Re: Good and Bad News for me

[Guest guest]

In a message dated 8/21/2006 1:13:58 PM Eastern Standard Time, leyna1964@... writes:

I am still waiting for them to call me back on this though, so maybe I can tell them I have GOT to be put to sleep....?

Leyna,

Keep in mind my other post about the types of anesthesia, and double check with them on their definition of "asleep."

Like I was saying before, some doctors do local and sedation, but sedate you enough to make you sleep during the worst, but you are still breathing for yourself so it isn't "general anesthesia." Then some doctors will do "MAC" (Monitored Anesthesia Care) in office, making you sleep, but you are still breathing for yourself so it isn't "general anesthesia" either.

The confusion is in that while you are out during MAC, people don't call it "asleep" because you are still breathing for yourself...

Some will do MAC and some won't. If they will not do MAC, and the only type of anesthesia they can do is "local with sedation" --they probably can't (or won't) do it "in office" at all. It usually isn't a matter of telling them you HAVE to be asleep. It's usually a matter of their liability issues, and malpractice insurance. If that's the case, they will probably make you do it "asleep" (MAC or otherwise) in a one day surgery center or hospital operating room instead--which costs more.

Many doctors in WV will not do it asleep, due to malpractice issues and their insurance... although, the costs for these extra fees in WV runs about $5,000, but in KY was only going to cost me $1,000 more. So... how much extra it is would really depend geographically. (We lose many doctors in WV each year because their malpractice insurance is so high... so things like that cost more here.) That may or may not be a big deal to you. Plus, if your insurance is covering it ---they may cover this as well.

Just keep checking -I know you are doing that already, but just wanted you to understand this so you'll know more going in.

Good luck!

Brigite

[Guest guest]

Hey try saying they are causing pain not making you sick.....my insurance will cover this not for them making me ill...make sure you say you have pain in BOTH breast...that did it for me.

[Guest guest]

My husband has also had multiple hand surgeries for genetic birth defect...I think 5 and counting. It doesn't seem like they sedate him nearly as much as me when I've had bigger procedures done, because like you're saying -he says he feels the pressure and hears everything, or it hurts when they aspirate cysts out. I just assumed they aren't doping him up as much because it's easier to numb an area like the hand. (He's had it done by both a surgeon and a plastic surgeon.)

So, check it out...

What concerns me most is the people who've already had it done saying it doesn't sound like they would do it right if you aren't asleep. They all know best...

Let us know when you find out if it's MAC or not. I'm praying it is.

Brig

[Guest guest]

something else to consider....

when I got my implants it was at my PS's office.. they said it was general but I later found it was not - probably the MAC as it is called.... IV sedation and local.... I remember absolutely nothing at all... when I went back in the next 2 times to fix complications it was the same place - the same anesthesia..... I remember being in recovery hearing lipo in the next room - I could hear the girl moaning and such and I guess it was freaking me out... the nurse said don't worry - she is out of it and won't remember a thing.... sure enough she was wheeled next to me and a few weeks later we were at a follow up together and I asked her and she said she didn't remember anything after they put the IV in... I think there are different levels of meds they give you depending on the surgery.... I had my explant by a different PS at the hospital under General....With an explant, if this "local" is the route you have to go - I would assume it would be more/different meds then your hand surgery so you would not remember... just a guess but if you can not go elsewhere or get him to do it in the hospital under general, make sure you mention the "hand thing" to make sure whoever is doing your sedation understands this so they give you what you need.... make sure this is discussed before hand although maybe you can still discuss this matter w/ your insurance and see if you have any benefits out of network as Lynda suggested?

shari

[Guest guest]

Will they pay the majority if you go out of network, most will.

Usually 80% or something like that.

Lynda

At 11:11 AM 8/21/2006, you wrote:

>I've got good and bad news. The good news is that I called my

>insurance company, and YES, they will cover having my implants

>removed, 100%.

>

>YAAHHAA!!

>

>The bad news is that out of the list of doctors that my insurance

>company gave me, only one of them does En Bloc, and they are the

>ones who do it under local anesthesia, in their office! I am still

>waiting for them to call me back on this though, so maybe I can tell

>them I have GOT to be put to sleep....?

>

>My insurance company says that they have to have proof that the

>implants need to be removed, in order for them to pay.

>

>I asked them if I could get this proof from my Gynocologist, who

>has been following me on this, and agrees that my problems are

>probably implant related.

>

>They said No, it has to be from my PCD.

>

>I have never even been to my PCD before....I had switched to a new

>one last year, and have never needed to go to him. I just go to my

>Gynocologist or Endocronoligist when I need anything.

>

>So, I called to make an appointment to see the PCD...how stupid-I'm

>gonna have to show him my boobs, like he can actually look at them

>and say whether they are making me sick!

