It's me again, the cataract question person, with a question about elective oophorectomy

[Susan Calvin]

Or having your ovaries and Fallopian tubes removed to eliminate the possibility of cancer. There, anyway.

I'm considering it, and I wonder if anyone else here has had it done.

The pros are that it eliminates the possibility of cancer there, and cancer there gives no symptoms until it's pretty advanced. There is no, repeat no, useful test for ovarian cancer. The cons are, that it's surgery, of course, and that it doesn't appear either Medicare or Tricare for life will pay for it. There's also the con of losing a body part, although I'm assured that at my age, 72, my ovaries are doing absolutely nothing. I'm not completely convinced of that, but that is what I am told. I know they don't produce eggs, of course, but I just have this sneaking suspicion they may be making a small contribution to something, totally without any actual evidence.

So as with cataract surgery per my previous question, I'm wondering if anybody has had this done, what it cost, and what you thought of it.

The reason I'm even considering it is that my new gynecologist wanted me to have the BRCA test since all my mom's sisters had some kind of female cancer, although my mother did not. The test came back clean, and I thought that was that, but she's still kind of pushing it, and the more I picture those things sitting there that will not show any symptoms if something does go wrong until it's gone very far wrong, the more I think about it.

Thanks.

Edited to throw in a piece of information that was rather hard to find. I looked for a while before I made this post, and I just now hit on the correct search terms, apparently. The cost I'd be looking at would be about $15,000, if I can trust the web search.

Edited again to add that the above I think now is just the cost for the surgeon. So I'm guessing I could double or triple that. That's a lot of money, but this new gynecologist has got me thinking about these things sitting there that won't show any symptoms until things are very badly wrong

[KatyaR]

1. I had one side removed several years ago because

the tube had twisted and died (soooo painful). I can't tell you the cost because of insurance, but it was a laproscopic surgery, done on an outpatient basis, and I was released with no restrictions. I had very little pain afterwards, mostly discomfort from the gas they use to inflate your gut.

[Susan Calvin]

2. Oh my gosh. What a thing to happen.

I am glad it turned out well, and I thank you for the information.

[deRien]

3. Are you sure

that Medicare doesn't cover a hysterectomy? I would double check with Medicare. I would strongly advise getting the BRCA testing done. It's a simple blood test. Whether you are negative or positive, you can make an informed decision about having a hysterectomy or not.

[Susan Calvin]

8. It's not a hysterectomy.

My new gynecologist actually does not recommend that, because it is a more major operation, and your uterus will give signs if there is cancer. Ovaries don't until it's advanced. What she's recommending is having my ovaries and Fallopian tubes out, and I've already determined Medicare and Tricare will not pay for that on a preventive basis. My BRCA, and several other tests they did at the same time, came back absolutely clean, so that is nice. However, my new gynecologist still thinks they should come out due to the fact that they don't announce cancer until it's pretty far advanced and ovarian cancer is actually fairly common and all my mom's sisters had female cancer of one type or another, although my mom didn't.

[buzzycrumbhunger]

4. I did acute care transcription for 15 years...

… and this is a fairly common procedure. They do have to do hormone replacement therapy to compensate (so you’re not suddently dumped in the pits of menopause), but if there’s really a family or personal history of reproductive cancer, it can be important.

And yes, as someone recommended, a BRCA test would also be a good idea for the same reasons.

[Susan Calvin]

9. Already had the BRCA test and several others while I was at it.

I'm 100% clean on everything they tested for. Menopause is not a consideration, since I am currently 72. My new gynecologist says my ovaries are doing zero, zip, nada, but I retain a nagging suspicion that they might be doing a little something that he somehow beneficial even at my age. That's with no evidence whatsoever, of course. I'm just kind of attached to my body parts. Literally and figuratively.

