Cancer Lesson #87: No More Port in a Storm

Cancer Lesson #87: No more port in a Storm

About a year and a half after my chemo ended, I got an EOB (Explanation of Benefits) for a “medical procedure” (one of my favorite euphemisms of all time) from our insurance company. This form explained how much they would and would not pay, how much the hospital would write off, and how much we owed. Since I couldn’t remember any recent appointments, I thought the hospital had mistakenly billed our insurance for someone else.

My daughter reminded me that I’d gone in for a port flush — a process so minor that I’d forgotten about it. A nurse stuck me in the arm — thereby accessing my port — ran saline through the device to keep it clean, and gave me a shot of Heparin to help prevent clots. Total time elapsed: About five minutes.

Seriously, it probably took longer to take off my jacket than it did for the “procedure.”

Imagine my shock when I read the following figures on the EOB.
Sterile Supply — $17.00
Procedure — $588.00
Insurance Company Payment — $309.76
Insurance Company Adjustment — $217.80
Amount You (I) May Be Billed — $77.44

I was sure it was a coding error.

When the actual invoice arrived, I immediately called the “Questions about your bill?” number. After three days of phone tag — don’t get me started on that topic! — I finally got to speak to a person, who told me the invoice appeared to be coded correctly.

How could this be? When I visited my doctor and have a port flush and have blood drawn, the bill is less than $600, more like $200.

The insurance lady couldn’t answer that question.

I understand medical treatment is expensive. No one survives any kind of major or chronic illness without learning that. But $600(!) for a five-minute treatment is beyond expensive.

It’s insane.

I asked if there was any way I could protest the exorbitant fee and learned I could dispute the bill.

I did.

I heard back a few days later. No surprise, they said the bill is correct. These costs, it seems, are set by Medicare and not the hospital.

Keeping a port means having it flushed every two months. How could I reconcile having our insurance waste $1,858.56 a year on this? And the $464.64 that I would be paying could certainly be better spent (perhaps on my daughter’s college texts?).

I had to have to have the device taken out, which really ticked me off.

ImplantablePort_2011Explanation of how a port works can be found at:http://tinyurl.com/y8snrty   Image above from same site.

If you haven’t read Cancer Lesson #13 and  Cancer Lessons #34, you may be wondering, “Why does she want to keep the damn thing anyway?”

Read them now.
I’ll wait.

After my MRI, I was bruised from several inches above both elbows to several inches below.  I wish I’d taken a picture.

I apologize for whining, but back then I had blood drawn every time I see my doctor. This meant I could look forward to a lot of poking and prodding around in my arms as the nurses try to find a vein.
Or, as they like to call it, I’ll experience a lot of “pinching.”

Still, chemo nurses are the best in the business when it comes to finding a vein. And it turned out I was making a tempest in a teapot.

That’s good.
Because I have no more port in a storm.

Addendum: Looking back, I know I wanted to keep my port for if/when my cancer came back. It’s the same reason I still have my wig. Pessimistic? I don’t think so. It’s more like carrying an umbrella because you know then it won’t rain. Also, in the interest of fairness, I should mention I asked a nurse about this. She said since ports access veins directly, what I called “poking” truly is a procedure, which can go very wrong if done incorrectly. I never did find out why it was cheaper to visit my oncologist, have blood drawn and my port flushed. 

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4 thoughts on “Cancer Lesson #87: No More Port in a Storm

  1. Holy cow! I feel deeply grateful to live in Australia, where the medical care surrounding cancer is free… I asked for a PICC line or Portacath when chemo started, but was told it wouldn’t be necessary, all would be well. It wasn’t. After that first dose I was hospitalised for febrile neutropenia and my left arm became one enormous black bruise as they took bloods, ran in antibiotic and saline drips, tried and failed with new veins when the old ones shut down or the lines blocked. You get the picture. So for the next dose, I stamped my foot and was given a choice. I chose PICC because you get a local, they insert a permanent line, and that’s the last time your skin is pierced until chemo is over. Yes, it has to be flushed, but there are no needles, no vein pain or shut down, and the whole chemo experience became just a little more tolerable. I have one remaining usable vein in that arm, and I treat it like gold, because if that goes down, it’s blood samples out of my foot, which hurts! The PICC line is out now, but I’d have it again in a flash, it was painless and trouble free.

    Liked by 1 person

    • Loved my port. I truly didn’t want to let it go. Like you, I have crap veins. Little ones in my hands are OK, but after axillary dissection, they said not to use my right arm, which has my only good big vein. I will say with the port, the nurses had to know what they were doing. I passed out once due to dehydration (my own stupid fault), and was taken to ER because I was out for a while. The nurse there tried to access port (several painful tries), finally thought he had it. Turned out he missed and all the fluids they were trying to pump in my veins went into tissue. I said that’s it. I’ll go home and drink fluids. Should note this was not my home hospital (which is actually 25 miles from my house). It was our local one. I was not impressed.

      Liked by 1 person

      • I sometimes see a venipuncturist looking longingly at my intact and sacrosanct right arm with the pink medicalert bracelet on it, while they’re rummaging around for something they can stick a needle into to draw a blood sample. It’s got to the point where anesthetists knock me out with gas before they try to get a cannula into me, otherwise the flinching and rocketing blood pressure put them off…;-) I must say, all this retrospective knowledge can be quite useful. If (God forbid) I ever have to go back for another round, I’ll be putting my foot down quite a lot about my treatment and the way it’s delivered.

        Like

      • Exactly. Even if I need to be hooked up for anything, I’ll have no qualms about demanding the person who’s best at needle sticks. I’ll end up with her/him anyway. Let’s just skip the bruising!

        Liked by 1 person

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