DIAM vs ADR

Katie · #1 (**permalink**) 04-09-2009, 11:38 PM

Thanks Cathy. I am on a roller coaster of emotions right now, with worrying about the funding coming through, etc.

We did have a marvelous time in the Big Apple though. Our two year old Australian Shepherd was awed by the glass elevator...to put it mildly! After a few trips up and down, we didn't have to convince him to come in quite so much...and the tropical trees inside the hotel sort of messed with his mind as well, from a dog's point of view

"But Mom...they are here for a reason!!!!" It took a quick walk in the morning to get him outside to the 'proper' trees.

Good news is that my neurologist has agreed to sign my application for the out-of-country surgery for the Insurance. After quite a lecture about what happens when 'something goes terribly wrong and our local doctors have to clean up the mess...."

He then offered to put in an 'urgent request' to the NS who I was supposed to see eight months ago........I politely declined, unless there is no way in h#&& that I can get to Dr. Bitan

Nairek · #2 (**permalink**) 04-16-2009, 02:11 AM

Katie,
I am 12 weeks out from an anterior/posterior lumbar fusion which was performed by Dr. Bitan. I can tell you from personal experience that he is an awesome doctor. Although I hated the idea of having to have go through another discogram, an SI joint injection, & a facet block, I knew he was doing that to make sure that I was the perfect candidate for the surgery that he was going to perform.

After my insurance company denied my request for ADR surgery, Dr. Bitan got on the phone with the medical manager to try & get them to change their mind. I believe he called them "narrow minded" when they continued to refuse to approve ADR surgery.

I spent 6 days in the hospital due in part to my body not behaving. Dr. Bitan stopped in to see me just about every day to see how I was doing. I was in total shock since I totally wasn't expecting that.

I can honestly say that you are in good hands with Dr. Bitan. I wish you the best of luck & hope that you get the relief that you are looking for!

Karin

Katie · #3 (**permalink**) 04-18-2009, 01:39 AM

Thanks Karin! I first read your response yesterday, but could not get logged into this site last night. I finally had success this morning.

As I said in my PM, you gave me such reassurance with the post here, but scared the c*#$ out of me with your other posts about complications. I was just about in tears last night before going to bed, as I read what I thought was very conflicting information....great feedback about Dr. Bitan himself, but lots of problems with pain control, etc. And that was with one level of fusion, and I am facing five levels over just a few days...two one day, then three more within a week.

AND, I know just enough about fusion to be afraid...I researched hard against it to force the insurance to approve ADR for me. Then came the conflicting information and here I sit...with an awesome doctor whom I have personally met and trust, who wants to do exactly what I didn't want...partly anyway.

I do believe that the fusion at the lowest levels of the lumbar will not be a bad thing, but I think I would rather have two levels of ADR and one fusion instead of one ADR and two fusion. What would be the reasoning for two fusion? I have no leg pain, but do have spinal stenosis, bone spurs and compressed flaval ligament in the lumbar. I understand the cervical more...because of the damage already done.

Would it be reasonable to ask for two lumbar ADR + one fusion? My problem is that I don't know what the indications are for that. How do they decide how many levels of which they are going to do, is my main question, I guess. Any answers out there? My MRI images, both cervical and lumbar, are posted on Pg 3 of this thread.

treefrog · #4 (**permalink**) 04-20-2009, 07:43 PM

Quote:

Originally Posted by Katie

I do believe that the fusion at the lowest levels of the lumbar will not be a bad thing, but I think I would rather have two levels of ADR and one fusion instead of one ADR and two fusion. What would be the reasoning for two fusion? I have no leg pain, but do have spinal stenosis, bone spurs and compressed flaval ligament in the lumbar. I understand the cervical more...because of the damage already done.

Would it be reasonable to ask for two lumbar ADR + one fusion? My problem is that I don't know what the indications are for that. How do they decide how many levels of which they are going to do, is my main question, I guess. Any answers out there? My MRI images, both cervical and lumbar, are posted on Pg 3 of this thread.

You should be able to ask Dr. Bitan these questions, and get answers that satisfy you. I mean, you definitely should get the answers from him, before surgery.

Katie · #5 (**permalink**) 04-21-2009, 10:18 AM

LOL, yes treefrog I will definitely talk to Dr. Bitan a lot more before the surgery.

I was trying to satisfy my ever increasing (and not so patient)quest for knowledge while we were away this week though.

I am unable to talk to him myself for awhile as I am stuck at my in-laws and have nothing else to do except come on here and ask questions

Errrr, that is, I'm doing extensive research for my upcoming surgery and can't join anyone right now for those cocktails and bridge....in-laws...can't live without 'em, can't shoot 'em

treefrog · #6 (**permalink**) 04-21-2009, 06:12 PM

Are you not able to put in a phone call to him? I know surgeons are sometimes hard to contact.