>

>I have an appointment with him on Thursday, and will get him to

>order me an MRI, unless I can talk him into agreeing to put, in

>writing, that my implants are causing problems and need to be

>removed, and that he will submit this to my insurance.

>

>I'm stuck between a rock and a hard place! Maybe if I hook my

>printer back up and then print out some articles to give to him.....

>

>Either way, that's my good and bad news. Good that my insurance will

>pay all of it, and bad that I can't find anyone who does En Bloc,

>except for the one doctor who does it in his office, and who says

>that insurance will not cover this!

>

>Not sure what to do next!

>

>

[Guest guest]

In a message dated 8/21/2006 4:41:01 PM Eastern Standard Time, leyna1964@... writes:

Wonder why that girl was moaning if she didn't feel anything though? lol

She said the chick was having lipo... which is WAY different. There's no numbing the deep fatty layers that they do lipo on. They numb as deep as they can, then as the suction rod rips through your fat tissues, it expells a numbing solution. So, you feel all the burning and stinging until the numbing solution makes its way through you, though you're so sedated it's tolerable.

(Not to stray off the subject -but I would *NEVER* go through lipo again unless maybe it were ultrasonic assisted, and even then I'd be leary. It left all my nerves damaged in the areas where I had it done. It hurts for the skin to even be touched by fingertips in those areas.)

But as I've been saying, I can't speak for what explant and removing the capsules would be like, only implanting -which was fine awake.

Brig

[Guest guest]

Yes, I understand the difference in the different

kinds of anesthesia. I guess it's just freaking me out

because I remember EVERYTHING that went on when I had

a nerve block surgery on my hand. I remember feeling

pressure and pulling, and I heard the surgeons saying

the details of what they were doing. I was " out of it "

and didn't care, but it was just on my hand...I think

it would be disgusting to hear " Ok, we are cutting

into the right breast and now removing the implant,

which is ruptured.. " UGH! lol

--- KissofSadness@... wrote:

>

>

> In a message dated 8/21/2006 1:13:58 PM Eastern

> Standard Time,

> leyna1964@... writes:

>

> I am still

> waiting for them to call me back on this though, so

> maybe I can tell

> them I have GOT to be put to sleep....?

>

>

>

>

> Leyna,

>

> Keep in mind my other post about the types of

> anesthesia, and double check

> with them on their definition of " asleep. "

>

> Like I was saying before, some doctors do local and

> sedation, but sedate you

> enough to make you sleep during the worst, but you

> are still breathing for

> yourself so it isn't " general anesthesia. " Then some

> doctors will do " MAC "

> (Monitored Anesthesia Care) in office, making you

> sleep, but you are still

> breathing for yourself so it isn't " general

> anesthesia " either.

>

> The confusion is in that while you are out during

> MAC, people don't call it

> " asleep " because you are still breathing for

> yourself...

>

> Some will do MAC and some won't. If they will not

> do MAC, and the only type

> of anesthesia they can do is " local with sedation "

> --they probably can't (or

> won't) do it " in office " at all. It usually isn't a

> matter of telling them

> you HAVE to be asleep. It's usually a matter of

> their liability issues, and

> malpractice insurance. If that's the case, they

> will probably make you do it

> " asleep " (MAC or otherwise) in a one day surgery

> center or hospital operating

> room instead--which costs more.

>

> Many doctors in WV will not do it asleep, due to

> malpractice issues and

> their insurance... although, the costs for these

> extra fees in WV runs about

> $5,000, but in KY was only going to cost me $1,000

> more. So... how much extra it

> is would really depend geographically. (We lose many

> doctors in WV each year

> because their malpractice insurance is so high... so

> things like that cost

> more here.) That may or may not be a big deal to

> you. Plus, if your insurance

> is covering it ---they may cover this as well.

>

> Just keep checking -I know you are doing that

> already, but just wanted you

> to understand this so you'll know more going in.

>

> Good luck!

>

> Brigite

>

>

>

__________________________________________________

[Guest guest]

Well, actually I do have breast pain a lot.

About a year and a half ago, I thought I was having a heart attack

and called an ambulance. They could not find anything wrong with my

heart-they said I was having a panic attack. I knew I wasn't, but at

that time I didn't think it was my implants causing the pain.

I've now read online that MANY women go to the ER with chest pains,

thinking it's their hearts.

A few days ago when I went to my Gyno, I told him it was time for my

yearly mammogram. I saw the paperwork before they put it up, and it

said Fibrocystitic breasts and breast pain...well, they used a

technical term for it but I asked and they said it meant breast pain.

>

> Hey try saying they are causing pain not making you sick.....my

insurance

> will cover this not for them making me ill...make sure you say you

have pain in

> BOTH breast...that did it for me.

