Fear

Lately I have been hit with what I can only describe as debilitating fear. Ever since the denial from the insurance company and most recently, the consultation and scheduling of the surgery with Dr. Ch.arles, I have been experiencing intense periods of fear and nightmares. I get up in the middle of the night drenched in sweat (despite it being 34 degrees outside), heart pounding, and my eyes welling up with tears. The most recent dream...... I was pregnant with twins, and at a routine appointment, I was told that the Lap TAC was failing and one of the membranes had descended below the stitch. I started bawling and whimpering in my sleep. Just when I am about to deliver my babies I wake up in a panic. I am not sure why I am having these dreams. Maybe because I do not trust Bar.bara (the office manager and his wife), maybe because I have been hearing that the Lap TAC can fail. Maybe it is due to the the e-mails I have gotten from a few of the women I have e-mailed who had this procedure done with this particular Dr.

I think I shared with you previously my impressions of the Dr. and his wife. I am sure he is a skilled Dr. He is a laproscopic surgeon and has been very successful, but I just feel as if I am settling for second best. I asked my husband this question this morning - would you take your BMW to the corner mechanic to be fixed or would you take it to the BMW dealership?
Unlike Dr. D.avis, this Dr. left me with the impression that this is simply a job for him. His wife uses tactics to scare you into doing the procedure (this rubbed me the wrong way). She stated that it is up to me to do something because the insurance company will sit there and let me lose my baby. I know I am not dealing with her, just the Dr., but she rubs me the wrong way. I am also suspicious as to why I have to put $2500 down. The Dr. is over-confident and that scares me.
I could be reacting this way because I am nervous about the procedure. I have heard of many women who have done the Lap TAC and have been successful, but everyone is different. How do I know definitively that it will work for me? Will he place it high enough Will it be tight enough? Ladies, please tell me I am not paranoid.

I sent the following e-mail to a few ladies who had their Lap TAC with this Dr.
Hello __________
I am not sure if you still come on to Abbl.yloopers, but I really need your input. I have just scheduled my surgery with Dr. Le.roy Char.les of West P.alm Bea,ch, Fl. I live in Sunrise, Florida, and had to find someone in network in order for my insurance to cover the procedure.

I have been hearing all the "chatter" about LAPTAC, but also know that the successes also due to the expertise of the surgeon placing the procedure. After speaking to my insurance company after my original plans were changed (I previously had the procedure scheduled with Dr Davis), they assured me that the procedure would be covered because they have documented proof that a TVC does not work for me. That being said, Barb.ara spoke to me today and said that they require money down (about $2500), that *may* be refunded once they get their payment from the insurance company. I have a few questions. Please bear with me, after two traumatic losses within 8 months of each other, my heart cannot take anymore.

1.) Were you also required to put money down? Was it refunded in full? Did you have problems with the insurance company to pay Dr. Cha.rles? How long did it take for them to refund the money?
2.) Did your insurance company pre-approve the procedure or was payment requested after the procedure was done?
3.) What was your experience with Dr. Char.les and Barb.ara (easy to talk to, good bedside manners, personable, communicates with your dr., etc.)
4.) How was the recovery period? How quick were you able to get back to you normal daily activities?

I am concerned about insurance not paying (Bar.bara said there is possibility they might change their mind) because there is no procedure code. As a teacher, I do not get paid in the summer and that money that I am using for a down payment, is usually what I use to pay bills in the summer.

I understand if it may take you a while to respond, but please respond when you get a chance.

Thanking you in advance
Marie

Below are the responses. Please let me know your impressions. I know everyones experiences are different, but.... well...just let me know what you think.

#1
Hello Marie
I'm so sorry to hear about your loss. I lost 3 babies in 1 year. So I understand that you can't handle any more disappointment. I've been their too.

I haven't been active on the board because I haven't gotten pregnant again, but do still keep up on the news. I'm happy to share my experience with you.
1.) Were you also required to put money down? Was it refunded in full? Did you have problems with the insurance company to pay Dr. Char.les? How long did it take for them to refund the money?
Yes I was required to put the $2500 down. They did refund it when my insurance company paid them. I did reach out to Dr. Charles as soon as I saw they were paid by the insurance to get my refund. I recommend you do this to get paid quickly.
2.) Did your insurance company pre-approve the procedure or was payment requested after the procedure was done?
The $2500 is due upon arrival. I believe we got the tac pre-approved when we arrived in FL. We had to be there a few days before the procedure for the approvals. You will have to see a primary care in FL (his office will set up the appt for you) and be examined by Dr. Cha.rles before the procedure and get blood work on the day you arrive. As soon as you land go straight to his office. I dilly dallied a bit and we almost missed getting my blood work done.
If your insurance doesn't cover the procedure you will not pay him more than this $2500.

