Surgeon Update: I’ve spent 2-3 hours per day the last three days trying to piece-together varying reports on how to find a good surgeon, and how to get Humana to pay for an out-of-network surgeon, which is what all my doctors recommend.
The supposedly simple process mentioned in my last email has turned into a convoluted morass. Highlights: Humana has outsourced the process for getting approval for out-of-network coverage. They will only talk to my Primary Care Provider (PCP), who has the least technical expertise to represent my case. I can only talk to Humana. I’m trying to reconcile differences between what they are telling me vs. what my PCP hears from the outsourced folks. I had to escalate my case to PCP management because the people handling it had the attitude that it was a lost cause.
I asked for and got super-duper help from an Oncologist Social Worker. She is doing lots of legwork, including identifying two in-network surgeons that have some experience in the type of surgery I require. What’s missing, and what I’ve asked all the doctors to help with, is getting a concise but thorough explanation as to what qualifications are required or a surgeon performing a distal esophajectomy, along with associated risks.
Fortunately, Nurse Jenny (my wife) came through again this morning, finding this R-rated adults-only scary horror story!
It certainly bolsters my contention that I need a very highly skilled and experienced specialist to perform the surgery, backed by a team of experts that know how to choose the best techniques and deal with likely contingencies swiftly.
Nonetheless, it looked like I needed to see an in-network surgeon first, and obtain an opinion from him. I picked what looked like the best candidate and at 2:45 (while still getting a chemo treatment) I told the PCP rep to set up the appointment. At 3:15, I got a surprise call out of the blue from UC Health, which is out-of-network. Their surgeon had refused to meet with me because of the insurance non-coverage. My paperwork ended-up in front of an Administrative Assistance who sincerely believes he knows how to get the required approvals quickly! So, another new ballgame begins tomorrow! To paraphrase Bengals fans: Who Dey Think Gonna Beat Dem Paper-Pushers?
Me! Team Doug!
Treatment Update: I got my 7th radiation treatment today, along my 2nd chemo treatment. I’ve felt good lately; had dinner with close friends two nights in a row; had a good workout yesterday for the first time since treatments began. I’m eating well and taking supplements I think will help. My older brother in Maine may visit soon for a few days. Both brothers are very supportive. Life is good for now.
Here I am pretending to be relaxing on the beach:
Here’s a photo of my “Rad Tech Team” with “Edgey”, my laser machine. Shown left-to-right are Janice, Sarah and Kat. Not shown: Susan, who was not in today: