I also had a fusion at L5/S1.:beer:

Okay, back to the drawing board. I'll fix the spreadsheet again. You are making me work! I'm amazed at the price of your surgery! Just so I get it right... you had a 2 Level Mobi-C and a 1 Level fusion so, you had a hybred surgery right?

I don't think it was a hybrid surgery. I've never been told that. The mobi-C's were placed at the C5-7 and the Fusion was in my lumbar at L5/S1.
I checked all my EOB's and this is what it cost. I'll triple check again!

Northern CO Anesthesia Professional's: $2, 646.00 Allowed: $521.41
Northern CO Surgical Association: $3,835 Allowed: $975.27
Rocky Mountain Associates and Ortho MED PC (Assistant Surgeon): $2880 Allowed$244.97
Poudre Valley Hospital: $110, 259.65, Allowed: $21,786.27
Rocky Mountain Associate & Ortho MED PC: 15, 589.00 Allowed: $2,420

Total paid by insurance: $25,861.85
Correct Total Paid by Insurance: 25,947.65

Triple checked. I put the wrong amount paid by insurance for Northern Colorado Surgical Association. Insurance paid $975.27

That is all the bills I have received up to date.
The only thing I am thinking is that my surgeon and the hospital agree to pay a reduced rate for retired military. That is probably the reason why my surgery was so cheap. I have Tricare Prime insurance.

I was confused because you quoted costs higher than what you insurance company paid out. Usually the patient pays the difference, but I'm guessing your insurance got the cost down, not sure why you included those costs then as they are apparently irrelevant. FYI you got a VERY good deal on your procedure. :)

I wanted to show how much insurance was charged and how much they allowed. This is typical practice in the United States.

As far as the surgery went, I should have never had to fight three appeals. The injuries that I incurred all happened on active duty. It's a shame that veteran's have to fight for there healthcare and then to be turned down 3 times is just to much. I am glad I fought and won. I hope it helps other's in the future.

I think you should still fight. You never know right? I agree with some others have said..If the cost of the procedure is close to what is offered overseas, why wouldn't you go? However, if it is cheaper to stay here in the states, I would just get it done here.

It's been 6 months now with my mobi-c's and I am so happy with the new disc. My migrane's have gone away and I have no issues with my neck anymore. I do have some issues with the fusion (sometimes sciatica and pain) but nothing like I experienced before. I am glad I didn't get the Pro-disc at the L5/S1 and just so happy that I have my life back. My surgeons, Dr Pettine and Techy have given me my life back. They are the best as far as I'm concerned.

That's brutal - both your personal circumstances and the US insurance price inflation.

Which way to go?
 

Colorado Babe ~ There are a few things I'm considering besides cost when it comes to surgery. I have to make cost not be a deciding factor on where I'll go because I have to put my future health first. But, I think you are right in that appealing the insurance company when all is said and done makes sense. (BTW, I removed you as a hybrid on the spreadsheet because I think that means an ADR next to a fusion.)

I could get the Mobi-C surgery here in Arizona but, I'm not thrilled with the surgeons here so far. I need to keep exploring my options though and try not to taint my decision before I have all the information. So, far all I have gotten is disappointment in my home state because they always say fusion. Dr. Yeung, who I think is one with the most ADR experience here is a Pro-Disc doctor. Because of the HO rate and all the failed surgeries I've read about with this disc, I'm not even going to consider it. So, it's down to the M6-C and the Mobi-C. (BTW, one surgeon thinks I need two discs replaced but, they are not adjacent so, a surgeon with experience doing two adjacent levels with the Mobi-C is not an issue for me.)

