My 3 mo X ray - Discs tilted all over the place

[mark-perth]

I was worried that they may increase the price and were just talking about the surgeons fee's as I said in an earlier post as this has been my experience. Ive also heard that the hospital cost in the US alone are expensive, I thought that was 1 of the reasons why people went over to germany in the first place. I also said in an earlier post like Fuzzy that I feel Dr B has waived his fees and only charged for the costs that are not going to him like the hospital and fusion hardware. That was just based upon my quote from Dr B for my surgery. Did they itemize the quote and if they did maybe ask if Dr B would waive his fee if there is one. The big difference I found with the Germany quotes is everything is usually included on it and itemized so you know exactly whats included and how many days in hospital and have an all up cost. Most other surgeons are just talking about their fee then you have the anaethetist, hospital costs, implant costs, medications etc etc. The worst part I find is that they are all just estimates and if the surgery takes twice as long and you stay in hospital longer it costs you more at the end which you havent planned for and must pay before leaving there.

I do think you have taken this extremely well and looked into your best options and it is so great that you have 3 choices. I know how hard it is waiting for something when you are like you are, you just want it done immediately but it all takes time. Did Dr Bertagnoli tell you how long you would have to wait for surgery? Was he going to put you ahead of others? I know I was told that I needed to pay 3 weeks before the surgery which meant I would have had to wait at least 3 weeks for surgery.

You are extremely lucky for the offer to meet Dr B at the airport, it shows that he is concerned about you and obviously would like the opertunity to correct the problem. If this is not 2 far from you I think that would be a great opertunity to see him so he can see you for himself and maybe ask him in person if he would do the revision for free or cheaper. Maybe he can do it as a teaching case to be able to waive the costs for you. That may also mean that he wouldnt be able to operate on you for sometime if he is away. Did they say he was away for long? It doesnt look like you will get a final quote and date for surgery before then anyway. I have been told I have an 8 week wait but my disc hasnt subsided like yours so its no great panick aslong as I rest. Are you still managing to work? If so U R doing amazing.

I definately understand your concerns with travelling back to Germany and would also stay closer if possible, it would be worth the extra costs. I think also a fusion will be alot worse than an ADR. After the ADR you are allowed to move alittle but after a fusion need to take it much easier and the long travel by yourself would be horrendous. Is there any chance that your aunt who was going 2 look after you in the US would be able to come with U if you did go back there. I know it adds onto the cost but is definately needed to ensure a proper recovery. The other thought would be to go in a wheelchair if you did go back to germany. At least then you would be helped and looked after hopefully.

I hope that you get some answers soon but I would definately keep questioning that it includes all costs associated with the surgery. You may be able to work out what costs are associated from your initial surgery costs because surely that would have similar fees or atleast state what fees to expect.

Stick with it all, you are doing everything you can and going about it the best way possible.

Take care
Mark

[steve55]

Well, it looks like I'm finally going to be on my way! Mark jumped in and re-kick started things with dr Regan's insurance precert person. I had waited 2 weeks with no satisfactory updates and I begged mark to intervene to see why they are taking so long and not providing any ETA either. After mark called her, lo and behold suddenly things started happening again. The precert lady said that humana had lost her precert request as it got hung up for a week in some fax basket over at humana. ( yea, whatever), I'm thinking, even if this is completely true, if she was following up properly, we could have corrected this a long time ago. If I wasn't in so much discomfort and experiencing numbing hands, I wouldn't be so impatient. Mark thinks he didn't do anything special except ask her what was taking so long, but still, he got this thing moving again. Since mark's call a few days ago, I've made tremendous progress. I've pretty much pinned down all the costs within each division, and by golly, unless I'm being misled, it looks like dr Regan is going to truly deliver his estimate!! Possibly come in under near $9,000. If this ends up true, it will show that dr Regan has a good handle on his estimates as compared to dr bitan. Bitan's quote of $15k was only his fees. And kudos to dr Regan for not upping his estimate even after they found out that humana won't cover ADR removal costs. Personally, I think his biller was going to increase the cost cause she did mention it would cost more if insurance did not cover it, but I did tell her dr Regan personally quoted 10k Sunday night, and I bet she consulted with him about it and he probably told her to waive it. She seemed certain it was going to cost more but it never did in regards to his fees, but in is supposed to slightly increase the hospital fees. The hospital was willing to take just the 70% insurance payout but now that is expected to change a little to where I'll have a little out of pocket on that.

