Tired of Strabismus Surgery Vs. Insurance

I'm tired baby. Tired of the insurance run around.

When I saw Michael Moore's movie "Sicko" a couple of months ago, I had no idea I would soon be embroiled in my own insurance battles. Scratch that, I had a feeling. Still, things have been frustrating. My surgery was set, cancelled, set again, and then cancelled again. The first surgery was cancelled due to a bad cold I contracted that left me with a cough. The anesthesiologist wouldn't have it, I had to be symptom free for four weeks.

So, I rescheduled for August. The date was quickly approaching when I got a phone call from the surgeon's office. Poor sweet Pat had to break the news that my insurance had denied coverage because the surgeon I chose was out of network.

Let me clarify, "out of network" does not mean that my insurance doesn't cover this surgeon, just that within the greater insurance network there are apparently multiple networks, and my surgeon and general practitioner were not in the same network.

Ok, so I asked how much it would be if I paid for the surgery myself (some generous friends and family had offered to help me out with this). Pat told me that she would contact the finance department and get back to me with a figure. An hour later, her voice was a little softer, more hesitant.

"Um, you can't pay for the surgery yourself."

Moment of stunned silence.

"So, if my insurance denies coverage, I can't pay for the surgery either?"

"That's right."

"I don't understand."

"I know, neither do we. Apparently your insurance company and the hospital have some kind of contract...(awkward silence)."

"I see. That doesn't make any sense, does it?"

So now I'm pondering the idea of bringing a lawsuit against...well, that's the question isn't it?
Who exactly is responsible for this? The insurance company? The hospital?

Or, I could go to a surgeon in my network. Start the process over.

10 Reasons NOT to Get Corrective Strabismus Surgery

Ok, I confess. I've dropped the ball again. I don't know how people go through these insurance and phone tag battles and still work, raise children, clean the house, or sleep! Still, part of my less than aggressive approach can be attributed to fears and demons.

Here are 10 of them:

1. The surgeon will tell me I'm not a candidate for the surgery and then all these years of working myself up to it will have been for NOTHING.
   
2. I will lose part of my identity. After all, I've looked this way my whole life!
3. I will be one of those unlucky patients that falls into the wee percentage of freak accidents and will be far worse off than I am now.
   
4. My surgeon will be distracted by a spat with their spouse the night before, operate on the wrong eye, and ruin me.
5. Insurance won't pay and I won't be able to justify the expense of a cosmetic fix.
6. I'll look "vanilla" when right now I'm a flavor twist!
7. I'll be blinded.
8. The surgeon will grossly over-correct.
9. The surgeon will grossly under-correct (not nearly as bad as #8...*shudders*).
10. Oh, I dunno. Because I'm SCARED!

The good news is that this list is not nearly as long as my 26 Reasons to Get Corrective Eye Surgery. That's something.

Stay Tuned

More updates are on the way, including the "26 Reasons Not to Get Surgery".

It's going to be juicy.

26 Reasons To Get Corrective Eye Surgery

After today's earlier post, I'm feeling renewed, refreshed, and ready to go another round with insurance companies and receptionists. Ready to be my own mental coxswain. Ready to get on the phone and start pushing buttons again.

I thought, "what better way to psych oneself up than to make a list of reasons"? Isn't that what everyone does? Ok, sure, I could listen to the Rocky theme over and over, or praise myself with positive self-help talk in the shower ("You are a winner"), or do 50 jumping jacks, but I like making lists. It means I get to write, and writing is good.

I want this surgery (no matter how petrified I am) because:

1. They say eyes are the "windows to the soul" and I don't want anyone thinking my soul is warped.
2. Eyes are the first point of contact when meeting someone new...unless of course, you're a woman, he's a guy, and he's staring at your chest instead...and we all know what a stupid no-no that is.
3. My character and intelligence should get a fair chance to speak for themselves. They've got a lot to say!
   
