runner's surgery blog, L4/5, 2008

[runner]

--------------------------------------------------------------------------------

Hi
It's good to hear that you are starting to cruise around the neighborhood and get some of your strength back. Those grabbers are so handy, you will have to treat them better! About your pain, you may want to call your Dr. just to let them know about these pains, especially if they are getting worse or are different than before. It may be routine but everyone feels differently during the recuperation time. The office and Dr. will understand.

I laughed and could really relate when you talked about your nurse manager. Mine called only once (I POURED MY HEART OUT)and then never called again. A new nurse called 3 months later and wanted to start over again since my nurse was too busy with her promotion. I said no as I didn't know who was helping who and I was now managing myself.

Take care and please keep in touch and let us know what's up.
phyly
__________________
Cervical fusion C4-C6 2002
Fall on tailbone April 2005
Discogram positive at L4-S1 2007
Prodisc ADR surgery L4-L5-S1 November 2007 Dr. Delamarter
Decompression surgery L4-S1 for left sided sciatica July 2008
Continued back pain, looking at possible fusion
Removal of Prodiscs and L4-S1 fusion February 2009

[runner]

--------------------------------------------------------------------------------

Hello Phylly,

Thanks for the advice. I called the doctor and left a message and I will see what he says. I don't know if they can do anything about it, but it really is preventing me from going out back into the neighborhood and walking.

So I am resting.

I start feeling like I am lazy but all of you on here say take it easy and don't rush into things.
Phylly, I called her the doctor's nurse manager, but she is my doctor's office manager and she has helped me so much, getting appeals done and so forth.


Sorry, but my life's mission just might be to get my insurance to pay for ADR surgery in all the cases where the candidates meet the FDA approval guidelines.

They won't cover one level and I know of Workers Comps covering hybrid and two levels and so forth.

On the road to recovery and redemption too.

[runner]

Best wishes for a smooth recovery. You helped me figure the surgery out a bit. I figure I can't be totally crazy if you took the disc replacement path.

your insurance, no wishes for them.
For your comparison, a context,
<LI>CIGNA will pay for 2-level fusion
<LI>CIGNA will not pay for 2-level ADR or hybrid ADR+Fusion

The ~plan to pay for the ADR / TDR myself & avoid 2-level fusion because ... and at some point Cigna might reimburse.


Take care,


Slackwater
Nov'04 MVA: two-level lumbar surgical candidate, reading about options, ADR / TDR , ~Fusion
__________________

----------------------------------------------------------


slackwater_sf
2004 MVA, 2-level lumbar surgical candidate


Slackwater
View Public Profile
Send a private message to Slackwater
Find all posts by Slackwater
Add Slackwater to Your Contacts

[runner]

--------------------------------------------------------------------------------

Phylly,

Thanks for the advice. Called the doc and he called back and said I might have bursitis. Plan is to take it easy and take Naprosyn or Aleve and see how it is Monday. Might have to go get an x-ray on Monday. Now, at least I am sleeping better as Aleve helps. Never a dull moment with this recovery.

Slackwater,

Thank you.
You are not crazy.
From what my doctor told me, the ALIF (fusion) approach is the same for ADR, so the cost difference is the devices--the disc vs. hardware for fusion.
The two-level is a more extensive surgery of course, just like a two-level fusion would be.
So basically, it is the same surgery as fusion, approach-wise, except for what is put between the vertebrae.

My doctor told me that when he had people get denied by their health insurance, and exhausted appeals, they would usually opt for fusion instead.
But not me.
I think he admired my pluck.

When it came down to ADR, there was no better surgery for me. I just followed my neurosurgeon's first choice. Why would anyone want the second choice? It didn't matter to me, either, that my doc is said to do excellent fusions. I was thinking about the future and wanted my best chance to avoid future surgeries.
And I wanted to preserve my mobility.

I refused too to listen to the negative rhetoric from other doctors, instead I did my own research and trusted my doctor.

When doctors want this surgery themselves when they end up with the same problem, that tells you that you are onto the correct path.

I may be a little crazy, but I always have a plan. I believe as more people stand up for their rights, the more this surgery will be done in the US and the more it will become a standard.
I looked carefully also at the contraindications and I had none. That was important to me as I did not want to do anything foolish. I couldn't believe the misinformation out there about ADR.

Happy hunting.

[runner]

I too, have had bursitis since my ADR. I had the same level as you. My surgeon did two cortisone injections about six weeks apart and it has helped a lot.

