Denied for breast reduction!!!!
In June 2015, I...
Denied for breast reduction!!!!
In June 2015, I began my journey and effort to seek approval for a breast reduction. The final straw was my getting a fungal (ring worm) infection which started under my breast. I've had it for over three months. I have always had upper neck pain, shoulder pain, indentation from bra straps, headaches, breast pain on the side (without bra). I've dealt with these issues for over 10 years. Just learned to deal with them. I guys my primary reasoning for that was the fact that I've been flat out afraid to have the procedure. I've definitely avoided the thought of considering BR during my child-bearing years because I was so afraid of losing the ability to breast feed. Also, there was the fear of losing my nipple sensation. I'm now at the point where, I'm willing to put all of my concerns aside all in the effort of seeking relief of this pain and discomfort.
My gynecologist referred me to a wonderful PS who I was very happy with. The PS was stated that he has no doubt that I would fit all of the criteria for reduction and agreed that I was a perfect candidate. He discribed my breast as being overly Hyperthrophic, and even went as far as saying that the distance of my nipple from the collar bone was one of the greatest that he has seen, which poses a greater challenge of reduction without the lost of the nipple or nipple sensation.
I am so disappointed in the denial from my insurance company, especially since I have still yet to get rid of this rash, which is the worst that I've ever had, and has now spread all over my body! It's out of control, and I feel like I'm now losing control of my hope, joy, and emotions.
I have every intention on appealing the decision, but would love some insight about how I can "properly" submit an appeal.
My insurance is through Anthem BC - California-HMO
All support is welcome!
Before - 2010 - 20 lbs lighter
This photo is from 2010. Even at 20 lbs. lighter, these girls will not go away.
I WON MY APPEAL!!!!
I received a phone call on 9/11/2015 from Anthem BC to inform me that they have elected to overturn the decision that my medical group made on August 6th, 2015. I am utterly shocked!!! I assumed that this would be a slow uphill battle that would take months to resolve, and I had prepared to fight this thing out at least through the beginning of next year. I'm not certain if someone at Anthem saw my pics, which I included in my appeal and felt sorry for me, lol!! Or, if my appeal letter, which was very detailed, was deemed irrefutable! But, needless to say, I will be able to move forward with the procedure!!! I am more than ecstatic, and am looking forward to my pre-op appointment! I have a bit of nervous energy going because this is now a reality!!
Surgery Has Been Scheduled Tentativley For December 2nd, 2015
Spoke with my PS's office, and was told that they are still working out all of the kinks regarding my procedure, but they have a date of December 2nd, 2015. I assumed that I would be able to choose my date, and wanted to strategically plan around my holidays off from work. But, I was told that they had to schedule the 2nd, because there will be a second surgeon who will assist. And if I were to wait any longer, my referral will expire. So Decemeber 2nd it is. At least I'll be able to enjoy Thanksgiving and recover before Christmas, and it will also give me enough time to safely drop at least 15 lbs before my date.
I am excited, yet nervous. The anxiety has begun to kick in.
Questions About Recovery
My surgery is now about two months out, and I have been doing all of the necessary planning for the surgery and recovery. I've requested my time off from work, and the guy in HR has made this process a breeze for me. He has even shown me the best way to maximize on my healthcare benefits! I didn't realize how great our benefits plan was. I am truly blessed!! I am also trying to set up my support team. I have two daughters who are at an age where they'd be able to help, but I plan on asking on of my friends as well, only because I want to make sure that I have someone who will not be afraid to assist me with drain care. I'm presently trying to lose some weight before surgery and this will also include a detox. I really want put my body in the best position for optimal healing. I've been researching on how to heal quickly from surgery. Does anyone know of any foods that has assisted them with healing? What are the best scar therapies for AA women, and how did most of you guys transition back into a workout regime?
Embarrassing Breast Sweat
Has anyone else ever had this problem? I am looking forward to not having these embarrassing moments once my breast are reduced! All it takes is for me to start sweating, and I start dripping profusely from the breast. At which point, all eyes are on me! December can't come any sooner!
Dreams About My Upcoming Surgery
I guess the stress and anxiety about my surgery it building at an all time high. I've started having very detailed dreams about the surgery, which include certain oddities. I dreamed that I was being prepped for surgery, and for some odd reason, a doctor that I use to work for was present in the surgery room. I didn't see my PS, and started to question why he was present. And then out of no where, there he appeared. He started comforting and reassuring me that all would be well, and then I woke up! Has this happened to anyone else?
Blood Work ?? Pre-Op Appt. Complete
My blood work came back great, and I completed my pre-op appointment on yesterday. The original appointment was set for 11/23/15, but due to an "oversight", while my appointment date and time appeared in chart, my case manager had failed to put it in the doctor's calendar. Needless to say, I had taken Monday off from work for absolutely nothing, and wasted a day that I could have utilized for recovery. Still very upset with this, but I guess it's water under the bridge at this point.
