Thanks, Beth.  Yeah, I already approached my surgeon with that one and he
said that he would only cut the bare minimum.  He's a really good "Joe", and
I trust him on this one.  Laura had surgery about ten years back and he was
the cutter.  I was really impressed with his bedside manner and suturing.

I've been fighting with "peer review" already at the insurance co.  At best,
these folks are LPNs, most don't have any formal medical education at all.
The doc is as frustrated as I am about their reticence to have someone else
close. He admits that a plastic surgeon could close better, even with no
reconstruction.  They are pretty adamant about the whole thing--because "the
book says it's not 'medically or psychologically necessary' for men to have
reconstruction."  If it ain't in the "book", they ain't payin'--pure and
simple.  Our benefits administrator said to me that I have to be careful
when deciding whether to fight or stand-down as the carriers are becoming
"hip" to all of the arguments.  She said that I've already become a
statistical liability to the carrier, so I need to pick my battles
carefully.  Still, the "breathing" angle is one I hadn't considered.
Thanks!  I'll call my cutter today and run that past him.  Who knows?  Maybe
he can plead the case that with my spastic CP, a second pair of experienced
hands might be cheaper in the long haul.

Kyle


-----Original Message-----
From: Elizabeth H. Thiers [mailto:[log in to unmask]]
Sent: Monday, July 28, 2003 4:52 PM
To: [log in to unmask]
Subject: Re: Hey all


You know, it may delay your surgery a bit but, you can ask for a plastic
surgeon to close for you.  My friend did this when she had her bilateral
mastectomy.  You can tell them you need all the muscles and soft fascia you
can in order to breath properly.  (the pecs are an auxillary breathing
muscle).

I'd keep harrassing the insurance.

beth t.