Finally Had Cervical ADR 9/16.....

[ajspine]

Hello Everyone,
I posted here about 4 months ago about postponing my cervical disk replacement surgery and well, I finally had it done 2 weeks ago, placement of an AD(Pro-C) at c5/c6 level with removal of 3 bone spurs. The pain had become unbearable and my family life and work were really beginning to suffer. From my Neuro's point of view the surgery went very well but took him longer than usual as one of the nerves was crushed by a calcified disc fragment that had practically cemented itself to the nerve. The 3 hour surgery took almost 4 and he is an excellent guy.

I have been home for 12 days now and I am slowly healing, I had planned on being back to work half days by now but it is not happening that way. My Doc will not clear me to go back to work except for 4 hours a day from home until I see him on Oct 16th. I was also informed that in a year or two I might be back for another ADR for the disc below because it is in almost as bad as shape as the one they just replaced, so I wonder why they just didn't do it while they were already in there?
As for out come, still numb in left hand and now my right arm goes numb along with the back of my neck. Head aches are still bad, but he said the headaches and nerves can take months to heal. So I guess I won't know anything for at least 6 months. I am happy that I have now been able to cut my pain meds to a little over half of what they were before the surgery. I still need them but that is improvement in my opinion.
On top of this when my Dr. writes my script the pharmacy takes it upon themselves to change the fill date. When I found this out and was almost out of meds I called the Dr, and she was P***ed. "I am the dr. not them"-her words. So I am also filling a complaint about the pharmacy. This just seems to be one big mess that never ends.
Any advice on how to handle the pharmacy would be greatly appreciated and thanks for allowing me to vent my frustration.
AJ

[mmglobal]

AJ, I'm so sorry to hear that you have had such a tough time. Single level cervical ADR is usually a pretty easy surgery. With any luck, you'll progress quickly. If you don't, keep in mind that it's all about how you are for years down the road and if you ultimately recover well and are functional, the difficult surgical experience will seem unimportant.

All the best... please keep us posted.

Mark

[Maria]

Sounds like you had a really rough time of things! I would guess that maybe the one level was done because that's what the insurance covers or that is what the surgeon requested authorization for so maybe that's all that could be done at the time. I don't really know if multi level cervical ADRs are FDA approved or not. Perhaps your complications were too significant to do more at the time? I've not kept up with this type of thing.

Re the pharmacy~ the doctor can order whatever but if you've got insurance that's covering the medication then you will get what the insurance will allow basically. I think that if you want to pay cash you might be able to work things out a bit better and or the doctor will need to fill out a certain type of form to give additional information why more than the allotted or approved by insurance count of medication would be dispensed. Still all in all I believe the insurance company has the last word not the physician actually. I could be wrong it's just I too had trouble when using my private insurance carrier vs. Work Comp in terms of prescriptions but that was long long ago.

You may want to talk to the insurance company and see what's going on.

Good luck with your recovery. Hopefully whatever happened will not set your recovery back too or create permanent problems for you. Please keep us updated. Wishing you the best. Maria

[jsewell]

AJ i am glad your surgery is over. I had fusion of my lumbar spine on Sept 9th so i am in the recovery mode as well.
I am thinking the next level was not worked on for a few reasons. 1 as Maria said, it did not have insurance approval. That is a biggie, no approval, no pay.
2) You had not signed a consent form for it, maybe?
I had spine surgery last year and came out puking for 2 days, but mine was do to a migraine , i know how that is.
As far as the pharmacy changing the fill date, what is that all about? Did they make you wait longer for your medication? I know a lot of people are having a hard time at big pharmacy chains lately filling pain medication. i happen to go to a small pharmacy so have not had a problem.
Keep us posted on your recovery. Oh i have had nerve symptoms continue, even pain about 4 months out from surgery so don't panic yet.
judy

[ajspine]