So, I had my post-op and was able to ask all of the burning questions that I had for my PS. He was very patient with me and thoroughly answered all of my questions. He kept making it a point to reassure me about my anxiety and letting me know that I'll be in good hands and he will work his hardest at giving me the most optimal result. That did ease my mind a bit. I've decided that I really like my PS, but just don't like his staff. For him to be such a good surgeon, his staff are sub-par. They are not at all throrough, and in my opinion way too relaxed about their jobs. My surgery is on Wednesday, December 2nd, and I still don't know the time or the location of the surgery center. They also failed to let me know that there are extra fees for the physician to complete things such as disability forms, medical certifications, etc. I found out at the appointment that my form which grants approval for my time off could not be completed until I paid $25. I was ill-prepared, and was only expecting to pay my co-pay. His receptionist had the audacity to ask me if I bothered to ask if there would be an additional fee. Smh....
Anyhow, this experience is now getting as real as it can get. I've received my prescriptions for my medications, along with instructions, and have been told what to expect. I am both nervous as well as excited.
So, I've been dating this gentleman since July, and while I have been on this BR journey since May, I elected not to tell him about my procedure because we were just dating and I didn't feel inclined to. As of Saturday, we've made things official, but I still haven't shared with him my intentions for the surgery. To be honest, I'm a very private person, and have only told a very select few about my procedure, and that was because I simply did not want to let the "negative" energy, comments, or opinions be affect me. I now have such a hard time telling him because I don't want to answer many questions, and to be honest I'm a bit embarrassed. And what's even more disheartening, is the fact that he is a "titty" guy, and is absolutely mesmerized by my breast. He's never seen them fully disrobed, but boy oh boy does he like touch and feeling the girls. I was trying to find the nerve to tell him last night, but couldn't because he was nestled and resting on my chest as if it were the softest place on earth. I feel so terrible. Any suggestions on how I could break the news to him?
An Emotional Mess Right Now
I'm feeling like an emotional mess right now, and have been crying for the last hour. Don't know if I am justified in feeling how I feel, or if I'm just being way too major. It all started this evening when my boyfriend had me waiting to hear back from him regarding if he was going to spend time with me this evening. I really just wanted the company because I am feeling the anxiety of the upcoming surgery. He expressed that he was tired and wanted to nap for an additional 2 hours. That was at 5:00 p.m., and I didn't hear back from him until 11:30 p.m. Under normal circumstances, I wouldn't even care, but I guess me texting at 10:00 p.m. to ask if he could take me to and from the surgery center and not getting an immediate response kind of put me in a bad place. I am equally upset with the fact that I had to ask him at all since my 20 year old daughter had obligated herself to assisting me, and ask me out of no where, "so mom, do you want me to stay with you this week?" I was perplexed as she had continued to explain that she told her basketball coach that she would not be available for their trip because of my surgery. She said that the coach told her that she understood, but that she should really consider coming with the team. I don't know if I'm more angry with my daughter or the coach. I feel that the coach is in violation, but I feel that my daughter is being totally disloyal and non-supportive!! But get this, she doesn't even get a chance to play in the game because she's being benched for an injury. And I tried to arrange for one of my friends to assist me months ahead of time only for my daughter to assure me that she was going to be available, the team would just have to understand, she's not going out of town while her mom is being put to sleep, blah, blah, blah. My only option at this point is to see if my friend can assist me (so last minute) or uber to and from the surgical center and have my 16 year old go along to ensure I'm fine. I have shut down on my boyfriend, as I am now feeling like a burden. I hate feeling that way, and it is the main reason why I always keep my feelings to myself, and business so private! I'll probably cry for the rest of the night, but the super woman in me will have everything figured out by the time the sun rises. Or, perhaps I'll wake up feeling silly for any of this.
I WOKE UP FEELING LIKE A WARRIOR PRINCESS!!!!
I just needed time to regroup!!! I cried, prayed, and cried some more, but now I am at peace!
It's Finally Over!!!
My procedure was on yesterday! I was suppose to be at the surgery center at 9:30 a.m., but received a call requesting that I come at 6:30 a.m. because there was a patient who got cancelled for their time slot.
I arrive at the surgery center, and was greeted by very friendly staff people. I completed paper work such as consents, and liability. The receptionist confirmed what procedure I would be having. She and I had a very good conversation about BR, as she is considering having one as well. We appeared to be the same size, and she asked me about my symptoms and the process that I went through. I shared all of the information that I had. I was then called back by the nurse.
