numbers while the nurse recorded them on her laptop.  

This is when things got amusing...at least to me.  I'm standing there half-naked and looking quite pale in that lighting that shows every flaw. All the while, Dr. O is looking very serious and pinching and pulling.  I am by no means thin and feel that I have plenty of belly fat to spare.  It was amusing to me that as Dr. O is pulling handfuls of my tissue, he says: "Well, you don't really have much fat here." My response:  "You're kidding, right?" He cocks his head to one side and says: "The only thing is.....well, did you know your bellybutton is a little high for you?"  Me: Ummmm.....nope.  Then, I looked over in the mirror and thought, "Well, rats, it IS high!. How'd I never see that before??"  Ugh.  

They are perfectionist by nature, I think, and artists whose canvas is the human body.

I've joked now that if you didn't have body issues before your visit to your plastic surgeon, you definitely will after!!  

Anyway....he was a really nice man and I felt quite positive after the visit.  He told me that I have enough belly tissue to create at least my current size or maybe a little bit smaller.  But, I will have the fat grafting option at Stage 2 if I don't feel that I am big enough.  He performed a Doppler of my abdomen to look for the vessels he will need for the reconstruction.  All in all, he said I was a good candidate for the DIEP Flap and he thinks I will be happy with the outcome. This was great news!

Image from www.uptodate.com

Here's how it is supposed to go....

Stage 1:  Reconstruction using my abdominal tissue.  I will have a hip-to-hip incision and a "lollipop" incision on each breast, plus whatever skin grafting incisions are needed.  This will be done immediately following my mastectomy by Dr. K.  Dr. O said to plan on at least 10 hours in the OR because of the delicate nature of microvascular surgery.  I will stay overnight for 3-4 nights.  I will most likely go home with 3-4 JP Drains that will stay in for 2-3 weeks.  I will have to be off of work for 6 weeks!

Stage 2: Scar revision, liposuction, shaping, fat grafting, and nipple construction.  This will take place approximately 3 months after recovery from Stage 1.  This will be day surgery.

Stage 3: Tattooing of the new nipple and areola.  This is an in-office procedure that should take place 3 months after Stage 2.

The office called me later that same day with a surgery date.....I was put on the schedule for Monday, March 6, 2017!  Good news:  I have a surgery date.  Odd news:  It happens to be on my 41st birthday!  

Those of you who have been following along already know what happened next....I spent more than a week dealing with an insurance mistake and had my surgery cancelled.  In the end, I got it taken care of and even got March 6th back.  You can read that post here. 

MY TIMELINE:

12/22/16  Routine Screening Mammogram

01/18/17  Repeat Imaging and US of left breast; LUMP found.
01/20/17  Core Needle Biopsy
01/24/17  Biopsy results positive...Stage 0 DCIS, left breast
01/25/17  Meeting with Breast Center Navigator and Genetic Testing
01/30/17  Consultation with Surgical Oncologist, Dr. K

02/08/17  Consultation with Plastic Surgeon

Insurance Fiasco and Near Meltdown

Today is Friday, February 17, 2017 and  it's been a rough week, folks!


Today I can finally take a deep breath and relax. Today is the first day in a week that I didn't wake up exhausted from tossing and turning all night. Today was a good day!

My brain has not stopped working overtime since they found that lump a month ago tomorrow, but at least it was on a low hum. This week, I feel like one of those memes about having too many browser windows open!

It all started last Thursday.  My surgery date had been set the day before for Monday, March 6, 2017. We had a plan! Yes!
Thursday, I was off of work and happily fiddling around the house, working in my craft room on a project, etc.  That's when the first call came....the Plastics office had verified my insurance benefits and said: "I'm pretty sure you were not aware of this before you came here, but we are OUT OF NETWORK with your specific plan."  

My brain didn't seem to be processing.  I was thinking:  What??!!??  That's not even possible.  The Breast Center referred me along with my Surgical Oncologist. The Breast Center that is affiliated with the hospital I work in!  Not possible.

