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? If I do, 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, Linda says 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.

[kimmers]

Steve55, I would do the two-level ADR surgery here or in Germany.
That is my opinion and you can take it as it is because I am not in your shoes, but a two-level now sounds more reasonable.

You have Aetna, makes you one lucky dude as I wish I had Aetna then I wouldn't have had to go through insurance hell.

I would speak to the two-level cervical patients on this forum and see what they say. From all that I have read, cervical ADRs seem to be doing pretty good.

The most important thing is to have a great surgeon.

Another thing about ADR: Before my surgery and when I was struggling with Blue Cross, I spoke to a couple of people who had fusion in the past and now had their other discs degenerating. This was within five years. This is what they speak about when they say adjacent disc degeneration.

This is why my doctor recommended ADR for me to prevent my adjacent discs from degenerating. (Lumbar disc replacement is more complicated than cervical, given that you have to go through the abdomen and that can cause a lot of problems.) Still, each surgery--cervical or lumbar--is a major surgery.

It just makes better sense to do the surgery once and not twice. There are always risks with surgery and why face those risks twice? Aetna seems very ADR friendly and just see what they are going to do. I think it will be less expensive to do the surgery once and have it covered. Plus your surgeon bills, which can be hefty, will be paid. That is if you stay in the states.
If your doc can do it, go for it. You have two painful discs and need surgery. Why get one repaired and still be in pain, when you can potentially be out of pain after a two-level surgery?

That is my humble opinion.

For me getting the ADR was a no-brainer. Fusion just didn't seem the way to go and if I had to fight to get the surgery paid for, I would. I wished I had Aetna, but I didn't and I put my health above everything. We have bills but we are dealing with them and I have found there are a lot of organizations out there that you can get financial help from.

Good luck with your decision and I hope you pick the one best for you.

Kimmers