Can't help with the insurance problems for ADR but I will say, I did a grievance for the BRAVO wireless esophageal testing device in January and it actually got approved. My doctor was amazed and asked if he could use me as an example as I'm the first that has had it approved. Hopefully they will "catch up" with ADR like they did with this procedure. GOOD LUCK!! Keep fighting.
__________________
DDD L4-5
Spondylosis L5-S1
6 different types epidurals no success
physical therapy/pain med no success
Refuse Fusion
Bone scan shows L5-S1 pars defect will hold ADR @ L4-5
7/31/07 pro-disc L4-5 Dr. Robert Watkins Jr. Marina Spine Institute-Mari

[runner]

hi ,
below is a link to the manufacturer site, of interest may be the template for the 'letter of medical necessity', the patient leter of appeal prior to surgery-, the 'physician letter of appeal prior to surgery'. also, if you go to the 2nd link there is access to the fda approval info for the disc l.

not sure if this is useful but thought it may be of interest. good luck,



L4/5, L5/S1 disc prolapses post wakeboarding accident Oct 06 (grade 5 and grade 4 annular disruption, repectively). 2X epidural steroid injections, lots of drugs and conservative treatment, positive discogram. Surgery May 08 (L4/5 A-Mav disc replacement and L5/S1 ALIF)

[runner]

--------------------------------------------------------------------------------

Hello OsteoRach,

Thank you for the links.
Can always use some information. Even though I have been on a lot of sites, I always find something new.

Take care.

[Maria]

BCBS is weird in that when hub had BCBS of Ma they wouldn't pay for the Forteo for my osteoporosis but BCBS of TX had no prob with it and paid all of it but $40 I think.

BCBS of Mass was really snotty re answers to questions and acted too bored, steered me to BFE re answers that should have been easy enough to come up with I thought and BCBS of Texas is like speaking to people from another planet as they are so nice and helpful! I couldn't believe the diff!

Now I have to work on getting Tricor and Zetia approved for my cholesterol..

[Terry Allen Blackburn]

Originally Posted by Maria

Now I have to work on getting Tricor and Zetia approved for my cholesterol..

I am on that same cocktail and it works fabulous. I was on Statins previously which damn near killed me from the side effects. The Zetia and Tricor keep my cholesterol and triglycerides nicely under control. Good-luck on getting these approved as, I believe, they are great for people that have spinal issues.

Terry Newton

[runner]

Terry,

Thanks. It is weird having an increase of back pain. I went to church today and spent the rest of the day recovering from sitting. I didn't feel like doing much of anything and eventually went to my bedroom to sleep and slept for five hours, I think.
It is easy to sleep, being on Gabapentin and Darvocet. Plus I stayed up late on Saturday night, might have something to do with being tired.

I don't really know why my back pain is increasing. I am wondering if I further herniated a disc or this is just degenerative disc disease. It is different pain then what I felt before my operation. The sciatica is a lot worse and really hasn't changed since my three ESIs. I don't think it is L4/5 because my symptoms are all L5/S1. So I will wait to see what the docs say this coming week.

I am watching Oprah (of course) and Michael J. Fox who has Parkinsons disease and Dr. Oz and i feel lucky just to have back pain. There are worse things but I feel kind of like that wrestling with this back and leg pain. They were talking on the show about stem cells and fighting disease and hopefully, stem cells may one day help DDD.

I found out some interesting things at the seminar i attended last week. One of the lectures was about spine and peripheral nerve injury and there is a material that has been developed to span nerves. It is complicated, sort of, but this material allows axons to reconnect. The lecturer said that they can use the material in a lumbar laminectomy. She said doctors are using it to wrap irritated nerves and the nerves like to be wrapped as this material helps nerves heal. I may have this a little mixed up because the notes are not very complete. But I think this material was originally developed to help burned skin heal.

Boy, i thought if people are having posterior fusions, I wonder if the doctors are using this to wrap those nerves and help them heal. If you can use it in laminectomies, why not fusions?

Hopefully, there are more therapies in the future for DDD that don't involve surgery.

Maria, I have given up trying to figure out insurances. They are a powerful company that doesn't seem to mind sticking me and others with outrageous bills. If my current doctors and surgical centers didn't accept the provided amount and adjust for it, we would probably be broke. We have to be easily paying more than 500 dollars a month for stuff. My husband said my medications are about 400 dollars alone. I think it varies. I could save some dollars but I don't take the generic for my Zestril, blood pressure medicine, as the brand works and I don't want to fool around with it. I was trying to explain to my husband today how generics can vary.
I just keep getting medical bills and evidence of benefits statements from insurance.

I know one thing, back pain has totally changed my life and I don't think it is for the better but eventually maybe i will.

[ans]

Runner, I've been trying to catch-up on your long story. I'm sorry that you're not as well as you "should" be. It's rough when you have to be philosophical in dealing with pain/limitations re:

" know one thing, back pain has totally changed my life and I don't think it is for the better but eventually maybe i will."

I certainly hope there'll be a resolution to your pain. Look at the new developments e.g. Mark's forthcoming/almost now surgery device, etc.

Best Regards, Allan