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#113918 03-11-2010 08:51 AM
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Patcey1 Offline OP
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Just heard from my doc that they can't get me an appointment with a head & neck guy in NJ for a 2nd opinion for resection and or reconstruction. Recommending that I try to get over to Philly (Fox Chase). Since I am Charity and Medicaid, it's up to me to facilitate this process on my own. I've called Social Services to put this into motion but now I wonder if it has to be Fox Chase. Problem is that I don't know anything about the hospitals or, more importantly, the doctors in Philly. I know U of P has a great reputation but so does Fox Chase. How do I make an informed decision?


Pat - 62 yr. old -DX 8/29/09 SCC stage III floor of mouth
Lower teeth& bone removed
Port& Peg
Cisplatin x3; Rad 35 - ended 12/21/09
Fox Chase 2nd opinion-mandibulectomy; tracheotomy; left neck dissection; jaw reconstruction 5/13/10; flap failed;new flap 7/13/10; lipo January 2011
Patcey1 #113920 03-11-2010 09:20 AM
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Posters here have been treated at both places -- I know Eileen was seen at Penn (Abramson Cancer Center) and Wilckdds was at Fox Chase. You might sent them both an e-mail or a private message (click on their profiles for information) and ask about their experiences.

Both places are NCI-designated comprehensive cancer centers; Fox Chase is also part of the National Comprehensive Cancer Network, an alliance of 21 leading cancer centers that develops and publishes the annual treatment protocols.


Leslie

April 2006: Husband dx by dentist with leukoplakia on tongue. Oral surgeon's biopsy 4/28/06: Moderate dysplasia; pathology report warned of possible "skip effect." ENT's excisional biopsy (got it all) 5/31/06: SCC in situ/small bit superficially invasive. Early detection saves lives.
Leslie B #113924 03-11-2010 11:26 AM
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I had my total laryngectomy and left ND at HUP and love my surgeon there. I however do not know if he does the type of surgery you will need. Anita Francis husband just had reconstruction done there which involved his jaw by a different surgeon who Suzanne didn't like. She moved on to Fox Chase. Both hospitals are very good. Obviously HUP is easier to get to for you. I know nothing about Medicaid or how this works with no insurance. I guess you would need to contact the hosptial social worker. email me if you have questions or want my surgeons name.

Take care,
Eileen


----------------------
Aug 1997 unknown primary, Stage III
mets to 1 lymph node in neck; rt ND, 36 XRT rad
Aug 2001 tiny tumor on larynx, Stage I total laryngectomy; left ND
June 5, 2010 dx early stage breast cancer
June 9, 2011 SCC 1.5 cm hypo pharynx, 70% P-16 positive, no mets, Stage I
Eileen #113934 03-11-2010 03:03 PM
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Patcey1 Offline OP
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Thanks! I've been on the phone all day trying to get past the bureaucratic bull...! The nurse consultant at Cooper has been a big help but at the end of the day I have no answers. If they do approve me to go over to Philly, I still don't know if I can pick my own hospital and/ or doctor. I don't even know yet if I'm a candidate for surgery; this all started because I wanted a second opinion. Tomorrow is another day!


Pat - 62 yr. old -DX 8/29/09 SCC stage III floor of mouth
Lower teeth& bone removed
Port& Peg
Cisplatin x3; Rad 35 - ended 12/21/09
Fox Chase 2nd opinion-mandibulectomy; tracheotomy; left neck dissection; jaw reconstruction 5/13/10; flap failed;new flap 7/13/10; lipo January 2011
Patcey1 #113938 03-11-2010 05:27 PM
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Posts: 235
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Medicaid in NJ is often reluctant to pay for any out of state treatment.

Have you contacted anyone in the Medicaid office in your area to see if this is a limition for you?
Sloan has an outreach center in NJ but I don't know if they are Medicaid contracted.

I'm sorry you have to deal with this. It must be very frustrating but keep advocating for yourself!!!


CG to Spouse BOT, Chemo and radiation started on March 29,2010
Ended on May 14,2010. LET THE HEALING BEGIN!!!
SusanW #113943 03-11-2010 06:00 PM
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In Ohio, my friend that took off has it and they pick and choose for her. Some involve a lot of needless traveling too. I hope your state is different.


Since posting this. UPMC, Pittsburgh, Oct 2011 until Jan. I averaged about 2 to 3 surgeries a week there. w Can't have jaw made as bone is deteroriating steaily that is left in jaw. Mersa is to blame. Feeding tube . Had trach for 4mos. Got it out April.
--- Passed away 5/14/14, will be greatly missed by everyone here
EzJim #113952 03-11-2010 07:26 PM
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Hi, Patcey,

My husband had all his surgeries at Penn and we have been very happy with the care and the people there. The most recent jaw recon was done in November by an OralMax and a Plastic. The original cancer surgery back in 2007 was done by a Head and Neck surgeon and the same Plastic. If you want numbers for any of these, send me a PM. I would also be happy to call you, too.

Most surgeons and hospitals will be happy to recommend other surgeons for second opinions. If that doesn't work, you could always call the Nurse Practitioner at each of the surgeons and speak directly to him/her. They may be able to answer some of your questions, thereby helping you make a decision on who to go to.

All the best-
Anita


Anita (68)
CG to husband, Clark, 79,
DX SCC 11/07, T4N0Mx, PEG 1/08, RAD, post rad infection 3/08,
HBOT 40 dives, ORN, Surg 11/09 mandibulectomy w/fibular graft.
Plastic Surg 4/10, 12/10, 3/11, 10/11, 4/12, 10/12. All PETS clear,
PEG out 1/11. 6/11 non union jaw fracture
Fractured jaw w/surgery 7/14
Aspiration pneumonia 7/21, 10/22
PEG 7/21
Botox injections
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Posts: 3,552
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I may be wrong about this but institutions receiving public money must take uninsured patients. I would shoot for Memorial Sloan Kettering since they are the top comprehensive cancer center in the US. I am sure that the clinic in NJ would be overseen by the main facility in NY.

http://www.mskcc.org/mskcc/html/662.cfm


Gary Allsebrook
***********************************
Dx 11/22/02, SCC, 6 x 3 cm Polypoid tumor, rt tonsil, Stage III/IVA, T3N0M0 G1/2
Tx 1/28/03 - 3/19/03, Cisplatin ct x2, IMRT, bilateral, with boost, x35(69.96Gy)
________________________________________________________
"You are a mist that appears for a little while and then vanishes" (James 4:14 NIV)
Gary #113974 03-12-2010 02:25 AM
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Posts: 5,260
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The patients with medicaid, do have ins. Medicaid is it .


Since posting this. UPMC, Pittsburgh, Oct 2011 until Jan. I averaged about 2 to 3 surgeries a week there. w Can't have jaw made as bone is deteroriating steaily that is left in jaw. Mersa is to blame. Feeding tube . Had trach for 4mos. Got it out April.
--- Passed away 5/14/14, will be greatly missed by everyone here
EzJim #113987 03-12-2010 11:02 AM
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Patcey1 Offline OP
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I received a call this morning from Fox Chase to tell me I have been approved by Medicaid. Seems that my doc at Cooper puts the name of the institution they are recommending on the letter of necessity that Medicaid requires to okay going out of state. The choice has already been made for me!


Pat - 62 yr. old -DX 8/29/09 SCC stage III floor of mouth
Lower teeth& bone removed
Port& Peg
Cisplatin x3; Rad 35 - ended 12/21/09
Fox Chase 2nd opinion-mandibulectomy; tracheotomy; left neck dissection; jaw reconstruction 5/13/10; flap failed;new flap 7/13/10; lipo January 2011
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