Size G - Breast reduction and tummy tuck

Excited for my surgery but I am stunned to find...

Excited for my surgery but I am stunned to find out how little insurance will actually cover. I am still going through the review process to get it approved, but OMG. The contracted amount they will pay my surgeon is less than $2000. I have Premera Blue Cross. So my out of pocket looks like it will be around $7000. I say that because I have to pay my deductible, then I pay 20% of the contracted rate of $2000. Meaning their only going to pay at the most $1400 for this surgery. I called to speak to a rep and she informed me that the surgeon has to only charge $2000 for the surgery. I said I can't think of a surgeon in the United States of America that I can go to that will only charge $2000 for a breast reduction. Maybe in Mexico. But not here in the United States. They stand by what they say and there is no wiggle room. I am so tired of the back pain, I want to live. Will keep posts on how this is going.

Day of Surgery - 03/24

I live a bit from Boulder. A hour on a good day. So I stayed at a hotel nearby. The night before surgery I was by myself because my helper wasn't able to get away until the next day. My doctor had told me that I was going to be constipated between the anesthesia and pain meds. So I stopped and picked up a bag of prunes and a bag of apricots. I ate about ½ cup of each with my dinner. I am sorry, I am not going down that road thank you very much. I didn’t get much sleep that night. Maybe 3 hours. I was actually excited for surgery so I could sleep. And all night I was doing Yoga breathing, trying to get my lungs as strong as I possibly could. I walked to the PS office where I was having surgery. I had read it was good to walk prior to surgery and thought well I can’t be a bad thing. I have to tell you I love my anesthesiologist. She was amazing. The fact that I went to sleep and woke up with no issues, I love her. Before I went in I had told her my fears about a previous surgery. That night (of the previous surgery) I had stayed in a facility. The nurse kept waking me up because my oxygen levels would drop to dangerous levels. And I was nervous about this. She ordered me oxygen and had it delivered to my hotel a couple hours after surgery. How amazing is that? Anyway they sent me with my helper. I had brought a walking stick and they sent me to the hotel with a portable oxygen machine. So in each hand something was keeping me upright. I had gone back and forth on the walking stick, but I have to tell you, if you can get one, bring one. The was a huge life-savor. It kept me upright instead of hunched, because until I was holding on to the walking stick and oxygen tank and someone was helping me, I was extremely hunched. The minute back to the hotel I started on my prune/apricot regimen. At dinner I ordered a whole wheat pizza (keeping up with the fiber theme) and had again my prunes/apricots (and of course pain meds). My huge fear was getting blood clots. I was in surgery for 5 hours. That is a long time for surgery. So every 4 hours I was walking around with my oxygen (even though they put me on an oxygen machine, I used the portable tank as a walking stick) and my walking stick for 20 minutes. The first 20 minutes was a little rough, getting up and laying back down is the hardest part. Most painful. Each time got easier and easier. Oh and using the restroom. I have a bidet at home and I am thanking god for that. This is going to sound super gross, but wiping yourself front or back is soooo painful. I should have gotten a handicap room with the higher toilet. I had bought the bidet a couple years ago to save on toilet paper and for cleanliness. Just a cheap one on Amazon. It is the greatest thing. It isn’t hooked up to an electrical so you still have to dab down there to dry. But if you are getting this surgery, I highly recommend. And I love my doctor. You can see he really enjoys what he is doing, not just in it for the money. Can’t say enough. aI had my surgery Monday the 24th, but I cannot change the date. Original review reflects the 31st.

March 25 – day after surgery

March 25 – day after surgery
Things are going pretty well. Sleep was not the best. With the oxygen machine I was not able to close my mouth, there was not enough air going through my nose. So I had to keep my mouth open the entire night. It wasn’t the best sleep. I had my alarm on my phone set to go off every 4 hours so I could get up and walk around (Before discharge yesterday the doc had said ideally to walk 15-20 minutes every 4 hours. But he didn’t expect too much the first day). By 6am this morning, I didn’t need the portable oxygen machine to walk around. Several times I was walking without my walking stick and I wasn’t hunched over. Had a 8:30 appointment with the doc. They removed my bandages. No one could believe how mobile I was. The doc came in when I was standing up by myself without help while the nurses were fixing my clothes. He was so happy with me. I told him my fear with blood clots and that was a strong motivator to keep me walking. Got home around 11am. I wasn’t able to get any drains out today, but he things my chest ones will come out tomorrow. That is pretty much it. Yet to have any constipation, and I love my bidet. I will also get my pain pump removed tomorrow. I was nervous about that being removed on how much pain there will be. Doc said it shouldn’t be a problem and not to worry. Most of my pain is in my groin and stomach when I stand up or sit down. I have had very little pain in my chest. More just uncomfortable. Will keep posts. I have added one picture. My dressings are on. Will take more on the way. Obviously still very swollen. I am so happy with what he has done. I didn’t take a before. I probably should have. Oh, on the picture, I am sitting down.

