Guest guest Posted September 2, 2002 Report Share Posted September 2, 2002 Hi , You have helped me soooo much and certainly worked very hard to try to get me the necessary assistance and help with all the 'details' (to somehow get this complex explant done). THANK YOU for all your effort!!! I will not be absent - but more silent. The ins: it 'seems' it is because they 'reduce' the fee. I am so sorry for your pain, . You certainly don't deserve it and I hope you begin to feel better soon! You are a wonderful person! Please know that! Love, J- And as always, we will keep in touch............ ---------- > From: Heer <idagirl@...> > > Subject: Re: please read - Thank you > Date: Monday, September 02, 2002 11:48 AM > > J > > I don't quite know what to say as I feel I have tried so hard to help you > and if you feel the need to be a silent member of the group, that is up to > you. It is not my choice to make. I am so confused by the ins and outs of > all this medical insurance stuff that I don't know what to make of it. If in > fact your insurance is good in any state why can't you find a Dr who will > operate on you? This is my biggest question and maybe it is yours too. > > Honey I wish you the best I hope that you will find help, and that you can > get the implants out of your body soon, no one should have to be in your > situation no matter what and it is a shame that you cannot find a good ps or > any ps that will work with you. > > I can only say that I wish you will reconsider your stance on not posting, > this group is here for you if you so choose to use it and we all care and > are wanting to give you support any way we can.' > > I am not doing well myself and am in pain 24 hours a day with my foot, it > has gotten so bad that my depression is bad and I am ready to try some > antidepressants if this doesn't get better soon. THe tendon in my foot and > heel is so inflammed that my only option may be to have it treated with the > ossa tron(eswt machine) which is $6,000 and not covered by insurance, so > despite getting rid of implants I am still suffering and once again looking > at spending tons of money to fix the problem. It sucks, I have been battling > pain for 4 years, it seems life is just not fair ! > ----- Original Message ----- > From: " JHH7 " <rogerlh@...> > < > > Sent: Sunday, September 01, 2002 7:02 PM > Subject: please read - Thank you > > > > Hi, > > > > Thank you for your time and reply. If I come across frustrated in this > > post, it is with the medical situation......... > > > > Let me reiterate, then I am politely returning to a more silent member of > > this forum............. > > (as I have been for the last several months). > > > > My initial questions were: > > 1) how does one meet the criteria for emergent explant???? > > 2) does anyone know a reputable surgeon in my area???? > > 3) or of any funds may be available to help me with the co-pay and travel > > if I find a dr. out of state??? > > > > 1st) > > Medicare DOES NOT LIMIT YOU by State!!!!! I have PRIMARY insurance any > > where in the US for any medical need - not just emergency care. I have > > received non-emergent care in other states. Any out-of-state physician can > > bill and accept Medicare!!! > > > > 2nd) > > Most DR's either accept Medicaid CO-pay or waive that CO-pay for patients > > with Medicaid as secondary insurance in most fields of medicine. It seems > > to be different for plastic surgeons. It is the Medicaid secondary ins. > > that presents a state to state billing problem for the co.-pay. There is > > not a problem with my primary ins. > > > > Any surgeon who would work with me on the co.-pay issue which would be 20% > > (that Medicaid would normally pay in my state but NOT PS) could have > > stepped up and performed my surgery in entirety. I have the same CO-pay > > problem in NY State as stated above. > > > > I was not told to simply start looking into explant arrangements. I was > > told " YOU NEED SURGERY!!! It is SEVERELY impacting your health and > > aggravating your medical condition. Silicone should not be spilt in your > > body and it will only get worse! " by 2 radiologist and several dr's. I > > was further told they will try not to " chop you to pieces but you need to > > get as much of the migration out as humanly possible " > > > > When you are told that you could have lymphoma, it is not a light > > conversation. The dr. has a genuine concern and wants this done ASAP. It > is > > not a stretch for ins. purposes but for my health and life. I was suppose > > to have surgery in July and waited for that but it was canceled because I > > was too sick with a respiratory infection. > > > > You do not biopsy calcifications of this kind ever or aspirate this type > of > > calcification. Nodes with this problem must be removed whole. Otherwise > you > > jeopardize your health even further. They are removed in entirety under > > general anesthesia in a Hospital. I don't know about other problems, as I > > can only speak about the specific calcifications I have - which are very > > deep and hard like a rock in the lymph nodes. > > > > It is not " I " who states the lymph's should be done simultaneously but > > rather my pc, rheumy, and the general surgeon I have consulted with. I > > have Dr's who are advising me that I would be crazy to undergo general > > anesthesia twice. Especially, since it is high risk with my general > > medical problems. With all do respect, my understanding is that removing > > lymph nodes is first year surgery and most dr.'s can do this no problem. > > This is a non issue. It is only an issue of time being of the essence. > > > > It is finding a ps to do the explant and address the migration of silicone > > that has been problematic. I have a general surgeon willing to do the > > nodes, but they do not have a ps to do the