T Nation

Getting Insurance to Cover Gyno Surgery


#1

I can feel hardened tissue (about half the size of a dime maybe) which to me indicates surgery is going to be necessary. I've been to one doctor who essentially blew me off (dickface) but I did get a series of lab results from him and I'm going to a DIFFERENT endo, results in hand, asking for treatment.

I took RPN havoc, which is what caused the gyno. I told the last endo this, should I lie to this endo? If you look at the description of RPN havoc it states that it shouldn't cause gyno, no estrogenic effects, etc etc. In order to get INS coverage for gyno surgery, it cannot be "drug induced." What would you do? It would seem that if you took a "drug" that claims won't cause gyno, then that either didn't cause it, or someone (other than yourself) is at fault and you shouldn't be liable for the surgery.


#2

They paid for mine because I've had cancer before.

So, you could try and get cancer.


#3

I feel for you. Research, research, research...

You're not going to get any sympathy from the insurance company if you tell them that you got gyno from using a steroid, legal or not.

RPN & IBE have both touted the fact that havoc / epi has anti-gyno properties, yet that is an exaggerated claim based loosely on old studies of individuals with pubertal gyno.

It doesn't mean that an otherwise healthy 18-25 year old who starts using 40mg/day can't develop gyno. Unfortunately there are many, many people like you who have fallen prey to this marketing. (Btw, I say this as someone who uses epi from time to time, so I'm not slamming the product, just the advertising claims by reps.)

RPN isn't going to pay for your surgery. They probably weren't stupid enough to use wording that guaranteed that you couldn't develop gyno. Even if they did go beyond "puffery" in their claims and made a clearly false representation, do you feel like getting involved in a drawn out lawsuit?

Anyway, I'm not going to tell you to lie to your insurer but there's no way they are going to pay for the operation unless you do. The problem for you, other than the ethics of lying, is whether the insurer will find out that you disclosed different info to the first doctor. There are central databases... I don't know your situation.

How much would the operation cost, and did the first endo tell you that the gyno is too advanced to be resolved via lengthy SERM/AI treatment?


#4

This wont really answer your question at all.

But your chest looks fine. I know that this is a very personal issue and Im not telling you not to have the surgery if it will improve your self image. Just that you do not look like you have anything abnormal about your nipples. Many many people have a slight case of gyno and it is barely noticeable if at all. Surgery is a pretty big deal so make sure it is worth it.


#5

LMAO! OP you cannot get a yes from a no. You should be cool with your endo if your the only one that knows of your use. Gain some weight, try to look like a normal American and blame it on faulty genetics. Fuck the insurance company. I pay out the ying yang and when it comes to them doing anything for me they nickel and dime me and tell me to loose weight because I'm severly overweight or they'll rework my policy.


#6

I wasn't kidding, at least about the first part.

Seriously though, none of us want to tell you that you should lie to your insurance company, but if you want them to pay for it, that may be what you have to do. It's up to you to decide your moral standards on the issue.

In my case, my surgeon didn't even biopsy the mass. Because I had cancer before, he just went in and took it out. My gyno was just pubertal. You may have to just keep going to different doctors.

Last, an Endocrinologist isn't, in my opinion, what you need for this. A general surgeon could do the diagnosis and operation. It is quick and easy. I was doing pushups by that evening.


#7

The picture in my profile is 2 years old..I get what you're saying though. It is something I want treated and I've had some serious surgeries in the past, so I think I'd be fine. Now what would REALLY suck is getting the surgery only to have the gyno recur one day. I'm not totally convinced the gyno isn't continuing to grow, which would indicate an ongoing hormonal imbalance (although my labs say otherwise). Stress maybe? my life is unbelievably stressful.


#8

Not sure about how much the operation would cost as the 1st endo never treated me or discussed even treatment options. He's by far the worst doctor I've ever had in my life (and I've had MANY). He ran a series of lab tests on the first visit and prescribed bromocriptine 2.5mg ed and after 4 weeks my symptoms hadn't changed. He then noticed that my test was extremely low (overall T - 116) from the first lab and accused me of taking stuff. When I told him I wasn't taking anything he then said there must be something in my protein shake. ON 100% whey gold standard. What a quack! So then he ran 4 more labs and since my test was "normal" (within range, but still low) he told me to follow up with the referring doctor, essentially telling me to fuck off. All the while my gyno was advancing. When I went to see him it was tender. Now its tender and solidified. I seriously should be able to sue that fuck....Yeah but anyways, since my levels were within the BS "range" his ass was covered and he gave me the boot. Unbelievable...


