Episode 9: My Surgery Bill Was 75K

This is the ninth entry in a multi-part series. Read the rest here.

The skin at the bottom of my new breast is loose, pale, and dimpled – like raw chicken fat. So gross. I now have two marks where the drains were, close together like a vampire bite. But my three favorite freckles survived the carnage, so I'll take that win.

Once a week I go back to the plastic surgery department to get a fill. At the first appointment, my plastic surgeon removes the tape covering the incision. The edges are scalloped and pronounced. It doesn't look great, but it doesn't look terrible.

Side note: Google "mastectomy" at your own risk.

He holds a magnet above my chest to find the tissue expander's port and marks it with a blue dot. As he cleans the area with an alcohol swab, it moves the dot around like a Fibonacci sequence. Then he grabs the biggest syringe I've ever seen.

He tells me we'll aim for 100cc today. I'm still numb, so I don't feel much. When we reach 100, he asks, "Keep going?"

It almost feels like a dare. Yeah.

I'm pretty competitive. My guess is he is too.

We get 150cc, a full 50 percent more than planned.

"It feels like you're filling up a balloon," I say.

"I'm literally filling up a balloon."

The next week we just do 100cc and I'm surprised by how big it is already, like a grapefruit sliced in half and glued to my chest.

On the way out, the surgeon's scheduler asks me what it feels like to get a fill. He whispers it like it's some kind of secret. "Do you want to watch next time?" I ask. "Really?!" Yeah, why not.

When I go back in a week later, I ask him if he still wants to come watch the fill. "You sure?" Yep. I'm with the nurse today instead of the plastic surgeon and she does it differently than him, having me lie down instead of sit upright. Other than that, it feels the same. "So what did you think?" I ask the scheduler after.

"It's like filling a balloon!"

Yeah, that's what I said.

Before I start physical therapy, I have to take a class on lymphedema. It's not that different than the chemo class – again, I'm the youngest person there by about 30 years and the material is so easy it's almost offensive. The main difference is this time all of the other patients have the same kind of cancer as me. One of the women, probably well into her 70s, keeps looking at me and saying to the group, "I'd love to give her a hug." She makes sad eyes at me and I know she means well, but it makes me uncomfortable. Don't feel bad for me, lady. I'm good.

Back to lymph. What does it do? It filters bacteria, debris, and waste, returns fluid to the bloodstream, and helps out the immune system. Because of the mastectomy, I'm at risk for lymphedema. Lymphedema is permanent and often painful swelling on the surgery side arm. One in five breast cancer patients get it. But my odds are higher because every treatment I do – radiation, reconstructive surgery – ups the likelihood. They don't know exactly why people get it and you can get it at any time, even years down the road. This terrifies me even more than cancer for some reason.

The best ways to prevent lymphedema are to maintain a healthy body weight and exercise regularly. No shit. Everyone should do that. Tell me something real, tell me something I don't know. Why am I here? This class is bullshit.

Some of the at-home exercises the physical therapist says we're already supposed to be doing aren't in the book I was given before surgery. I'm kind of pissed but only because I'm scared I'll get lymphedema. I tell her that the exercises weren't included in my pre-surgery guide and she says, "Oh, well…Kaiser's big, you know."

That's your explanation? Kaiser's big? Kaiser, you're missing important steps in the patient experience. I have some suggestions for you. Call me.

"Are you a hot tub person?" the physical therapist asks just me. How did she know? "Be careful. Temperature extremes can also trigger lymphedema."

Great.

I get the bill for my surgery. I'm one of those weird people who likes to play The Price Is Right-style guessing games so obviously have been waiting for this day. Drumroll, please…

It's just shy of $75,000. Holy shit.

It's almost $60K for the operating services. Another five grand for my deluxe private accommodations. I'd definitely like a discount on the three thousand dollar recovery room post-surgery—that nurse was rude.

Just kidding!

I didn't pay $75,000 or anything close to it – so far, I've paid less than $300 for my surgery. Thanks, Obama!

What would you do if you had a healthcare bill that big? What will I do next year? Will I still have health insurance? Will you still have health insurance? Kaiser, I take it all back. I love you. I appreciate you. Let's be friends.

Billing is sporadic and confusing so I have no idea how much my chemo and radiation treatments cost. What, at the end of this – if there is one – the grand total will be.

Who deserves to live? People with money, apparently.

I start looking for a job because I'm afraid of losing my health insurance. I make it to the second round at a cool company, but the five back-to-back interviews put me in bed for a day or two after. I'm just not ready.

In better news, physical therapy is great. Highly recommend. My physical therapist reminds me of my grandparents, both caring and a little gruff. I'm sad when she tells me after three visits that I probably don't need to come back. As a parting gift, I get two rubber bands to stretch and strengthen with at home. No charge (that I know of).

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