Gwendolyn Themba tells us how she went from being a private hospital patient to a public hospital patient due to a shortfall in her medical insurance.
Gwendolyn Themba (64) lives in Mayberry Park, Gauteng. She has three adult children and six grandchildren.
In December 2019, Gwendolyn felt a hard lump in her left breast so she went to a public regional hospital for a mammogram and biopsy. There was quite a delay in the results coming out so Gwendolyn’s children decided to pay cash for her to be seen at a private hospital. There she had another mammogram and biopsy and it was confirmed that it was breast cancer.
“I was panicking as I only have medical insurance and not medical aid so I went back to the public regional hospital. By this time, the results were out and I was referred to an academic hospital. However, due to an extremely traumatic event that took place while I was there during the first lockdown, I decided to find out exactly what my medical insurance will pay for and how far it will get me in receiving treatment at a private facility,” Gwendolyn explains.
After enquiries, it was found that an amount of R150 000 would be allocated for Gwendolyn’s treatment from her medical insurance. Another breast cancer survivor told Gwendolyn about the Breast Care Centre of Excellence, Netcare Milpark Hospital. “I made an appointment but was still stressing as I didn’t even know if they would accept the medical insurance I have. But by the grace of God, the centre was willing to work with it,” she explains.
Disclosure of financial situation
Gwendolyn explained her full financial situation to the specialist breast surgeon and thankfully the doctor cut out unnecessary costs. “Instead of doing another mammogram and more tests, she used the results from the regional hospital as they were more detailed then the private hospital mammogram. The specialist then brought in the reconstructive surgeon and we discussed the situation of the medical insurance. They looked at what options were available and assured me that the amount my insurance had allocated would be enough to cover the surgery. I was told that the lump was small and the chance of needing chemotherapy after surgery was low.”
The grandmother had a lumpectomy and reconstruction in April 2020 as well as all the lymph nodes on her left side removed. “Thankfully, the cancer hadn’t spread,” she adds.
After surgery, the tumour was sent for testing (and to Gwendolyn’s horror cost R20 000) and, unfortunately, it turned out that Gwendolyn would need radiation and chemotherapy after all.
“I wasn’t expecting this, emotionally, mentally or financially,” she explains. “The oncologist went on about my age and how the 12 sessions of chemotherapy would be weak and that I would need a port and then told me that chemotherapy alone would cost over R100 000. I refused to sign; I told him I can’t commit to something that I can’t afford, explaining my medical insurance predicament and the small amount that was left.”
Counsellors from the Breast Care Centre of Excellence then sat with Gwendolyn and explained the reasoning of why she needed chemotherapy and radiation. “They helped me to accept that chemotherapy was needed,” she says.
Becoming a patient at HJBCC
“The next step was to find out what balance remained in my medical insurance to see if it would cover chemotherapy. There was a small amont left but some costs still needed to be deducted. That is when I sat down with the breast specialist again, explaining my predicament that even though my children were willing to put money together and pay for my treatment, I didn’t want to put that financial burden on them, so can I please be referred to a public hospital for chemotherapy and radiation. She was extremely understanding and supportive.”
“I was then transferred to Helen Joseph Breast Care Clinic (HJBCC) and the navigators, Ouma and Janette, set up all my oncology appointments at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH).”
The 64-year-old goes on to explain that she has always been comfortable with getting treatment at a public hospital. It was just due to that traumatic event that she didn’t want to go back to that specific hospital.
“My kids kept on asking if I was willing to wake up early and stand in queues, and I was; I don’t mind. They were supportive of my decision but a bit sceptical. But, I’m extremely happy with the treatment received in the public hospital,” she adds.
Side effect free
Gwendolyn went for four sessions of chemotherapy (with no port), which started in May and ended in August as there was a delay due to a COVID outbreak in the ward. However, she is still waiting to have radiation; she went for the first consultation in January where her breast was marked.
Another cancer patient advised Gwendolyn to drink medical marijuana as a tea three days before chemotherapy. “I had no side effects and a good appetite. Once I even came home after a chemo session and washed my windows. So chemotherapy went very smoothly.”
The grandmother is feeling good and hoping that she won’t need radiation. She enjoys exercising every morning at a free gym in a park near her house with her two friends.
“You see, I really don’t mind going to all these public places,” Gwendolyn jokes. “I work out for about 1 ½ hours every week day. It makes me feel good.”
Other than that, Gwendolyn enjoys spending time with her grandchildren and going on picnics, and enjoys socialising.
Images by Chantal Drummond Photography | chantaldphoto.co.za
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Laurelle Williams is the editor at Word for Word Media. She graduated from AFDA with a Bachelor of Arts Honours degree in VLive Performance. She has a love for storytelling and sharing emotions through the power of words. Her aim is to educate, encourage and most of all show there is always hope. Write to the firstname.lastname@example.org