As part of chemotherapy, my doctor gave me several prescriptions to be used before, during and after each treatment. One said it wouldn't be needed till after the second treatment. Since that's coming up soon, I thought I'd better get it filled, but as I read the actual prescription, "one cranial prosthesis, and no refills.
I may not be a doctor, but I do know that "cranium" means skull, and prosthesis means an artificial one. So what am I to surmise? Has the cancer spread to my head? If so, is it possible to simply prescribe a prosthetic skull? And why specify "one"? Could anyone need more than one? I also wondered just what sort of pharmacy fills such prescriptions. Wouldn't it require at least an outpatient surgery?
The explanation for the order read "secondary to alopecia due to chemotherapy." Well, obviously secondary means occurring second and I know the dictionary defines "alopecia" as hair loss. It's true, I'm not looking forward to losing all my hair, but is it really going to be so serious that I'll need an artificial skull?
Something had to be amiss. I slipped into the clinic restroom to examine my scalp and hair in the mirror. Obviously the hair was already thinning slightly, but my scalp looked fine and my "cranium" showed no signs of tenderness or reddening. I decided to just ask the nurse for an explanation but she was busy with several patients so I went out to the car and showed the prescription to John.
He read it with a puzzled look, reread it, and burst out laughing. "Don't you remember the lady at the wig shop said you'd need a prescription before your insurance would consider paying for a wig?"
"Yeah, but a cranial prosthesis? How could that possibly mean a wig?"
"It doesn't," he snickered. "I think that's the whole point. It has to sound like a medical device - something necessary to help you recover from treatment. You know, the way your walker helped you after surgery."
"Yeah, the walker I only needed for two weeks, yet the insurance company insisted on paying for a brand new one that's now folded away just taking up space in our garage. At least the wig I'll need every day for six months, maybe more."
So we went home and I called the insurance company. I read the doctor's prescription, word for word, to my patient advocate, trying hard to keep my composure. She sheepishly, but promptly, informed me that my company will not pay for even a portion of it. In fact, she didn't even care to know what the wig would cost. It was rejected out of hand. Ah, yes, "the company that listens, the company with a heart, the company that cares . the company that wouldn't even let me finish a sentence.
Just to add to the joy of all this, there is another Joyce Minor in the local hospital's system, so I always request that my files, prescriptions, blood work orders, etc., all use my full name including middle initial. Nevertheless, confusion often ensues. And no matter how many times I tell the hospital that my insurance only pays if they use a specific lab, they still use their own and the charges are denied, then billed to me.
I certainly hope if that other Joyce Minor ever needs a "cranial prosthesis" to recover from "alopecia due to chemotherapy," she has an insurance company run by people who understand that a wig is much more vital to a woman's ability to stand tall as she moves toward recovery than a walker could ever be.