Endometriosis Surgery Question

I called my Insurance back again to verify what was or was not covered. Taking multiple peoples’ advice I contact my Doctor’s Office first to get the more precise information to ask the Insurance company. I called and spoke with Lisa* who was specific to my doctor(a nurse, secretary, or something like that). When I spoke with Lisa* she told me the procedure code for the Diagnostic Laparoscopy. She then told me to not mention Infertility at all(which I knew after talking to you fine folks). I then contacted the Insurance company to ask the question yet again. I told the woman on the phone that I had a procedure code and wanted to verify if it was covered under my new insurance? I gave her the code and she said,” Yes, it is covered…depending on why it is being done.” I was baffled that she could even say that, “depending on why” What? Why does that matter? I asked the obvious question, “What do you mean by that?” She responds with, “Well, if you have predetermined symptom that suggest Endometriosis that it could be covered but if it is being done for Infertility purposes then it could be denied” WHAT? I didn’t even say Infertility, do you have a note on my file? Do you know me? I was blown away. At that point I was just confused as to what I was supposed to do but held it together and pushed the confusion aside to finish this conversation. After we hung up I was so pissed. There is no way to candy coat this. I was confused as to why a procedure could be approved for patient A because they have signs of Endo but Patient B wants to have a child and needs to this test but it is not approved. Why is an Insurance Company allowed to do this? UNBELIEVABLE!

Today I decided to contact my Doctor again to find out the soonest I could have the surgery and get a quick overview of the surgery because I knew nothing about what was going to be done to me. All I knew is that I was going to get 2 small cuts and a camera was going into me to check for Endo. I called the Doctor and it was Lisa* again. I told her what my insurance said and she was very kind. She looked over what I had done last year to see what was and wasn’t covered. Everything was covered but that wasn’t any help to me see as I have a whole new Insurance Company now. But it was nice she went out of her way to look into that. She then said that we should hopefully be able to cover it so that it is mostly covered by the insurance. Once I heard that I felt a little relief. Now time for procedure questions: I asked when was the soonest I could have the procedure done? She said that it depended on my cycle and asked when my period started. Well, it started Sunday Night. Lisa responded with, “Next week then….so….Monday Tuesday or Wednesday….Tuesday the 27th would be when it is available.” WHOA that is quick. Well, my job is extremely short staffed so I know that is not possible. “When would be the next time?” “Well, again, that depends on your cycle. You would call us when you start and we could schedule from there.” Thats fine. Thats how most things work when you are getting testing to have a baby. Lisa continued, “The procedure takes about and hour and a half depending on what she finds” What do you mean by that? I thought she was just looking around. “If the Doctor find signs of Endometriosis then she will remove what she can which could potentially make the surgery last longer and the recovery last longer as well.” Ok, that makes more sense now but it also makes me a little more nervous. I have never been put under…EVER! So, the idea of almost an unknown time of how long I will be under is a little unnerving. I told Lisa* that “I was under the impression that I would be able to get the surgery Friday and come back to work on Monday.” Her exact response, “Oh, you are a strong woman! We suggest taking a week off(thats the max.) and you are limited to what you can do.” How in the world am I going to be able to take a week off work when we are short staffed? I don’t want to use vacation time for this. What if I don’t even have Endo and I have to take all this time off? OH GOODNESS! Lisa* then asked me what I do and I told her(I work at a bank). She said, “You are limited to lifting 10 lbs. which means no lifting Coin or heavy bags of money, are you in charge of the Vault(yes)? Then you will definitely need help with the money once you go back. You need to be very careful you don’t tear or rip anything the Doctor did.” Rip or tear….that sounds great. That was all I needed and was exhausted from the information I received. I told her that I would contact her once  verify when I can have the surgery and it would most likely be next month after my period.

I contacted HR through my work just to verify what I am supposed to do when I have the surgery and I will use sick time to cover my time off. I was just comforted that I didn’t have to use any vacation time(if I use more then a week I will but I don’t plan on that). After doing some basic math I believe that it was between CD 9-11 I am supposed to get the surgery done. Well, instead of guessing I figured I would just call the Doctor’s Office back to ask. When I called the new lady I spoke with said that it didn’t matter when I had the surgery, I just couldn’t do it when I was on my period. Now I am even more confused. I want to do this sooner rather then later but I don’t want to overwhelm myself. The 26th of February I am having a wisdom tooth pulled and having a crown put in. An hour and a half appointment that I will need some recovery from for sure.  I was hoping that if there isn’t a time frame that I can get it done on February 20th. Six days of recovery should be enough right? Maybe? So here are my questions for you ladies:

Is there a certain time I need to get this surgery done?