[brer cat]

5. Did your gyn tell you that medicare would not cover it?

I had a hysterectomy and oophorectomy in June even though I had no symptoms or test results indicating cancer. My bladder and uterus had fallen into my vagina so we had choices on how to fix the situation. My gyn recommended a "permanent" solution which was to remove it all my lady parts since I don't need them (I'm 77 years old) and he especially wanted to remove the ovaries since my mother died of ovarian ca. He put my bladder in a sling back where it belonged.

I asked both the hospital and Dr. office if medicare had approved the surgery and they said yes, that I would not be billed.

The hospital bill was about $55k and the combined bill for physicians (anesthesia, pathology, and gyn) was $11k. A truly astounding amount, but my Medicare summary shows the amount I can be billed as zero.

It is my understanding that how the physician writes up the proposed procedure makes a big difference in whether it is approved.

As for recovery, I thought it was fairly easy. The surgery was done vaginally, and I did not have a lot of pain or bleeding. There is certainly discomfort especially as noted above, from the gas they fill the belly with. I took very little pain medication and was up moving around quickly, albeit slowly at first.

Best of luck to you! I am glad that it is over for me and I have far fewer worries.

[Susan Calvin]

10. I determined that Medicare and Tricare would not cover it by looking at their sites

It's possible that she could write it up so they wood cover it, but I'd be taking a chance, I think, monetarily. I'm glad you mentioned all the other things besides the surgeon, because that makes me realize that the number I came up with and put at the end of my original post is probably not the whole story. I wish I was fonder of my new gynecologist and her communication skills. I am taking her advice to have them removed under consideration, but I'm really not crazy about her and her communication skills. Possibly I should think about seeing a different one next time, but Medicare only pays for a Well Woman gynecological exam at my age every two years, and I'm trying to make a decision on this fairly soon.

[brer cat]

14. Will Medicare pay for a second opinion?

I think that is reasonable before surgery, especially if you are not entirely comfortable with your gyn.

[Susan Calvin]

15. Don't know. I should look into that.

My initial thought is they wouldn't, since the surgery itself is something they wouldn't pay for if it's preventative rather than after cancer has occurred.

[Joinfortmill]

6. My experience

My experience is a bit different, but it may help answer some of your questions. I had a total hysterectomy at 45. I'm now 75. The doc thought I might have a cancerous ovarian tumor. It was not cancer, but I was a mess with endometriosis. For the first four years after the surgery I was on hormone replacement therapy until I read an article about the risk of heart attack when on hormone replacement therapy, and I told my PCP at the time I wanted to go off it. It was the best thing I ever did. I had no side effects at all. My hair, skin, my everything was fine and has been to this day. And I did not gain weight.

The recovery after surgery from the total hysterectomy was long and painful, about six weeks. I don't think you will have that experience. I would not presume to advise you, but I think if there was cancer in my family, I would seriously consider it. You are 72, you don't want to be having anything like this after age 75, unless you really need it. The older we get the less ability we have to recover.

I did a quick look on Google and it seems Medicare doesn't cover this if it's preventative, so it's going to be costly. If it was me I'd ask the doc if there is some way she can justify the surgery to Medicare.

Best of luck with the surgery if you decide to go that way. Trust your intuitive sense. I find it's usually right.

[Susan Calvin]

12. Thanks. I was interested to hear of your experience going off of hormone replacement therapy.

A gynecologist shortly after menopause was really pushing it on me, and she got so annoyed with me that I changed gynecologists. I didn't see any sense in taking medications when I had no symptoms. I think I had one of the easiest menopauses ever, and it sounds like you did as well.

That's one of the things that makes me wonder if my ovaries aren't still doing a little something, even if they aren't producing eggs. I really don't look or feel my age, knock on wood. Nor have the bones of my age, knock on wood.

[Joinfortmill]

13. They may be doing a little something. I don't know, but I do know this

whatever little thing they are doing, the lack of it hasn't done anything negative to me.

[XanaDUer2]

7. Medicare doesn't cover?

[Susan Calvin]

11. Not as a preventive measure, no.

Neither will Tricare. I don't remember which it was, but one of them will cover it if your BRCA test is positive and if you have a family history, but my BRCA test was negative.