explant and migration. > > > > My Dr.'s are appalled at the lack of care they can find me for this > > procedure. The only ps they know personally actually suggested > > reimplantation with more silicone implants since this was reconstruction > > and I meet the criteria for silicone replacement. She would not be > > addressing any of the migration. This is not a consideration in our > > opinion. My Dr.'s will no longer be referring patients to that ps. > > > > I have two lymph issues: the axilla's full of silicone and the groin with > > calcification. > > > > Also, any time a Lupus patient is undergoing surgery it complicates > surgery > > and requires a VERY good physician / surgeon and usually in best case > > scenarios an attending rheumy who is familiar with Lupus. > > > > I was not asking for a complete " charity " case - just a dr. who is > > experienced in extracapsular silicone migration and lymph involvement who > > could work with me for the " co.-pay " issue. > > > > I have been urged by many - including dr's - not to go to an inexperienced > > ps. To go to one of the Dr.'s that are very familiar with explant of > > silicone and polyurethane. > > I understand the polyurethane are known to make people the sickest and are > > the hardest to remove. > > > > There are innumerable surgeons in NY city and no doubt someone is > qualified > > - - but to the patient it is like finding a needle in a hay stack. I was > > mutilated with my initial surgery and know first-hand how bad an > > " inexperienced " surgeon can be - and I required 2 subsequent surgeries for > > repair. Not to mention the emergency surgery for hematoma. And yes, I had > > drains. A personal recommendation goes a long way. So, I am more scared > > now based in my previous experience. > > > > I have already had 5 ps consults in NY (see below) after hundreds of phone > > calls to no avail. > > > > Maybe what you say is true for an intracapsular rupture but an > > extracapsular rupture with SILICONE clearly seen by ultrasound and MRI in > > my chest outside of the capsule and in the axilla lymph's should not be > > delayed this long. It is already 7 months since I have been working on > > this. This is too long for my specific case and the progression is clearly > > present on the new tests. > > > > I am inclined to believe that all insurance companies recognize spilt > > silicone as " medically necessary. " People may delay when they are either > > " not aware " of their rupture or have intracapsular rupture only. I don't > > know. But once a patient knows of extracapsular silicone rupture then only > > bureaucratic / financial issues, or health would delay a person in > > obtaining the necessary explant, I would think. > > > > OK with all that said.... > > I posted the other day in simply response to who has been a great > > help and a good friend and support through all this. I decided to post on > > the forum in hope that I could broaden the ideas that I may receive. > > > > Everyone keeps telling me " you need to get money and go to Dr. Feng or Dr. > > Kolb ect. " So, I thought I would post for help. > > > > Thank you for listening. > > > > No patient should ever find themselves in the position I find myself. I > > speak not just for myself, but for all the rest of the woman who have and > > will encounter this injustice. > > > > I am just beginning to understand the magnitude of this issue. > > > > Signed, > > Another.....naive, trusting patient. > > > > J- > > > > CONSULTS: > > > > I had already been on 5 ps consults in NY (after hundreds of calls) prior > > to even agreeing to let a the begrudging original surgeon schedule me - to > > no avail. > > > > 4 were totally out of the question. Only one was qualified but now tells > me > > she " can not accommodate me as my case has progressed to much. " She urged > > my not to let my care go beyond Aug. Only underscoring my concerns. > > > > Samples of my experience are as follows: > > > > 1. How do we detect and remove the spilt silicone? Reply " we don't have > > to. Silicone is not a problem. Pacemakers, hip replacement, et. are made > of > > silicone. (not raw spilt gel) Suggestion/recommendation is that you > > replace with more silicone since you have such a nice result. You can be > in > > the study. " > > > > Note: I would have to be crazy and clearly they are not going to concern > > themselves with removing the migrated silicone. > > > > 2. Not even concerned what type of implants I have (saline vs. silicone). > > Tells me he will leave the capsule and scar tissue so it will serve to > > " augment " me. Are we kidding here? Did not even look at the films. > > > > 3. Has done a total of 20 explants only 2 without replacement. 2 explants > > only. I don't want to be only the 3rd - especially with the poly. > > > > 4. Rude - Rude - Rude has only done 20 explants total. Only 2 with a lift. > > Did not even take a medical history. Did not look at the films. Clearly > did > > not want the case. > > > > 5. Dr. Mentioned above whom states she cannot take the case now. Could > > have, but not now because of the progression and time-frame. > > > > Oh yes and then there were my 2 general surgery consults. > > > > One tells me " no need to excise " silicone and did not investigate what > > exactly was in the nodes. > > > > In the interim, I had my ultrasound after about 50 phone calls I found a > > radiologist skilled to do silicone mapping w/ ultrasound. > > Lymph Findings: silicone in axilla nodes and the groin is calcification.. > > > > With that, the second general surgeon was the surgeon I WAS scheduled with > > and he was going to operate with the original ps > > > > Thank you for reading this through. > > > > > > > > Quote Link to comment Share on other sites More sharing options...
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