#9

My family has quite the history for cancer....What type of test would they run to see if it was indeed male breast cancer? Aside from checking all endo type bloodwork (adrenal too), the doctors did 2 MRI's to check for a pituitary tumor (which came back negative). The endo shrugged off cancer, saying its very aggressive in men and would be very large in size by now if that were the case.


#10

Again, to be able to 'fake' it, you need an aggressive doctor that will take out the lump, and THEN biopsy it; in that order. It is possible for them to biopsy it while it is still in you, you have to explain to them because of your family history, you're scared and want it removed as soon as possible.


#11

I'm not sure it's possible for gyno to come back. I am under the impression that the surgeon will remove the gland which would prevent the possibility of a reoccurance.


#12

Since my surgery, I have gained some weight, on purpose of course. I have noticed that on days when my carbs get high, my right (non-surgery) nipple puffs up, but the nipple I had surgery on will stay flat.

However, I do not know the medical reasons for your statement, or if it is true.


#13

What I said doesn't have a medical reason. What do you mean?

Are you saying you don't know why a surgeon would remove the mammary gland when removing gyno?


#14

I'm saying I am not educated enough medically to know what they removed. Regrettably, I wasn't too interested when I had my surgery, I just wanted it over with. My mother is a registered nurse, I may get some more info from her next time I see her.

I was unaware it was impossible to get gyno again once that had been removed. I was just sharing my experiences on that matter.

Sorry if I sounded rude.


#15

have you tried Letrozole? I've read it can help w/ getting rid of the gyno.

try using Letrozole and nolva? many people have reported success w/ this combination. If you've had it for a long time, I don't think it would help.

here are some studies on nolva


#16

I've used nolva...adex etc...nothing got rid of mine. And trust me mines BAD. Pubertal...totally. When I'm ready to get surgery done, I'll make a case that it really hurts etc.


#17

Letrozole has reportedly been effective. its a lot stronger than adex or nolva.

however from what i've read it works for minor gyno and not "bad".


#18

Letrozole and nolva is a bad combo from what I've heard. I read somewhere that nolva actually reduces the levels of letro in your blood? Not sure, but anyways I'm crossing my fingers that it's not too late to take letrozole. Honestly I was just going to order it off the internet but its damned expensive. I know that nolva isn't enough at this stage though. I read somewhere that in minor cases, letrozole can actually destroy tissue growth (again, minor cases) caused by gyno. Anyone else read this?


#19

Letro is not expensive in research chemical form. Search around.


#20

You may actually be onto something. My little sister had cancer 3 times until it finally killed her. My father had fatal cancer and I have Crohn's Disease which is treated with Remicade.

"Journal of the American Medical Association, May 2006, cite an increased rate of several types of cancer and of serious infection with the use of Remicade and Humira. It has been known for a long time that these treatments increase the risk of certain types of cancer or infection like lymphoma and tuberculosis. However, there now appears to be an increased risk for a broader set of cancers and infections in patients undergoing medical treatment for Inflammaotry Bowel Disease.

The study examined Remicade® (infliximab), which to date is the only anti-TNF therapy that the FDA has approved for the treatment of Irritable Bowel Diseasae as well as Humira® (adalimumab), a treatment that is currently undergoing clinical trials for the treatment of Crohn's disease. The study, led by investigators at Mayo Clinic, used "meta-analysis" to combine and assess the results from a large set of clinical studies already in the literature. Less common events associated with treatment can be detected with the large number of patients and years of treatment represented by these combined studies.

Overall, the study suggests that the increased risk of cancer like lymphoma, skin, gastrointestinal, breast and lung or serious infection may be three-fold and two-fold, respectively. The risk appears to be mainly in patients receiving high dose treatment which is more than 6 mg/kg every 8 weeks; or use of Humra (adalimumab, 40 mg every other week). The increased risk of cancer occurred early, and there was not a further increase of cancer with longer times."

I receive remicade intravenously every 7 weeks, 5mg/kg. Shit maybe it is cancer lol