3.) What was your experience with Dr. Char.les and Bar.bara (easy to talk to, good bedside manners, personable, communicates with your dr., etc.)
I struggle a little with the phone communication and emails before the procedure. I didn't feel like they got back to me in a timely manner (so keep following up). They are very busy. Dr. Char.les goes to Mexico and South America regularly to perform TAC. In person they are AMAZING!!! He is a very kind, mild manner man. He explains everything in detail and you walk away with pictures of your Tac. He also is willing to talk to your future OB GYN to answer any questions they have. My experience was great. I really liked them.

4.) How was the recovery period? How quick were you able to get back to you normal daily activities?
I am quick healer, so I was off of pain meds by the next day. You'll be back to normal in less than a week.

Dr. Charl.es has done tons of these procedures and I really respected him. There is a women Lisa on the board who even carried twins with his tac.

Please let me know if you have any other questions. I'll be happy to tell you what ever I know.


#2
Hi Marie,

I hope that I can answer your questions now.
My insurance was preapproved before the surgery. There were some issues after the surgery and I had to *fight* a little bit to get it complete. I did have a deductible to meet also. That part of it I can't give you any advice on. I am sorry that it is complicated for you. I would hope that you would be refunded. I would demand the insurance company let you know ahead of time but I know it is not that simple.
I really liked Dr. Char.les and his wife. They seem like kind and caring people. He got me right in for surgery as I was almost 9 weeks pregnant and running behind on getting anything done. I will say that he did right by me and I have no complaints.
I will say that when I had my c-section that Dr. noticed that the TAC had rubbed a bit on my utererus and had to remove the TAC. This is not normal. I really don't know the full details but from what I have gathered it seems that the LAP TAC was placed very high. It held very well. It may have been put a bit too high and I my uterus did not have quite enough room to expand. I made it through ok. I did have contractions daily from 30 weeks on. The TAC surgery went smoothly. I did have contractions for about 24 hours after the surgery and then they went away. Overall, I think it all went well. As far as the LAP TAC goes, I don't know for sure if it was the best way to go but I would do it again. It took me about 5 days to recover but I felt pretty good after 3 days. Everyone is different. I was able to go on as normal for the entire pregnancy. I hope I did not sound negative about the my TAC situation but I just wanted to let you know what happened. It got me a healthy baby and that is what I wanted.
Dr. Char.les is a wonderful man. I really have him to thank for Marla.ina.
I hope that I have answered your questions. Please let me know if you have any other questions or if I can help in any way.


#3

Marie,

I completely understand your anxiety about paying an out of pocket expense. The proceedure was not covered in full by my insurance, I owed $5000 out of the billed $25000, because Dr. Charl.es was not in network. We paid up front (and for his airfare to Boston) and have never looked back. Plus it is all Medically Tax Deductible.

One of the main reasons I am not on Abby.loopers anymore is that the list doctor (Dr. Da.vis) doesn't support the LapTAC. Which is complete and utter bollux. I am currently 25/5 in my second TAC pregnancy (this time a singleton). My first, a twin pregnancy, was 4 years ago. My twins are now 3 years and 7 months old and I had a very uneventful pregnancy for a 38 year old woman carrying twins.

My healing was really great. In about 4 days, I was solely caring for my [then] 2 year old quadrapalegic daughter, at the end of 2 weeks I was 95% healed with only little twinges of discomfort. I purposely waited 8 months before ttc again, mainly to ensure that my entire body had healed both internally and externally, although Dr. Char.les said I only needed to wait 12 weeks (I also had a herniated belly-button repaired at the same time as the surgery).

If this doesn't answer all your questions, you are more than welcome to call me (just remind me of who you are when you call). My number is ---------.

I hope this helps you. I think one of the main reasons you are being asked to put a down payment is that some insurances in FL consider any pre-conception surgery as infertility treatment (erroneously) and infertility is not a mandated coverage in FL.

#4

Sorry I have not responded sooner to you. I don't really come to this email address anymore. So, I will give you my other that I visit daily if you have any other questions.