How long should I give myself for recovery?

Is it a bad idea to do the surgery so close to my dentist appointment?

What was the surgery like for any of you that had it done? and the recovery?

How long was the surgery?

Whats the next step if it is Endo?

What’s the next step if it isn’t Endo?

Any help would be greatly appreciated! =]


6 thoughts on “Endometriosis Surgery Question

  1. I had this exact procedure done and he did remove endo, so if you go back to my posts from July 2013 you can get the lowdown on what it was like for me. I did take a week and i recommend that fully. They sent me home with percocet which i only needed a few times. After the first few days the pain is very manageable. Chief stayed home with me the first day and checked on me a lot the second day. I had mine done over a holiday, so he was off a lot and i didnt have to be alone much, but after that first day i was okay to hobble around the house on my own.

  2. Oh-and also this. I was dealing with IF at the time of my surgery, but i had the surgery because of EXTREME levels of pain. So thats probably the answer your insurance company wants-is that youre having heavy pain and long heavy cycles that are debilitating.

  3. So you did not have an HSG before the Endo Surgery correct? Because I did and the test came back that my tubes where clear. Thats what also makes me nervous that I could potentially not have it and thats its Unexplained Infertility. LAME! btw loved your post. I was very informative.

  4. I feel for you right now. I had a laparoscopy and hysteroscopy last April checking for endometriosis and removing what they thought was scar tissue from my uterus. It turns out that the scar tissue they saw was actually a septum. While my procedure and yours are different, there are a lot of similarities. My hour long procedure turned into 4.5. When they say it depends on what the find, they really stick to it. Severe endo is going to take more time to remove than stage 1 endo.

    As far as recovery time, that all depends on what they do and how quickly you can recover. I took 2 weeks off originally and them had to add an extra 3 because i was in so much pain. Regardless of whether theynfind anything or not, you will have some pain. They will blow your abdomen up like a balloon, which causes all the muscles and nerves to stretch out for a few hours. Its painful! I would say take a week off and see how you do. If you need mre time you can always extend your leave

  5. Well I can’t provide any insight on the surgery itself, but here are some thoughts on insurance:

    1. Health insurance in America is F*CKED. It’s honestly terrible. I could go on and on about all the reasons why this is, but basically, it’s because of monopolies and capitalism gone wrong.

    2. Your insurance company probably doesn’t have a note in your file. That procedure is pretty common for infertility, right? So that’s probably their standard response when people ask whether or not it’s covered. As for the “why they’re allowed to do that,” see #1.

    3. Being put under ain’t no thang. I went under for my wisdom tooth removal when I was 18 (do you remember that??) and it was kind of like falling asleep really, really fast and taking forever to wake up. So the lady started to inject me, I remember her boob pressed against my face because she leaned over for some reason and it made me laugh. Then everything went hazy and dark around the edges. The next thing I remember is walking through the parking lot with my mom supporting me on one side and the nurse on the other. No recollection of coming to inside the office, haha.

    4. Don’t freak out about the rip/tear stuff. Just don’t lift anything heavy or exert yourself and you’ll be totally fine 🙂

  6. Hey there! Did you by chance read my latest post about my lap? Hopefully some of my experience can help you..

    Is there a certain time I need to get this surgery done?
    My doctor did not specify a time. I was actually just going off of her schedule. Although I did not go in for endo… so maybe because yours is for enod, there is a better time to do surgery.

    How long should I give myself for recovery?
    I was about 60% recovered 48 hours later and 95% recovered by day 7.

    Is it a bad idea to do the surgery so close to my dentist appointment?
    The only thing (coming from someone without any medical background) would be if you were planning on taking Vicodin post surgery. I only took ibuprofen, so I think I was fine. I guess that is really a question for the Dr.

    What was the surgery like for any of you that had it done? and the recovery?
    Again – it wasn’t horrible, but it wasn’t comfortable either. TOTALLY worth it!!!!

    How long was the surgery?
    I had quite a bit of scar tissue, so mine took just over an hour.

    I hope that helps a little bit! GOOD LUCK!

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