I have a 1cm nodule on my left adrenal gland, with the characteristics of an adrenal adenoma. The chances of it being cancer are very, very tiny. The chances of it being an aldosterone-secreting nodule are pretty strong.
Next step: a salt-loading test (sorry, can’t find a good link) or saline-suppression test. The hospital my doctor works out of doesn’t do the latter; the former would require three days off from work, while the latter takes a half-day or so. I would prefer the latter, so my doctor is going to try to arrange to have it done at UCLA.
Next step after that: adrenal vein sampling (AVS), also at UCLA. It’s a pretty gnarly sounding deal and I’m not looking forward to it.
If those tests are enough to persuade the insurance company to cover it, and if the AVS proves that it’s only the left adrenal that will be affected, then I’ll have choices: laparoscopic surgery in which the entire gland will be removed, or remaining on medication for the rest of my life.
I’m a crappy candidate for surgery due to a very small support network and my own stubbornness when it comes to avoiding asking anybody for help. But you know what?
The CT scan is done and I should have results by tomorrow evening. It was uneventful except:
The receptionist tried to charge me a $150 copay because I “hadn’t met my deductible.” On NO COFFEE – gasp, horrors! – I had to explain to her that I have fancypants Cadillac insurance with no copay and no deductible.
My vein went into spasm when the nurse tried to put in the IV line. Ouch. Fortunately the other arm cooperated beautifully.
The IV contrast, which I’ve had before with no problems, burned like hell when the technician turned it on. She fixed it immediately but wow, I wasn’t expecting that.
And thus my week as a lab rat concludes. Back to the waiting!
ETA: If you’re having a CT scan done with oral contrast – which this was, which I had never had before – you may want to skip eating afterward. Evidently this stuff takes a couple days to leave your system and can cause nausea for some people. Guess what? I’m one of them.
I’m having the CT scan and an ultrasound next week, don’t know which day yet. My doctor escalated my case as far as he could but still couldn’t get the insurance company to spring for the CT angio. Based on what the CT and the US reveal, if anything, I’ll have to *go back* for the CT angio if they then decide it’s necessary.
In the meantime, all I can do is… nothing, really, except keep taking the big-ass potassium pills.
My employer changed our insurance provider to Cigna on the 1st of the year. When this happened, my out of pocket cost for insurance almost quadrupled – I pay almost $300 a month for this plan. Now that I need it, I’m glad I have it. But. But, I do expect a certain degree of service in exchange for my dollars. (I know, I know – I should just lower my expectations. Trying. Really!)
Last week my doctor submitted the preapproval stuff to Cigna for a garden-variety CT scan, as well as a more complex abdominal angiography. Today I got a phonecall from a Cigna “patient advocate,” which I think is marketing-speak for a case manager, which I gather they assign whenever one of their insured suddenly is going to cost them a lot of money.
First, the good news; the CT scan was approved. Now it’s just a matter of scheduling. Then, the bad news; Cigna rejected the request for the angio.
I’m not going to even go into the ridiculousness of this – it’s not a pleasant procedure, people; my doctor would not order it out of frivolity, nor would I consent to have it if it wasn’t absolutely necessary. It’s up to my doctor to fight for it now; I have a feeling that the outcome of the CT may predict whether this will be a fight or not.
BUT. It gets better. After explaining all of this to me, the “patient advocate” moved on to her next order of business: to ask me if I would mind having the test done at a less expensive location than the one my doctor picked.
Haggling? Like at the flea market? Are. You. Freakin. Serious??
Needless to say, the test will be done at the expensive facility of my doctor’s choosing.