I'm going out on June 23rd and surgery is June 25. One problem though. I have a feeling I'm going to need c4/5 removed and fused also. I mean it's clear as day that it is also well tilted with the bottom plate sinking. Mark now is thinking the same thing after getting a closer look at my x rays I mailed him. I meet dr b Saturday night at dfw airport and I'll let him look at my x rays and take his opinion along with dr Regan's and do what needs to be done. I hope the c4/5 subsidence is within tolerable limits so I can keep that disc. I don't like the idea of fusion at such a mobile upper level. If I need 2 levels done, I've been told I'll have to fly back home and wait again for new precertifications (ughhh). Anyways, I'm still working full time and just dealing with the pain. It's really draining the life out of me same as preop, super hard to get out of bed. Weekends I just lay in bed all day mostly. Hands usually 30% numb too. I'm not in good shape at all, but at least I'm able to work still. I need the $$$.

[steve55]

Forgot to add,....Kudos to dr Regan getting me in so fast!! I only confirmed my surgery date yesterday. As busy as he is, Im thinking they must have made a special exception to get me in so fast. Part of my conversation with dr Regan that Sunday night was that I was also weighing how fast he, dr bitan, or Bertagnoli could get me in. He said it would only take 2 weeks. Given it's been 2 weeks already, he must have wanted to honor his initial quote in that regard also. Im just speculating of course. I'm really appreciating how dr Regan is keeping to his word in every way. I really have to think he is pulling strings in costs and date, he is to popular to be having such immediate surgery dates available. Just my thinking.

Oh, and I go in to my local family doctor tommorrow morning for all my prelab tests.

I still can't believe I'm having complete ADR meltdown in two discs. Ughhhh!!! Why me??? I went to the best!! I haven't read any of dr b's cervical, or lumbars having subsidence issues and I read maybe 30-50 patient stories. I'm that 1 dam outlying statistic I guess. And hell I got strong bones, I played football junior high through high school, played c league ice hockey, I motor crossed and had many wipe outs. NEVER have I broken a bone! And ive drank 2 gallons of milk per week throughout my life. But for some dam reason my spine bones must be like soft puddy. Well, at least I don't have cancer right? That's how I manage to stay positive. I'd rather have spine surgery than so many other diseases Im darn glad I don't have. The sugery itself doesn't bother me much, it's the fear of not fusing properly or not becoming pain free afterwards that scares me. I've heard too many people still in pain up to 6 mo to years after fusion. On the positive side, dr b did a absolute terrific job on cleaning up my nerves. After all, dr b did specifically mention that my normally 3 hour surgery took 6.5 hours due to his having to free up my nerves. I was 100% pain free for about a week until this subsiding disc started hurting me.

[dshobbies]

Well it's about time! Glad things are finally beginning to move forward. I don't know why 'lost' papers can't be refaxed, remailed, re-anything. My comments are not printable. But, good news on top of the bad.

One question - I thought Dr. R operated out of either Cedars or Doctor's. Has Humana taken over Doctor's which I heard had gone bankrupt? Where is this hospital?

Whatever, you're only one week out and I wish you the very best of luck. Perhaps not exactly what you want but at least your pain will hopefully be history.

My fingers are crossed, Dale

[Michelle Maree]

Glad to hear things are moving full steam ahead for you Steve.
Thanks for the post,
Michelle.