The nurse instructed me to get undressed, took my vitals, and had me use the bathroom for pregnancy testing. She then started my IV. We had small talk amongst us, which made me feel at ease. My PS arrived shortly thereafter. He made his markings, and went over any last minute concerns that I had. He was so reassuring and let me know that he would take good care of me.
After the talk with my doctor, in came the anesthesiologist. He explained what he would be doing, and also reassured me that I would be in good hands. I told him that he had to make sure that I woke up, so he was the man of the hour.
After I was all prepped, my daughter came back one final time, and I was sent to the restroom on more time to empty my bladder, since my PS didn't want to give me a catheter. His plan was to have the procedure done in less than three hours. He bought his partner in to assist with the surgery to make that possible.
I was then wheeled back to the surgery room where I was placed on the surgical bed. The anesthesiologist explained that he would be giving me something to relax me and at that point, I do not remember any other details.
I was awaken by my doctor in recovery and he explained that the surgery went well, and that he was certain that I would love the results. I looked down at my boobs, and recalled saying, "damn!" I guess I was shocked that he was able to get me so small! I never realized how small my frame was with all of those titties. I was told by the nurse that as they were bringing my out of sedation, I was trying to fight. I remember laying there perhaps another 15 minutes and then I was told to get dressed. My daughter and nurse help me out with that. I was then placed in a wheelchair and wheeled to the front of the surgery center. At that point, I felt as though I was going to pass out. I was given a drink of water and a cold compress to help with that. I waited another 15 minutes for my guy friend to arrive, and everyone had to assist me with getting into the car. My daughter said that it took a while because they couldn't get me to bend my legs. Don't ask me why! Lol!!! The only thing that I can think of is that I was afraid of falling.
Once I arrived home, at around 12:00 noon, my daughter made sure I was comfortable and made me some soup. I took my meds, and spent the rest of the day and evening in and out of sleep. I got up a few times to go to the restroom and to ensure that I was walking around.
My pain level has been between a 5 and 8. I'm taking Norco for pain, and while it doesn't stop the pain altogether, it still helps. The most uncomfortable part for me is the swelling. My PS did not use drains, so at this point, my breast are swollen and feel engorged. It kind of feels like when you are breast feeding and your breast become engorged for to much production of milk. I'm taking it easy for sure, and am looking forward to full recovery. My first post-op appointment is tomorrow at 9 a.m.
First Post-Op Appointment Completed
My first post-op is complete! I took all of maybe 15 minutes. The MA took my blood pressure and temperature. Both were just fine!! The doctor came in and removed my bandages, but left the tape in place. He stated that the tape will more or less fall off on its own. He expressed that he was very pleased with my results and admitted that I was one of the best results that he has completed. He tested my nipples for sensation, and I am happy to say that they both work just fine. I then stood in the mirror for my big reveal. I AM AMAZED!!!! I can not believe that these are my breast!!! The results are better than I could have ever imagined!!! They are quite swollen, and now appears to look like a Full D cup, but I'm almost certain that once the swelling goes all the way down, I'll be at most a Full C. I am cleared to shower, and can start wearing sport bras. I have elected to continue with my compression bra, and even paid for an extra one so that I'm able to have one to wear in between washes.
I'm so swollen right now and I can not seem to get comfortable. My PS did not place drains, and I'm certain that this explains all of the swelling. Is there any of you guys who have had procedures without drains and have experienced the same thing? How many days will it take for this to subside? I've taking my pain meds, but I would love to be able to start weening myself off of them. Please share if possible!! ????????
3 Weeks Post Op - Back To Work
I retuned to work on Monday, December, 21st, 2015. I thought I was ready, but I was not! Lol!! It seemed to be the longest day every, and by the time I got home, I had only enough energy to eat a sandwich before going to bed. I was in bed by 8:00 p.m. and slept through the night.
My swelling was unbearable!! I guess it was the result of way too much activity in one day! I had intended on taking Tylenol before falling asleep, but.......
I woke up a little less tired than yesterday, and am hoping for a better day. The swelling subsided somewhat, but not all of the way. I can also tell that my breast are beginning to drop and settle as my PS described hat they would do. At times, with this swelling, the look to be a D cup, so I'm hoping that when all is said and done, I will end up at a full C.
I have areas that concern me, but I must admit that I have the tendency to worry and try to self diagnose. Lol!! I will be contacting my PS just to ask about my concerns. I am noticing discoloration in the bottom half of my breast. I've read and read, and it seems that it could be either the result of the swelling subsiding and bruise coming to the surface of the skin, or it could be blood pooling. I am just concerned that it might be necrosis, and I would like to have that ruled out.
