If you’re one of my dedicated readers, you’ll remember that I had my third Endometriosis excision surgery on July 18th of this year. You may remember that during that surgery it was discovered that I had a few big ol’ chunky Endo lesions on my bowels (where my small intestine and large intestine meet) that couldn’t be superficially removed. A colo-rectal surgeon was brought into my surgery and advised that a bowel resection should take place.
The only problems?
- I hadn’t prepped for a bowel resection (oh man, it’s a whole process for the few days leading up to surgery);
- The colo-rectal surgeon wasn’t in my insurance network.
The plan? That surgeon was going to apply to become a member of my network and I’d have my bowel surgery with him as soon as everything was legit. I met with the colo-rectal surgeon on August 8th for a consultation (oddly enough covered by my insurance since he poked his head into my surgery) and had a discussion of our future plans.
I was told in August that the network acceptance process could take anywhere from one to three months. So, I sat patiently…for a while.
A month passed. Then I called my insurance company to see if there was anything they needed from me to speed along the process. Nope. Then I called my colo-rectal surgeon’s office to ask the same question. Nope. Big fat nopes all the way around.
So I waited another month and then googled my medical group assigned by my insurance company. On their webpage was the name and telephone number of the Director of Networking – the person to whom inquiries were to be made if you were a physician looking to join the medical group.
So what did I do? I called and left a voicemail message. A week later, I left a second message. And a week after that, I left a message with her secretary.
The day I left my third message…she called me back. The Director! I don’t know what I expected, but certainly not what happened next.
She apologized for not calling me back sooner but stated she was having my medical history and records pulled to review. She found that there was no mention of any pending referral or need for a bowel resection; which wasn’t unheard of since the surgeon wasn’t (yet) an in-network physician. BUT Dr. Schutzel (my soon-to-be-colo-rectal surgeon) likely wouldn’t be approved for another three months. Early 2019! I wanted to cry.
I briefly filled her in. Well, that’s a flat-out lie – you know I can’t do anything “briefly.” I mean, look at this blog entry already! Anyway…she heard me out. All of it. And offered a suggestion: have my gyno-surgeon put together a written request explaining my need for a bowel resection and why we wanted it to be this particular out-of-network surgeon (rather than one of the four already in-network). Then needed to tack on a copy of my July op report, and the Directory may…and I stress the word may…be able to get a one-time-only approval to have the out-of-network (aka yet-to-be-approved) surgeon covered by my insurance to do my surgery.
I gushed my appreciation and thank yous to her and hopped on the phone with my gyno’s office. They prepped the letter the next day and sent it off! A few days later: *abracadabra* I get a phone call (which I missed) and listened to in my voicemail.
It was the Director of Marketing…calling me after hours to let me know that the request had been APPROVED and the next step was to coordinate the surgery date!
She did it!! We did it! But I never would have known it was possible if it weren’t for her taking the time to review my records, listen to my tale, and offer the suggestion!
Literally less than a week from the day we spoke to the day she called to let me know it was approved! I’m so grateful to her and my gyno’s office!
The following morning, I called the colo-rectal surgeon’s office to see if they needed any information from me. By lunchtime the same day…everything was all set up:
My bowel resection is scheduled for Monday, November 26, 2018, at 7:15 in the morning!
And to make things even better?
- It will be a robotic-assisted laparoscopy, using the DaVinci system (which is what’s been used for my three prior laparoscopies); Aaaaaaaaaaaaaaaaaaaaaaannnnnnnd…
- Dr. Kurtulus, my Endometriosis excision surgeon (and gyno and incredible human being) will be scrubbed in and at-the-ready to take a peek under the hood to look to see how I’m doing since my July surgery! And to excise any Endo they may spot along the way!
I’m so comforted by the fact that my medical care team fought for this to be approved and scheduled so quickly. But the super-duper comforting thought? Dr. Kurtulus, my gyno and my surgeon, made himself available (and insisted on being present) for my colo-rectal surgery. And influenced the decision for the surgery to be robotic-assisted.
And…this entire endeavor is a huge reminder on why we should be persistent and self-advocate.
Now here’s my question to you gals and guys: If you’ve ever had a bowel resection, do you have any tips for surgery prep, recovery, or diet? I have my pre-op packet and I’m sure I’ll receive a whole slew of post-op instructions…but I also like to hear your experiences and suggestions. If so, drop me a comment below! Please!!
I’m so excited. So ready. So appreciative!