My post op follow up is in a week and I'm already going to bring a box of donuts for the office as a thanks, but I was wondering if a hand written card for my doctor as well would be too much? I would write stuff like a thank you for her attitude and expertise throughout the whole process. And would flowers be too much too?

I also feel bad because apparently when I woke up from the anesthesia, I asked for her just to give her a hug lol. I'm pretty sure I interrupted her lunch break then too...

When I met with my gyno for a regular well women exam I mentioned wanting a bi salp. She told me that based on the data of regret or whatever she wouldn’t want to do it until I’m 25 (currently 23.) I currently am getting my certifiction to teach and am working part time. Does it seem better to wait until I’m working full time maybe summer of 2028, or use the list to get a gyno who will do it sooner?
She also said that insurance may not cover a bi salp and only a tubal. My dad has good insurance so I’m not too worried, but I just want this over with. Also my dad doesnt super support it, but I dont think he’lll try to stop me. (currently living at home)

I got a bill two weeks after the procedure. $7000+. I know I’m not paying it but I was told the provider used two different codes!!

Z30.2 this is the correct one but I also see…

Operating Room Services: General Classification

(Diagnosis Code D259)
LEIOMYOMA OF UTERUS, UNSPECIFIED

(Diagnosis Code N946)
DYSMENORRHEA, UNSPECIFIED

i have no clue what these mean!! The insurance said ask the provider to change the different label and then they will pay. How easy is it to just call up the hospital and get them to code it differently??

I got a $7000+ bill from my provider. I checked with my insurance and they said they used two different codes for the procedure & surgery.

the first code seems to be correct but there are two others I have no idea what they mean.

Operating Room Services: General Classification

(Diagnosis Code D259)
LEIOMYOMA OF UTERUS, UNSPECIFIED

(Diagnosis Code N946)
DYSMENORRHEA, UNSPECIFIED

They couldn’t tell me what codes would be accepted but they said to reach out to the provider and tell them the different code would need to be changed for them to pay for the remainder.

Anyone have insight on what I should do?

So I was able to get a bi salp set for 9/15, the doctor's appointments were a breeze but insurance is a little difficult as usual. After a slew of phone calls today, I verified the codes the hospital gave to insurance were correct (58661 & Z30.2), I was able to get an insurance rep to verify that my plan (PERS Platinum PPO Basic/Blue Shield of CA 2026) covered this procedure in full under these codes as 'Preventive Care' and obtained a 'reference number' which they said was only the current date you called plus their first name and last initial (no idea if that's true), and also verified that my plan was ACA compliant and my surgeon and health system were in-network.

Hospital financial dept is still saying I owe ~$4k, but I was like nah, I rummaged through my plan's 'Evidence of Coverage' and 'Summary of Benefits and Coverage' docs and pinpointed language verifying that my plan is ACA compliant and that my plan covers 'sterilization procedures' in full w/o cost-sharing and before my deductible is met (the deductible I honestly wouldn't mind paying, it's almost through).

When I asked about pre-authorization, the hospital said they received a letter from my insurance specifying that it wasn't required for this surgery. The assistant I spoke to submitted the request again today, and received yet another letter stating that it wasn't required, which she graciously sent a copy of to me.

At this point the only thing I have left to do is call my hospital's financial dept back tomorrow to see if they'll accept my 'reference number' from the agent I spoke with today. I had asked the hospital rep if there was a way to specifically request the authorization, but she reiterated that the (2nd) denial letter indeed means there's nothing else. I at least have a copy of it for my evidence file I guess. But I'm definitely expecting to fight after everything is done.

Has anybody ever dealt with insurance saying pre-authorization isn't necessary?

I'm one day post-op for my bilateral salpingectomy and I can't tell you how liberated and free I feel. Having the autonomy to prevent unwanted pregnancy and to choose this for myself has given me relief that will last a lifetime. My experience was still complicated and difficult and I'd like to share my struggles and also my joy in now being sterilized...

TLDR: It went well and this is just my personal experience at the hospital I went to, with the medical staff and doctor I was sent to.

