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Insurance Issues Discuss Kaiser? in the Main forums forums; Feh! I may have to change to 'em from necessity. Anyone know of any good spine surgeons in Southern CA? ...

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Old 05-25-2009, 10:30 PM
ans ans is offline
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Default Kaiser?

Feh! I may have to change to 'em from necessity.

Anyone know of any good spine surgeons in Southern CA? I know from another forum they do ADRs (sometimes) but I have no idea if I'd be the "3rd patient" human experimental subject.

Be well people. - Allan
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Old 05-26-2009, 01:26 AM
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any good Kaiser surgeons or any good regular run-of-the-mill type surgeons?
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Old 05-26-2009, 03:06 AM
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Default How would you respond to being the 1st?

Hello Allan,
I thought you would get some enjoyment from this :0

My No. Cal Kaiser surgeon offered to do my 2nd ADR as his 1st ADR surgery! Wow! I was in shock! I thought maybe he had not done many.... but zero? And then for my 2nd ADR at an adjacent level? Is he insane? Maybe not insane but at the very least overconfident. He said he would call the manufacturer, get the instrumentation figured out, and do my surgery. He did not say that he would have someone with experience in ADR join him or anything.

Needless to say, I respectfully declined. I will spend 30k before I be someones 1st case on my 2nd level. My hat is off to all those who may have gone 1st.
__________________
MVA 2005 - impinged and displaced cord at C5/C6
Prodisc C5/C6 2006 Germany - Dr. Bertagnoli
C6/C7 no bulge, just tears and fissures.
Multiple ministrokes 2009 prevents ADR surgery
As of 10/2010 no relief on radicular C7
Trying to arrange C6/C7 prodisc
FDA has not approved for 2nd Levels on cervical.
Headed to Germany as soon as I am cleared for surgery.
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Old 05-29-2009, 02:10 PM
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Jessica ..... Good call on your part

I don't know if I am any worse off up here where we only have the government system. At least you have the option of moving around a bit.......
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DDD
Herniated discs C4/5 & 5/6, L3/4, L4/5, L5/S1
Severe compression of spinal cord in two levels
All conventional therapy exhausted, including spinal injections, PT, massage, etc.
In appeal with Gov't Insurance for Out-of-country coverage for ADR hybrid surgery of above discs.
Recently discovered that I am severely allergic to all common metals used in surgical hardware except for Titanium.
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Old 05-29-2009, 05:27 PM
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What does it say about our health care syster when Kaiser used to be considered a joke and is now considered one of the best HMO's available?

From the stories I still hear, they are still Kaiser but the other stories are so much worse.

Even if you find a good doctor, getting your ins co to pay is another story

Ouch, all the way around.(for lack of a better word)
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Old 05-29-2009, 11:24 PM
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Default Kaiser

I have Kaiser no. CA also. I have an appt. to see the surgeon in a week. I knew they were kinda inexperienced but this is crazy!!! I have two other appts. with non Kaiser docs and think that is the way I will go. How I'll scrape up the money I have no idea how but I've got to do this.

Also fyi...do you have a copy of your contract? This may be helpful for you in regards to the future and knowing exactly how they will cover you after surgery if you do go out. At first when I asked them people said they would not cover me, then I got a different answer. My question now is...when after outside surgery are they willing to start coverage? I.E. what happens if I have an emergency from surgery while I'm out of state and have five extra days in the hospital as a result. Who covers this.
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Chemically sensitive disc/Annular tears, DDD, mild bulging, facet arthritus

Dancing accident in 96. tried PT, acupuncture, pilates, pain mgmt. nothing worked. Epidurals, facet blocks, caudal blocks, discogram. Opiates for ten years, oral prednisone, toradol inj. & more.

Two level spinal fusion with BMS, cages, hardware. due to bone density problems from chemotherapy, they had to go in front and back. Surgery Nov. 6, 2010. So far no regrets.
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Old 06-12-2009, 10:04 AM
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Default Kaiser

Well I am surprised to say I met with Dr. Baines and had a really good experience with him. He did feel adr was a no go for me which I kind of knew might be coming. He hasn't done so many ADR's but has done over 300 fusions so I feel better with that. I was expecting them to give me a hard time as I've gone through a lot with them but he was thorough, very supportive and felt there was about a 75 percent chance of helping me and that was without what the artile I had from Derby. So, I'll let you know what happens. I believe he replaced Dr. Gorek who was head surgeon at Kasier Oakland and I believe Dr. Baines has now replacemtent. I will do my research but so far I was really surprised. Maybe the squeaky wheel finally got the grease?
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Chemically sensitive disc/Annular tears, DDD, mild bulging, facet arthritus

Dancing accident in 96. tried PT, acupuncture, pilates, pain mgmt. nothing worked. Epidurals, facet blocks, caudal blocks, discogram. Opiates for ten years, oral prednisone, toradol inj. & more.

Two level spinal fusion with BMS, cages, hardware. due to bone density problems from chemotherapy, they had to go in front and back. Surgery Nov. 6, 2010. So far no regrets.
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Old 06-13-2009, 07:50 PM
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Default Insurance

I'm beginning to feel for me it's like....lose my home or lose my back. Such a terrible position to be in. Such an impossible decision to make.
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Chemically sensitive disc/Annular tears, DDD, mild bulging, facet arthritus

Dancing accident in 96. tried PT, acupuncture, pilates, pain mgmt. nothing worked. Epidurals, facet blocks, caudal blocks, discogram. Opiates for ten years, oral prednisone, toradol inj. & more.