I understand about just trying to get some answers yourself, and then verifying them with the Dr. I have found it is very helpful to me to do this. It helps me to understand what questions to ask, and to understand the answers as well.

Kathy · #7 (**permalink**) 04-18-2009, 03:31 AM

Quote:

Originally Posted by Katie

Good news is that my neurologist has agreed to sign my application for the out-of-country surgery for the Insurance. After quite a lecture about what happens when 'something goes terribly wrong and our local doctors have to clean up the mess...."

He then offered to put in an 'urgent request' to the NS who I was supposed to see eight months ago........I politely declined, unless there is no way in h#&& that I can get to Dr. Bitan

Katie, I completely understand the lecture about the what could go wrong and we don't want to have to fix their mess stuff. I mean, in no industry do you want to have to go back and fix someone else's mess up. I think that there is the close mindedness toward the ADR surgery and they want you to stick with THEIR plan and do it their way. I get that too. But, when you know something is out there better, then you want to do that. I think you are making the best decision with the information you have. I'm sure my surgeon wasn't thrilled that I left the state and did the trial, as they were just ready to jump to fusion when insurance denied me. I knew that the best thing for me was ADR and I went with it. Trust your gut instinct and know you are in great hands! Let us know how it's coming along, Kathy

Katie · #8 (**permalink**) 04-18-2009, 03:40 PM

Yes, but this was almost a threat...'do this and you are on your own'. What he will not recognize is that I'm on my own anyway....no referals have produced a treatment plan for me. While he said he contacted the NS last summer, I have heard nothing. Yet all of a sudden he can put in an 'emergency referral'? My MRIs are from 07 and last fall, so my condition was the same then...urgent and critical....at risk for quadraplegia at any point from a small fall or bump.

So now he can get me in because I want to go out of country? This enrages me.

Also, another patient here has had treatment that did not solve her problems, and the acting surgeon then refused to see her again. Why is that acceptable when he is threatening the same if I go elsewhere?

Why are there no morals in health care anymore? My veterinarian cares more for my dog than the local doctors care for me. Dr. Bitan jokingly said that I should have gone to a vet....I would have been fixed my now, and he is right!

Kathy · #9 (**permalink**) 04-18-2009, 03:46 PM

Dogs do get better quicker care than us, maybe we should all switch to seeing vets

There would be an uproar if the (what's the groups that are all about animal rights?), anyway, if one of them found out animals were being treated like we are. It would be inhumane.

I wasn't saying that I agree with the dr., just that I get where it is coming from. I did the same thing and went outside of their treatment and did what I wanted. I've also had dr's 'dump me' when their treatment did not work. Bottom line is that you are in the only one living in this kind of pain and you are doing what is best for you, not their ego.

Katie · #10 (**permalink**) 04-18-2009, 04:39 PM

LOL, I wonder what the time line is from first starting medical school to the giant ego setting in? Or maybe you have to have one to qualify for medical school

Present company on the board exempted of course, Dr. J

And Dr. Bitan as well....I've never met any doctor quite like him....very caring and empathetic as well as brilliant. What an unusual and wonderful combination. I know from others' posts here that more doctors like that do exist, but they only seem to be in the upper levels, that once they have achieved 'greatness', then they join the human race again

(PS: PETA is the animal rights group) And Dr. Bitan's daughter is a veterinarian...so he knows what he's talking about with that as well it seems

My best friend is also a vet, and is able to give me a number of comparisons with this. It's time to get that pet insurance just in case my pup needs the same surgery some day. He may hurt himself trying to keep up with me after my surgery...how's that for optimism !

Thanks again for raising my spirits. Off to search for some spring wildflowers...a short walk that is.

Nairek · #11 (**permalink**) 04-19-2009, 12:38 AM

Quote:

Originally Posted by Katie

Dr. Bitan's daughter is a veterinarian.

I didn't ask Dr. Bitan about his family. I had no idea that he had kids, let alone 1 who was a veterinarian. How cool is that?!?

Interestingly enough, I had always wanted to be a vet but never pursued it.

Katie · #12 (**permalink**) 04-19-2009, 01:47 AM

Yes, we started talking about horses, one of my passions, and he said his daughter was the same way. And that she eventually went on to be a large animal vet. Very cool as one of my best friends is a vet as well, and has helped me a lot with this battle.

Dr. Bitan was very talkative with us, and I was surprised when I think you said that he didn't talk a lot with you. Could have just been the day, I guess. He had just come out of surgery when he saw us, and it wasn't a normal patient day; he made special room for us and was very kind. Maybe I just talk too darn much