My insurance voided the pre-approval application after a single attempt to contact Dr. Coufal for a peer-to-peer call fell through. They say the process must be restarted. Idiots.
In the mean time I got a second opinion from a pain management doctor at Scripps in San Diego. Contrary to Dr. Coufal he felt the L5S1 facets were not necessarily a pain generator. Also contrary to Dr. Coufal he felt L4-5 could be a pain generator. Currently the medical community rarely recommends discograms but the PM felt like it would make sense in my situation to better understand L4-5 prior to a surgery.
I feel his conclusions on my L5S1 facets are incorrect mostly due to his lack of knowledge of my history. I do like his recommendation about the discogram. In fact I would like to conduct more diagnostics to better understand the pain generators. At a patient seminar in 2004 Dr. Yeuug (of
DISC - Desert Instititute for Spine Care, The Leaders in Minimally Invasive Endoscopic Laser Spine Surgery fame) said he could always find the pain generator. I wonder why surgeons seem happy with only a MRI and CT.
If anyone has any thoughts I'm all ears.