By Desiree Johnson
Killeen Daily Herald
A mastectomy is physically and emotionally draining, and some health insurance companies are making it even harder for breast cancer victims to heal.
Breast cancer survivor Alva Williams recently told the Killeen Daily Herald about what has now been dubbed a "drive-through mastectomy," which involves sending a woman home after surgery without a hospital stay and makes her more susceptible to infection and other complications.
Lack of health insurance coverage means that for many women, any extra hospital stay is unaffordable.
In 2005, Williams missed getting her flu shot for the first time in her life. Shortly after, while suffering from flu symptoms, she decided to take a hot shower to make herself feel better.
When she emerged and looked at herself in the mirror, she saw a lump in her breast.
After multiple doctor visits and treatments for what would eventually be diagnosed as breast cancer, Williams required a mastectomy.
"There was no surgeon in Jacksonville that took my insurance, so I had to drive all the way to New Bern for outpatient surgery," Williams said. "I had a caravan of family members go with me so I could be transported back home afterwards."
Her recovery was extremely difficult. Unable to pay for a hospital stay the insurance would not cover, Williams and her family were forced to drive back to Jacksonville over the course of a day.
"I had tubes coming from my body to collect discharge, and I was so afraid I would catch one of the tubes on something and pull them out of my body," Williams said. "I started wearing my husband's pajama bottoms and stuffing the tubes inside the pants to keep them from getting caught."
Once she made it home, the situation only seemed to get worse.
"Everyone else was asleep, and I was wide awake and scared to death; it was horrible," Williams said. "I sat in a chair and started talking to God out loud. I just said, 'If you just help me through this, I will do my best to help even just one other woman get through this.'"
Soon after, Williams discovered that her health situation was becoming even more complicated. She had developed a staph infection.
"The surgeon would not admit that I had one, but my longtime family doctor recognized that I had a problem and taught my husband how to wrap gauze around a Q-tip and clean out the inside of the holes in my body so I could heal," Williams said. "Then, I couldn't start my chemotherapy until I had healed from the staph infection, so I was six weeks late starting my chemo."
Since then, Williams has recovered. While helping others, she has met many other women who have been involved in so-called "drive-through mastectomies."
"I talked to a woman who went through a similar experience where she was sent home right after surgery, and what's more, the insurance company raised her premiums by $1,500 per month," Williams said.
"She couldn't afford it, so she no longer has insurance. She makes just enough to not qualify for Medicare, so she's simply waiting until she's old enough to apply for Medicaid."
Scott Clark, public relations representative for Scott & White, a system of hospitals and clinics in Central Texas, says determining the length of a hospital stay is on a case-by-case basis.
"It depends on the patient as to whether or not they need more hospital stay, but we require one overnight stay for observation," Clark said. "All lumpectomies are outpatient procedures. Besides that, it depends on the insurance." A lumpectomy involves a procedure in which only the part of the breast containing the tumor is removed.
Margaret Jarvis, public affairs representative for Blue Cross Blue Shield health insurance in Texas, also says that coverage is on a case-by-case basis.
"It depends a great deal on her doctor and her policy," Jarvis said. "I'm sure a woman who is 20 will heal at a different rate than a woman who is 50."
Jarvis said the company adheres to federal and state laws, which are posted on the Blue Cross Blue Shield Web site. The medical policies Web page contains no mention of the amount of hospital stay the company covers in the event of a mastectomy.
The company, however, does refer to Texas and federal legislative mandates that require Blue Cross Blue Shield to provide coverage for all breast reconstruction surgeries in connection with a mastectomy.
For years, groups have urged Congress to pass the bipartisan Breast Cancer Patient Protection Act.
The purpose of this legislation is simple. It allows a woman and her doctor, not insurance companies, to decide whether or not she needs to go home directly after major breast cancer surgery.
The act has yet to be passed. A longtime supporter of the bill, Rep. Rosa DeLauro, D-Conn., has been laboring to convince her colleagues to get the bill put on the calendar for a floor vote.
Her press secretary, Adriana Sufras, explained that there has been work to get this act passed for the past decade.
"Before, it really wasn't an interest, but we have a new Congress, and it's an issue of priorities," Sufras said. "A number of states already have this provision in place, but it's important for your health to not be determined by where you live."
Lifetime and activism
In an effort to get things moving even faster, Lifetime Television is trying to get people more involved in pushing the bill. Lifetime's Geralyn Lucas, also a breast cancer and mastectomy survivor, is involved in that effort.
"Around here, we call it the 'common sense bill' because it is just that – common sense," Lucas said. "After a surgery like that, you're uncertain, groggy and emotionally drained. You're not in a position to start fighting with the insurance companies to get more hospital stay."
Lucas has been working for the past 13 years on breast cancer awareness, and her position with Lifetime Television has helped her get the word out.
Last year, Lifetime aired a movie based on Lucas' memoirs, titled "Why I Wore Lipstick to My Mastectomy," which was nominated for an Emmy, in conjunction with other programming that was breast cancer-related. This year, Lifetime has even more up its sleeve.
The network is beginning a campaign titled, "Be My Support, Be My Strength, Be My Bra," that features women and the people who supported them through their cancer ordeals.
A new original movie is in the works entitled, "Matters of Life and Dating." The movie is focused around a woman re-entering the dating scene after a mastectomy, and stars Ricki Lake and Holly Robinson-Peete.
Toby Graff, the netw1ork's vice president of public affairs, recognizes the importance of using entertainment to influence the government.
"I have a background in politics and government, and when I decided to leave Washington, I discovered the open position at Lifetime," Graff said. "It's interesting to use the power of entertainment to incite change."
The company also is working extra hard to get noticed again in Washington, D.C. Armed with personal stories such as Williams' and an online petition that has gained more than 18 million signatures, the group plans on presenting the updated petition to create more awareness.
"People are feeling disconnected, and we're trying to give them an avenue and show people how to use their voices," Graff said. "Their signatures and voices can really make a difference."
Lifetime wants to keep things rolling.
"We just want to keep the heat on," Lucas said.
The legislation and Texas
While the bill is getting more attention nationally, statewide breast cancer advocates are focusing on other aspects of the disease. Ramona Magid, executive director of the Austin affiliate of the Susan G. Komen Foundation, and a representative for Texas collaboratives of the foundation, said Texas activists have their sights set on something different.
"Our focus has mostly been on prevention and research. We want Texas to be on the leading edge of cancer research," Magid said. "There are so many aspects to focus on, and we work through volunteers, it's better if we give one aspect our attention than trying to split our focus 10 different ways."
An eight-year survivor of cancer, Magid does understand the importance of the bill and hopes to put more attention on it in the future.
Until the bill is passed, people can sign the petition on Lifetime Television's Web site, as well as read personal accounts such as that of Alva Williams, at www.lifetimetv.com/breastcancer/petition/signpetition.php.
Get in touch with the Central Texas affiliate of the Susan G. Komen Breast Cancer Foundation through the Web site at www.komencentraltexas.org.
Contact Desiree Johnson at firstname.lastname@example.org or call 501-7559