Hi Guys,
So Sorry for the late reply since all of you are so kind to respond to my inquiries, but the healing process for me has been long and so very painful. First I would like to answer the questions on why I only received one replacement: my Neuro said that one levels are the only approved ADR surgery at this time. Now I know this is not true because many people on here have had multiple. I think he means that through the VA, only one level at a time is approved. So this means that when the one below gets as bad as the one just replaced they will go in and do that one
On my Pharmacy question: I guess I should have been more clear. I had this done at a VA Hospital and all of my medications go through that hospitals pharmacy, so insurance was not the issue here. When my doc asked about the problems they said that usually these types of Rx's are for a 30 day supply and if she wanted to fill it more often then she would need to write the exact day supply on the Rx, so now she actually rights 10 day supply(even though I do not take that many) and Please ship overnight right on the Rx. I guess we will see if I continue to have problems with them.
Now for an update: My deep pressure pain is relieved but I am still in quite a bit of neck, left arm and NOW right arm pain. The surgical site on my neck also throbs, did this happen with any of you following surgery? I mean new and different pain and surgical site pain? It has been 17 days and I still get very tired, very quickly and my neck and upper back muscles are rock hard even when I take the prescribed valium.
On a good note, I have been able to cut my pain med daily dose in half. Proud of that
Thank you all for your responses and concern. Hope to hear from you soon!

[jsewell]

Hi AJSpine,
I will probably forget half of what you said because unlike you , i have not cut my pain meds in half. I was thinking of not taking a dose before i went to bed, but decided i would be up at 3 or 4 so i gave in and took it. I see my pain management doc in less than 2 weeks so we can discuss it then.
Now about still being tired, it has ONLY been 17 days since you had major surgery. I am about a week ahead of you surgery wise and not allowed to do anything, but i can shower and that can wear me out. Don't worry you will get your stamina back. Give it a few more weeks as i notice a difference even between last week and this week.
Now the new pain in the right arm, i would be telling my surgeon about that one. As a comparison, my surgery was done for the lower back and i still have a considerable amount of pain there, more than before surgery. They did have problems with my bones and i have new fractures do to the surgery, so that may be some of it in my case.
Remember a lot of trauma was done to your neck and it is so early after your surgery. the only thing i would be concerned about is the pain in the right arm. When is your next appointment?
judy

[Maria]

Like Judy I can't remember everything you wrote without looking at it again however like Judy I will say you're ONLY 17 days out from surgery so go easy on yourself re recovery! Also like Judy I will advise to report new pain to your doctor (new pain, new location). It never hurts to keep the surgeon over informed vs. under informed!

I'm not sure about how many cervical levels are FDA approved. If I'm not mistaken and I could be I think we are still at one lumbar level being FDA approved here in the US though I do not know how many cervical levels are FDA approved in the U.S.

Good to read about your prescriptions and how your doctor is trying to handle that. I hope it all works out as it's supposed to. It's great that you don't have to deal with stupid insurance limitations and such. They can just be so stupid!

One of my neighbors just got an ADR in her cervical spine and she also needed another level worked on so she had a fusion there. She's doing good but it's been a bit over 2 months out from her surgery. At the 17 day post surgery point she was still pretty uncomfortable and spent a lot of time resting/sleeping I believe. She has shown marked improvement since then and I hope you will as well.

I know you said you're taking Valium I guess for some relaxation tho I wonder if you're on a muscle relaxer? That might be helpful too. Also you may be doing a fair amount of compensating re your pain and how you carry/hold yourself so this alone might be adding to the musculature being knotted and hard.

I think generally people like to cut their pain meds down a bit quickly post operatively especially if not experiencing a great deal of pain necessitating more pain meds than before surgery however I'm of the belief that your body will let you know when you are ready to decrease pain medication or other medications as well.

There's been a great deal of work done in the area so realize that there is a fair amount of inflammation in the area and that just takes time to calm down.

Wishing you a continued good recovery and as much resolution from pain as you can get from this surgery. Please do let your surgeon know of any new and different developments however.

Maria