Reply To: Surgeons / Travelling for Surgery

[Edelmf19]

Hi JaniceB,

Apologies I am just getting in touch. I finally became a member of EAI (have been meaning to join months ago!) tonight so I could respond to Kathleen’s request via social media.

I see from your last post that you already got prior approval for your surgery so many congratulations. I am delighted for you as I know how unbelievably difficult it is to get that, especially with the VHI. Also the anxiety that goes along with it…

I am one of the two women you mentioned that got VHI approval (in Jan 2019) for surgery with PBS on 23rd Feb 2019. At the time of my consultation with PBS on Dec 20, he was unaware to the best of his knowledge, of anyone being successful with the VHI so I was in a complete state over it all. However he thought my case was severe enough for them to approve and I have no doubt that his detailed reports, including scan report strengthened my case.

I didn’t have a large medical file to send to the VHI, have been misdiagnosed for 25+ years. IBS etc. Only one laparoscopy done at 17 years of age for a suspected ovarian cyst.

After a lot of reading and research, plus getting in touch with and talking to other women who opted to go abroad for excision surgery –
I contacted PBS via email in September’18 on foot of an MRI Summer 2018 which showed nodule of endo in rectovaginal area etc.

I met with Mr Kelvin Boos, Beacon who agreed to support my decision and help in anyway possible with VHI form. He thought I would end up with a bowel resection and stoma (I didn’t end up with either under PBS).

The VHI had to post a hard copy of the ‘VHI Questionnaire for Prior Approval for Treatment Abroad’ to me (which as you know basically states you need to prove this surgery can’t be done in Ireland and/or it’s life threatening or could become such). Enter more anxiety into the mix!

I then brought the form to Boos, left it with his secretary and as my referring consultant, he very kindly completed what was applicable to him within a day or two I think.

He left a number of questions unanswered relating to effectiveness or success rate of excision surgery, cost, safety of technology, and staff training questions etc

I picked it up in person and then typed out the remaining questions more applicable to PBS and emailed them to him along with a copy of what Boos wrote plus a list of clinical research papers supporting the case for excision over ablation, quality of life etc. I think I included the one Kathleen cited above. Anything I could find. PBS has a number of peer reviewed research papers (some of which are available on his website).

PBS very kindly completed this in November, before I had even seen him in person. All was then put on hold with VHI until I had my scan and consultation with PBS on Dec 20th. He emailed me detailed reports the following morning (21st!) and I got everything together for the VHI fist week of January 2019. I had been told it would take 7-10 days to hear back. I was amazed to hear back within 3-4 days and even more amazed that they approved surgery costs.

I had to pay PBS myself prior to surgery (then sent VHI receipts post surgery)

Post surgery I also paid the anaesthesiologist’s fee and another consultant’s fee who was on standby to check my diaphragm.

The Princess Grace Hospital accepted a letter of guarantee from the VHI re direct payment from VHI to the hospital. This had to be done at least 1-2weeks prior to my admission which was more stress to get sorted but took the financial burden of paying the hospital up front as that was the biggest part of surgery’s fee. The girl I dealt with in VHI was Caroline and she was excellent.

Overall the process was more straightforward than expected. I was prepared to appeal and fight if they hadn’t approved surgery costs in the first place. I was incredibly lucky.

For me, recovery post surgery has
been quite tough but I am beginning to get to a good place re energy etc and am a million times better than before (a number of symptoms alleviated) would do it all again in a heartbeat, the surgery that is, not deal with the VHI! PBS is excellent. Sorry for rambling on! I realise this info is too late for you but posting in the hope it might help others too.
Happy to answer any other questions or chat on phone. Best wishes, Edel