Do I dare to dream?

[Munchkin]

In a mere 3 years, I can get Medicare. Actually less than 3 years. I have a large hernia that needs to be fixed. I also think my abdominal muscles are split. Diastasis recti. Pretty sure of this because I can actually feel my guts under the skin. Sometimes it's painful but I live with it and I have become an expert at reducing the hernia myself.

Here's what I want. I want the muscle and hernia repair...plus a panniculectomy. Mostly because I know I will never be able to afford plastics! Hell, I can't even afford to have the hernia repaired! I know the scars will be horrendous.

I used to run a lot. Mostly for weight control. The hernia/panni issue limits my mobility. And if I had to guess I would say it's possible the panni may have been a contributing cause to the hernia. I can feel it every step I run. And there is no shapewear that fixes the problem. Plus with these issues no exercise in the world can fix the problem. And the panni does hang past the pubic bone.

Do I have any chance? Is there anything I should be doing now to make approval more likely?

 

[KathrynK]

I would start saving! On plain Medicare, your surgery still won't be cheap. For the hospital stay alone, if the surgery is covered, with part A, the deductible is $1316. That doesn't cover associated costs. You have to pay monthly for part b.

Understanding the rest it is very complicated and you need to study Medigap and Medicare Advantage plans in your state and see which one will help you most with your doctors and other needs and cover as much of the costs of surgery as possible. One person I know chose the wrong plan and ended up spending $700/ month for drug costs that weren't covered by his Medicare Advantage plan.

I find it very confusing. I still have my husbands plan until he retires, but I also have Medicare part a. I know this decision about Medigap is coming and I have been trying to figure it out. Even if you have the right plan, they might put you through hoops to get the surgery. Whatever it costs, I guarantee it will be cheaper than Trumpcare!

 

[Munchkin]

I will have both Medicare and a Medigap policy. I haven't actually started looking at plans yet because they change so much from year to year. For the Medigap, I will sign up for the best policy I can find because I know I plan to use it!

 

[southernlady]

I will have both Medicare and a Medigap policy. I haven't actually started looking at plans yet because they change so much from year to year. For the Medigap, I will sign up for the best policy I can find because I know I plan to use it!

Currently on the Medigap, Plan F covers the most with the least out of pocket costs.

 

[DianaCox]

In terms of getting the surgery covered, what you're going to want to do is make a case for NOT having mesh, no way, no how. Then, you're going to want to figure out whether you can get a plastic/reconstructive surgeon who is qualified to do a proper abdominoplasty with plication of the diastasis to reinforce the hernia repair without the use of mesh, to work with the general surgeon. If you have an umbilical hernia too, that can help - but you'll probably lose your navel (the scar from removal can be a decent substitute). Since the code for abdominoplasty with plication ALSO includes removal of excess skin, you might be able to get it all done under insurance. Like Charles did.

But start building a case for no mesh. In Charles' case, he had a prior mesh inguinal hernia repair which has never been right (scarred), so we argued that we wanted repair of his umbilical hernia with plication instead of mesh. Try and think of a good reason.

 

[Munchkin]

In terms of getting the surgery covered, what you're going to want to do is make a case for NOT having mesh, no way, no how. Then, you're going to want to figure out whether you can get a plastic/reconstructive surgeon who is qualified to do a proper abdominoplasty with plication of the diastasis to reinforce the hernia repair without the use of mesh, to work with the general surgeon. If you have an umbilical hernia too, that can help - but you'll probably lose your navel (the scar from removal can be a decent substitute). Since the code for abdominoplasty with plication ALSO includes removal of excess skin, you might be able to get it all done under insurance. Like Charles did.

But start building a case for no mesh. In Charles' case, he had a prior mesh inguinal hernia repair which has never been right (scarred), so we argued that we wanted repair of his umbilical hernia with plication instead of mesh. Try and think of a good reason.

I don't care about the BB but I am pretty sure it's not umbilical anyway. The hernia starts right below my xiphoid process and goes down almost to the waistline. It COULD be hiatal and abdominal. My mom had mesh and it was a total failure. Didn't last more than a few months and her only previous abdominal surgery was an appendectomy when she was a young adult. That abdominoplasty with plication is just what I need. I will be looking for reasons to avoid mesh for sure.

Anyway now that it's out there, if anyone finds reasons to avoid mesh please post them here!!!

