Please share: Return to the US post ADR

[Spine Journey]

Hello community, it's been VERY helpful to read everyone's post and overwhelming with all of the ADR studies online. It's been recommended that I have the L ADR L5/S1. While I agree with the recommendation, I'm a bit apprehensive about the US device the pro disc. I'm actually scheduled for surgery next week, but feeling apprehensive about the device and have a consult scheduled with Dr. Boeree this week -- I'm very curious about the M6 and willing to travel. Based on what I have researched( day & night) it appears to be the better device. But, there are some positive outcome with the prodisc I have not found one negative thing about Boeree or Clavel.

My questions:
1. for those that travel out of the US for surgery, what post op care do you arrange upon return to home?
2. Does insurance cover any post op care once you return home e.g. Xray's, PT...
3. What dr do you use to order the required post op treatments/services.

I appreciate the guidance, and appreciate you ALL!

SJ

[herron65]

SJ
I went to my Primary care physician for all the post op care and to a sports medicine center for pt I went to both of them before and after so insurance has been paying, I let them both know what I was planning to do so all went very well.
As far as the M6L I could not be more happy, they have not given me any problems and Dr. Clavel placed them perfectly.
Good luck on your journey
Jeff

[jss]

SJ

All great questions.

1. I did not arrange for post-op care before leaving for Europe. My surgery was sufficiently successful that I've not needed any further medical attention (almost 2 years). I had an 18 month checkup with an ADR surgeon, but it took weeks to find one that would agree to see me. They were openly miffed that I went out of country and seemed to want to punish me. So I would encourage you to line up some medical support before going overseas.

2. My checkup was done by an ADR surgeon that moved his practice from Seattle the week before. His office was still in the process of setting up insurance payments, so I paid cash. $75. My bet is that BCBS-TX would have covered the checkup, but I can't say that with 100% certainty.

3. My PCP was supportive of my decision to go to Europe. He performed all of the pre-op tests, and I carried all of that with me from Dallas to Barcelona.

Good luck, Jeff

[laid up doc]

as you know, i haven't finalized my "where" decision beyond UK vs Spain, but i have been looking into this.

the standard preop required can be done by any dr - i'm planning to just see a pcp locally and don't anticipate much issue having anything covered. it's generally a cbc, chem, coags, ekg, and cxr - at most. the ekg and cxr to me are a bit much for someone as young as i am (early 30's) - but i'm not the surgeon or anesthesiologist!

the ADR surgeon i saw here in the US said he wouldn't officially "follow" me, but would look at my xrays.... which a surgeon overseas can easily do nowadays. how magnanimous, dude (not!)

i do have a pain dr who is willing to see me after for any lingering muscle issues, and will take care of my meds and any xray orders. i hope to eliminate the need for a pain dr sooner than later - hate hate HATE pain clinic!!!

[Spine Journey]

Thanks everyone, this is GREAT information. I'm pending a consult with Dr Boeree. I've been apprehensive about the L-ADR because my leg pain is so MUCH worse than my LBP. While LBP is there ( 4-6 pain scale), my leg pain after standing or walking just 30mins quickly becomes excruciating!!! Sitting doesn't bother as much. From the beggining I've been apprehensive about ADR because of the resaon described above. Yes, my disco was concordant at L5/S1, but I don't have debilatating LBP. So, I'm investigating Sacroilliac Joint Pain. Can anyone else relate to this when you were pre op? My leg pain I'SNT back of the leg at all. It's front and side leg area from hip down right above the knee.

Thanks ADR Community~

[laid up doc]

SJ -

my disc problem was misdiagnosed as SI joint dysfunction for YEARS... the thing is that "radicular pain" from the L5/S1 disc is very often to the SI joint area and buttock.

w/o radiographic changes of the SI joint, or some other reason to have an SI issue (direct trauma, recent childbirth, concomitant rheumatologic/autoimmune disease) - SI joint pain is often a wastebasket diagnosis.

if you want to rule it out, you can get the SI joint(s) injected. the pain you describe can also be muscular from the biomechanical changes of having lumbar spine issues.

my advice? get thee to a good spine pain dr and PT. they should be able to give you a better idea where your pain is coming from. surgeons are nowhere near as skilled at this...

[MeggieLynn]

Hi SJ,

Like LUD mentioned you could get an SI Joint injection to help you rule out this area as a pain source. I think it's important as you can have both lumbar disc pain and SI Joint pain. I don't remember from your signature if you had a discogram, but I think you did and it was positive, right? My point being some people go on to have fusions and/or ADRs and they have continued pain, learning later that the SI Joint was also a pain generator.

For myself, it was a no brainer as my lumbar MRI was essentially pristine, and the injection was just like magic for how well it worked. While your thinking about it, there's a website you can look at www.borgess.com/default.aspx?pId=885. There's a video on there by Dr Bruce Dahl who gives a presentation on the SI Joint. It rather long - you don't have to listen to the whole thing, but he talks about the signs and symptoms specific to the SI Joint. Most specific to it is the Fortin's sign. He developed an algorithm for diagnosing SI Joint pain. That is also on the website - you just have to click around a little bit.

My pain is very specific to the Right SI Joint. I can point right at it and say, "Right there, that is where my pain is." That is the Fortin's sign. I have leg pain down the front and side of my leg also, but that is because of the funny way I've been walking for several months, and not being able to use my quad muscles correctly if I had a normal gait.

[DAnn]

SJ
I am so sorry for your anxiety and your pain. I only had cervical issues, but I too fretted over the device and whether I should go overseas.

Do talk to Dr. Boeree. He is wonderful in my non-expert opinion.

I ended up staying in the states, but I did have my preop all done through my pcp.

Post op might be a bit more difficult.....see Jss's posts.

DAnn