different opinion same dr.

[fred c]

A few months back i had sent my MRI to a few different docs from germany,spain,and so on.dr clavel from spain said he could do a 2 level fusion on c5-6 c 6-7 with a 2 level adr above.two weeks ago sent a recent MRI to him,he said c 3-4 and c4 -5 dont look that bad and he could do a 2 level adr c5-6 - c 6-7. i was very happy at first but got to thinking shoul i be happy or nervous with this infor?


fred c

[jss]

Fred,

That is ... disconcerting. At first glance I was like you; thinking, GREAT - two levels instead of four and NO FUSION. Either something has changed, or reading these images is not such an exact science, or Dr Clavel was having an off day. (if he was having an off day, WHICH?)

What has been the suggested treatment with other surgeons? I talked to six surgeons, and five of them suggested the EXACT same treatment. I would certainly get to the bottom of his change in suggested treatment before I had him, or any one else, operate.

If you can find out why the change, please update us.

Good luck!

Jeff

[Jarrod]

Fred,

Maybe he thinks that c5/6, 6/7 ADR's will help insulate c3/4, 4/5. If so that may help with the DDD of c3/4, 4/5. Just A thought.

Jarrod

[Harrison]

Fred, it sounds like different imaging studies were reviewed, is that right? If the rate of degeneration is rapid, and/or the studies were different protocols, that might account for different assessments, perhaps...

[catelynnw3]

Hi Fred,

I know from my own experience that all three times I had MRIs and x-rays done, each test and report showed slightly different things. Dr. Clavel mainly went by my most recent tests, but I still questioned what the previous reports said that the most recent didn't. Actually, at the last minute just before going into surgery, I suddenly panicked a little and mentioned to Dr. Clavel what my "older" tests (1 & 2 years ago) showed, and asked him if when he "gets in there" would he be able to see and check everything. He assured me that while in surgery he always starts at one side and then goes to the other to make sure all the nerves (and the spinal cord) are free from obstruction and also checks for bone spurs.

Prior to surgery, it was unclear as to whether there would be bone spurs to remove or not since each report was slightly different. Based on my tests, he thought there was hypertrophied ligament; but the tests aren't always definitive. Afterward, he told me that he did find and remove bone spurs and also hypertrophied ligament that was protruding into the spinal canal.

Prior to getting Dr. Clavel's opinion, I saw two neurosurgeons here. Dr. Pollina recommended ADR at C4-5 and C5-6. Dr. Cappuccino recommended ADR at C4-5, C5-6, and C6-7. After speaking to Dr. Clavel on the phone and reviewing my tests in his office, I felt very comfortable that doing only the two levels was the right decision. While my tests show a bulge at C6-7, it wasn't affecting anything. I feel confident at this point that the right decision was made. I hope you will speak to Dr. Clavel yourself (on the phone) and ask him what changed his mind.

Have any of the other doctors reviewed your most recent tests? I would be curious to know what their opinions are after seeing them. I truly wish you all the best in making your decision because I know how life-altering spine "issues" can be!

Cathy

[wendriful]

@ Fred C: Did this question ever get answered to your satisfaction? @Cathy: did your insurance company reimburse you for your surgery with Dr. Clavel? @ Anyone who also used Dr. Clavel: Do you feel you made the best decision? How is your pain level now/activity level? You can certainly write me privately with any advice as well. Thanks

[catelynnw3]

Hi!

As far as insurance, I submitted the paperwork several times, but BC/BS keeps asking for more information and in a different format. I had to ask Dr. Gilete (he handles the business end of Barcelona Spine Center) several times to change the breakdown of the Invoices according to what my insurance company was asking ~ also for the hospital bill. He was always quick to respond with whatever I needed! After I received the paperwork back again recently, I called BC/BS feeling very frustrated. The woman could understand why and told me she would talk to someone in their Claims Processors/Adjusters Department to see if they could proceed with what they have.

I did receive some money back in our Income Tax refund though. I submitted all of our medical and dental expenses for last year (besides what was paid for out of our flex spending account ~ untaxed). The amount that exceeds 7.5% of your adjusted gross income is counted. You can include things like your health insurance premium paid, mileage to/from appointments, co-pays, taxis/subways to/from appointments, etc...

Anyway, I wish you well in your research and hope you find the best solution for you!! I see you are considering two-level ADR ~ make sure you ask lots of questions and do your homework ~ your spondylolisthesis may be a contraindication. See Harrison's post from 12/28/08 listing ADR Risks, Complications, Disqualifications. (I'm not sure how to post a link to it)

[Jstuckey]

Originally Posted by catelynnw3

Hi!
I did receive some money back in our Income Tax refund though. I submitted all of our medical and dental expenses for last year (besides what was paid for out of our flex spending account ~ untaxed). The amount that exceeds 7.5% of your adjusted gross income is counted. You can include things like your health insurance premium paid, mileage to/from appointments, co-pays, taxis/subways to/from appointments, etc...

Thanks for that! Hadn't thought about this before! Better than nothing!

[annapurna]

If you're dealing with the US income tax, it does get a bit tricky to make sure you can file your medical expenses without beggin for an audit. We've done it for better than seven years running but we assemble an additional package with every receipt and a copy of surgery reports etc. and send that as supplemental information along with the return. You also need to be careful with what's deductible and your arrival and return dates if you're travelign for surgery. It needs to look like you're simply traveling to an expert surgeon rather than traveling to take a vacation and seeing an doctor during your travels. It does add up quickly but you need to be very careful with documentation so you can show that all the expenses were actual related to medical.