 

[Settledownnow]

Can someone explain more about mesh and plication or refer me to more readings? I will be having abdominoplasty in the future and it seems that mesh and component separation will be involved. I was told surgeons use either a synthetic or biologic mesh. Confused.

 

[DuodenalSwitchaRoo]

Anyway now that it's out there, if anyone finds reasons to avoid mesh please post them here!!!

I look a hot mess where I had my appronectomy but Im so glad that hanging dead weight is gone! I was never going to win swimsuit model of the year anyhow. I also gave up my belly button....I was VERY clear I would rather have more tissue gone and less wound to heal (Thank goodness I opted out!) than have a fake belly button. It's weird, cos in the shower, my belly button feel gooey...you know...fat girl gooey lol. It's not there!!! It phantom belly button goo! So weird!

Anyhow, I have a huge square of biomesh in my abdomen where Ernie was and I have had no issues. I have no experience of normal mesh but the reason biomesh was chosen (rare on NHS!) was that Ernie was bloody huge and needed to be contained. I wore my abdominal binders for 5 months and again for a couple of weeks when I got ill and was coughing up a lung. I don't want to take any chances to invite Ernie back into my life.

I hope it all goes well for you!

 

[Munchkin]

I look a hot mess where I had my appronectomy but Im so glad that hanging dead weight is gone! I was never going to win swimsuit model of the year anyhow. I also gave up my belly button....I was VERY clear I would rather have more tissue gone and less wound to heal (Thank goodness I opted out!) than have a fake belly button. It's weird, cos in the shower, my belly button feel gooey...you know...fat girl gooey lol. It's not there!!! It phantom belly button goo! So weird!

Anyhow, I have a huge square of biomesh in my abdomen where Ernie was and I have had no issues. I have no experience of normal mesh but the reason biomesh was chosen (rare on NHS!) was that Ernie was bloody huge and needed to be contained. I wore my abdominal binders for 5 months and again for a couple of weeks when I got ill and was coughing up a lung. I don't want to take any chances to invite Ernie back into my life.

I hope it all goes well for you!

Thanks Roo! I still have time to research and worry about it!

 

[hilary1617]

My panniculectomy and adbdominoplasty, which I had pre-DS, while SMO, was covered by insurance due to (1) lovely photos of the rashes / raw skin patches I would get beneath the apron and (2) need for hernia repair. So grab your camera!

The panniculectomy / abdominoplasty resulted in multiple DVT / PE, nearly killing me and putting me in the hospital for a month, so far from a risk-free procedure. I had the unexpected delight of the birth of my second child about a year and a half later. The pregnancy and c-section effectively undid the abdominoplasty. The hernia recurred and has been repaired twice since then. My plastic surgeon insisted on putting in an artifical bellybutton though I didn't care about it. It is noticeably off center, which is super annoying.

That all said, the benefits of the panniculectomy remain and despite the complications, I am incredibly grateful to be panni-free.

Best wishes!

 

[Marquis Mark]

Ladies,

What's all this talk about forgoing belly buttons? And gooey belly buttons?

Why would a doctor not "re-create" your naval, or did I miss something?

 

[southernlady]

Ladies,

What's all this talk about forgoing belly buttons? And gooey belly buttons?

Why would a doctor not "re-create" your naval, or did I miss something?

Other than looks, why have a belly button? It's a left over spot from birth and other than everyone has one, why bother?

 

[Marquis Mark]

Other than looks, why have a belly button? It's a left over spot from birth and other than everyone has one, why bother?

Because it looks normal and doctors can replace one. I mean, I don't need my nipples, but I'd rather have them than not. So why not?

 

[hilary1617]

I didn't really want a new bellybutton because from an appearance perspective, I don't find bellybuttons attractive and wasn't convinced that it was worth the pain of the additional flesh wound and stitches and possibility of infection as it healed. Now that I have a new one that is probably an inch and a half to the left of center, I find it an annoying defect...

 

[bearmom]

Because it looks normal and doctors can replace one. I mean, I don't need my nipples, but I'd rather have them than not. So why not?

It's not always a super easy thing to do, to recreate the belly button. I was told the bb stalk would be too long and too difficult to make mine look normal, so I said "don't bother with it", and didn't want extra surgery time with anesthesia just for a belly button. I did in fact wake up with a new bb, when he said he got in there and saw mine wouldn't be as much of a problem as he thought, but I'd have been bugged about it if he risked my life with much extra surgery time for it.