6:30 am – I wake up in a serious panic because in just 12 more days both of my breasts will be surgically removed. Simultaneously I rehash in my mind that, as late as yesterday afternoon, my surgeon’s office had yet to schedule my pending double mastectomy, port removal and “sentinel node injection with visual” with St. Luke’s.

I discovered this yesterday after checking both MyChart apps for the 9th time in six hours. As late as 2 pm I can still see that there is no surgery actually scheduled on my St. Luke’s calendar. Shouldn’t my surgery be on their calendar by now? I message my surgeon between my school meetings and inquire. The certified medical assistant (CMA) replies with an incoherent message which basically said, oops, sorry for not scheduling your surgery, but it’s now scheduled with St. Luke’s for the 25^th.   The message additionally instructs me to physically go to the St. Luke’s 5 to 7 days before the 25th (for some unclear pre-procedure) and so I can complete the pre-surgery intake with a hospital nurse. Huh? What pre-procedure? I decide to deal with this in the morning.

So, at 6:30 am this morning… Hmmm. What pre-procedure, I wonder? Can I schedule this pre-procedure around my last-minute rush to get everything settled with my assistants, four schools and four caseloads before I am out for 2-4 weeks? Will the hospital require someone to go with me, as they have done in the past? Why wasn’t any of this mentioned last week during my appointment?

I abruptly get up to make some coffee while considering whether I will or will not have to go to the hospital for a “pre-procedure” before my surgery on the 25th, and if so, how I’m going to work it out. I am thinking about a lot of things, actually, and I am feeling fairly overwhelmed. 

I call my surgeon’s office the minute they open this morning and get a front desk person. She quickly reads through yesterday’s MyChart message chain and then tells me that the CMA’s message regarding the necessity of a pre-procedure is incorrect. She says she will double check with the surgeon’s PA just to make sure. Ten minutes later I get a call back from the CMA who apologizes for sending me incorrect information in yesterday’s MyChart message; there is actually no pre-procedure that needs to be done before my surgery. She also tells me that I DON’T have to go to St. Luke’s to do a pre-surgery intake either.

“I don’t? Why not?”
“Because you are only having an outpatient procedure,” she says.

I, as calmly as possible considering everything, remind her that I am supposed to be scheduled for an in-patient double mastectomy, etc. and will be in the hospital a minimum of one overnight.

“Oh, yeah, that’s right. Well then you WILL have to go do the pre-surgery intake with St. Luke’s, but you might be able to do it over the phone.”

Sigh.

After I hang up, I call St. Luke’s. After going through their automated system and then two real people, I finally get transferred to the pre-surgery intake department where I am informed that, yes, I will have to physically go into the hospital to complete this pre-surgery intake; and, no, they do not take appointments. The agent has no idea how long the wait might be once I am at St. Luke’s, or how long the intake itself will take. Sometimes hospital staff automatically assume that I don’t have any other obligations besides going to medical appointments. I hear this all the time: “You have cancer and you’re working?,” generally produced after I’ve already explained that I work, and therefore need to schedule (whatever medical procedure or medical appointment) around this. 

I hang up the phone and make a mental note to go to St. Luke’s tomorrow morning first thing to complete my pre-surgery intake before I then drive over to Baylor to have my port flushed. At this point I am totally engulfed in my emotions and tears are actually running down my face. Again. It’s not even 10:00 am.

What the hell is wrong with me? Why am I crying about this?  This is ridiculous. I am being ridiculous, I mentally tell myself. And then I begin worrying that living with my emotions right there on the edge is my new norm; and then I cry some more. 

Last night I research “How to Prepare for your Double Mastectomy.” I also post a message in my MBC group asking for tips. According to, basically everyone on the earth, I was supposed to have started prepping for this double mastectomy a minimum of four weeks before the surgery. I am starting my prepping 19 days late. Apparently, there are all these (expen$ive) post-surgery special mastectomy pillows, drain holders and clothing  items to buy, (which I will not be buying, because I’m telling you, the breast-cancer-product business is a total racket).  The various articles I read on breast cancer sites highly suggest that my house be immaculate before the surgery (HAHAHA), that my bedroom and bathroom be set up for ease of movement and comfort, that meals be taken care of for at least 2-4 weeks, etc. It is also strongly recommended that I not be alone at all in my house for at least the first full week. Are you kidding me?