4. I want to lose myself in a beloved's eyes.
5. When I get tired, I don't want to feel the pain caused by the muscles of my "lazy eye" straining.
6. Physicality is important in circles of influence and importance, even if nobody dares say that out loud.
7. I'm tired of "overcoming" it in new situations, having to prove myself a little more than the next Joe. So much energy having to be wasted that I feel is being channeled away from more important and noble things.
8. Yes, I'm going to say it, I want to feel pretty. Not gorgeous, not perfect, just bloody symmetrical.
   
9. The elephant in the room really misses his family and wants to go home.
   
10. I want to hold a gaze and not wonder...
11. I want to put to rest that quiet, subconscious, yet persistent voice of self-doubt that has accompanied this condition for so many years. Stupid sub-conscious voices!
    
12. People should feel at ease around me. More is accomplished when people are at ease with one another.
13. I want to stare the whole world straight in the eye.
    
14. I want to beam love-rays outa my straight eyes.
15. I want to have staring contests with strangers in bookstores...and win.
16. I've still got peripheral vision and I want to maximize it.
17. I deserve it.
18. You deserve it.
19. The medical technology exists.
20. Surgeons need practice.
    
21. Cruel people shouldn't have automatic ammunition.
    
22. It's a terribly awkward moment for all involved when I call on someone and they don't know I'm looking at them. And why should I have to memorize names to compensate?
    
23. I've lived with it long enough.
24. It can close doors of opportunity.
    
25. The tendrils of childhood anguish still have hold of my soft innards.
26. I deserve it.

Now look, I can hear some of you tsk tsking that I'm feeling sorry for myself. BBNNNNHHHH...wrong answer! For a small girl, from a poor town, with a lazy eye, I get a hell of a lot done. I've never sat around feeling sorry for myself while the world passed by, and surgery or not, I'm certainly not going to start that business now. But these are the honest truths, and I want to face them. I want you to face them.

Where I listed things relating to judgements, or closed opportunities, I am referring to my experience and the confirmations of science (follow the links on the right). Where I list things referring to human relations, I am referring to the poetry of symmetry, and the harmony of beauty.

Surgery or not, successful surgery or not, I will always be me. And I'll still kick your arse in a staring contest any day of the week!

Update II

There is no update. Sad. But true.

I was afraid this would happen. There aren't enough bloody hours in the day to make all the necessary phone calls. When I hit that last dead end, I dropped the ball. Albeit temporarily, but still dropped it. It nags at me daily but my work situation doesn't allow for too many personal calls during the day.

Actually...as I sit here, I realize there is a profound update. Not on insurance companies, or who my surgeon will be. On a personal level.

Some of you have remarked, either here or through personal email, upon my bravery at sharing this story so "publicly".

Yeah, damn it, I am brave! I'm finally talking about the elephant in the room. Blogging about this is seeping into my "walking in the real world" life, and I'm talking about it more openly there too. And I'm pushing others around me to talk about it more honestly with me.

Trouble is, with something of this nature, mentionings are in two categories. "Those who mention" and "Those who don't". The first group (this is from a lifetime of experience folks) tends to mention callously, without forethought, or they are downright rude or cruel. The second group, being of the more polite and kind variety of human beings, don't mention it unless I do, or they do so politely and with curiosity, and generally after knowing me for some time.

This...this alone is enough reason to help you understand why I want this fixed. I don't wish to be defined by this one piece of my physicality, nor do I want that feeling of knowing that it is an uncomfortable subject for others around me. That second part? That's why I'm blogging about it.

Meanwhile, I've been quoted here.

Update

Hi everyone. As always, thanks for coming along for the ride. Unfortunately, I don't have any news to report. Still playing phone tag with the doctor's office. The nature of my work and work environment make it difficult to make calls during the day, and of course, the doctor's office closes at 5:00. So...{sigh}.

Still working in that direction.

Had an interesting exchange with a visitor that was adamant I should try vision therapy instead of surgery. I'd really love if people would share their experiences with both. Not just for my benefit, but also for everyone who is reading and considering surgery. Vision therapy doesn't seem like a viable option for me, not having enough vision to work with. Yet I would be interested to know if it has worked for other readers, or what they know about it. I'll do some digging myself in the meantime.

Still

Currently still playing phone tag with doctors. I will write more this weekend, and hopefully will have something of interest to report.