Overall, I am in love with my results!!! I tend to like the result of my right breast over the left one. It seems to be close to perfect!!! I am amazed!!! I was not at all expecting the results that I do have, and I am so thankful to my PS for his expert work!!! He had truly given me a new lease on life!! I am feeling myself!!
I have tried on all of the clothes that I could not fit because of my breast, and all of those that I have always imagined wearing without a bra. I can not wait to be fully healed, and am especially looking forward to spring and summer! ????
Since being reduced, I have now noticed how big my stomach is!!! Lol!! I was unable to see it before the reduction. I'll have to admit, I am totally out of order for waking around looking like I'm 5 months pregnant! Lol!! I am motivated to workout and put all of my effort in getting rid of the belly! Can't wait to be cleared for all normal activity. I know that I'll be starting off with just walking and changing my diet. I am hoping, wishing, and praying for a FitBit for Christmas. My sweetheart has hinted around that he will gift it to me!
I hope that everyone is doing well with their preparations and recovery!! Happy holidays to you all!
Follow-Up Appointment 11/29/2015
I had a follow up appointment on yesterday. My PS says that I am healing wonderful, and I must say that I agree. The swelling is going down more and more, the bruising is diminishing, and there is less pain. My nipples are still really sensitive, but I am getting use to it. I expressed a concern that I was having with my right breast and how there is discoloration that I was worried would be necrotic tissue. It turns out that this discoloration is something that will never change. I was told by my PS that it's part of my old areola!! ???? I felt so silly hearing this because I had been so worried, and had my daughters constantly taking pictures and keeping an eye out for this area!!! Lol!!!
My next appointment is in one month, and my PS says that I should continue to see my breast drop and round out at the bottom. I am so amazed at my results and the entire process of this procedure. I am looking forward to my continued healing, and can't wait until I am fully healed!
1 Month Post-Op!!! Happy New Year!!!
I woke up this morning and it dawned on me hat today makes 1 month since my surgery date. I can't believe how the time has flown by, and I am equally amazed at my breast. I've been looking back at my before pics, and I can't even imagine those breast to once have belonged to me! I have tears in my eyes because God is so amazing, and I am so blessed!!! When my journey first began, I thought I would never even get past getting approved! And while I was only looking forward to getting relief from all of my symptoms, I'm feeling like I've won the lottery because the aesthetic rewards are equally gratifying. I look absolutely amazing, and I can truly say that I have not enjoyed my body since I was 22 years old when my first child was born. I now feel sexy!!! ???????????? Tears of Joy!!!
8 Weeks Post Op
I am now 8 weeks post op, and am still quite amazed at how wonderfully I am healing. My beast have begun to drop as you can see in the pic, and the are becoming softer like they were before surgery. I do have moments where I feel like they are getting larger, but I think it's all in my mind since my greatest fear is that I might gain the breast tissue back. My sweetheart was taking a peek the other day, and he said, "they are so pretty!" Lol!!! I didn't know he had been paying that much attention, and that he would enjoy them so much. I have a follow up appoint meant for 02/05 and my PS plans on taking before and after pics. I am hoping that he will also clear me to begin to workout and lift weights, as I am so anxious to get into better shape.
I have decided to take the plunge and get my hernia repaired and a tummy tuck. While the BR was not done for cosmetic reasons, it has motivated me to care more about correcting what I am uncomfortable with. A while ago, I would have been very hesitant to even consider it, but now I'm so willing to. Now I'll have to focus on how I can finance it. If anyone has any suggestions, please fell free to share!
Final Follow Up Appointment
I had my final follow up appointment with Dr. Ku on yesterday. All is well, and I have been cleared to return to all normal activities! Dr. Ku took after photos, and provided me with before and after pics. He might also include those pics on his website. I will keep you guys posted about which patient case number I have been assigned in the event that those pics do make it to his website.
After the appointment, I met with his patient care coordinator regarding a tummy tuck. Yes!!! I have decided that I am moving forward with getting the body I want and deserve!! I will sharing that journey as well. So for anyone who is interested, please feel free to follow that journey and offer support, and suggestions as I go along. I will update on this review from time to time with pics.
4 Month Update
Me and the girls are still doing just fine! I grow to appreciate them more and more each day. Still in total disbelief that they are mine! They have dropped a tad bit more, but are still very perky. I never imagined how liberating not wearing a bra could be! While I don't go without a bra often, I do go without one when ever I can. Nipples aren't as sensitive as they were when I does got the surgery, but they are still more sensitive then before the surgery. I feel so free, and especially sexy! There are so many perks to having these new girls! The pain and discomfort that I was having before the surgery is a thing of the past. I can't even recall how uncomfortable I was. I still find myself attempting to lift my breast to clean under them while showering. Only to realize that it's not necessary! I guess some habits die hard! Lol!!! No more rashes!!!