I consider the following: Already, I barely have energy to work, to go to endless medical appointments, to keep up with endless medical billing errors plus my own stupid bills, do the grocery shopping, clean the house, etc. Today I have exactly zero energy to pre-plan this double mastectomy; I am thinking I am just going to wing it. There. Problem solved.

Also happening last night… son comes home, comes upstairs and quickly becomes annoyed because I am demonstrably irritated, emotional, and very distracted. 

“Why are you upset with me?”
“I am not upset with you.”
“Why are you taking it out on me?”
“I am not taking out on you. This is not about you. I am just upset.”
“Why?”
“New BMC bill is showing I owe them a lot of money, once again; and it says that I am behind in payments. It’s wrong; but now I have to go through each insurance EOB and look at the patient responsibility section, add it up, and then compare those amounts with each date of service from August 2018 through February 7, 2019 to prove to them that it’s wrong. I’ve already worked all day, and now I have been working on this damn billing error for over an hour. I am tired. I am overwhelmed. I am upset. But not with you.”

I don’t add that I am also seriously pissed off because I have only just gotten another major billing error corrected with Baylor as recently as January 17. I also had to go through the same process to correct St. Luke’s bill last week. Two weeks ago, I had to do it for a Physician’s Group because they incorrectly billed me for over $9,000(!). Keeping up with the financial aspects of cancer is a full-time job in itself. The bills that come from my hospitals, physicians groups, labs, etc. never seem to match the EOBs from my insurance company; the medical bills always show a higher amount owed than my EOBs show patient responsibility. The billing departments will and eventually do correct their bills, but only after I go through each one, line by line, and then send an email or  snail mail with the  bill matched with EOBs from my insurance company. It’s exhausting.

“Let me help you,” says saint Patrick.

We spend an hour and go through each date of service line of the bill and compare it with each EOB, and he even makes an Excel spread sheet. I knew it; the bill is off by quite a lot. 

Here’s another thing I think about: I wonder how many people just resign to paying their medical bills without verifying them because they are too sick or too tired to do all of this double checking, or maybe even because they don’t know how? Why can’t the bills just match the EOBs? And then I start to feel sorry for all the people who don’t even have insurance. How do they pay their bills. Stop it. Can’t mentally go down that rabbit hole right now. 

This morning, after dealing with my surgery not being on the hospital’s calendar, dealing with the pre-procedure non-issue, and then working out whether or not I have to complete the surgery pre-intake, I send an email to the BMC billing department explaining their billing errors. I write in the email that this constant over billing and my subsequent efforts to figure out their billing errors is adding even more stress on top of the cancer stress.

I receive a return email from the billing department this afternoon (with no apology, of course): 

“Thank you for using BCM My Chart.  
Review of the account shows that the current balance showing as patient responsibility is $XXX. Charges for service date 02/07/19 in the amount of $XXX are pending with insurance at this time and you made the $XXX co-pay at time of service; if processed as co-pay only this date will reflect as paid once insurance has paid.”

So, the Baylor billing is now correct. For today. Hurrah!

Later this afternoon… I finally receive the long-awaited MyChart message from St. Luke’s hospital showing that my surgery is now legitimately scheduled on their calendar. But… Damn it; there’s no procedure listed for port removal, and the “sentinel node injection with visual” actually says WITHOUT VISUAL. I message my surgeon’s office, once again. Hopefully the CMA will have these orders corrected with St. Luke’s by my actual surgery date (so that when I am on the hospital operating table, totally incapacitated under anesthesia, I might actually receive the correct procedures).

And, in between attempting to jump over all of these cancer-related hurdles, off and on throughout my day I think about how my life will be without my breast friends, and I grieve a bit.

Today was a no good, very bad day. Tomorrow will be better.  Suck it up, Buttercup.