Monday, June 14, 2010

You can't fire me, I quit!

My plastic surgeon called me this morning. He, once again, apologized for the error that caused me to spend four unnecessary hours waiting for a surgery that did not take place.

Then he shocked me. He wanted to see me, not because he was changing the size of my implants, or because he wanted to switch from silicone to saline.

He was firing me.

Apparently, a while back he had decided he no longer wanted to do reconstructions. I was his last patient. With the error that happened and the fact that there would be a delay, he figured it would be a good time for me to start over with another doctor. I will need several revisions and surgeries down the road and for continuity, he thought it would be best for me to find somebody I can stick with since he won't be doing them.

Ann's Translation: The hospital fucked up, he's sick of it, doesn't want to deal with it and insurance companies anymore, doesn't need to financially - and I got caught in the middle.

He gave me the name of a plastic surgeon who still takes insurance. I googled her, she seemed experienced. She was a combat doctor and has gone around the world reconstructing the faces of injured and disfigured people - sticking a boob in a piece of skin should be a piece of cake after that, right?

Dr. S.'s office had sent the referral, and the scheduler said she'd just talked to them and they could fit me in quick.

So, I called.

Now, I don't know if the scheduler made that story up, but there is no "fitting in quick." In fact, Combat Doctor had suffered an injury over the weekend and was rescheduling all her surgeries, and she was full until October. She can't even see me for a consultation until July 29th.

I go back to work August 2nd.

I want this expander out of me. It hurts. It gives me shooting pains in my chest. I can't sleep on it, and I can feel it rubbing against my ribs and the inside of my skin. Having it in for over a year - when I didn't even have radiation? It's unimaginable.

I made the appointment with Combat Doc, but I also wanted to look around. I called Dr. Lee, listed in my last blog post.

He no longer takes insurance patients.

In fact, several people listed under my insurance plan have changed their minds - they don't see insurance patients.

Can you blame them? If you can charge a vain woman $7,000 for fake boobs and do it in your own basement surgical center, and be in control of the entire process (including ordering implants), and schedule 3 or 4 of them a day ($28,000), and end up with a happy patient - why would you do difficult reconstructions that never come out perfect at hospitals under the rules of petty bureaucrats who just might forget to order your implants and leave you and everybody else hanging?

You wouldn't.

I wouldn't.

So, now I'm stuck. My new doctor is injured and can't operate. None of the others listed on my insurance plan actually takes insurance. There is one exception: my only other option is a person who is over an hour away by car (if I'm lucky enough to have no traffic.)

Considering that it's out-patient surgery and I will have to drive straight home after it, and then go to his office several times in the next few days for wound checks and drain-removal, I don't want to have to go that far, especially when there are two hospitals within 15 minutes of my house.

I don't live in a rural area - I should be able to find a doctor closer.

One would think.

I'm beyond frustrated that I can't get medical care. Now, everything that I didn't want to happen is going to. I will have this painful and ugly expander in for the summer, and the next school year will be impacted. It will cost me money since I'll have to take more time off work and have no sick leave left and won't for a while. Not to mention how patient my coworkers have been with all the time off I've had, and I wanted to begin the school year as if it was normal.

Emotionally, it's difficult. While I'll still have herceptin and oncology visits and some minor surgeries, the end of my cancer treatment - in my mind - was this surgery. This was the final big thing, and I've been telling myself that when this surgery is done, I could finally start to put it behind me and get back to my life.

And, that won't happen for quite a while.

I just hope Combat Doctor doesn't see the light and decide to give up insurance patients before my consult.


  1. I am fuming!! I am so sorry! This is absolute and 100% bullshit!!! I will write something nice later for you, for right now I am so sorry! There has got to be another route. Meanwhile, is there is any threat to your health in having these expanders in for so long? you might want to have a meeting with your former plastic surgeon, perhaps with a lawyer present, and have him make sure he or someone else gets those things out of you, this summer! He put them in right? Talk about continuity, finish the damn job! If he can't, he needs to make sure he gets you someone who can.

  2. Oh, Ann! I can't believe that he would 'drop' you. I agree with Katie. He owes it to you to finish what he started. That's just plain awful.

  3. I really can't believe this. I am SO sorry, this is absolute BS

  4. That's just not right. If you still want your ps to work on you, I'd talk with him about your having signed up with him "for the duration," and while he might have made other plans since you started with him, your needs as a cancer patient should come first. Honestly, they should, and he should see you through, unless he's retiring for good from everything right now. Or if you'd rather move on now (I could see that), and no one else in your area will take your insurance except for an injured dr. who can't help you in a reasonable timeframe, I'd suggest calling your insurance and asking/insisting that they find you a suitable doctor in your area who will take the insurance or allowing you an exception because of a "network deficiency"--they aren't contracted with a viable dr in your area, so you should be cleared to go with anyone else in your area who is competent and can see you more quickly--especially if you're in pain, that's never acceptable. Just my 2 cents, good luck to you!

