"Drive-Thru Mastectomies"
I especially call your attention to her post immediately below this one, "This is Outrageous" and beg you to follow through on it. This issue is important for every female in America. When it was publicized in the past the media dubbed it "drive-thru mastectomies". Breast cancer and the treatment for it is a vital issue for all women ( and believe it or not, sometimes young girls and even a few males are affected. Cancer, even breast cancer, is no respecter of age or gender).
Breast amputation is no minor surgery; it is a major procedure and is also emotionally and psychologically devastating for the woman and her husband or life companion. It is too serious to be treated as no more than excising an ingrown toenail and insurance companies should not be permitted to address it as such.
This post is somewhat graphic.
Ladies, do you want to be sent home the same day after having this surgery; can you learn to care for your surgical wound after a few minutes instruction from a nurse while groggy and emotionally shocked? Gentlemen, do you want a woman in your life to be treated so callously by insurance companies?
These illustrations present the more drastic form of mastectomies. There are a number of procedures, depending on the extent of the cancer and other factors, and point up the importance of early detection so that less invasive surgery may be employed.
Radical Mastectomy - Medical Illustration | ||||||||||||||||||||||||
EXCERPT: SURGERY CHANNEL: Surgical Procedure General anesthesia, which renders the patient unconscious, is administered for all types of mastectomy. The surgeon makes a curved cut, called an elliptical incision, into the skin. The incision includes the nipple, areola, and the biopsy scar. The tumor and all of the breast tissue, including the nipple and areola, are removed. The initial incision may extend to the armpit to allow for removal of the lymph nodes. If a radical mastectomy is being performed, the surgeon also removes the muscles beneath the breast. At the end of the operation, one or two drains are inserted to drain excess fluid that may collect under the skin. (end excerpt) Illustrations below demonstrate various mastectomy procedures, depending upon how much lymphatic system is affected by cancer. Blue markings indicate the extent of surgical removal. it has become the most common type procedure for removing the entire breast.
Pink areas indicate extent of surgical removal depending on amount of lymphatic involvement.    Woman+with+radical+mastectomy Excerpt: Health a to z: Aftercare In the past, women often stayed in the hospital at least several days. Now many patients go home the same day or within a day or two after their mastectomies. Visits from home care nurses can sometimes be arranged, but patients need to learn how to care for themselves before discharge from the hospital. Patients may need to learn to change bandages and/or care for the incision. The surgical drains must be attended to properly; this includes emptying the drain, measuring fluid output, moving clots through the drain, and identifying problems that need attention from the doctor or nurse. If the drain becomes blocked, fluid or blood may collect at the surgical site. Left untreated, this accumulation may cause infection and/or delayed wound healing. Every effort is made to leave as much healthy skin intact as possible, but sometimes a substantial amount of skin is removed, resulting in a large, possibly disfiguring scar, and making breast reconstruction difficult. A mastectomy usually takes 2 to 3 hours. A radical mastectomy may take longer because the surgery is more complex. >>cont: Emotional care is another important aspect of recovery from a mastectomy. A mastectomy patient may feel a range of emotions including depression, negative self-image, grief, fear and anxiety about possible recurrence of the cancer, anger, or guilt. Patients are advised to seek counseling and/or support groups and to express their emotions to others, whether family, friends, or therapists. Assistance in dealing with the psychological effects of the breast cancer diagnosis, as well as the surgery, can be invaluable for women. Measures to prevent injury or infection to the affected arm should be taken, especially if axillary lymph nodes were removed. There are a number of specific instructions directed toward avoiding pressure or constriction of the arm. Extra care must be exercised to avoid injury, to treat it properly if it occurs, and to seek medical attention promptly when appropriate. >>>>> Please note that these illustrations demonstrate the more radical procedures for invasive breast cancer. Early detection BEFORE cancer has spread is of great importance. Do NOT allow fear to cause you to procrastinate. A lumpectomy allows only a small wedge of tissue to be removed, saving the breast. >>>>>>>>> Reconstructive Surgery Post-Mastectomy Photos of post-mastectomy breast reconstruction. This is possible if sufficient skin can be preserved, if your insurance company will pay for it or if you can pay for it yourself. It is an option to discuss with your surgeon and insurance provider. Since the nipple is removed during surgery, a new nipple can be constructed for appearance sake but will lack the sensations of the natural nipple.If the surviving breast needs a bit of cosmetic surgery to make the breasts symmetrical, it can be done. Note that nipples and areolae appear quite natural. These are real photos of real women who have had reconstruction surgery, before and after, demonstrating the natural appearance of the breasts. Reconstructive surgery helps women overcome some of the devastating psychological effects of having a mastectomy. For complete gallery of examples, click on to: http://breastcenter.com/breastrecon/beforeafter-images.htmlExample of Reconstructive Surgery 62 year old post right mastectomy Procedure: GAP flap reconstruction right breast and left breast lift/augmentation for symmetry  Obvious suture lines fade in time.Her left breast has been lifted and augmented so that both breasts have natural symmetrical appearance. >>>>> | ||||||||||||||||||||||||
Labels: "Drive-thru" Mastectomies
posted by Anonymous @ 7/22/2007 02:43:00 AM
0 Comments
I signed the petition, but, having worked for an insurance company I fear that legislation will be needed to make changes because, unfortunately, that’s the way insurance companies work. I fear it is going to take laws to end it. It the same way with many procedures: like giving birth (“the kid’s born; you go home”).