Two level spinal fusion with BMS, cages, hardware. due to bone density problems from chemotherapy, they had to go in front and back. Surgery Nov. 6, 2010. So far no regrets.
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Old 06-14-2009, 03:37 PM
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Oh my lordie, I feel so bad for you. No one should be in that position. Does Kaiser not pay for this? I may be confused, but I thought it was just the other NYC doctors who would be draining you dry, that if you stayed at home with one, it would be covered with your insurance. I guess I'm misunderstanding....again.

I truly hope this all works out in your favour. Things can't get much more stressful, can they!
__________________
DDD
Herniated discs C4/5 & 5/6, L3/4, L4/5, L5/S1
Severe compression of spinal cord in two levels
All conventional therapy exhausted, including spinal injections, PT, massage, etc.
In appeal with Gov't Insurance for Out-of-country coverage for ADR hybrid surgery of above discs.
Recently discovered that I am severely allergic to all common metals used in surgical hardware except for Titanium.
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Old 06-15-2009, 02:09 AM
ans ans is offline
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Thanks for your replies. I sure wouldn't want to be a two level ADR guinea pig.

My best in your surgeries and glad there's a good surgeon in Oakland. Wonder if one in LA could have surgery there.

Yeah, says something that it's considered the best HMO.

Allan
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Old 10-27-2009, 11:13 PM
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Default Fusion/ADR Kaiser

Well, after all the tests it turned out I wasn't an ADR candidate due to my bone density so I had to get a two level fusion. I went to see about six doctors and then went to heavily research the kaiser doctors in Oakland.

Three weeks ago Dr. Baines performed my two level fusion at Kaiser Oakland. I would recommend him to anyone and I had many outside non Kaiser surgeons give me the green light with him. There are also a few other surgeons in Oakland who have good reputations. He is currently head of the Spine Department.

In the end, I feel very happy about how the surgery went, the hospital stay and I feel no more nerve pain (that was my goal). I would have no problem sending anyone to the spine clinic in Oakland, CA.
__________________
Chemically sensitive disc/Annular tears, DDD, mild bulging, facet arthritus

Dancing accident in 96. tried PT, acupuncture, pilates, pain mgmt. nothing worked. Epidurals, facet blocks, caudal blocks, discogram. Opiates for ten years, oral prednisone, toradol inj. & more.

Two level spinal fusion with BMS, cages, hardware. due to bone density problems from chemotherapy, they had to go in front and back. Surgery Nov. 6, 2010. So far no regrets.
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Old 12-10-2009, 03:29 PM
ans ans is offline
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Glad you found an excellent doctor and good luck!

(I'm still reeling about the surgeon who wanted to read the ADR manual before performing surgery).
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Old 07-12-2010, 02:21 AM
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Default Six months later

I felt it important to write about my experience as I really do feel Kaiser has improved tremendously. I had serious issues a long time ago with them. I had my fusion in November 2010. I could not be happier with my surgeon, Dr. Baines, who is the head of the spinal dept. in Oakland. As well as being what I believe is a great surgeon, he has a heart.

While their experience with ADR may be limited, I was not a candidate due to my bone density and many other docs agreed I wasn't a candidate so in the end I didn't travel. I just wanted to mention this as I really do feel things have changed and am very happy with the outcome of my surgery.
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Chemically sensitive disc/Annular tears, DDD, mild bulging, facet arthritus

Dancing accident in 96. tried PT, acupuncture, pilates, pain mgmt. nothing worked. Epidurals, facet blocks, caudal blocks, discogram. Opiates for ten years, oral prednisone, toradol inj. & more.

Two level spinal fusion with BMS, cages, hardware. due to bone density problems from chemotherapy, they had to go in front and back. Surgery Nov. 6, 2010. So far no regrets.
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Old 07-27-2010, 01:47 PM
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Default do you mind

If I ask what your bone density level was? I'm wondering if it was osteopenia or osteoporosis level? I have the latter and at this point I'm no longer a candidate for ADR however I'm pretty much doing well with no further surgery to date. One can never tell what the future holds tho...

Am very glad you've had such a great experience with your 2 level. What kind of fusion was it or what materials were used? You may have already stated this somewhere and if so my apology for asking redundant questions.

So many people so many surgeries. Can't keep 'em straight!
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Old 07-31-2014, 04:54 PM
elf elf is offline
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Default Kaiser OK, finances scary

I see that this is an old thread, but--
I've just within the last month discovered how bad my spine is, what surgery is likely involved, and what the recovery time is likely to be.

I was a Kaiser patient over 30 years ago and I couldn't wait to get out. I signed up again about 5 years ago and it has been a whole different place. I've always felt listened to and cared for and that I'm getting the best medical advice.

I am going outside Kaiser for 2nd, 3rd, whatever opinions, to be absolutely sure that I've got the best advice, because the proposed surgery in theory will require over a year of disability, and even if Kaiser covers most of those expenses, I don't know that I can live on disability, so on top of everything, I may have to move everything out of my house, find a cheap place to live (Silicon Valley! Ha!) and rent it out to keep from losing it.

This is all early in the process. Your discussion here gave me some other things to pursue.

BTW, at this time, this surgeon (Patrick Suen) is the regional spine surgery director, who's also involved in evaluating and incorporating new techniques. I haven't talked to him yet, but I plan to. My Doctor Online
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*DDD + severe spinal arthritis = sudden lumbar scoliosis
*Looking at "adult deformity surgery", (anterior and posterior surgery, or posterior alone; a thoracolumbar decompression plus fusion for adult scoliosis (screws and rods))
*Trying acupuncture, chiro, cortisone epidurals, phys therapy, anything to stop pain and stabilize spine w/out surgery (on my list also to try: yoga)
*A shock to me--I'm healthy and active and not really that old and have had no injuries.

Last edited by elf; 07-31-2014 at 04:58 PM.
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Old 08-05-2014, 11:30 PM
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I'm in the same situation. Where is this Dr. Suen?
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