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heart ache

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Re: heart ache
« Reply #15 on: June 27, 2007, 06:08:27 PM »
Kids take a while to get used to things. I dont think you should force him to have the surgery. Just calmly explain what will happen, that to the best of your knowledge the operation is safe, he will experience no pain during it and fairly minimal discomfort afterwards and then his gyne should be gone. And be prepared to keep repeating it when he asks, thats how children learn, by repetition.

If you have to take him out of school for a week to 10 days later on thats better than making him have the op now when hes not ready.

The worst outcome for most adults with gyne surgery is that the surgeon doesnt fix the problem, necessitating another operation later. This wouldnt be any different when operating on a child so you should make sure that the surgeon is confident that he/she will resolve the problem and intends to excise the gland and do the full amount of lipo.


Re: heart ache
« Reply #16 on: June 27, 2007, 06:18:37 PM »
I have a similar condition to his and am almost 19 now.  My life has been pretty devestated from it and now I am not even in college or doing things that normal kids my age would be doing.  I am working and saving up for a damn titty removal surgery.  If my parents would of fixed this when I was young I would be a completely different person right now.  Good luck to you and I hope everything goes as planned.

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Offline sammi

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Re: heart ache
« Reply #17 on: June 28, 2007, 12:50:09 AM »
Kudos!  Thanks for the support!  Well here's the latest... I spoke with the ps assistant today and schduled a consault for July 13th.  I asked alot of ?'s  She said the ps has done many gyn procedures and if very familiar with this all.  She said after the consault that the surgery would be scheduled shortly thereafter...BUT she said most likely it will be cancelled b/c the insurance company will not allow billing for this UNNECCESSARY procedure?????  Ok. Then the ps will have to file an appeal in which it can take months to get an approval.  All this when my son seems at ease about this all.  Why would the endo. clinic even refer me if they knew that the insurance wouldn't allow it?????  All this is to much.  I was really counting on his first day of school being a fresh start for him.  I will pray for the best though and it will work itself out.

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Offline sammi

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Re: heart ache
« Reply #18 on: June 28, 2007, 12:56:20 AM »
Oh I also asked ?'s on his age being a factor and explained that after extensive research that I am yet to find a child so young and the woman assured me that they perform pediatric gyno procedures often.. Also keep in mind that after the skeleton test my son at 9 has the bone frame of an 11 1/2 year old.

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Offline sammi

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Re: heart ache
« Reply #19 on: June 28, 2007, 01:08:39 AM »
Thanks for the encouragement!  I am hoping for the best!  My son has suffered enough and he deserves to feel good about himself.  God has led me this far and I know he will make it happen.  Just a week ago I didn't even know Tre's condition had a name more or less a website with support and information.  I know he will make a way.

Re: heart ache
« Reply #20 on: June 28, 2007, 03:52:33 AM »
The insurance has to play this game because at this point in history it is not generally realized how psychologically tramautizing this "cosmetic" condition is.

If your docs play the appeal well you should get it covered. There is a recent court precedent for them to point at.

Hello.. I am 17 years old and just had my surgery 2 days ago! As i'm typing this i'm in bed on my laptop. Anyhow, I just wanted to add that Insurance actually covered my operation! I felt the need to add to this thread after reading the quoted reply. Though it technically is 'cosmetic', my doctors linked it to significant depression and insurance approved. But honestly, it depends on your insurance on whether or not you will be approved -- even more so, whoever is on the other end of the phone.  :-\ All in all, I wish the best of luck to you and your son and I know that he will thank you in the end. He's very lucky to have such a caring parent like you . . it took me a lot of reasoning and discussion before I was able to schedule an appointment.

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Offline sammi

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Re: heart ache
« Reply #21 on: June 28, 2007, 10:54:41 PM »
The insurance has to play this game because at this point in history it is not generally realized how psychologically tramautizing this "cosmetic" condition is.

the appeal welIf your docs play l you should get it covered. There is a recent court precedent for them to point at.

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Offline sammi

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Re: heart ache
« Reply #22 on: June 28, 2007, 11:02:11 PM »
What court procession are you refering to maywest?  I spoke with the specialist today and she did tell me that the insurance company will deny us at first but assured me that we will be ok because they will build a strong appeal.  She has already written a letter on behalf of Tre and we haven't even submitted our request yet...she is awesome!  I have had so much support!  I can definatly say between her and you guys that I am not alone.  I told her that I will take some pics of Tre shirt off to submit with her appeal and she said that definatly wouldn't hurt anything.  I had her look at this discussion board and all of the wonderful people here that have been so informative.  I told her I am sure that his mental well being will be stronger if the surgury is complete.  She says that they all know that but there is not much they can do the firsyt time around that they must appeal.  She also told me that when you appeal it that a real doctor actually reviews the appeal which will work in our favor because he will have emotions...compassion...what if it were his child?  I pray for the best. 

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Offline sammi

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Re: heart ache
« Reply #23 on: June 28, 2007, 11:08:52 PM »
Congrats onofmany!  Two days ago you started a new life!  And it gives me hope that the insurance company will say yes!  Can't we all pull together and start a campain to make the insurance companies recognize this as a necessary procedure?  I mean hell this is a persons life were talking about here!  A person can smoke their way into cancer and then need treatment and it's covered, but you can be born with a gyne gene and it isin't...only in america...go figure!!!  I will sell everything I have if I have to...he deserves a chance to see what life is like without being ridiculed!  If a person is born with like clef lips and things you always see them on the news having the surguries and things, what makes this any different? 

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Offline sammi

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Re: heart ache
« Reply #24 on: June 28, 2007, 11:23:35 PM »
That is awesome!  That is just what we needed!  Thankyou so much!

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Offline sammi

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Re: heart ache
« Reply #25 on: June 28, 2007, 11:30:14 PM »
I found another case in CT. where a boy was denied and when they went to court they over ruled the denial.  There is hope!  Why are their so many people on here who say they are saving for the surgery?  Is it that they have no health insurance or that the insurance companies deny the claims?

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Offline Chodel

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Re: heart ache
« Reply #26 on: June 29, 2007, 06:10:36 AM »
Sammi, has your son asked you to have 'them' removed?  What is his reaction to the idea of surgery??

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Offline sammi

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Re: heart ache
« Reply #27 on: June 29, 2007, 07:26:17 PM »
Actually he wasen't to happy about the surgery at first but now is is very happy, happy that te kids will quit making fun of him.

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Offline Grandpa Bambu

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Re: heart ache
« Reply #28 on: June 30, 2007, 07:28:25 AM »
Is it that they have no health insurance or that the insurance companies deny the claims?

Most (not all) IC's deny the claim. If you go to court, it 'can' be an expensive, long, and drawn out affair. With no guaranteeing that you will win your case. So I'm guessing that most sufferers don't pursue the issue after being denied.

Sure, these few court rulings are a step in the right direction for Gynecomastia and its sufferers, however, IC's are not going to all of a sudden say "Okay, we will now pay out on all Gynecomastia cases". It's just not gonna happen. I would say for now, it will prolly still be on a case by case basis.

Please keep us informed as to what your IC has to say...

GB
Surgery: February 16, 2005. - Toronto, Ontario Canada.
Surgeon: Dr. John Craig Fielding   M.D.   F.R.C.S. (C) (416.766.8890)
Pre-Op/Post-Op Pics

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Offline Grandpa Bambu

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Re: heart ache
« Reply #29 on: June 30, 2007, 07:31:59 AM »
Actually he wasen't to happy about the surgery at first but now is is very happy, happy that te kids will quit making fun of him.

Yeah, it truly is a different world when you are Gynecomastia free...  ;)

GB


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