When I had my gall bladder removed it was supposed to have been an out patient procedure. I was surprised to awaken from the anesthetic in ICU. They didn’t send me home because some problem developed while I was anesthetized and the gas pusher fears I might croak. I don’t know how my insurance carrier reacted to paying for an over night stay in the ICU.
Saturday, July 21, 2007 10:27:00 PM
The bill would make it mandatory for insurance companies to pay for a 48 hour stay.
I'm sorry. This bill may be a step in the right direction, but it may also end up just as bad as the insurance company deciding on how long one stays in the hospital (or not) after a radical mastectomy.
The fundamental issue is not the length of the stay because if you legislate 48 hours, then insurance companies will just come back and say "OK ya got 48 hours no matter how serious your complications are". Having legislators decide the issue is just as bad as having insurance adjusters decide the issue.
There is one, and only one person, who should be making such a decision, the doctor. Insurance companies have a job. It's to decide how to set rates so that doctors can do their job in deciding the length of care. The legislator's job, such that they have one is to ensure that doctor's are allowed to give the best care possible.
I'd much prefer to see a bill that untether's the doctors.
Sunday, July 22, 2007 1:54:00 PM
Kvatch and Nick, you'll get no argument from me.
I was a little reluctant to even single out mastectomy because I'm sure the "drive-through" is common to much surgery these days.
I haven't read the law but certainly if a person, for whatever surgery and whatever reason, needs more than 48 hours they should have it.
And we shouldn't need laws to do the right thing with any medical care.
Sunday, July 22, 2007 2:17:00 PM
And "drive-thru" deliveries - enter the hospital, squirt out the kid then go home. Insurance companies dictate the length of stay for normal deliveries, regardless of varying pre- or post partum conditions. Also, due to insurance restrictions and rising costs, many hospitals opted to maintain a skeleton OB/GYN staff and call in "floaters" if the patient load becomes heavy. A floater is a licensed nurse registered with an agency who will send out a warm body to a hospital when needed, regardless of her qualifications. She need not have but little or no experience in Obstetrics since her classes in nursing school. She is merely a warm body to fill a staffing slot, so for X number of in-labor patients the hospital has Y number of nursing personnel for the moment.
Our family OB/GYN physician was not one of those doctors who schedule an early C-Section because he has a vacation planned for the due date of a patient. He would not subject a patient to the risks of major surgery unless it was medically indicated. My youngest daughter had certain conditions that led him to believe that a C-Section might be necessary. BUT the insurance company dictated that a patient must be allowed to try to deliver normally before they would pay for a C-Section, even though procedures followed during labor increase the risk of post-partum infection if a C-Section becomes necessary.
When she went into premature labor, the nurse (Nurse? Hah!!) was a floater and apparently had no idea what she was feeling of when she manually checked for cervical dilation. Furthermore, she seemed to have no idea how much bleeding was normal during labor and just kept cramming towels under my daughter to soak up the excessive bleeding. And last but not least, seemed not to have the vaguest notion how to read the signals of the fetal monitor. In hard labor after many hours that night, my daughter stated that her pains were worse than when she had the kidney stone. The nurse scoffed at her and derided her complaint by saying those were just "little baby pains; she was only 3 cm. dilated." (Dilitation of 10 cms. is necessary for delivery). She shamed my daughter and made her feel like a wimp and a cry-baby. She ignored my daughter's anxious warning that the fetal monitor was showing fetal distress; after all SHE was the PROFESSIONAL and my daughter was only a lay person.
When the doctor came in for early morning rounds, the nurse reported only a 3 cm. dilation and went off duty. The first thing the doctor said when examining my daughter was an alarmed "she's bleeding too much!" and the second was that she was a complete 10 cms. dilated, and the third was that the baby was floating high in the uterus (not engaged in the pelvic cavity) and was in acute distress. In fact, meconium (baby stools) was passing from the birth canal, a sign of fetal distress besides the beeping fetal monitor. My daughter's and the baby's conditions indicated a need for an emergency C-Section but there was no time to set up for it.
(Another foul up; the doctor had ordered that preparations be in place in case of an emergency C-Section, which was ignored). The doctor had to manually push the baby down and extract it with forceps. The baby was tangled in the umbilical cord, his entire head looked like a purple plum and he appeared dead, a horrible shock to my daughter when the doctor flopped him on her belly as he strove to stem her hemorrhaging.
Both she and the baby survived but since she had had a "normal" delivery, the insurance company refused to pay for a continued hospital stay, refused to pay for the badly needed blood transfusions but since the baby was a preemie and in bad shape, they did graciously agree to pay for his neo-natal preemie ICU. And ofcourse they refused to pay for therapy to treat her severe post-partum depression as that condition is "normal"also. I called it PostTraumaticStressDisorder due to the horrors she experienced during labor and delivery.
Oh yes, they also agreed to pay for the post-partum surgical repairs and hysterectomy necessitated by the complications during labor and delivery, which effectively limited her to one child.
All of which cost the dorks more in the long run than it would have cost them IF they had allowed the doctor to make the call and perform a C-Section in the first place. It would have saved my daughter months of acute depression and emotional stress, and saved her baby several years of certain complications. Plus it robbed her and her husband of the bonding joys of delivering their first (and only) child.
Insurance bean-counters should NOT be allowed to dictate patient care.
Sunday, July 22, 2007 6:07:00 PM