  5. Thank you ladies, for your outrage on my behalf. I appreciate it.

    Katie, it's not dangerous to have the expander in for long periods. Women who have radiation routinely have them for a year, until their skin heals. But, I didn't have radiation and now it seems mine will be in for more than a year.

    I agree that it isn't responsible - or kind - to leave me hanging like this. It's hard to imagine how somebody who supposedly enters the field of medicine to help people can end up being this uncaring. But, I'm not begging a doctor to perform surgery on me when he doesn't want to - that would be stupid.

    I did call my insurance company and they told me that everything has to originate from my original PS's office. That was before I knew how few surgeons there were who would do this. I will call tomorrow and see how to get an out-of-network provider but I'm concerned that they won't think my reason is good enough. (Not wanting to drive over an hour for the one left who can do it - who also does very few breast reconstructions).

    Ms. Combat Doctor actually looks like she's got the chops to do this but waiting that long seems unfair to me. Not her fault but's just very very disappointing.


  6. In terms of the your excuse not being good enough for driving that far, well frankly you should not have to even have an excuse. However, like you said, there are many follow up visits, and a portion of them you are bound be under the influence of pain killers (hopefully :P) Just say your husband, friend, whoever would be driving you while on these meds cannot take that much time off, an hour and a half in both directions, plus an hour or so for the appts. if the docs are on time. Explain you did all the work and made all the arrangements, as did people who were going to help to care for you, and you are unable to reschedule everyone's life around this jerk's mistake. I know I am taking this far, I am just so shocked. Feel free to disregard this looong comment! ;) Hope things fall into place soon!

  7. I am so sorry, I would be livid. I don't see how that is legal to leave you hanging like that. I would think it is the former plastic surgeon's job to find a replacement to do the job quickly, or cover the difference. to leave you stranded in the middle, disgusting. I think involving a lawyer is a good idea.

  8. Yikes I can't believe he did that. From what you say, Combat Doc sounds qualified. I'd call her office every morning and afternoon if necessary to get in on a cancellation AND get on her cancellation list. I just got back from seeing one of my docs, and she said that calling in every day might work as docs don't always get to their cancellation list before the slot gets filled. Also, I don't know if you have checked this site out, but it is a place to explore I agree with Meg that your former PS should be bending over backwards making the transition happen, and I would demand it of him. "The squeaky wheel gets the oil", and now is the time to squeak and squeak and squeak so you can be done and well on your way long before school starts for you. Getting an attorney might not be such a bad idea. Maybe the American Cancer Society in your area can help. I just can't believe that your PS did this to you.

  9. You know I find the whole American system so weird ... it necessary wrong ... or right ... just so different to the English system which is much more joined up. I am grateful ... I have two wonderful consultants ... and I know under the NHS I have the right to "Choose" expertise elsewhere ... but am very grateful for what I have.

    Hope you are fortunate with your search.


  10. Hi Ann, bugger about your PS - but I agree with you that any surgeon that is reluctant to operate, is not the surgeon I'd want operating on me. I think his behaviour probably qualifies as unethical, however - better have someone who recognises his deficiencies (for whatever reason) and backs out now, than one who plunges on and potentially causes more problems in the future. This hiatus in your treatment is frustrating and inconvenient, but gives you lots of time to build yourself up for the next stage. And get over the shock of a medical profesional leaving you in the lurch. thinking of you.

  11. Hi Ann:
    I am outraged for you. I think you should call your insurance company and get them to work out a new solution. If cancer patients are eligible for paid disability and handicapped plates, there's no way they can expect you to travel so far, so frequently, for your appointments. Hell, it's California - you can't swing a dead cat without hitting a plastic surgeon, right? Don't take "no" for an answer.

    Go git 'em, girlfriend.

    - Sarah

  12. Hi Ann,

    This is infuriating, indeed!! I have fantasies of having expanders placed in the surgeon who fired you and let the jerk see how it feels to be in your shoes.

    I hope the Combat Doctor gets better soon. In the meantime, there's a society of plastic surgeons (I forgot the name, still suffering from chemobrain). Maybe call them to complain about what's happening to you. Maybe they can put some pressure on the docs to get things moving, or you can tell the docs you'll report them...

    That being said, I know what it's like to hit the brick wall of shame that doctors can set up. It took me 10 months to get my double mastectomy with reconstruction (the mastectomy was a preventive; I had breast cancer a few years before). I had doctors wanting to remove ovaries, give me a colonoscopy, remove my uterus, and do nothing. I had doctors scolding me for not listening to them.

    I fought very, very hard to get what I wanted and needed. You will get the surgery you need. Like me, you are not just a fighter, you are a warrior!


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