Hiram woman struggles to get access to fibroid surgery
ATLANTA (FOX 5 Atlanta) - Close to 80 percent of women of childbearing age are thought to have fibroids or non-cancerous tumors of the uterus.
A decade after her first fibroid surgery, Tammy Heyward of Hiram, Georgia, started getting the feeling the growths were back.
"I'm exhausted going up a flight of stairs," Heyward remembers. "I just feel winded."
A blood test showed the 45-year old was once again severely anemic, likely caused by excessive bleeding during her heavy periods.
Dr. Soyini Hawkins of the Fibroid and Pelvic Wellness Center of Georgia says about 40 percent of fibroids that are treated re-grow within 5 years, bringing back with them the same difficult symptoms.
"A lot of patients will complain of heavy bleeding," Dr. Hawkins says. "That is the number one complaint with fibroids. But, they can also have pain, and they can have bloating that comes from their fibroids."
Heyward did not want to undergo a hysterectomy or surgery to remove her uterus.
So, she went online and started researching her options.
She found Dr. Hawkins in Alpharetta, who performs a minimally-invasive laparoscopic radiofrequency ablation procedure known as Acessa, using a needle-tipped probe to heat up and destroy fibroid tissue.
"It's still surgery, but the beauty of Acessa is I'm getting much smaller fibroids," Hawkins says. "Because those are the ones that have the potential to grow over."
Heyward was excited about the idea that she would be able to return to work in three or four days, rather than the six-week recovery she would need after a hysterectomy.
So, Heyward says, she contacted her health insurance company.
"Every customer service representative was under the impression that, 'Yes, this is the procedure that it is, and yes, it is covered, 100 percent.'"
After signing the consent forms, Heyward says she contacted the company again and was told the procedure was covered.
Then, a week before her scheduled surgery, Heyward says, the insurance company requested more information from her physician, which Dr. Hawkins says her office provided.
But the day of her surgery, Heyward says the company denied her request, telling her RF ablation for fibroids was not covered by the plan.
"I was crushed," Heyward says. "They just had something to the effect, that, it's investigation, it's unknown, it's unproven," and, therefore, they denied it."
On its website, Acessa Health lists insurance companies it says cover the Acessa procedure.
Heyward's insurer is not among them.
And, while Dr. Hawkins says the technology is new to Georgia, it's been on the market in the U.S. for seven years.
"FDA-approved since 2012," Hawkins says. "Over 3,000 patients have had it."
Heyward decided to appeal the denial, but as the months passed, she gave up.
"It just got to the point that the symptoms were so intense, I just felt like I had no other choice," she says.
In August of 2018, she requested pre-certification for a hysterectomy, the surgery she'd hoped to avoid.
Within days, Tammy Heyward says, the company authorized the surgery.
"Well, with the hysterectomy, I was out from work for six weeks," she says. "It is just inherently wrong. It's just wrong."
Currently, the Georgia Department of Insurance does not track the number of uterine fibroid procedures denied by insurance companies, but the Insurance Commissioner's office says the issue has been brought to the Commissioner's attention, and they are exploring all options regarding the matter as well as the legality of it.
Georgia State Representative Park Cannon has pre-filed a resolution for the upcoming legislative session, asking the Georgia Department of Public Health to create a reporting system for uterine fibroids.
Cannon hopes that will help determine how many women in Georgia are struggling with this problem.
Close to 80 percent of women of childbearing age are thought to have fibroids or non-cancerous tumors of the uterus.