Turns out she was surprised too--having never had this happen with one of our employees in the past.  But, she was obligated to tell me what she had been told.  I was confident this was an error and let her know that I'd check into it.  I immediately contacted my Breast Center Navigator....who was equally shocked and also started looking into it.  There were lots of long phone calls Thursday and Friday between me and my insurance carrier, me and the Plastics office, me and my bosses, me and my family, etc.  No one could figure out the problem, but everyone felt sure it was an error. Both evenings, my insurance carrier assured me that it was a mistake and that they would let the provider know.  And, the next morning, I'd receive a message from the Plastics office that it was not an error.  

I had to work Saturday and Sunday, but I still received emails from the Plastics office manager and some of the folks I had contacted to try to figure the mess out.  It was a fairly sleepless weekend.  

I knew that everything was in God's hands and I had faith that there was a reason for this stressful situation even though I could not see what it was.  But, it was not easy. My mind raced with thoughts...what would I do?  How could I possibly afford this?  I can't afford this...so now what?  This is the only group of surgeons in the area that do this procedure...ugh.  Do I really have to consider a lesser surgery because I can't afford the one I felt confident I needed?  It was all so smooth, why now, Lord? 

On Monday, I was off of work and waiting to hear some good news....instead, the Plastics office informed me that they could not hold my surgery date while we tried to remedy this.  She told me that she would still be trying to help me, but the date would NOT be held.  This was quite a blow!  I felt like the wind just went out of my sails.  I was clinging to that date...that date meant we had an active plan...that date was hope. And, just like that 

it was gone. I nearly cried right then.  I came close several times this past week.

I reached out to everyone I knew who might be able to help.  And, it turns out it was a good thing I did because it was a much bigger confusing mess than anticipated and it had the potential to affect other employees trying to access benefits.  A couple more days and still no closer to a resolution.  Finally, I reached out on Thursday morning (afraid of going into another weekend) to my administrators.  I let them know how nervous I was getting about this rocking on.  Everyone I knew was praying. And, that morning, the absolute right contact from our corporate benefits called me!  Not only was he a sympathetic and kind man, he instilled confidence immediately. He was finally able to identify where the issue started and address it.  He was so very nice keeping me updated all day on his progress.  By 6pm, as my shift was winding down, I got the final word that it was fixed!  And, not only for me, but addressed with the carrier so that no one else should run into the same issue.

The Plastics office manager called me within 15 minutes and confirmed that my benefits were exactly as I had believed all along and that they could reschedule me!!  My original date had been given away, but just that same afternoon she had cancelled.  My Surgical Oncologist was still holding the date for me, so this morning, I had confirmation from both offices that I was back on the surgery board for March 6th!!  Praise the Lord! Prayers were answered.

All this week, I questioned the reason this was happening to me.  Why everything had fallen so easily in place just to have this horrible, stressful, scary week.  My mother commented that Satan was trying to shake me because I have been so good with all of this.  Nothing has gotten me down until now so he hit me with a big area of concern...finances.  Maybe.  

Maybe, it happened to me so that it wouldn't happen to someone else....someone else whose cancer is more invasive and a delay would have been scarier....someone else who didn't do medical billing in a past job like I did and might not have understood that this wasn't right and questioned it....someone else who needed the stress even less than I did. 

From: https://www.flickr.com/photos/brizo_the_scot/4013939756

It doesn't really matter why it happened. What matters is getting through it...lessons learned. 

You might not face insurance worries, but you are likely to hit some kind of roadblock on this journey....your flock of sheep in the road.  It might be finances, or your significant other getting time off work, or a family vacation that has to be cancelled or a 
hundred other things that throw you for a loop. Just know that you can get through it....or maybe you will have to detour around it....but you will get to the other side if you keep moving, keep pushing, keep going.

I got through my scary bump....or LUMP...in the road this week and I slept better last night than I have all month!  And, tonight, I spent enjoying a night out with my son.

This is quite the journey. I'm learning things I never really wanted to learn. But, say it with me:  

God is good ALL the time!  

And, ALL THE TIME, God IS good!