First off I am sory to hear about your losses. After speaking with Dr. Dav.is, DH and I decided that we would have the TAC after we conceived. Needless to say, we have ran into fertility issues and I have not been able to conceive for 2 years now.

However, I can answer the questions about Dr. Char.les. I met with him 1.5 years ago. I had not explored options of the traditional TAC versus Lap before meeting with him. I have to say that he was generally nice however it was very hard for my husband and I to understand him. He seemed as though he was very skilled at what he does but at that point he had only performed around 11 lap TAC, if I am not mistaken. He gloated on the fact that he had a sugeon from another country come and observe his surgery, which to me meant nothing.

I had a lot of issues with his wife. I paid my copay of $50.00. After I got my insurance EOB it stated that I should have only paid $25. I called down to the office and had a run around with Barbara about it. I told her that the insurance company said that Dr. Charl.es was not considered a "specialist" and that I should only have been charged $25. Well, she refused to refund my money or contact the insurace company. Even though she received the same Explanation of Benefits as I did. I don't think you should have to pay anything up front. Either the insurance company has approved it on there end or they haven't. They can always submit a pre-appoval letter to the insurance company. The insurance company would process it as a "fake" claim to see if it would be covered. I used to work for an insurance company so I know this can be done. I would not pay for anything up front....that is what you have insurance for! Oh and there is a procedure code for both TVC and TAC. I will have to look and see if I can find it in my emails from Dr. Da.vis. I called the insurance company myself when I was trying to see if it would be covered. I don't know why Barbara would say there is not a procedure code.

After all of this I spoke with Dr. Dav.is and felt at more ease about getting traditional vs lap. Yes, it does take experience doing lap and I didn't get the vibe from Dr. Char.les as I did from Dr. Da.vis. I actually was able to talk to Dr. Davis for a longer period of time on numerous occassions than I did taking the 3 hour drive down to West Palm to see Dr. Char.les. I believe Dr. Dav.is used to do Lap and then went back to traditional.

Have you talked to Dr. Dav.is about what the insurance is doing? I think he only charges one flat fee if you don't have insurance or the insurance won't cover it. Perhaps they could take payments? I would definitely check in to it. I know there are a few on Abbyloopers when I used to visit the site that rave over Dr. Char.les and his wife and they have had successful pregnancies. For me though, I just didn't get the same experience from him or his wife that they did.

I would definitely talk to Dr. Davis th.ough. I actually talk to Na.ncy, I don't know if she still goes on Abbyl.oopers or not, but she met with Dr. Char.les like a week after I did and pretty much got the same vibe. She has had a failed TVC. She ended up going to Dr. Da.vis last October and had TAC placed prepregnancy. I can ask her if she minds giving you info on recovery and so fourth. Another one of my friends had TAC done by Dr Da.vis post pregnancy and had a little girl last May. Another person I know lives in Miami and she ended up going to Dr. Haney and having pre TAC. She just delivered early not do to IC problems have just brought her son home. Dr. H.aney and Dr. Da.vis are the best in the field for TAC.

I hope this helps and I hope you receive this before you paid the money to them. I wish I would have seen this earlier. Please feel free to email me at -------. I check that email reguraly.

What do you think?
I prayed and decided that I am going on a fast. I told God that I am leaving it in his hands. If the procedure gets approved then this is the rout he wants us to take. If it gets denied, I won't be disappointed - this just simply means that my insurance company has to approve it with Dr. D. One of the reasons it might be denied is because the procedure code that Dr. Charl.es' office uses is labeled as cosmetic surgery.
I realize that I have to trust God. Not the surgeon, but God. He is the one guiding the surgeon and nothing else matters. Whichever Dr. that does the procedure I am taking it as God's hands in the mix.
Despite this revelation, I am extremely nervous. I am afraid that the procedure will fail. When it is done laproscopically, the Dr. cannot accurately get a "feel" of the condition of the cervix. I already know that my cervix is floppy, if it is done lap, how will the Dr. know this? How will he know that when pressure is applied it won't give way. I am very afraid to put my heart on the line and possibly lose another child.

Hopefully this fast that I am about to go on, will reveal his plans for me. I am taking my hands off it. I will stop questioning it, and let his plans be revealed. I will resist calling the insurance company and let this thing play out in His time. I hope you will pray with me. Pray for peace of mind. Pray for his will to be done and for his plans to be revealed. Pray that whoever does the procedure is simply a medium through which God guides. Pray for my fear to subside and that I lay my burdens at his feet.

Awaiting my expected end.