>

[Guest guest]

Hi! Ok, I guess that does make sense about the different anesthesias. Wonder why that girl was moaning if she didn't feel anything though? lol I called my insurance back and asked them if they would cover me having the surgery out of Tennessee. They said that No, they would not-it had to be done here in Tennessee, but that IF no surgeons qualified are found here that they MAY make an exception, if certain procedures and letters to them are obtained. I called Dr. Kolb first, and she does not take my insurance at all. I called Dr. Melmed and have been talking to them. They quoted a price of $7,000 which includes a lift too. And they said they would work with insurance companies, but that I would have to already be seeing them as a patient. Which would mean spending a few thousand to fly to Texas, just for a consultation, and then another few thousand to fly back once

they schedule the actual surgery. There is no way I can do that!halvey70@... wrote: something else to consider.... when I got my implants it was at my PS's office.. they said it was general but I later found it was not - probably the MAC as it is called.... IV sedation and local.... I remember absolutely nothing at all... when I went back in the next 2 times to fix complications it was the same place - the same

anesthesia..... I remember being in recovery hearing lipo in the next room - I could hear the girl moaning and such and I guess it was freaking me out... the nurse said don't worry - she is out of it and won't remember a thing.... sure enough she was wheeled next to me and a few weeks later we were at a follow up together and I asked her and she said she didn't remember anything after they put the IV in... I think there are different levels of meds they give you depending on the surgery.... I had my explant by a different PS at the hospital under General....With an explant, if this "local" is the route you have to go - I would assume it would be more/different meds then your hand surgery so you would not remember... just a guess but if you can not go elsewhere or get him to do it in the hospital under general, make sure you mention the "hand thing" to make sure whoever is doing your sedation understands this so they give you what you need.... make sure

this is discussed before hand although maybe you can still discuss this matter w/ your insurance and see if you have any benefits out of network as Lynda suggested? shari

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[Guest guest]

I don't know if this will help, but I had twilight sedation for my removal. I had no idea about the different kinds of anesthesia, so I just went along with the doctor who was on the recommended list and who did an en bloc removal with lift. It took 4 hours. I have to say, I was indeed out for MOST of it....I do remember sort of coming to while they were stitching up my right breast, hearing them talk about a movie or something, and then I started letting them know I was waking up. They put me out a little bit more and the next I knew I was waking up in recovery. It wasn't sooooo bad. (If that helps!) I go through explant anyway, and that was all I wanted. Oh, he performed this surgery in a hospital setting...and my insurance paid for it (including the lift!) PattyLeyna <leyna1964@...> wrote: Yes, I understand the difference in the differentkinds of anesthesia. I guess it's just freaking me outbecause I remember EVERYTHING that went on when I hada nerve block surgery on my hand. I remember feelingpressure and pulling, and I heard the surgeons sayingthe details of what they were doing. I was "out of it"and didn't care, but it was just on my hand...I thinkit would be disgusting to hear "Ok, we are cuttinginto the right breast and now removing the implant,which is ruptured.." UGH! lol--- KissofSadnessaol wrote:> > > In a message dated 8/21/2006 1:13:58 PM Eastern> Standard Time, > leyna1964 writes:> > I am still > waiting for them to call me back on this though, so> maybe I can tell > them I have GOT to be put to sleep....?> > > > > Leyna,> > Keep in mind my other post about the types of> anesthesia, and double check > with them on their definition of "asleep."> > Like I was saying before, some doctors do local and> sedation, but sedate you > enough to make you sleep during the worst, but you> are still breathing for > yourself so it isn't "general anesthesia." Then some> doctors will do "MAC" > (Monitored Anesthesia Care) in office, making you> sleep,

but you are still > breathing for yourself so it isn't "general> anesthesia" either.> > The confusion is in that while you are out during> MAC, people don't call it > "asleep" because you are still breathing for> yourself... > > Some will do MAC and some won't. If they will not > do MAC, and the only type > of anesthesia they can do is "local with sedation"> --they probably can't (or > won't) do it "in office" at all. It usually isn't a> matter of telling them > you HAVE to be asleep. It's usually a matter of > their liability issues, and > malpractice insurance. If that's the case, they> will probably make you do it > "asleep" (MAC or otherwise) in a one day surgery> center or hospital operating > room instead--which costs more. > > Many doctors in WV will not do it asleep, due to> malpractice issues and

> their insurance... although, the costs for these> extra fees in WV runs about > $5,000, but in KY was only going to cost me $1,000> more. So... how much extra it > is would really depend geographically. (We lose many> doctors in WV each year > because their malpractice insurance is so high... so> things like that cost > more here.) That may or may not be a big deal to> you. Plus, if your insurance > is covering it ---they may cover this as well.> > Just keep checking -I know you are doing that> already, but just wanted you > to understand this so you'll know more going in. > > Good luck!> > Brigite > > > __________________________________________________