I traveled six times to Pittsburgh already for spinal surgery so, I have that experience behind me. It really wasn't pleasant as you can imagine and this has been a long hard road of suffering. I know you get that too! I want to make sure that when I have surgery this time, it will be my best shot at my last time! These are the things I'm thinking about:

Surgeon - Who is the best surgeon to give me the best shot at recovering? I think Dr. Pettine is one of them so, I haven't ruled him out. I think there are three really good ones in Europe as well. The three in Europe have so much experience it's kind of hard to stack anyone in the U.S. up against them. But, like I said before, I won't proceed with surgery until I have explored all my options in the U.S. too.
Disc - What disc is going to give me the lowest HO rate and avoid further degeneration of my spine? I don't have enough information to compare the Mobi-C and M6-C. I just know that in Europe, they use the M6-C more often and the fact that it is self constraining is a selling point.
Physical Therapy - I've read and believe that immediate physical therapy after surgery is critical to the healing process. Dr. Bierstedt charges an extra $2000 euro over Dr. Clavel and I'm pretty sure it's to cover the cost of PT. He offers a very extensive PT program. Here's what his rep said to me "Post-surgical rehab is very beneficial and has a significant impact on the final success of the surgery. The extended stay gives us the chance to supervise for 2 weeks post-surgery including wound control and final check up. That patients would only stay 1-2 days as in-patient and then send home without further close supervision is almost unethical. This procedure is rather associated with costs and legal responsibility – factors that are not really having the focus on the patients well-being and care." I don't know what the other European doctors offer when it comes to PT. In the U.S., many people don't start P.T. until six weeks after surgery. I kind of like Dr. Bierstedt's approach that includes a daily program with massage and guided stretching to wake up the body. I wish we had something like that here.

I am so appreciative of you sharing your experience with me and offering your thoughts and suggestions. Knowing that your migraines went away is huge. I just spent the last two days in bed again because of them. They have completely crippled my life so I cannot make any plans whatsoever. The headaches on top of all the other pain are just a bi***! Every time I read of someone who no longer has them, it makes me happy and gives me hope. I would not wish them on my worst enemy.

I know the experience that you and several others have shared with me is truly invaluable so, THANK YOU, THANK YOU, THANK YOU!

The Insurance Racket
 

Jeff ~ Both the numbers that Colorado Babe posted are relevant. Here's why,

I had to really fight hard to get disability (turned down twice) but, when I got it, with it to my surprise came Medicare insurance. It is truly a blessing I don't take for granted. Prior to getting disability, I was paying for private pay health insurance that went up 370% over five years. I was out of work and having surgery after surgery. Fortunately, I had a hefty savings account at the time to get me through it but, I went through every cent of it plus some! What I was paying for by getting health insurance was the negotiated rates the insurance company had with the doctors and hospitals that Colorado Babe mentioned in her post and a cap. My insurance didn't help me much at the time until I was out of pocket $7,500 in a year because that was my cap. I had to pay full fare when I went to a specialist or doctor PLUS pay the huge monthly insurance premiums.

Here's the really sad thing in this country and why so many people with medical problems can quickly go bankrupt. If you don't have health insurance, then the doctors and hospitals come after the individual for the billed amount NOT the allowable amount. The amount she posted over $100 K is what would hit the poor individual's credit that didn't have insurance and had the surgery. This wouldn't happen with elective surgery because they would just turn you down and you would get to suffer with your back/neck pain unless you could negotiate payment terms. But, if you happen to get in a car accident for example and end up in the hospital without insurance and they do surgery to save you, they will come after you for the full ticket!

I learned that prices for procedures are all over the board for the SAME procedure. It pays to shop around if you have to pay cash because insurance isn't helping bring the costs down. I really wish that Health Insurance was a regulated business in this country! Having lived through the hell of having creditors call me constantly to pay for medical bills I didn't have the money to pay for, I am all for the Healthcare Act even though it's not perfect! Insurance companies have us by the tail and there should be a standard price for medical costs IMO. (One place charges $100 for a mammogram and another $400....how do they justify that? Oh wait, they don't have to!) People need to have health insurance and even then, it's still not an easy road to travel financially speaking.

People need to understand that healthcare bills are negotiable. After I got disability, I went back and paid my bills but, for the most part, I only offered to pay 50% of what they billed me and they gladly took it. After that, the bill was off my credit.

