As an HME provider in the women’s health arena, I deal with beautiful and amazing women for a living. The women I see need to be fitted for their mastectomy bras and prosthesis in an effort to help achieve a more natural and symmetrical look underneath their clothing. Since starting in the world of women’s health, I have come to recognize that many people have strong misconceptions about women who have or have had breast cancer.

However, I am probably most surprised at the misconceptions that many breast cancer patients and survivors have about their own personal health matters.

Insurance Concerns
We often hear, “My insurance will not cover mastectomy or chemotherapy items” or “My insurance will cover only one bra and one prosthesis per lifetime.” Women are often surprised to find out that their insurance will cover such items as postsurgical camisoles, external breast prostheses, mastectomy bras, leisure/swimforms, custom-molded breast prostheses, and in some instances, cranial prostheses (wigs).

Women should speak with their insurance providers to find out exactly what items are covered. For instance, many providers will allow two or more new bras per year and a new prosthesis—or if you are bilateral—two new prostheses every 2 years. These items are not limited to those that are newly diagnosed. If a woman has a history of breast cancer, whether it has been 1 year or 40 years, she is eligible for mastectomy items. In addition, some insurance providers may request a letter of medical necessity, a prescription, and possibly preauthorization before items can be purchased. Each of these documents can be provided by an oncologist or a primary physician who is familiar with the woman’s medical history.

Remember, it is always important to speak with your client’s primary insurance provider to find out exactly what items are covered. It is also helpful to keep a notebook documenting whom you spoke with, along with the day and time of the conversation.

While you may be used to speaking with doctors, some clients are not good at it. “I can’t ask my doctor” is a refrain we hear. A woman should never be afraid to ask questions of her oncologistor any other medical professional. As DME providers, we deal with patients on an intimate level. However, we are not medically qualified to diagnose medical conditions. Therefore, we should encourage our clients to speak freely with their physicians.

Enhancing Peace of Mind
Some women think, “I am going to look exactly like I did before I lost my breast!” We find that women may not look exactly like they did prior to surgery. In some cases, they may not even have an areola/nipple, or the reconstructed breast may be higher or lower than the intact breast. Generally, the differences are not visible to the untrained eye. However, for the woman who is hoping to look the same, it can be somewhat upsetting.

Periodically, we come across women who need to undergo a number of surgeries to reconstruct the lost breast. This can be emotionally devastating particularly if they have a staph infection, or the initial reconstruction surgery does not achieve its desired results. Fortunately, we can reassure these patients that there are prosthetic enhancers that can help achieve an extremely symmetrical and balanced look. Also, there are even custom-molded breast prostheses that are a great noninvasive alternative to reconstruction surgery—and these may also be covered by insurance.

Chemotherapy and Hair Loss
“Will my hair fall out all at once?” No. It would be easier if it all fell out at once. Unfortunately, this is not the case. Hair tends to fall out a little at a time over the course of several days. Also, it can be itchy and occasionally painful as the hair is falling out. Generally, as larger amounts of hair begin to come out, it is easier for a woman to shave the remaining hair off of her head. This typically will alleviate the itching and pain associated with the rapid hair loss. Some women do not realize that 90% of their body heat escapes from the head. Therefore, most women feel cold when all of their hair is gone.

Lymphedema
“My doctor says I am at a low risk for developing lymphedema because he did not remove all of my lymph nodes, only a few.” We believe it is better to be safe than sorry. Following the postsurgical guidelines prescribed by your doctor is extremely important. However, this does not always guarantee that patients will not develop lymphedema. Anytime the lymph nodes are compromised, there is a risk of lymphedema.

Some simple and helpful guidelines are no blood pressure readings, no needles used, and no blood should be taken from the arm on the same side as the surgery site. Getting the range of motion back as quickly as possible after surgery can also be helpful.

As HME providers, we inevitably share these clinical and insurance tips with our clients. However, we should continue to encourage patients to become knowledgeable about their own personal health matters. At the end of the day, these women are turning into survivors—and our relationships with them will be long term.

Danine Harden is the owner of the Houston-based Women’s Health Boutique. She can be reached via email: wb11@sbcglobal.net.