Sunday, June 23, 2013

Surgery Scheduled for September

I am scheduled for surgery on September 16th at Brigham & Women’s Hospital in Boston.  Many people, including my doctors, have asked why I postponed the surgery until September.  My primary reason is fear about this procedure in general, especially when I am asymptomatic.  I understand that there is a possibility of a bowel obstruction but I need to prepare myself emotionally and psychologically for the operation.  I also have a family wedding in August and want to be healthy for that event.   I am lucky to be able to think about and plan the surgery without an immediate major medical problem like a bowel issue.  

I wanted to have the operation in September because the summer will be over and everyone will have returned from vacation and gotten back to work.  I also wanted to do it after the Jewish holidays because many of the healthcare staff may be out for those days.  Dr. Clancy, my surgeon, operates on Mondays so that is how I arrived at September 16th.

Brigham & Women’s Hospital's admitting office has already sent me some material about the hospital, policies and procedures.  A book they suggested is Prepare for Surgery, Heal Faster by Peggy Huddleston. It is about mind-body techniques to reduce anxiety, use less pain medication and heal faster.  There is also a set of 2 healing CD’s that one can buy with the book.  I bought both items in the hospital gift shop last week when I was in Boston. I have not read the book or listened to the CD’s yet but it is definitely on my “to do” list.  Two of the other things I need to sort out are:
1)     Finding ourselves a temporary apartment in Boston.  We will be required to stay in the area for post surgical appointments and in case of complications.
2)     Determining disability/healthcare coverage situation at work - more complicated.

I’ve looked into temporary apartments in Boston but it is still early for a September rental.  I think I’ll need to wait until mid-July to August to get one pinned down.  I have spoken to a few realtors, checked out the neighborhoods and made some progress.

The work situation is very complex. I work for a company that has good benefits. It’s also a very competitive work environment and the company almost always does a reduction in force (RIF) of 5% - 10% of its staff every year, usually just before Thanksgiving.  I’m not sure whether to tell my boss that I have cancer or just that I am having a major gastrointestinal surgery and could be out for 6 or more weeks.  I’ve asked several people about what to do when speaking with my boss. The answers have been emphatic but very mixed – no decisive opinion either way.  My boss knows I have been out for medical tests and procedures and has asked about it but in response I have been vague but not misleading.   Moreover, I’m not having a very good year for bringing in new clients.  I’m wondering if I could be included in our annual RIF later this year. 

If the surgery does not go as well as expected and I have longer term problems, I would have to go out on long term disability.  My company has a long term disability income policy that pays 40% of my base salary.  I don’t understand a lot about how it works and coordinates with Social Security disability income.  Once I talk to my boss, I will try to discuss this with a good benefits person.

In addition, if I go out on long-term disability, I’m not sure how my medical insurance coordinates with Medicare.  I understand that there is a 2 year wait for Medicare after applying for disability. I’m wondering if I will be on my company health insurance or COBRA until Medicare takes effect.   COBRA lasts for 18 months and then I’m not sure exactly what happens for the other 6 or more months.  I’ve heard of COBRA continuation coverage and HIPAA plans.  I’m not sure how these interact with my company health plan if I end up on long term disability or if I am RIF’ed - this term is used as a verb in my company!

If I get RIF’ed, I might not be able to get long term disability. I’m not sure if they would RIF me if I were out on short term or long term disability.  I'm sure my global benefits department already knows I have cancer from looking at my medical expenses. My situation would be no surprise to them, just to my boss and department.  I'm hoping for a speedy recovery and back to work with no layoff but I need to understand the issues if that does not happen.

All of this gives me a big headache!  If I lived in another developed country, the employment and healthcare issues would not even intersect as they have single payer programs not affiliated with work.  Stay tuned. Once I figure this all out, I’ll try to explain it to the best of my ability.

Meanwhile, I'm going to enjoy the summer and prepare for September.