When I worked, I had great health insurance and long term care insurance. I never thought a day would come when I wasn't covered. I never imagined when I was healthy that I would become so crippled and not be able to work. I was laid off from my job after 10 years and wasn't worried because I had a huge savings account so, I took time off from working to be a caregiver/patient advocate for my Mom and Grandma through their health crisis-es. Then, a few years later my issues with my neck and back got chronic and I was really in a bind not having a job with healthcare benefits and long term disability insurance!

Cynlite,

Here's a few pics I took at Medicos and the Marriot. I was there over Christmas which is why there are few people in the pictures.
https://www.dropbox.com/sh/ysaxz0jui...9SsNKgdKa?dl=0

Thanks so much for posting the pictures Stonewall_Boris! What a beautiful facility and what's not to love about the Marriott! Very nice!

Hi Cynlite,

Here's a few pictures of the hospital in Hattigen. Dr. Bierstedt is in one of them.

https://www.dropbox.com/sh/dawx29y70...dlHdawCWa?dl=0

Great Pictures
 

Stonewall_Boris ~ Thanks again! Those are great pictures. I still don't know where my journey is going to lead me but, it's good to know that Dr. Bierstedt works in such a nice hospital. I did have a nice phone conversation with him and I'm sure I'll speak to him again before all is said and done. All the pictures make it look like you were on vacation LOL. :wiggle:

Hi Cynlite,

I've advised a few that it is serious surgery and not to take it lightly. But my wife and I did make a detour prior to flying back to Canada.

https://www.dropbox.com/sh/2rvikm99x...gjpR6YLja?dl=0

Beautiful Paris
 

Stonewall_Boris ~ I'm glad you were able to detour to one of the most beautiful cities in the world prior to going home. I've spent some time in Paris and really loved it there. I have a friend in Paris and a friend in Switzerland I would love to reconnect with while I'm in Europe. But, I'm not sure how I would plan for something like that not knowing how I'll feel after the surgery. It seems that many do extremely well after surgery with Dr. Bierstedt, Dr. Zeegers and Dr. Clavel. But, I imagine at best I would still be pretty tired from the surgery while my body was healing. How did you feel two weeks after surgery?

Hi Cynlite,

We did not plan on going to Paris when we went to Germany for my surgery. Rather it came to "us", my wife that is, while we were in Medicos since my rehab was going quite well. I would not plan on side trips. If you have friends or places that you want to visit I would leave it open ended and see how you feel after surgery.
LauraB, another member on this site, did her travelling of Germany before her surgery. Something that I never thought of! She was also a cervical patient of Dr. Bierstedt, you might want to PM her as to her post op experience.

Hi Stonewall_Boris, Thanks for your reply. That is sort of what I expected. I really wish I felt well enough to do some site seeing when I arrived in Europe before surgery but, I feel pretty bad most days here in the U.S. so, I can't anticipate feeling any better in Europe. If I go, I'll have to fly business class, take drugs and hope I can sleep all the way there. I think I'll have to plan for the worst and hope for the best. Since my condition has been going on for such a long time, it will probably take time for the nerves and body to heal from such a dramatic change.

I agree both numbers are relevant (now that I understand them), but note not only non-elective folks get quoted full amounts - I got pretty much that when I went through TBI and I was out of country and out of pocket. My procedure which would have been similar to colorado_babes and was quoted at 125K for a hybrid with two pro-discs.

My improper definition, I meant hybrid surgery in that you had a fusion and an ADR at the same time, not a hybrid fusion (which is something different).

Did you know that Dr. Pettine was the first surgeon in the world to perform the first, second, third and fourth level ADR? He is well known and I truly owe him my life for saving me. He and Dr. Techy are amazing and I truly believe they were the best surgeons for me. I am also glad that I fought the insurance and won. If we all give up so quickly, we are just letting them get away with denying everyone after us. The Mobi-C has been great. I have no complaints at all.

I didn't start my PT until about 3 months after surgery. However, I did have occupational PT in the hospital. I really needed the time to recuperate and get off all the drugs I was on. I don't think I would have done well if I had started right after my surgery but I started on the treadmill right away.

