Honest Opinions?

[Lynlw]

The rules are this. You have 60 days to elect the coverage and then 45 days to pay the premium. Remember - that's 45 days from the day you elect it. (a maximum total of 105 days) You'll have to pay the back premiums and then monthly. You should have a 30 day grace period each month. (but it depends on how the group pays their premiums)

The other thing you have to remember is to abide by the rules of the plan. If you're on a PPO, ALWAYS ALWAYS ALWAYS use network contracted physicians and facilities. If you go out of network, you'll not only have to pay higher percentages but will be subject to Usual & Customary.

While COBRA may not be cheap, it will be cheaper than paying retail for that procedure.

I agree with even tho COBRA is expensive it is MUCH less than surgeries or even some of the more expesive tests..Justin's MRI/MRA was about 10,000. We had to pay COBRA for a couple months and for our family of 3 it was about 1300, which of course was tough since you usually need it when you are in between jobs.

One thing about PPO, we've had it for most of Justin's life, is IF you want to go out of network, you can try to get it approved IN ADVANCE and chances are if you have a good reason it will be coverred the same as if you were in network, it may take jumping thru some hoops tho. We live in Nj and Justin had heart and arm surgeries in PA, delaware and a appt in Boston with 2 days of testing. since we contacted them in advanced and got in WRITING it was oked, we had normal copays

 

[dcc617]

Lylnw - you're absolutely right! Get it in writing. You're fortunate that you were able to get the out of network services approved as in-network. Also, hospital stays require a precertification. Your doctor will normally handle this for you. But it's your responsibility to make sure it's done. When in doubt, make the call yourself.

Knight - you're also right. Continuity of coverage is best, particularly given the reasons why we're on this board.

 

[TenPly]

Ovie, to answer your question about deflating a lung, this is true. If you're going to be on cardiopulmonary bypass (the heart-lung machine) during your surgery, the surgeon will have to slow down your heart, bringing it to a complete stop. The lung becomes stationary as well. If you think about it, it makes sense – they need a quiet environment to do the procedure in. It'd be tough for the doc to work if your heart and both lungs were still dancing around in there.

 

[Ovie]

I couldn't agree more about continued insurance, although Cobra could be pricey monthly, you're absolutely right, if something else, or just regular check ups will be much more without it. However everything else that you're all talking about I leave up to my parents, I don't know alot about the insurance field and policies, probably something I should eventually Learn about.

Tenply, I guess that makes sense, I just wasn't informed about that part. Which is exactly why I'm here, to gain as much statistical facts and personal experience. Also to try and give as much support to others on this site that I can, because I know that even if they don't know it, alot have already helped me out tremendously on this site with support and information.

 

[TenPly]

I couldn't agree more about continued insurance, although Cobra could be pricey monthly, you're absolutely right, if something else, or just regular check ups will be much more without it. However everything else that you're all talking about I leave up to my parents, I don't know alot about the insurance field and policies, probably something I should eventually Learn about.

Tenply, I guess that makes sense, I just wasn't informed about that part. Which is exactly why I'm here, to gain as much statistical facts and personal experience. Also to try and give as much support to others on this site that I can, because I know that even if they don't know it, alot have already helped me out tremendously on this site with support and information.

Cool man, yeah definitely stick around. I got so much encouragement/information here when I had my surgery in '05. I was 21 at the time. Really glad I didn't wait, and even more glad to have found this site. I don't post much anymore b/c of work, but I'll try to check in more often, as I know it's kind of an unusual spot to be in, being 20-something and having heart surgery, but youth is def on your side for healing/recovery.

 

[Jkm7]

This site provided so much education and support for me when I really needed it, I promised myself I would continue to visit here for as long as I thought I had anything useful to say/help. My last surgery is coming up to four years ago and I am still tremendously grateful for having had this site then....... and now.

I feel bad to see so many come, have their surgery, often not even letting us know how it went and we never hear from them. I wish them ALL well but would love to at least hear how'd it go. Everyone has at least one little something that made their experience a tiny bit different than everyone else's.

Share it. Someone can benefit from that.

IMO

(sorry......... if anyone wants this post removed, just say so and I'll remove it immediately but that is how I feel.)

 

[dick0236]

...... Which is exactly why I'm here, to gain as much statistical facts and personal experience. Also to try and give as much support to others on this site that I can, because I know that even if they don't know it, alot have already helped me out tremendously on this site with support and information.