Finding affordable Healthcare in the US is almost impossible, unless you're poor and qualify for state funded health insurance, where I live. This was my worst hurdle. I got Medicaid essentially. It's just so flipping expensive otherwise! Doctors and hospitals are short nationwide too, especially anesthesiologists, which can make access worse, especially in rural areas. Also my state is inundated with a Catholic healthcare system, which can sometimes cause religious objection, which is a huge hurdle since Roe v. Wade was overturned. The fear of living in a country where healthcare limitations are getting some women hurt, or killed, or left to suffer, was a huge personal motivation for me to get sterilized, just as a personal note.

My personal experience:
My doctor and surgical team were amazing. Dr. Thai is wonderful. Her clinical office staff not so much, tbh. They messed up my paperwork and caused considerable delays, which was the worst part. I want to emphasize that the nurses, doctors anesthesiologists and surgical team were phenomenal though! It was clerical office staff at the Puyallup Women's Center that were unorganized and rude at times during calls. The doctor was wonderful and the team at St. Clare were informative, kind, ethical, professional and transparent when I had TONS of concerns and questions though. I have to give them credit.

Prior to surgery: After considerable delays, we made it! I was glad I didn't give up! I was given a phonecall the Friday before surgery and directed to use hibiclens soap the night before and day of surgery in the shower. This prevents bacterial growth and is key in recovery. I was told not to eat 24 hours before surgery and only to drink small amounts of water after midnight the night before surgery. Water is ok up to 2 hours before surgery, but keep it light. I held off on drinking water and only had a small amount of water that morning of surgery. THIS IS EXTREMELY IMPORTANT SO YOU DON'T ASPIRATE FOOD AND CHOKE DURING ANESTHESIA. You will want to drink a small amount of water 2 hours before surgery, just to do a pee test before you go into surgery. I'm talking like sips of water, not a lot. It's minimal what you'll need and you'll want to completely pee and get everything out before surgery.

The day of: It's go time! No food, no drinks other than water, up until 2 hours before surgery. Potentially bring a comfy towel or small pillow to brace between you and the seatbelt when you're getting a ride home, to prevent the belt from rubbing on your post-op incisions. We drove 45 minutes, grabbed breakfast for my partner- DO NOT EAT! Had to make sure the hubs was fed though lol They might be waiting in the waiting room all day. Heads up- this takes hours, so be prepared. Books, video games, your phone- all helpful to stay entertained while waiting. Then I got to the hospital. I was briefly checked in, waited in the surgery waiting center less than 15 minutes and instructed to give my emergency contact and driver's phone number, (my husband to take me home,). They will call them post-op to come get you.

The surgical waiting room: When I was brought back, I was put in a private room with a sliding glass door and hooked up to a vitals machine. They usually have a TV and call button for the nurses. I was told to do a pee test, for one FINAL pregnancy test (Hurray! Fully go too, because they don't want you walking around, and peeing completely can prevent having to use a catheter later,) and then told to strip down. Wear something comfortable. I wore only a light cotton dress, not constricting to my waist and body, underpants and sandals to avoid bending down post op. Don't wear constricting pants, because it could rub and hurt your incisions. Think long nightgown and slippers. No one is judging you at the hospital. Keep it comfortable ♡ It's really just for post-op comfort. They give you a gown, (open in the back, but don't worry, you're sitting most the time covered,) socks, a head covering that's like a shower cap, and blankets to cover yourself with in bed. I was told to use 6 medical wipes to wipe down my arms, legs, back and chest. Then put in a sterilized gown, laid in bed and told to wait.

The nurse and doctor came in to give me an IV and then debrief me on the procedure for the day. They will all ask you the same medical questions for their records. This is redundant by design, so don't get discouraged by how repetitive it is, they each are required to ask for unified department records. They gotta check. Each person is also quietly doing an audit to ensure your decision to get sterilized is YOUR CHOICE and you're not getting forced, or harmed, or are under the influence of anyone or anything. They are extremely thorough. The nurse asked what procedure I was getting, then the doctor and then the anesthesiologists and surgery team. I was very polite and appreciative they have so many checks and balances, so answered all their questions and was briefed by all of them. Also now is the time to verify your pharmacy for any meds they prescribe you! Very important. They might have an in-house pharmacy you can use, or they'll ask the address for the one you use. We used the in-hospital one, because they were open. We sure to ask hours and check. You will want whatever the doctor prescribed, that day.