[Guest guest]

Wow! They paid for the lift too? Awesome insurance you've got!Tricia Trish <glory2glory1401@...> wrote: I don't know if this will help, but I had twilight sedation for my removal. I had no idea about the different kinds of anesthesia, so I just went along with the doctor who was on the recommended list and who did an en bloc removal with lift. It took 4 hours. I have to say, I was indeed out for MOST of it....I do remember sort of coming to while they were stitching up my

right breast, hearing them talk about a movie or something, and then I started letting them know I was waking up. They put me out a little bit more and the next I knew I was waking up in recovery. It wasn't sooooo bad. (If that helps!) I go through explant anyway, and that was all I wanted. Oh, he performed this surgery in a hospital setting...and my insurance paid for it (including the lift!) PattyLeyna <leyna1964 > wrote: Yes, I understand the difference in the differentkinds of anesthesia. I guess it's just freaking me outbecause I remember EVERYTHING that went on when I hada nerve block surgery on my hand. I remember feelingpressure and pulling, and I heard the surgeons sayingthe details of what they were doing. I was

"out of it"and didn't care, but it was just on my hand...I thinkit would be disgusting to hear "Ok, we are cuttinginto the right breast and now removing the implant,which is ruptured.." UGH! lol--- KissofSadnessaol wrote:> > > In a message dated 8/21/2006 1:13:58 PM Eastern> Standard Time, > leyna1964 writes:> > I am still > waiting for them to call me back on this though, so> maybe I can tell > them I have GOT to be put to sleep....?> > > > > Leyna,> > Keep in mind my other post about the types of> anesthesia, and double check > with them on their definition of "asleep."> > Like I was saying before, some doctors do local and> sedation, but sedate you > enough to make you

sleep during the worst, but you> are still breathing for > yourself so it isn't "general anesthesia." Then some> doctors will do "MAC" > (Monitored Anesthesia Care) in office, making you> sleep, but you are still > breathing for yourself so it isn't "general> anesthesia" either.> > The confusion is in that while you are out during> MAC, people don't call it > "asleep" because you are still breathing for> yourself... > > Some will do MAC and some won't. If they will not > do MAC, and the only type > of anesthesia they can do is "local with sedation"> --they probably can't (or > won't) do it "in office" at all. It usually isn't a> matter of telling them > you HAVE to be asleep. It's usually a matter of > their liability issues, and > malpractice insurance. If that's the case, they> will probably make you do it

> "asleep" (MAC or otherwise) in a one day surgery> center or hospital operating > room instead--which costs more. > > Many doctors in WV will not do it asleep, due to> malpractice issues and > their insurance... although, the costs for these> extra fees in WV runs about > $5,000, but in KY was only going to cost me $1,000> more. So... how much extra it > is would really depend geographically. (We lose many> doctors in WV each year > because their malpractice insurance is so high... so> things like that cost > more here.) That may or may not be a big deal to> you. Plus, if your insurance > is covering it ---they may cover this as well.> > Just keep checking -I know you are doing that> already, but just wanted you > to understand this so you'll know more going in. > > Good luck!> > Brigite >

> > __________________________________________________

[Guest guest]

*SHUDDERS* lol....I'm such a wus! I don't know how you did it! Well, it's after 5pm and I did not hear back from that surgeons office. They did say they were really busy though, and trying to return calls either later this afternoon, or in the morning. I also didn't hear back from my Gynocologist, who will want to know that my implants are in fact, silicone, not saline. He will probably refer me for an MRI to see if they are leaking, although I've heard that this does not always detect it-but it may be benificial in getting my insurance to cover it. Also, I'm hoping my Gyn will be able to refer me to someone better to do my explants....hopefully I'll hear back from these people tomorrow.KissofSadness@... wrote: In a message dated 8/21/2006 4:41:01 PM Eastern Standard Time, leyna1964 writes: Wonder why that girl was moaning if she didn't feel anything though? lol She said the chick was having lipo... which is WAY different. There's no numbing the deep fatty layers that they do

lipo on. They numb as deep as they can, then as the suction rod rips through your fat tissues, it expells a numbing solution. So, you feel all the burning and stinging until the numbing solution makes its way through you, though you're so sedated it's tolerable. (Not to stray off the subject -but I would *NEVER* go through lipo again unless maybe it were ultrasonic assisted, and even then I'd be leary. It left all my nerves damaged in the areas where I had it done. It hurts for the skin to even be touched by fingertips in those areas.) But as I've been saying, I can't speak for what

explant and removing the capsules would be like, only implanting -which was fine awake. Brig

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[Guest guest]

Leyna . . . Breast pain could go a long way in getting your insurance to pay for your surgery! Rogene