Day 3 after surgery

Hello again. Yesterday I had all but one of my drains removed. Just one in my tummy tuck area. Things are going pretty well. Yesterday I got so sick of being stuck in doors today I walked around the block. Did it in the morning, noon, and before dusk. I am super slow. I think it took me 20 minutes to walk around the 2 blocks that I did. But that is fine with me. Made sure I had my walking stick and cell phone in my pocket. But all that mattered was that I was outside and got to breathe the fresh air and I did my walking. I saw an article saying the first week you should only walk 1 mph, second week you were allowed to walk 2 mph, 3rd week 3 mph, and so on. I like to just walk, not speed walk, so I will stick with the 2 mph after a couple weeks. I am nervous because I run out of my heavy meds tomorrow. Will be switching to over the counter Tylenol. It has been nice not to be in a world of pain. The other downside is that I have found my emotions running high. I had a call today that normally would have just angered me, but today it left me in tears. Something which shocked me completely because I am not a crier. I thought it funny a stupid phone call brought me to tears and not my surgery, or the pain after. My dog came home today. I have a 9 month old border collie and had him boarded for a few days. I know most cases animals are aware of your injury and are more mellow, but him being one a border collie and two being 9 months old, I thought it would be good for him to stay at facility. I guess he found a girlfriend (the facility is one where they keep all dogs together). He did pretty good coming home. We only have had one incident and he didn’t know better. I was sound asleep and my hand must have fallen off the side of the bed. I flew up when my dog was licking my hand and my abs hated me for it. Sorry, I am still on the heavy meds, so my verbiage is not the best. Anyway, this is how it is going. No real complaints. I am super happy with what I have done. Have a great night everyone! Oh, no pictures yet. I have not even seen myself yet. Don't have the nerve. I know what it looks like, isn't going to be what it is going to look like, so I feel like no point in stressing myself out about it.
Dr Swail

Quoted $15,700 for surgery, including anesthesia – I made sure to clarify this is what someone off the street paying cash would pay. I paid the Dr. Swail $13,500. My insurance paid the office $1771.08 (making total paid to Dr. Swail $15271.08). My insurance paid the Anesthesiologist $577.60. Received a past due bill from the anesthesiologist for $544.40. Talked with Allison at Dr. Swail's office and she says I owe it. I tried to explain that between insurance and me the total payments were $15848.68. Making it an over-payment of $148.68. If I paid the anesthesiologist $544.40 (which guess what I have no choice unless I go to collections) that would mean that after said and done that between me and the insurance we paid $16,393.08. Remember I said my quote including anesthesia was $15,700? That would then make an overpayment of $693.08. And this is legal? They don’t seem to think the money from insurance is real money and Allison talks as if I was given some discount. I am furious. Canceled my “revision” surgery and will not step one foot in the office again. If you have surgery and insurance is going to pay any portion, go to another doctor. I did like the doctor, I really did. But there needs to be more communication as well. I didn’t find out that I was to supposed to stop taking birth control 3 weeks before surgery and that was looking at another plastic surgeon’s website on “What to expect after surgery”. Who knew that would increase my risk of blood clots? I sure didn’t. I started googling this and found it standard for many plastic surgeons websites. I should have been informed. Received an email from April, the office manager. She again speaks as if I was given a discount for multiple surgeries at once. Any plastic surgeon would have done that. Will be more than willing to share these emails so you can see how they are reacting. I am stuck paying this additional money to the anesthesiologist. Will be speaking to an attorney to see how to recoup the money. If you have any kind of insurance and using a plastic surgeon, in my opinion, from what I have been through, I would go elsewhere. Now I need to find a plastic surgeon to do the revisions since I have those “dog ears”.

2 out of 5 stars Overall rating
4 out of 5 stars Doctor's bedside manner
3 out of 5 stars Answered my questions
4 out of 5 stars After care follow-up
3 out of 5 stars Time spent with me
1 out of 5 stars Phone or email responsiveness
1 out of 5 stars Staff professionalism & courtesy
1 out of 5 stars Payment process
1 out of 5 stars Wait times
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Comments (2)

you are doing great, a little walking around is very good, get yourself off the pain meds as soon as you can, bromleain is great to relieve swelling, just make sure to take it between meals
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Thank you for starting your review.   Hold on and keep pushing through this.  Dealing with the insurance is the longest part and can be a pain.

Let me know how everything is going.
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