Now is the time to ask your doctor and team questions. I requested photos of my before and after, to confirm my tubes were removed, but if that makes you squeamish you can opt-out. I just think medical science is fascinating and wanted the photos for my records. Also ask whatever you want to know. They are there to help and be transparent.

At this point my nurse gave me a "pain relief cocktail" both intravenously in my IV and pills to swallow with a small amount of water. It will make you feel cozy and warm and fuzzy. That's the best way I can describe it lol Then the surgical team lead and anesthesiologist will come in and brief you on what will happen when you're intubated/asleep for the procedure. My team was so funny lol They were friendly and kind and made me feel secure and safe. I was apprehensive about the anti-nausea medicine (because it always makes me throw up,) but the patch they put behind my ear was actually different than most anti-nausea medications, so it was wonderful. You can opt out if you like, but that patch was phenomenal.

Surgery time: After one more quick evaluation to see if you're lucid and pain free, they'll roll you into the sterilized surgery theater. Your ride home can hangout with you until this point. St. Clare has a wonderful system in their waiting rooms, with TVs that state a patient's status in surgery, to keep your partner/friends/family informed. My husband said it was like watching plane arrivals and departures at an airport lol xD Just a lovely system for whomever you bring along to help you.

I was rolled back in bed, covered in warm blankets, surrounded by excellent medical staff and they put my legs in these warmed leg coverings to prevent potential blood clots from forming. I was beyond comfortable lol This was the most hysterical part too. We turned a corner, rolling my bed into surgery, and I kid you not 12 surgical staff were there to help xD lol I was so surprised by the large team that I pointed at them and they all 12 pointed back, like that spider man meme lol xD We all audibly went "Hey!" together lol And laughed and cheered that, "It's finally happening!" The team said, "Time to rock and roll!" And rolled me in lol They were so funny and sweet towards me, while also just being excellent and kind. Amazing people all around ♡

The last thing I remember was being put in a bed in the sterilized surgery room, (kind of slid over by towels, still in my gown,) and the medical team hooking me up to a large green mouth piece. Kind of like scuba diving. They said, "OK, this is it, just take deep breaths." I took 3 very deep breaths and the anesthesia hit me. I was out! lol Just fell asleep almost instantly. I never felt anything, was not awake for the intubation, never felt the throat tube go in, or the catheter, or any of the pain of surgery. You just get a really nice nap and the next thing you know you're in the post-op surgery room. Easy peasy loves ♡

Recovery room: We're out of the woods now! The hard part is over! Congrats on your sterilization surgery! The first thing I noticed when coming in and out of sleep was the post-op nurse and the gentle beeping of the machines around me. You will be covered in blankets and potentially dressed back in your gown. I had a pad placed in my underwear, to prevent bleeding. You might have a small amount of bleeding, but nothing that soaks a pad within an hour. They will do their best to comfortably wake you and ensure you're out of pain. I had mild cramps that just felt like a light period day. That's the best way I could describe it. Very low on the pain scale, maybe a 2 or 3. This room might have other people in it, doing the same thing you are, in their own private space, separated by curtains. I felt very comfortable and was debriefed about everything that happened, what they did.

Then the most amazing and handsome person in the world walked in: My Husband lol xD

At this point your driver, or partner, or friend or family will be invited back to join you. The medical team will potentially give you pain meds and more blankets, show you your post-op photos and help you pick up whatever medication you need, either from the in-house pharmacy there, or the one you designated before surgery. I was instructed to dress myself and gather my belongings, (They close the curtains for privacy, don't worry). Getting up might make you feel dizzy at first. Take your time and relax. I felt wonderful to be honest. I used the bathroom no problem and was able to dress myself and grab all my things. This shows you're ready to go home too. I thanked everyone, phenomenal staff, and my husband drove us home. I braced myself with a towel, under the seatbelt, so it wouldn't rub and it worked perfectly.

