After deciding on a double mastectomy for stage I breast cancer, Lynn Michael sought a plastic surgeon to perform reconstruction.
Several doctors told Lynn, 37, they wouldn’t do surgery because she smokes. Smoking constricts blood vessels, narrowing the passage for oxygen to reach healing skin. Smokers are at risk for tissue necrosis, death of skin cells because of lack of oxygen.
Like many women, Lynn struggled with quitting smoking during this stressful time. A surgeon who agreed to perform the procedure on the Littleton, Colorado, woman encouraged her to quit for a few weeks before her mastectomy and immediate reconstruction. But Lynn began smoking occasionally again after. She soon developed tissue necrosis and needed more treatment to fix it.
Lynn had always enjoyed her breasts, so losing them felt overwhelming. “I couldn’t even look at my wounds,” she says. “It’s like taking the hands off a boxer.” She believed reconstruction would help her feel more like herself.
Expenses Create Problems
The tissue expansion phase of reconstruction took longer than expected, with Lynn approaching the end of her health insurance year. Her plan requires $10,000 annually in out-of-pocket expenses before it covers charges. With a new insurance year, Lynn would need another $10,000 to continue the process.
“Financially, I’m struggling hard all the time,” says Lynn, who works two jobs. She is divorced, has two teenagers and owns a house from the marriage that costs most of her monthly earnings.
“I applied for state insurance, but do not qualify due to my income,” she says. She had begun looking for a more affordable place, but her diagnosis made relocating “more than I could handle.”
When the expansion started, Lynn told the plastic surgeon about her insurance situation. Although she had made some payments, she couldn’t pay all she owed. The office reduced her fees and directed her to financial assistance programs. Lynn found she was ineligible for most because of her income and treatment type.
The financial barriers forced a stop to reconstruction. A year later, Lynn’s expanders remain in place, but the process is far from complete. She cannot pay the balance to finish expansion, or afford the next phase, when the expanders are replaced by implants.
The plastic surgeon’s office told Lynn the expanders can stay in place for up to two years. They cautioned that leaving them in could cause complications, such as infection and scar tissue build-up.
Now Lynn is trying to find money to finish reconstruction. “My plan is to start doing fundraisers—a Harley bike run, garage sales, whatever,” she says.
Lynn’s daughters have supported her, as have others. “I started dating a guy right before diagnosis and he was there for every doctor appointment,” she says. Yet, “emotionally, I haven’t really dealt with it.”
Through LBBC, Lynn learned about My Hope Chest, an organization that provides financial support for uninsured and underinsured women to obtain reconstructive surgery. The group negotiates directly with providers to accept the Medicaid rate for services.
Lynn is applying for aid from My Hope Chest despite a long list of women awaiting help in her state and others. She must stop smoking for six weeks before surgery and agree to undergo nicotine-testing before she can qualify for a grant. She wants to try, especially now because the expanders have become painful. (If you want to quit smoking, here’s free help.)
Alisa Savoretti, founder of My Hope Chest, says that Lynn’s situation is “a very common story…there are a variety of reasons women can’t afford to complete their breast reconstruction.”
Yet it’s important for many women. “Reconstruction is the final phase of breast cancer treatment,” Savoretti says. “It’s not a cosmetic procedure. It is a restoration of your body to how it was before.”
That’s what Lynn is working toward achieving very soon.
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This article was supported by Cooperative Agreement Number DP11-1111 from The Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.