I found this site almost 40 yrs post-op and it has been amazing how much info I have gotten from it in the past five years. I have had little need to see a cardio, other than checkups every couple years, since my surgery.....but I had little questions, from time to time, that I never thought to bring up to my doctors. I have had most of those questions answere on VR.org. I continue to learn :biggrin2:.

ps: This was the first site, after I began to search the internet, that made any sense to an ole kentucky hillbilly:tongue2:.

 

[dcc617]

JMK7 - why would you want to take your post down? I'm really glad I found this site. Never fear - you'll hear from after I return home.

 

[Jkm7]

Thanks, dcc.

I'm a direct speaker, a no nonesense type of person and am sometimes too outspoken.
If anyone found my message offensive or objectionable, I wouldn't want them disturbed.
I hope all goes well for everyone waiting their surgeries and those who are post op to thrive and enjoy the gift we've been given.

I hope you will come back and share with us, dcc. I know you'll do great!!!

 

[Sean L]

Well, you can count on me to keep coming back here and bugging you folks pre/post surgery - for the rest of my life. Nothing worse than feeling all alone with something you have yet to fully understand. Some say the internet is cold and emotionless. This site, to me, refutes that claim entirely.

As for insurance, that has been a concern of mine as well. My surgery is mostly likely years down the road...but, where will my family be at that time? My current insurance comes thru my wife's employer. We live in a small town on the Southern Oregon Coast, so my job has no health insurance at all. I don't know how people would pay for a 200K surgery without insurance.

 

[Boston Tiger]

I found this site almost 40 yrs post-op and it has been amazing how much info I have gotten from it in the past five years. I have had little need to see a cardio, other than checkups every couple years, since my surgery.....but I had little questions, from time to time, that I never thought to bring up to my doctors. I have had most of those questions answere on VR.org. I continue to learn :biggrin2:.

I'm a relative newcomer to the site, since I found it a year and a half after my operation. Boy, I wish I had discovered it back in 2010, when I was going through my own waiting, then operation and recovery. Reading through the messages, you can immediately tell that this site is different since the posters here know exactly what the valve patient is going through, and want to provide whatever support they can. I immediately knew that I wanted to join in this community.

 

[Bill B]

This thread is chock full of brilliant, well-informed advice and comment.

I don't think anyone can say when is the "best" time to do this surgery. Lyn described a package of measurements and symptoms that are used, but it's still a judgment call. My cardiologist thought I was OK for the time being despite a rapidly shrinking valve, since I had no clear symptoms at all and felt fine. Still, I was uncomfortable with my incredibly tiny and restrictive valve, so I sent myself to see a surgeon. He did his own tests and exam and said my valve looked so bad and the pressures were so high inside my heart that my heart was working overtime to compensate and it was losing the battle rapidly. As to my lack of symptoms, he said my first symptom could be my last. He felt I had 3-5 months before I would be in trouble. So, I went ahead and did the surgery thinking I was lucky to have it done before serious damage occurred. But I could have been too late. I have had a good recovery but it is not nearly as complete as I had expected. My heart still does not do all that well on echo evaluation and has some impaired and abnormal function two years later. So, did I inadvertently wait too long due to the wait and watch attitude of my cardiologist with my lack of symptoms? Would it have made any difference had I waited longer or gone sooner? I don't think there is any way to know, but I like what Dick said - I'd rather be a little too early than a little too late.

 

[Ovie]

Yeah, this site has been almost a lifeline for me. I defiantly plan on sticking around.

 

[Lynlw]

Well, you can count on me to keep coming back here and bugging you folks pre/post surgery - for the rest of my life. Nothing worse than feeling all alone with something you have yet to fully understand. Some say the internet is cold and emotionless. This site, to me, refutes that claim entirely.

As for insurance, that has been a concern of mine as well. My surgery is mostly likely years down the road...but, where will my family be at that time? My current insurance comes thru my wife's employer. We live in a small town on the Southern Oregon Coast, so my job has no health insurance at all. I don't know how people would pay for a 200K surgery without insurance.

Nothing personal, but your post made me smile and shake my head, you can't imagine how many people just in the 6ish years i've been here that swear they will never leave since they got so much help they will always stick around and give back and shortly after surgery or recovery we never hear from them again..well some pop back when they have problems or around anniversaries, but the majority forget all about us when they get on with their lives..Alot of it of course is they ARE busy living their lives, but...

 

[escargome]

From a lurker in the shadows. I found this site about 2 months after my surgery. At times I comment on posts and at times I don't cause I don't have valuable input to add to a post. But I check in a few times a day everyday. This site took the post-op scared outta me. Whenever I came upon a new twinge or pain after surgery I could always find a calming answer on this site. So I will be around for as long as I can. Hopefully my valve will continue to serve me well, but I am always thinking of those going through a bump in the road.

