Reduction scheduled for Thursday - very scared!!

Charoo · 07-25-2006, 03:57 PM

Hello everyone,
I was so pleased to see this forum available to talk about reduction. There aren't many places you can. I am scheduled for my reduction on Thursday. My husband and I found out about a month ago that we were pregnant with triplets. I was very surprised and happy, yet very scared. I have a severe back injury from a car accident years ago (I was hit by a drunk driver), so I was scared about carrying three. We had originally considered reduction to twins, but were still talking about it. Last week we met with a specialist for an ultrasound. They wanted to first make sure there were still three. There were, but one of the babies didn't look well. The doctor said it has some type of stomach or intestinal deformity. He let us know that it would probably lead to us losing that baby soon, so he recommended the reduction to ease the stress on the other two babies. We were sad but wanted to do all we can for the other two little ones. I know I am doing what's best for those two, but it's still very hard. If anyone has any advice or similar experiences, I would be greatful.

Charoo · 07-25-2006, 04:30 PM

We have HMO Illinois and they are flat out denying any coverage saying that it is not a threat to "my life". However, what about the threat the doctor told us about the third baby and how it could affect the other two (possibly losing all three). Has anyone ran into this and were you able to successfully fight it?

daniboo · 07-25-2006, 05:42 PM

Hi Charoo,

First off, let me say that I know that this is probably the most difficult decision you will face. I'm so sorry that you are in this position.

I too found this board just like you did. I had an SR done at 13 weeks. We reduced from quads to twins. We also have HMO Illinois, however, ours covered everything.

What did your EOB state as the reason they denied the claim? I think that the level of coverage varies based on what the employer has purchased.

At any rate, I would gather all relevant medical info and file an appeal. I'm sure your doctor or nurses can provide you with what you need to do so.

Good luck and I'll be thinking about you on Thursday.

Charoo · 07-25-2006, 06:32 PM

Thanks so much Daniboo, I appreciate your kind words and support. How far along are you now? Have you noticed anything unusual after the SR? How many days did you stay home and rest? Sorry for all the questions, I just am looking for any information possible.

HMO is saying that there's no harm to me, so it's not covered. If you don't mind asking, did you doctor write a report saying that quads were a danger to you? I asked my doctor for a full report of what he told us about the danger to the other two babies and he said it wasn't worth it because he knows they will still deny it. I will definitely fight it afterwards, for sure.

daniboo · 07-25-2006, 06:46 PM

Charoo, unfortunately we lost the pregnancy at 22 weeks due to pPROM. I didn't initially post that because I did not want to be insensitive and post that with what you have coming up.

I had no pain or complications or anything after the SR. It was done on an outpatient basis with a local anesthetic. The procedure caused really bad cramping. If you've had an HSG, it's much less painful than that.

After the procedure I came home and rested for the remainder of the day. If I remember correctly, I went to work the next day, but just kind of took it easy. I have a desk job, so there was no concern regarding strenuous activity.

I don't exactly know what my doctor said to make HMO Illinois pay for procedure. I would insist that my doctor give me the report regardless of what he believes the HMO will pay. If they won't fight for the coverage, you need all info you can get to file your appeal.

I just remembered, we also have BC/BS through dh's insurance, so we have primary and secondary insurance. Still wasn't a problem for either one to pay though.

Good luck!

jan21 · 07-26-2006, 06:10 PM

I didn't have a similar situation in that all 3 of my embies were growing well, so it was especially hard to make the decision to reduce. But DH and I decided that we did not want to have triplets for a number of reasons, and that SR was the best thing for our family. We went on to have healthy twins born at 36 weeks.

Can't help with the insurance - ours wasn't covered because it was out of state and therefore out of network. The doc who did it gave us paperwork on why it was medically necessary but I just didn't have the energy at the time to fight the insurance company over it and just paid for it. Maybe your peri and/or the doc who does the reduction can help!

Just wanted to lend my support and let you know we are here for you.

Janice

bebe72 · 09-20-2006, 05:18 PM

I too am sorry you are faced with this. (((GENTLE HUGS)))

I would think your doctor (especially a perinatologist) would be able to write a letter of medical necessity for the SR procedure. Carrying a HOM pg IS life threatening to the mother and ESPECIALLY if there is a risk of a prenatal defect causing PTL. Your doctor probably needs to write the letter of medicial necessity as well as send along any notes and u/s reports. Good luck and keep us posted.

bebe72 · 09-20-2006, 05:30 PM

I am sorry. I just now realized the dates on the thread. I am late by a long shot. I hope things worked out for you.

07-25-2006, 03:57 PM	#1 (permalink)
Charoo Registered User Join Date: Jul 2006 Location: Illinois Posts: 3	Reduction scheduled for Thursday - very scared!! Hello everyone, I was so pleased to see this forum available to talk about reduction. There aren't many places you can. I am scheduled for my reduction on Thursday. My husband and I found out about a month ago that we were pregnant with triplets. I was very surprised and happy, yet very scared. I have a severe back injury from a car accident years ago (I was hit by a drunk driver), so I was scared about carrying three. We had originally considered reduction to twins, but were still talking about it. Last week we met with a specialist for an ultrasound. They wanted to first make sure there were still three. There were, but one of the babies didn't look well. The doctor said it has some type of stomach or intestinal deformity. He let us know that it would probably lead to us losing that baby soon, so he recommended the reduction to ease the stress on the other two babies. We were sad but wanted to do all we can for the other two little ones. I know I am doing what's best for those two, but it's still very hard. If anyone has any advice or similar experiences, I would be greatful.