Recovery at home: Make yourself a "nest" beforehand. A quiet, calm, comfortable place to sit and rest and sleep. Have meds handy, pillows, blankets, etc. Whatever makes you comfortable and makes it easy to sit and stand. I suggest the "log roll method" to get in and out of bed. You roll to a good side, to swing your legs over the bed, to then stand. I RECOMMEND A BED OFF THE FLOOR. If you only have a mattress on the floor, or a very low bed, use the squat method and use your arms and legs to lift yourself and stand, more than your core. Don't activate your core too much, because it can hurt. Depends for people tbh. When sitting, squat with your legs to sit, to keep your torso straight. It might hurt to bend and you want to keep your stitches and wounds clean and unbothered. Rest. Rest. Rest. It helps to walk a little to get the procedure gas out of your system. Just light walking though! Don't push yourself and try to sleep if you can, while staying up on your meds. Set an alarm if you need to, because keeping your meds back-to-back will keep you out of pain. Some people get nauseous. Thankfully I did not. Some people are hungry, so either have great snacks, or an amazing partner who will cook you a phenomenal steak dinner, (Thanks hubs lol).

Snacks: Water all day! Stay hydrated to keep recovering and to help get the gas out of your system too. Apple juice, orange juice, mango vitamin drinks, (like mango machine, so good,) chicken noodle soup, apple sauce. Avoid fatty greasy and surgery foods, because this will cause inflammation which inhibits recovery. My throat hurt from the intubation tubes, so lozenges are great! I like riccola and mucinex insta-soothe, in elderberry and wild cherry flavor, because it has a numbing/cooling effect for your mouth and throat. Not an ad. lol I just really like it xD lol

I'd also love to add a picture of my post-op surgery incisions, if people are curious about my surgery incisions and what to expect. My doctor was a rockstar and only made 2 incisions! Absolutely wonderful, because usually it's 3. Rarely more. Also I think it's really important to see surgery pictures to understand the procedure and how to care for wounds after. Keep it dry and don't rub or pick at them! Always make sure your hands are clean too! It's minimal incisions, so easy to care for, thankfully ♡

Side note: I am a larger person, so I think it's also important to see what incisions look like on larger bodies. Most post-op incision pictures I found online were of very small people, (no offense, just not me,) so I'd like to share mine, for resources for bigger patients like me. ♡

Med notes: Ask your doctor if it's ok to be on your medication PRIOR TO SURGERY. Ask far in advance too! I'm taking ozempic and metformin for my diabetes. That slows digestion and can potentially get your surgery cancelled if you don't disclose it and don't postpone it! YOU COULD CHOKE DURING ANESTHESIA IF YOUR STOMACH ISN'T EMPTY! Don't aspirate food and choke or die! You have to stop ozempic and drugs like it ONE WEEK PRIOR TO SURGERY. My doctors gave me some fast acting insulin to prevent blood sugar spikes the day of, so I would be ok ♡

Periods post op: You might have irregular periods after surgery for up to 2 months, while your hormones balance out again and your body recovers. Some people even experience mild menopause symptoms for a bilateral salpingectomy, if their ovaries are effected. It's rare though. I haven't experienced this.

I hope this helps anyone with surgery anxiety like me. I was overly cautious and overly planned, just to be safe. It all worked out. Just remember people go through this every day with zero problems and your team is a group of well trained professionals. You will do great. Phew! I know this was long, so if you read all this, thank you and I hope everything goes well for you, like it did for me ♡​

I got my tubes removed yesterday!!!! I’m so happy. But pathology has me confused. On my procedure report my doctors noted that the tubes were cauterized at the cornua and removed. However on the pathology report they stated that one of the tubes was “ partially fragmented” and the other arrived in “ two separate pieces and a detached piece of fimbria” so now my brain is just in over drive thinking not all of my tubes were removed. Why would it show up in pieces? Anyone have something similar?