Help Michelle Get Surgery & Her Life Back

Michelle needs our help!

For a number of years Michelle has suffered from immense abdominal and pelvic pain. After years of doctor visits, test, and trial and error she finally received a diagnosis – endometriosis! This disease is a painful disorder in which tissue similar to the tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. It can grow anywhere in your body and affect multiple organs. Michelle's is mostly in her pelvic and abdominal region and ranges from a daily dull ache to excruciating, crippling pain that is all-consuming and debilitating. In addition, she has recently been diagnosed with adenomyosis, the sister of endometriosis, in which these same tissues grow in the muscle wall of the uterus.

Unfortunately, the average diagnosis of endo takes patients 7 years and Michelle's case has been no different. She's lost count of how many doctors she's seen since she moved to the Jersey City area and their treatment options have ranged from multiple types of birth control to "have some wine” to an IUD to vaginally inserted Valium.

In the fall of 2021 Michelle saw yet another doctor who finally diagnosed with her with endometriosis and offered a surgical option- what's called “the gold standard” of treatment - a laparoscopy with excision of the endo tissue.

The day after Thanksgiving in 2021 Michelle had her first surgery, where several inches of inflammation/scar tissue were removed, as well as fibroids (Fibrosis was discovered during surgery.) Dishearteningly, the biopsy came back as “no evidence of disease” - how could that be? Her symptoms were very real and very painful and the surgeon found significant inflammation and scar tissue that had to be caused by something! The surgeon concluded that her current treatment – birth control/IUD – was suppressing the disease to microscopic levels, making it impossible to remove the root cause of her pain. Michelle's insurance did not cover the surgery (other than the hospital facility fees) because the procedure was "not proven to work". Further appeals failed and Michelle paid thousands of dollars for a procedure that ultimately proved unsuccessful.

After her recovery from surgery, Michelle felt relief for the first time in a long time – she was thrilled! Unfortunately, her relief was short-lived. Within two months, the pain returned with a vengeance. For several months, she returned to her surgeon for experimental radio wave treatments that cost $800 a session – but the treatments proved useless. Because this was experimental, insurance also denied these costs and Michelle again paid out of pocket. Frustrated, Michelle ended her journey with this particular doctor and began a new search to find answers and treatment that could improve her quality of life.

There are a surprisingly very few surgeons in the U.S. who specialize in endometriosis, recognizing it as a whole-body disease and who are capable of performing the excision surgery needed for a cure.

Enter Dr. Ken Sinervo of The Center for Endometriosis Care in Atlanta, Georgia!

At the advice of a friend whose life was saved by Dr. Sinervo, Michelle went for an in-person consult in August 2022. Dr. Sinervo immediately recognized both the endometriosis and the adenomyosis and recommended a major, detailed surgical plan. This plan includes a month of “pre-surgery preparation” that, through medication, will encourage the endometrium tissue to grow exponentially so that during surgery it can be easily seen, identified and removed completely.

Over the last few months, Michelle's quality of life has suffered tremendously. Her condition continues to deteriorate – she has more bad days than good and the bad days are much worse than they have ever been. She has had to take time off from work due to illness and is more often than not, forced to stay at home near her heating pad and bed due to medication she is taking to manage the pain.

But thanks to Dr. Sinervo, for the first time in a long time, Michelle has HOPE! Hope for a life free from pain and endless medications. Hope that she can return to the active life she had before!

Michelle has surgery scheduled at the CEC in Atlanta on November 28, 2022...a year and two days from her first surgery. During this time she will live in the Atlanta area for about 3 weeks to follow up with Dr. Sinervo himself.

Similar to the surgery in 2021, insurance has once again denied coverage for this surgery. (*for more information on why please see the end of this plea*). In fact, if the CEC files the claim with her insurance, her copayment would be approximately $41,000. Instead, Michelle is going to self-pay the CEC and her current estimate is $9,000 to $21,000 for the surgeon’s costs. She is incredibly grateful that insurance WILL cover most of the hospital fees and expects additional costs from the anesthesiologist.

The funds we are asking for will cover the cost of the Center for Endometriosis Care’s fee. Your donations will also help with the living costs for the time she needs to spend in Georgia. Michelle has already spent thousands on her medical care herself and this time is reaching out to the community for help. Anyone who knows Michelle knows that she is unimaginably generous and regularly goes above and beyond for the people and animals near and dear to her. Now is our chance to give Michelle back her quality of life. (there’s lots more dogs who need saving and Michelle is their hero!)

Rest assured that Michelle as the beneficiary, has direct access to your donations, they will be deposited directly into her bank account.

Thank you so much for your support! Every penny counts and is so appreciated.

*Why doesn't insurance cover this procedure? Please see information below from endofound.org

A 1992 Medicare Part B ruling grouped removal of endometriosis via fulguration, ablation, coagulation, and excision as one and the same thing.

All insurers base how they reimburse on Medicare tables. There is literally no code in these tables for excision surgery because of the above.

Excision is the only specialty not recognized by the American Medical Association (AMA). There are no boards or standard certifications.

The American Congress of Ob-Gyn's (ACOG) also does not recognize excision as a specialty, and does not recognize excision as the gold standard of surgical therapy for endometriosis – even though there are hundreds of clinical, peer-reviewed journals that say otherwise.

Medical schools don't teach excision or identification of endometriosis – because doctors literally cannot make a living doing it unless they are at a major university.

“Standard of care” protects doctors. This healthcare term basically means that if the type of treatment you are giving patients is similar to what your peers give, you are protected from negligence charges. Even when, as in the case of endometriosis, hormonal treatments including the pill, have been shown to be palliative for many women at best, and further damaging at worst.