07-25-2006, 04:30 PM	#2 (permalink)
Charoo Registered User Join Date: Jul 2006 Location: Illinois Posts: 3	Forgot one other question about insurance We have HMO Illinois and they are flat out denying any coverage saying that it is not a threat to "my life". However, what about the threat the doctor told us about the third baby and how it could affect the other two (possibly losing all three). Has anyone ran into this and were you able to successfully fight it?

07-25-2006, 06:32 PM	#4 (permalink)
Charoo Registered User Join Date: Jul 2006 Location: Illinois Posts: 3	Thanks!! Thanks so much Daniboo, I appreciate your kind words and support. How far along are you now? Have you noticed anything unusual after the SR? How many days did you stay home and rest? Sorry for all the questions, I just am looking for any information possible. HMO is saying that there's no harm to me, so it's not covered. If you don't mind asking, did you doctor write a report saying that quads were a danger to you? I asked my doctor for a full report of what he told us about the danger to the other two babies and he said it wasn't worth it because he knows they will still deny it. I will definitely fight it afterwards, for sure.

07-25-2006, 06:46 PM	#5 (permalink)
daniboo Registered User Join Date: Jul 2006 Location: illinois Posts: 41	(loss mentioned) Charoo, unfortunately we lost the pregnancy at 22 weeks due to pPROM. I didn't initially post that because I did not want to be insensitive and post that with what you have coming up. I had no pain or complications or anything after the SR. It was done on an outpatient basis with a local anesthetic. The procedure caused really bad cramping. If you've had an HSG, it's much less painful than that. After the procedure I came home and rested for the remainder of the day. If I remember correctly, I went to work the next day, but just kind of took it easy. I have a desk job, so there was no concern regarding strenuous activity. I don't exactly know what my doctor said to make HMO Illinois pay for procedure. I would insist that my doctor give me the report regardless of what he believes the HMO will pay. If they won't fight for the coverage, you need all info you can get to file your appeal. I just remembered, we also have BC/BS through dh's insurance, so we have primary and secondary insurance. Still wasn't a problem for either one to pay though. Good luck!

09-20-2006, 05:18 PM	#7 (permalink)
bebe72 Registered User Join Date: Jan 2002 Location: New York Posts: 8,033	I too am sorry you are faced with this. (((GENTLE HUGS))) I would think your doctor (especially a perinatologist) would be able to write a letter of medical necessity for the SR procedure. Carrying a HOM pg IS life threatening to the mother and ESPECIALLY if there is a risk of a prenatal defect causing PTL. Your doctor probably needs to write the letter of medicial necessity as well as send along any notes and u/s reports. Good luck and keep us posted. __________________ B Blessed with 3 BEAUTIFUL DANCING PRINCESSES~~ ^i^ ^i^ ^i^ ~~~ My three baby angels in heaven. "God may not always give us answers, but He always gives us grace"


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07-25-2006, 05:42 PM	#3 (permalink)
daniboo Registered User Join Date: Jul 2006 Location: illinois Posts: 41	Hi Charoo, First off, let me say that I know that this is probably the most difficult decision you will face. I'm so sorry that you are in this position. I too found this board just like you did. I had an SR done at 13 weeks. We reduced from quads to twins. We also have HMO Illinois, however, ours covered everything. What did your EOB state as the reason they denied the claim? I think that the level of coverage varies based on what the employer has purchased. At any rate, I would gather all relevant medical info and file an appeal. I'm sure your doctor or nurses can provide you with what you need to do so. Good luck and I'll be thinking about you on Thursday.

07-26-2006, 06:10 PM	#6 (permalink)
jan21 5000-9999 post king of hearts Join Date: Feb 2003 Posts: 6,227	I didn't have a similar situation in that all 3 of my embies were growing well, so it was especially hard to make the decision to reduce. But DH and I decided that we did not want to have triplets for a number of reasons, and that SR was the best thing for our family. We went on to have healthy twins born at 36 weeks. Can't help with the insurance - ours wasn't covered because it was out of state and therefore out of network. The doc who did it gave us paperwork on why it was medically necessary but I just didn't have the energy at the time to fight the insurance company over it and just paid for it. Maybe your peri and/or the doc who does the reduction can help! Just wanted to lend my support and let you know we are here for you. Janice

09-20-2006, 05:30 PM	#8 (permalink)
bebe72 Registered User Join Date: Jan 2002 Location: New York Posts: 8,033	I am sorry. I just now realized the dates on the thread. I am late by a long shot. I hope things worked out for you. __________________ B Blessed with 3 BEAUTIFUL DANCING PRINCESSES~~ ^i^ ^i^ ^i^ ~~~ My three baby angels in heaven. "God may not always give us answers, but He always gives us grace"

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