 

[Superman]

I come and go. I disappeared for quite a while after my surgery although posted during recovery. Life gets busy. I do check in to read far more than I post.

OP - I wish you success in your endeavor to quit smoking. Almost nothing could be more important. Just a reference point. I had my first AVR at 17. I had never smoked. Both my older brother and older sister were smokers. While still in the hospital recovering, I let them try out my spirometer. I could move the bar farther than either of them and I had just been through open heart. Your lungs will thank you during recovery - so please stick with it, for your own benefit.

Regarding insurance - obviously I was on my parents the first time. Laws were different then, and I didn't have coverage through 25. I knew I would have to take any job I could that provided decent insurance. I took the scenic route through college working full time entry level for a large company during the day and taking classes in the evenings because the health benefits were what I needed. Typically left my apartment at 6 am for the gym, went to work till 5 pm, then in class from 6 pm - 10 pm for my last two years of college with one or two evenings off a week for homework (plus weekends). You may want to look for work in some company that offers coverage to all employees, regardless of wages. Even if it's entry level mail room work. It would allow you to wait a year (to be FMLA eligible) if you think you're rushing for the wrong reasons. Most large corporations benefit plans don't have exclusions for pre-existing conditions and many company's extend those to part timers. It may not be glamerous, high paying, or even in your chosen field - but the coverage would be worth it until you find a profession/career more suitable to your interests/talents.

 

[Chris M]

I will add my voice to the quit smoking advice. A smoker for 37 years I finally quit in March 2010 as I was getting breathless and had a chronic cough that kept me awake at night. The cough cleared up but the continuing breathlessness turned out to be a symptom of my mitral valve issues (from Rheumatic fever as a child, not from smoking), a condition I had no inkling of until then. In May last year (2011) I had my valve replaced. I am so glad now that I had that period of over a year smoke free before surgery as I feel sure my recovery would have been so much more difficult otherwise. As others have mentioned, coughing and sneezing is to be avoided if possible as it is uncomfortable/painful in the early weeks.

Sorry I can't help with the timing and/or insurance advice, we have a different system in the UK. But if your doctor recommends surgery then I think you probably do need to do it.

Best of luck to you!

 

[Boston Tiger]

As others have mentioned, coughing and sneezing is to be avoided if possible as it is uncomfortable/painful in the early weeks.

That reminds me of when one of the residents came in to check up on me in the ICU. I was once again being asked to hug my heart pillow and cough, but really didn't want to at the moment. I gave a half hearted effort, and he immediately told me that I was clearing my throat instead of coughing. I finally figured out that I had to give in and do what he asked, or he would never leave me alone.

My first sneeze was at week six, and that was the only time in my life I had half of a sneeze. My body instantly shut down whatever reflex causes sneezing!

 

[Ovie]

From a lurker in the shadows. I found this site about 2 months after my surgery. At times I comment on posts and at times I don't cause I don't have valuable input to add to a post. But I check in a few times a day everyday. This site took the post-op scared outta me. Whenever I came upon a new twinge or pain after surgery I could always find a calming answer on this site. So I will be around for as long as I can. Hopefully my valve will continue to serve me well, but I am always thinking of those going through a bump in the road.

That's why I feel like I'll be sticking around. My entire life I've had severe anxiety and panic attacks...than this happened, lucky me. I can only imagine that after my surgery every little thing is going to have me wondering if something is wrong.

Which is kind of ironic because I kept having issues breathing and I kept being told by my doctors that "it's just your anxiety", but I was so consistent that I knew something wasn't right that I switched Doctors and what happens? My heart has been doing double the work it's suppose to be doing. So sadly, and I guess thankfully as much of a curse as it is on my life, it kind of saved it.

But I also want to be here for people who are new to OHS and hopefully share my knowledge to them as the great people have and are sharing with me. It feels like an obligation. BTW day 5 of no smoking is over, onto 6, almost a week. Isn't fun but I don't see myself touching a smoke again.

Cheers to all of you!

 

[Jkm7]

Ovie,

You're doing GREAT with the non-smoking.
Keep on keeping on..... it is without question the biggest gift you can give yourself.
When I gain weight or don't exercise or don't do whatever it is I know I should do for my health, I think to myself........ why should my doctors care about giving me the best care possible if I don't value myself enough to do what I can to keep me as well as possible. It's human nature.

It doesn't always work but for the most part snaps me back to doing what I know I should
Your doctors will be thrilled when they learn you have successfully quit!

Good going........ now shoot for a smoke free tomorrow. One day at a time.