010, The $500,000 Toothache

In the beginning of 2017, my wife was diagnosed with a brain tumor about the size of a walnut.  It was located behind her left eye, approximately two inches deep from her temple.  Luckily, she wasn’t having strokes, seizures, balancing problems, vision problems, or significant pain.  She was literally experiencing only a very slight toothache that the dentist and doctors couldn’t diagnose or make go away. I’m convinced that having the proper insurance helped save her life and her functioning as a whole and happy person. Keep reading, it gets better…

She tried antibiotics, nerve medications, expensive dental x-rays, acupuncture… all to no avail.  Something told her to continue to pursue the slight, single toothache.  Most people, including myself, would likely just have given up and lived with it.  But she stuck to it and I’m sure glad she did!  She continued to see our general physician after the dentist was convinced the tooth was not the issue.  Our doctor suspected that something may be going on with her Trigeminal Nerve, prompting him to prescribe a CT scan. My wife called me at work the next day telling me that two masses had been found on the CT scan.  This began our introduction to the world of neurologists and neurosurgeons.

The journey began with seeing a neurologist who immediately referred us to a neurosurgeon.  The neurosurgeon quickly ordered an MRI and then an MRI with contrast.  When all was reviewed, he said she needed to have surgery on the tumor that was attaching itself to the trigeminal nerve (thus the tooth ache) and that he could perform the surgery.  Not being what she wanted to hear, we agreed on getting second opinion.  We met with another brain surgeon at one of the most recognized brain surgery centers in Dallas.  Again, a very experienced neurosurgeon said she needed surgery and he could do it.  She still was looking for the answer she wanted…no surgery.  By this time we asked a friend who had actually had successful brain surgery years ago for his brain surgeon’s information.  When we met with this neurosurgeon, he said he agreed that she needed surgery, but refused to do it because it was located in too difficult of an area.  He told us she needed a specialist!  Who knew?  I thought all neurosurgeons were “special.”  She needed a true specialist in skull based surgery. He recommended two doctors in the Dallas area.  However, we also researched others throughout the country.

Thanks to a couple of people we met who had gone through similar “complicated” brain surgeries, we chose the best skull based brain surgeon in Dallas – one of the two the doctor had recommended.  This guy only takes on the most difficult cases. (That’s four brain surgery consultations if you are counting.)

We continued with many MRIs in order to get “more slices” in the MRI and, of course, more consulting with our chosen special surgeon.  Within a few weeks, surgery was scheduled.  The 10 hour surgery was, thank God, successful and she was on the long road to recovery!

What followed were more MRIs, more doctor appointments, checkups, staple removals, meds, etc.  Today, I’m happy to report that she’s recovered and doing well.  The tumor was benign too! (The secondary tumor is currently behaving itself. Prayers appreciated.)  It has definitely been a long ride back to health.

One thing I haven’t brought up in this post so far was costs.  With me being retired military, along with having great insurance through my employer, the costs were never really a concern.  My primary insurer had no deductible and a $6,000 catastrophic cap for out of network coverage.  It was only $3,000 if we stayed in network.  My Tricare insurance from the military would also cover part of that expense if any was remaining.  That was well within our emergency fund’s capacity.  If there ever was an emergency, this was it.

This knowledge that our financial risks were very limited allowed us the freedom to get the best care available.  We were able to get multiple opinions and consultations without giving it a second thought.  We were able to have the necessary MRIs for proper diagnosis and a successful surgery.  We were able to go to all the follow up appointments. Cost just wasn’t an issue and never got in the way of the best care available.

I’m also convinced that if one of the other non-specialist brain surgeons would have done the surgery, she would be plagued with complications from the involved surgery.  Where this tumor was located required a team of specialists to ensure the best possible outcome, not just a confident brain surgeon.  Sure, they could have gotten the tumor out, but at what cost to her brain and surrounding nerves?  We’ll never know because we were able to choose the absolute best.

The total cost for my wife’s brain surgery was just over $500,000.  Early on in this process, we reviewed our policies to ensure what our financial exposure limit would be.  We reviewed this against our emergency fund.  It was well within our means to only pursue the best.  This wasn’t a coincidence.  We had made decisions long before to set us up to be in this position.  We chose wisely on the insurance coverage and types we needed to get quality care.

We could have gone the cheap route and only used Tricare and a cheap supplement versus full medical insurance from my employer.  But then, life or death decisions could be influenced by the financial impact at the expense of excellent care.  We could have been forced to go to only “approved” doctors.  That’s something that we were not willing to sacrifice.

Having adequate and appropriate insurance allowed us to pursue a long journey to a happy ending.

Always be prepared for that $500,000 toothache!

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