Working with your doctors and insurers

I’m very lucky. I have health insurance and excellent doctors. I’m still learning how to make the most of too-brief appointments, how to get through surgery without panicking, and how to make the time to schedule important follow-ups. Getting the best care isn’t just about getting the best doctors... it’s also about acting as a team. I try to make sure all the health care professionals helping me have access to all my information, even if that means personally carrying files from one office to another, or calling the radiologist to make sure the doctor has the scans in hand when I show up for my appointment.

Years of passively accepting lousy coordination of medical records, poor communication between my providers, not asking enough questions, and failing to take personal responsibility for my own care probably cost me my voice. I now take a powerful, proactive approach to my own care. Here’s my team:

The “A” TEAM

My Laryngeal Surgeon, Dr. Peak Woo
CLINICAL PROFESSOR  Otolaryngology
Mount Sinai Hospital, New York.
Dr. Woo is an innovator. He pioneered the use of Cymetra™ (a toothpaste-like mixture of sterilized, pulverized human skin cells and saline) to “plump up” a dead or thin vocal fold and enable it to make contact with its partner. The procedure is simple and the results, for me, were spectacular. Although the body absorbs about 40% of the substance within a few months, enough remains in the cord to make a measurable difference in vocal quality.

My Speech Pathologist, Dr. Linda Carroll
Previously an Assistant Professor of Otolaryngology at Mount Sinai Hospital, New York, now in private practice as a licensed, certified speech-language pathologist, vocologist, voice trainer and voice teacher. She lectures, teaches, leads seminars for other voice professionals, and is a world leader in the development of innovative techniques and software for measuring and evaluating vocal function.
Dr. Carroll is the Most Valuable Player on my team. She literally taught me to swallow and breathe after the paralysis occurred. Her tireless coaching and commonsense approach to dealing with my vocal challenges has given me not just techniques that work, but also encouragement and hope. Whatever voice I have, I owe to her and Dr. Woo.

My anesthesiologist Dr. Allen Reed
ASSOCIATE PROFESSOR  Anesthesiology
Mount Sinai Hospital, New York.
Dr. Reed was my anesthesiologist for vocal cord surgery. (Dr. Woo chose in my case to do the procedure in the OR under general anesthesia rather than in his office under local anesthesia) He provided good counseling beforehand, but nothing could have prepared me for suddenly “coming to” while the breathing tube was being removed! The experience was brief but unnerving. However, I recovered quickly and was happily on my feet in a short time.

My thyroid surgeon, Dr. Eric Genden
PROFESSOR & CHAIR  Otolaryngology
Mount Sinai Hospital, New York.
Dr. Genden performed the thyroid surgery that freed me from what I nicknamed the “Godzilla Goiter”. He removed only the left lobe, leaving the still-functioning right lobe intact. Although he is notoriously overbooked, my surgery occurred right on time. At my follow-up appointments, he arrived characteristically late but then spent as much time as was needed, answering every question in careful detail and personally making sure I had access to every service and professional who could help me.

My Anesthesiologist, Dr. Adam Levine
ASSOCIATE PROFESSOR  Anesthesiology
ASSOCIATE PROFESSOR  Structural and Chemical Biology
Mount Sinai Hospital, New York.
Dr. Levine performed anesthesia during my thyroid surgery. What I remember most about him is his easy, reassuring bedside manner, and waking up afterward feeling comfortable, happy, and relaxed. I jokingly called whatever chemical cocktail he injected into me the “Juice of Joy”.

My Endocrinologist Dr Traci Breen
ASSISTANT PROFESSOR  Medicine, Endocrinology, Diabetes and Bone Disease
Mount Sinai Hospital, New York.
Someone has to keep an eye on the remaining right lobe of my thyroid. Dr. Breen is in charge of assessing its function, along with the radiologists at Mount Sinai who measure its nodules. I’m hoping it stays healthy for a long time, because, as much as I like my surgeons, I’d rather not see them in the OR again anytime soon...

Internal Medicine, Dr Iris Sherman
I’ve been a patient of hers for many years, and yes, Dr. Sherman, I’ll get that colonoscopy now that I’m 50! She recommended Dr. Genden when I found out that Dr. Lopchinsky didn’t take my insurance.

My acupuncturist, Dr. Jin Han
Formerly a doctor in Beijing, now working on pain alleviation with cancer patients at Sloan-Kettering Hospital and doing acupuncture in his own office.
So many people recommended acupuncture for treating Vocal Fold Paralysis that I decided to try it. I worked with Dr. Han for about four months. Although I found the treatments relaxing and somewhat helpful, the stress of trying to get to regular appointments (his office is inconveniently located for me) while working my 12-hour-a-day job proved too much. I miss my visits to Dr. Han.

My cranio-sacral therapist, Mark Delabarre, LMT
After a string of failures with more conventional massage therapies, I was ready to try something different. I had zero expectations for cranio-sacral work, so I was astonished when it had a genuinely positive effect. I’m delighted to have found a technique that works for me. (And no, I have no idea how it works).

And the man who started it all...

Dr. Richard Lopchinsky
Now retired from his practice in New York, Dr. Lopchinsky probably saved me from an untimely death by incremental suffocation. (check out the CT scan of my neck in the “My Story” section of this site: you’ll see what I mean). With endless patience, humor, and wisdom, he guided me to an understanding of what was happening to my body and encouraged me to do something about it. (He would have done the thyroid surgery had he been on my insurance plan). I originally was sent to him by Dr. Alex Tepper, my genial OB/GYN, who was concerned about cysts in my breasts. Dr. Lopchinsky found plenty of cysts, but was more interested in the massive goiter in my neck... the rest is history. Dr. Lopchinsky, thank you for everything.

The “B” Team, or: Dealing with Your Insurance Company

As a member of a union, I am one of the lucky Americans with health insurance through my job. Like any insurance company, Empire Blue Cross Blue Shield does not automatically approve every claim. I’ve found that when a claim is rejected (for example: anesthesia was deemed “not medically necessary” for my thyroidectomy. Please. When’s the last time you had part of your body removed without at least a strong drink? Yeah, I thought so.) the best plan is to patiently resubmit, resubmit, resubmit. Eventually, the claim will be approved. The trick is to never give up, and try not to lose your patience when dealing with what appears to be colossal, mulish stupidity. The insurance company employees are obligated to save their company money; they work for Oxford, or Aetna, or Blue Cross Blue Shield, not for you. Keep calm, be polite, and keep at it until you get “yes” for an answer.

The insurance company is trying to make a profit. You are trying to receive the benefits to which you are entitled. It can take time, phone calls, letter-writing, and emails. But remember, you are entitled to the benefits for which you or your employer has paid. Never give up.

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