What would you do? Thoughts?

[steve55]

Had my discogram today.The bad news is that it looks like I will need 2 level ADR instead of just 1. Here are the results:

C4-5 -small posterior leak-volume pressure normal-no pain
C5-6- Abnormal, degenerative, leaky -reduced pressure-moderate pain
which patient rates 7/10
C6-7 - Abnormal, degenerative, leaky -reduced pressure-sever pain which patient rated 8
out of 10
C7-T1 - Normal-pressure normal- no pain

INTERESTING thing is that my discgram in June of 2008 (with a different doctor) only showed C6/7 causing pain. Seems I am getting worse now that C5/6 is bad now also.

I guess I should try to go for the 1 level since my Aetna will most likely approve it. Then go to Germany for a 2nd surgery as soon as I recover from the 1st? My doctor says"no need to go to germany if you need a 2nd level, we can do it here". I didnt say what was on my mind which was "yea, but at twice the cost?". Even if I am willing to do 2 level ADR at the same time and just pay out of pocket for the 2nd, one member here says insurance will come back after surgery and say 2 level is not approved and use that as an excuse to deny covering the 1st level!! I dont think I like that risk.

On the other hand, once you do ADR, there's no turning back.Soooo, maybe I should go for the fibrin (sealant) procedure first? For those of you not familar with Fibrin, it is a very promising brand new procedure currently undergoing FDA trials. Many patients are reporting success. If I do try out the fibrin procedure first, I can kiss my Aetna option goodbye as my employer is changing insurance carriers to Humana as of Feb 28th. Humana is not ADR freindly. Regarding Fibrin, one patient who had it done and knows about it says that they report that it has about a 80% success rate and it lasts for at least 3 years or more. (seems ADR is also about a 80% success rate from what I have observed by perusing outocomes on boards like this) Though there are only a few posts I have read of people getting fibrin done. Hardly much to go off of. Then again, I dont want to have to have fibrin redone every 3 or 4 years if that is how it is with many patients. WHat if Im in the 20% who dont get relief? If so, Ive just blown $20K by letting my Aetna option for 1 level expire. . Fibrin is not yet FDA approved. Might there be risks, after affects? Cancer causing agents in the fibrin material? On the positive side, ADR seems a "known" and lasts 10-20 yrs?

If I go the fibrin route, and it doesnt work, Im going to have to pay $30 -$40K for 2 level in Germany. I will have to use all my savings,(sell stock, cashout 401K, etc). Ill be a broke dude for sure.

So far, Im leaning towards getting ADR 1 level (paid by insurance) and then trying fibrin sealant for the other level (guessing fibrin will cost about $4K). If that doesnt work, I can go for a 2nd ADR and pay only $20K in germany.

It isnt a big deal to do back to back cervical ADR surgeries is it?

[SandyW]

C4-5 -small posterior leak-volume pressure normal-no pain

C5-6- Abnormal, degenerative, leaky -reduced pressure-moderate pain
which patient rates 7/10
C6-7 - Abnormal, degenerative, leaky -reduced pressure-sever pain which patient rated 8
out of 10

You need advice from the more knowledgeable members!

IMHO I like your last scenario, BUT??

1) C6-7 ADR, insurance pays now
2) C5-6 Fibrin, you pay. It lasts 2-3 yrs and in that period of time maybe?? insurance starts paying and there will be better devices, more experienced surgeons.
3) C4-5 might go bad during that time period and by then insurance will pay, etc. for 2 ADRs

As Smokey the Bear says "only YOU can decide". A bummer! You're sort of between a rock and a hard place.

If going to Germany won't leave you destitute, I'd go there and have the two done - get it over and start enjoying your life? Can you take money out of your 401K without a penalty, is it invested in stocks? Not a good time to sell stocks. Can you get a medical loan?


I took some cash advances on those credit card offers you get in the mail, like no interest till Oct, 2009. I only had to pay 3%, then chop away at it till the no interest date ends. If you can't pay it off then, transfer to another credit card with 0% interest. Only do this one time unless they are waving the cash advance fee. Remember the 3% interest (cash advance fee) for 6 mos is the same as 6% interest for 1 year. A medical loan might be higher? Not sure you'll understand what I'm saying, but if you do, you can move money around and reduce your costs.


I know this doesn't really help you, just more ideas. Good luck and God bless, Sandy

[mmglobal]

You can generate pain in a healty disc. Was it concordant pain? Were you saying... "yes, that's what I feel when I'm having a bad day" or was it unlike your 'memory pain'?

[dshobbies]

I don't understand why Aetna will pay for 1 disc and not 2. Have you asked them about it or are you assuming the 2 will be denied?

Tell your doctor about your plight. He can argue your case with Aetna.

The problem is that you're changing ins. co.s in one month's time so the time element is the important factor here. Find out Aetna's policy for fast authorizations and/or appeals and start now.

Good luck, Dale

[phylly]

If I had a "mulligan", I would take the one paid for by the insurance and see how I felt after. No surgery is good but maybe one will work. Less may be better?
Phylly

[steve55]

Originally Posted by mmglobal

You can generate pain in a healty disc. Was it concordant pain? Were you saying... "yes, that's what I feel when I'm having a bad day" or was it unlike your 'memory pain'?

Yes, in fact, both of the bad discs said concordant pain on the report.

The pain was definitley "unlike my memory type pain". It was darn near horrific. My normal pain I feel on a daily basis is more like a deep penetrating ulceric dull type pain that is so bad that I get nautious.

Mark, question for you. Ive read many posts where people either end up waiting for 1-2 mo to get surgery in germany, or cant contact the german doctors at all. Many have inquired or sent their films etc over 4 weeks ago and still havent heard anything back. Whats the deal on that? Is there a very long wait to hear back and get surgery scheudled?

[mmglobal]

I'm not sure I understand... is it concordant pain that is like 'your pain'... or is it different. Perhaps you are saying that the discogram pain was more intense? But, they are trying to identify it the pain is much like what you experience with your back problems.

All of the docs are different in responding and they vary from time to time. Sometimes they respond very quickly, sometimes they get backed up. Sometimes there is a glitch in the communication. Just like most things spine... there is no definitive answer.

Mark

[steve55]

Originally Posted by mmglobal

I'm not sure I understand... is it concordant pain that is like 'your pain'... or is it different. Perhaps you are saying that the discogram pain was more intense?
Mark

Mmm, its hard to say, but I think it was a similar type pain, x 100. I mean, normally, I just have that deep dull, penetrative pain. But the discogram simply HURT like hell. LOL. Its hard to compare one with the other due to the severity of the discogram pain. But ya know, it makes sense because when they gave me epidurals at C6/7 I felt 100% better for a few days, and then when they did the Plasma disc decompression at c5/6 and C6/7, I also felt 80% relief. So, once again, another test shows issues at these same levels. It has to be the disc.

Gosh, I sure wish we had more people who had the fibrin procedure done. I wonder what the real success rate is. If fibrin really works, then who needs ADR or fusion? Mark, is linda the only person you know who has had success with fibrin?