Showing posts with label letter. Show all posts
Showing posts with label letter. Show all posts

Sunday, February 13, 2022

2/13/22: My Hepatologist Sent Me a Message Online

It looks like my hepatologist was working on Saturday. I got a notification about a new message in the online patient portal. A letter from my hepatologist dated yesterday says my latest blood tests showed an "uptrend" that is "not concerning" but apparently is still noteworthy enough that I should expect someone to contact me about scheduling a FibroScan

He also confirmed that he will talk with my oncologist about whether or not I should stop Tamoxifen. I wonder, though, if he will want to wait until after he gets my FibroScan results, so I should not expect any new developments before then.

Tuesday, March 17, 2020

3/17/20: The Hospital Called Me to Re-Schedule My Echocardiogram

The scheduler asked if I would mind pushing my echocardiogram appointment 2 weeks out. I said that's totally fine, but I also asked if it would make sense to keep it sooner rather than later, since the coronavirus situation is only expected to get worse in the next couple weeks. She said, well, that's not actually an option, they are simply re-scheduling everyone. Sounds like they are in full preparedness mode.

My letter of authorization from the insurance company says I need to schedule the procedure within a one-month time frame. The scheduler assured me that it's easy for them to re-request authorization if they need to push my appointment out past the existing window.  

Tuesday, November 26, 2019

11/25/19: Insurance Letter Confirming Approval for Echocardiogram

Last Wednesday, when I made my appointment for another echocardiogram, I was given a range of allowable dates. Today I received the letter from my insurance company giving authorization for the echocardiogram within those dates. 

The echo is to monitor my heart because one of the possible side effects of Herceptin is weakening of the heart's pumping action.

Thursday, October 3, 2019

10/3/19: Insurance Letters Confirming Approval for Medications

Wow, I did not know that insurance pre-authorization was needed for Lupron and Herceptin. I got a letter for each today, authorizing the use of these drugs for a 1-year period.

I guess the doctor's office will need to renew authorization for Lupron every year? Interesting. 

Wednesday, September 25, 2019

9/25/19: Insurance Letter Confirming Approval for Echocardiogram

Apparently, tomorrow's echocardiogram requires pre-authorization. I received a letter stating that my request had been approved.

Amusingly, this is the first insurance approval notification that arrived prior to the actual procedure/test.

Friday, September 20, 2019

9/19/19 - 9/20/19: Insurance Letters Denying and then Approving Oncotype Testing

I didn't even realize that Oncotype DX testing required pre-authorization from my insurance company. I learned from the MRI and genetic testing that all the pre-authorization business is between the doctor's office and the insurance company; there's nothing for me to do.

I know my cancer was tested because we discussed the results with my medical oncologist. On the same day as that appointment, I got a letter saying the Oncotype testing was denied by my insurance. I didn't worry about it too much, because the testing already happened, though I wondered if I'd get hit with a giant bill later.

Today I got a letter approving the testing.

Can't say I understand how the insurance industry works.

Tuesday, July 30, 2019

7/30/19: Letter with Surgery Information + Medical Records + Support

After a completely stress-free vacation, returning home is actually kind of overwhelming. The "glad to be home and can't wait to sleep in my own bed" feeling is fantastic! But then there's laundry and grocery shopping and unpacking and piled-up mail and all the to-do items that have long been mentally shelved under "Things To Do After Vacation".

I was anxious to go through our accumulated mail to look for the letter with surgery details and any testing results that might have been mailed to me.

I did receive the letter with surgery information. It's amazing how having a paper in hand, with details laid out in print, can relieve my anxiety. 

I also received my genetic testing results in the mail. In addition to the 2 variants of unknown significance (VUS) that my genetic counselor already mentioned (in the BRCA2 and PALB2 genes), I have 2 additional VUS among the 83 cancer-related genes that were later tested. (The 2 new variants were found in the CDKN1C and MSH2 genes, each associated with less common syndromes.)

It now being over 2 weeks since I requested online access to my medical records, I gave the Breast Center a call to follow up. One brief phone call, and I got my patient portal login. Again, it's a wonder what resolving open issues does for my anxiety! Now to print out a whole bunch of appointment notes and test results to keep for my own records. (I have a binder.)

Among the many pieces of accumulated mail, there were 2 unexpected items. One was a card, the other was a package which turned out to be a water bottle with straws. Both were from the same person, my friend's friend who is giving me DMX advice and support. As relaxing and stress-free as my vacation was, it was not anxiety-free; my cancer diagnosis is always with me. Cancer-related thoughts and worries come and go every day. I can't express enough how incredibly uplifting it was to come home to two pieces of encouragement. I have heard it said that only people who have been through a certain experience know how best to support someone going through the same thing. The water bottle is for my post-surgery days, when drinking water is supposed to be critical to recovery, and with straws because even the smallest items may feel too heavy to lift at first. And the card is just what I needed to cheer me up during this pre-surgery waiting game.

Tuesday, July 9, 2019

7/9/19: I Cancelled the MRI with Biopsy Appointment

Hm.

At the breast surgeon appointment, my nurse navigator said she would cancel my MRI with biopsy appointment for me. (Since we decided on a double mastectomy, and both breasts would be tested, a biopsy of the left breast before surgery is no longer needed.)

But yesterday, I received in the mail a letter confirming my MRI appointment, scheduled for tomorrow. Maybe the letter was prepared before my nurse had a chance to cancel the appointment?

I called the radiology department to confirm my appointment was cancelled. The scheduler said my appointment was still there! She asked if I wanted to cancel it, and I said yes.

For my own sanity, I confirmed with my husband that both the breast surgeon and the nurse said the appointment was no longer needed, and that the nurse said she would handle the cancellation. I guess I'm a little troubled that this fell through the cracks - what else might also fall through the cracks then? - but my husband said cancelling appointments is probably low on the nurse's priority list.

Meanwhile, I am still waiting for the phone call telling me when my surgery will be. We have lots of summer plans that have been thrown up in the air until we find out the surgery date. I feel super anxious, and just want to have a known schedule.

Wednesday, June 26, 2019

6/26/19: Insurance Letter Confirming Approval for Genetic Testing

The genetic testing required pre-authorization, and I received a letter stating that my request had been approved. It was back-dated to June 20, and the service had to fall within a month's window of time.

6/26/19: Letter with Mammogram & Ultrasound Results

It feels weird getting these formal results in writing after already moving forward with verbal results and next steps.

This time, the letter informed me that the diagnostic mammogram and ultrasound on my left breast "showed an area of abnormality...[and] a biopsy is recommended."

I already have an appointment for the MRI with biopsy, but I'm leaning towards getting the double mastectomy, which would make the MRI with biopsy moot.

Friday, May 31, 2019

5/31/19: Insurance Letter Confirming Approval for MRI

I can't remember when I received this letter, so I'm just guessing the end of May... I guess it doesn't matter.

The MRI required pre-authorization, and the letter stated that my request had been approved. It was back-dated to May 19, and the MRI had to fall within a month's window of time.

Friday, May 17, 2019

5/17/19: Letter with Mammogram & Ultrasound Results

I received a letter in the mail informing me that my diagnostic mammogram and ultrasound "showed no evidence of cancer."

However, the letter went on to say (with bold emphasis as included in the letter):

"[T]he area of concern in your breast that prompted this exam should be further evaluated by your physician/healthcare provider. He/She will determine the necessary follow-up at that time... The area of concern should not be ignored despite a normal mammogram."

Of course, I had already followed up with the NP at the Breast Center.

Monday, February 25, 2019