Jessica Schein

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Posts tagged with "Melanoma"

Saturday Rant: The High Cost of Medical Bills

If you’ve been following this blog at all you know that in early April my dermatologist and I found a stage 1 melanoma on my arm. This diagnosis required four successive doctor’s appointments—two more to the dermatologist and two to a plastic surgeon who handled the excision. The surgery took a total of 25 minutes and required six stitches. As far as procedures go, this was a minor one. 

Overall, I’m lucky: No further treatment was required, I am on pretty good health insurance thanks to my boyfriend’s employer, and I have money saved up for unforseen circumstances exactly like this one. However, not everyone is in such a good place. In fact, many aren’t.

My doctor’s bills over the past few months have amounted to $500+ in out-of-pocket fees for me. Without insurance, a possibility I don’t want to imagine, I would have paid $3,500+. Each doctor’s visit was $175, the various biopsies and pathology reports cost about $750, and the actual in-office procedure was $1,350. I broke it down and figured out that my surgeon was paid $52.00 per minute, which to me seems, well, unacceptable.

Up until recently I rarely thought about my health insurance. I am young and outside of some allergies and a congenital heart murmur that only means I have to take antibiotics before going to the dentist, nothing has ever been wrong with me. I simply accepted that my various employers would take out Aetna/Horizon/Blue Cross’s monthly pre-tax fee from my salary and paid the small bills I received after my annual doctor visits. Yes, I’d read stories about people whose lives had been upended because of medical debt, and I sympathized as much as I could, but I didn’t truly understand their plight because I hadn’t been there at all. 

Now, I get it—and my case, much like the small procedure done on my arm, is a pretty minor one. I don’t want to think about what a mastectomy or heart surgery bill would look like.

I know going to medical school is a costly endeavor—don’t get me started about the ridiculously high cost of an education in this country—and I respect that doctors want to earn their keep. I also understand that health care companies have the right to reel in some dollars too. They are, after all, businesses that are publicly traded in the stock market. However, someone (hello, elected representatives) needs regulate these escalating costs and protect this country’s citizens from the “bottom line.” 

After receiving a $400 bill yesterday my first thought was, “I’ll just wait until my next doctor’s appointment in July to get that other other freckle checked out,” but that isn’t right. I shouldn’t be weighing my future health against an upcoming bill, yet I have a feeling I’m not the only one who approaches his or her medical care this way.

I wish I could end this with some revolutionary new idea of how we can fix this, but I have no answers. There’s too much politics, lobbying, and big business interests intertwined with our own heath. Instead I have only a lingering sense of frustration, an emotion I’m sure those of you who’ve dealt with a similar or much, much worse situation, can understand.

May 5

When Freckles Stop Being Cute

Here’s a piece I wrote for The Conversation about my melanoma scare. Read it, if you’d like, but more importantly take the message to heart: Be vigilant about checking your freckles regularly for changes, go to the dermatologist once a year, and wear sunblock (of at least an SPF 30) every day.

Apr 7

PSA: Don’t Wait to Get Your Moles Checked

For years if someone told me to pick the place I’d most like to spend my time I’d always say, “in the sun on the beach.” To me perfection is being stretched out on a cushioned lounge chair, chilly coastal waters threatening my spot as the tide rolls in, with a stack of books at my side. In fact, as I write this, I’m smiling. Yes, I love the sun and surf that much.

Then yesterday my dermatologist called. The changing mole we’d both assumed was fine but had removed anyway isn’t in fact fine. It’s melanoma. Yes, it was caught early on, and yes, I will be fine after a deeper excision that will confirm it’s not spread, but as my doctor wished me a good weekend (okay, buddy) he said, “It’s a good thing you noticed it. If this has been 6 months down the line, you wouldn’t have been so lucky.”

In the past I’ve come across skin cancer stories on WebMD or CNN. Some articles cite young people who, like me, are lucky. Others talk of the less fortunate. All mention the dangers of the sun. Whenever I read those pieces I’d come up with a caveat to explain away the melanoma. “Oh well I’m sure she went tanning when she was a teenager,” I’d tell myself. Or even, “He clearly doesn’t wear sunblock.” It’s a coping mechanism, of course—the “that can’t happen to me” approach.

But, guys, it can.

Here’s my history: I’m 32-years-old, I’ve never been to a tanning salon, and although I spent summers in the sun as a kid I’ve always—always—been vigilant about putting on sunscreen. I wear a 15 SPF on my face every day, even though in Seattle the sun is pretty rare. Thanks to my grandfather’s Sicilian heritage my pale, olive-tinged skin is more likely to darken in the summer than turn red. In fact, I can think of only one burn in my life that turned crispy and no, I’ve never had sun poisoning. Last but not least, although cancer (breast, leukemia, non-hodgkins lymphoma) is prevalent on my dad’s side no one has had melanoma in my family. Ever.

This morning when I couldn’t sleep I spent some time on the Internet researching skin cancer. The first link I came across was for this article, somewhat ironically published earlier this week, which explains that the number of melanomas found among women under 40-years-old increased by more than eightfold between the 1970s and 2000s. But the news isn’t all bad. Because people are more aware of their skin now there’s been a decline in the number of deep melanomas, which are harder to treat.

So here’s my plea: check your own skin as well as that of your partner’s. You know yourself best and if something looks odd, get it checked out. I’m glad I did, because if I hadn’t mentioned to my dermatologist that a mole I’d had my entire life was losing its even border and looking like a splotch of paint, well… I don’t want to think about that.

As for me, I’ll never stop reading by the ocean or the pool but from now on, in order for the sun to reach me, it will have to get through an umbrella and an SPF of 60 first.