[steve55]

Well, I met with dr b for about an hour in the baggage claim area at dfw airport. It turns out he was at the tx back institute just 3 minutes from where I live and if he had known, I could have met him there. Oh well. The airport suited us fine. My main purpose in meeting with dr b was to get his opinion again regarding the c4/5 ADR, especially if dr Regan might recommend that I need 2 levels revised. I really wanted two opinions. But as it turns out, dr b said he recommends I hold off from surgery and give my body a chance to correct itself. He says the subsidence isn't that bad and now that he has a 2nd set of x rays to look at, he can confirm it is no longer subsiding. Needless to say I was shocked. Here I am looking forward to surgery in 5 days and even already paid dr Regan a $3500 deposit, all based on dr fenk meyer's email telling me to fuse NOW. And now the spine god is reversing directions and telling me to wait and see for 5 more months. So, what else am I to do but follow his advice? He wants to see if massage therapy and physical therapy and time can resolve this pain. He says I'm not in any danger of nerve damage and that the episodes of mild numbness in my hands is not something to worry about. He also suggests I get a MRI and CT scan to get a better view of everything. What's odd about all this is that the original email I got from dr fenk meyer said dr b had reviewed my x ray and reccommended immediate surgery due to risk to the middle ADR if I continue to subside, and risk of curvature of the spine called kiosis or something like that. I think his current thinking is that because the x rays show I'm not subsiding further, we can afford a wait and see approach. Meanwhile, he wants me to take ibuprofen, lyrica, and therapy to try to keep the pain at bay while we wait to see if the body somehow adapts and fixed itself.

And he recommends I see dr ziglar or guyer at the tx back institute. I told him that dr ziglar already turned me away with his secretary/receptionist remarking "he remembers you and he doesn't see other surgeons patients". Dr b said he would get me in to see dr guyer instead. My best friend came with me and we all three got a good chuckle at the idea of a resistant dr ziglar cutting on me, LOL. Not the ideal situation. LOL. So, of course I cancelled with dr Regan for now, but I emailed him explaining everthing and thanking him for all he did, and told him, I may yet still need him down the road, and that I still would love to have an opinion from him once I gathered a MRI and ct scan along with my x rays for him to look at. I really wonder if dr guyer and dr Regan will agree with the wait and see approach. I would have thought a fusion surgery 5 months from now would be more difficult than doing it now due to the ADR cementing in position even tighter. But dr b says it doesn't matter.

Oh well, I can agreed it's best to be sure before jumping into surgery. Dr b did say that as safe as most spine procedures are, such as fusion, you never know what might go wrong. He said surgery is always high risk and should always be considered a last resort. Dr guyer is top notch and I believe dr b and him together will guide me in the right direction. I'll try to wait this out as long as the pain is held at bay. So, my saga continues after all. (sigh)

Lastly, he did say my c4/5 is perfectly fine. He explained the obvious slant of the lower disc plate being due to my natuural vertebrae slant. Strange, but ok.

[Katie]

That's all I can say. After all the other consults, including his own, that's what he comes up with? Holy crap.

Sorry Steve, god or no god, what if he is wrong, and further waiting will make this damage permanent? I understand your wanting to believe him, but has Dr. Guyer seen your case? What happens if he (and Dr Regan) disagrees and then you are perhaps stuck with a much higher bill or worse? I would have perhaps checked before canceling that quickly .

I am terribly sorry to throw this opinion out there, but no one else at the beginning thought that this was much to worry about since Dr. B did it either. Perhaps he doesn't want to admit to any 'mistakes', even if they weren't preventable? I'm playing devil's advocate here for your benefit.

Again, I am so sorry that you are in this position, truly. But in your heart do you truly believe that leaving your spine that crooked is good in the long run? Even if the numbness subsides, what is going to happen in ten or twenty years? What about the damage to additional discs from that pressure? He hasn't answered those questions for you, has he?

As to the 'obvious slant of the lower disc plate being due to my natuural vertebrae slant', was that really there before all this went wrong, or even before surgery? Take a hard look at that. I still believe in going with the multiple opinion theory and not jumping too fast.

Again, I may be waaaay out of line here, and I apologize for that, but I am truly worried about this decision. It sure doesn't feel right in my gut.