I am so sorry you are having to go through all of this and be in so much pain as you research. It is no fun -- last year I was suicidal and the only thing that kept me going was fighting insurance and not taking no as an answer. You need to keep doing your research and reaching out in order to figure out what is best for you. As far as the surgeon goes, I went to three before I chose Dr. Pettine. As soon as I met him, I knew he was the one. Glad I was right because I couldn't have possibly been able to handle the pain much longer. 16 years of pain is just to long but like most of us, we don't want to do surgery but finally give in when we can't take it anymore.

If you ever want to talk, I would be happy to share my phone number with you. Stay strong and keep on doing what your doing. You will find closure. :jacks::jacks:

Yes, you are correct. I had both surgeries at the same time for my cervical and lumbar!:o

You are right that going to Bierstedt has a much better rehab after. In Spain, two days after surgery, you go back to the hotel. Every day, once a day, a therapist comes to your room and will work with you for as long as she feels is necessary. One time she was there for 40 minutes, another time, it was 1 1/2 hours. That is it. You can then go out and walk around. It is highly encouraged that you do that. Four or five days after my surgery, my brother and I took a cab to Montserrat, about 1 1/2 hours outside of the city. There is a narrow dirt trail that is probably a couple of miles long that winds up to the top of the mountain. We started walking it, and we got almost to the top before we turned around because it was starting to rain. I wanted to go on, my brother said no way, he shouldn't have even let me do it at all. To answer the question of how you recover, before surgery I couldn't walk a block on a flat paved surface without pain. After, I walked a couple of miles up a steep, slippery dirt trail five days after surgery in a soft collar (I'm not completely stupid). You should have seen the looks I was getting from all the other people on the trail, especially the ones turning around and quitting. We also spent most days walking all over the city. I bet, I probably walked a hundred miles or so while I was there. That was what I did for rehab, and I am glad I did that instead of massages, rub downs etc. Too be honest, I wanted to go to Germany for other reasons, but also because of the rehab. Due to other reasons, it was decided for me to go to Spain and I am glad I did.

I don`t think you can think of Rehad being BETTER in Germany, it is more of a question of a different strategy or philosophy. Clavel wants you to be mobile after surgery and do physio to help get moving and stretch things out - but not to over do it. Bierstedt wants you to be much more active post surgery and get started on the physio much more aggressively. As for which is BETTER I don`t know if there have been any long-term studies on ADR outcomes based on post surgical physio intensity - I think each surgeon is going with what they perceive as working for their patients.

The physio at Medicos was not that intensive. They did do some things I was not a custom to. The ever time I worked up a sweat was in the gym. And if it was too much I just said that. Medicos has you doing a full day but with a lot time between sessions. Between going back to my room a the Mariott and going to the lounge at Medicos I never felt pressured. It was good, in my opion, that a doctor was checking up on me, at Medicos, also my bandages were being changed there by a nurse.

Great Comments!
 

Scoop, Jeff and Stone ~ Thank you for giving me your thoughts on how rehab went for you with the two different European doctors. I have not contacted Dr. Clavel yet. I really want to hear what Dr. Zeegers has to say after looking at my full back MRIs before I bring another surgeon into the picture. My history is extensive and Dr. Zeegers requires quite a bit of information so, we are still a work in progress. Anyway, I am interested in Dr. Clavel's opinion too. I just need to get to him. I'm not sure if it would be a good idea for me to walk around Barcelona by myself. What are your thoughts on that? I'm on my own in this journey!

Since this is my US thread, the update on that is that I'm still waiting for the Barrow Institute to allow me to see their Mobi-C doctor. I had to get new MRIs, wait for the report and disc to be sent to them and then after that if they like what they see, they will allow me to set up an appointment which will probably be six weeks or more out. What a pain in the you know what!

I ruled out Dr. Yeung in Phoenix who is on the list of the top ADR docs in the US (not in my insurance plan anyway) because he does not implant the Mobi-C. He's still a Prodisc-C surgeon!

I've explored another surgeon locally but, I don't think I'll see him since I want to work with someone who has a lot of experience with disc replacement surgery. Having spent six months reading the surgeries that failed, I surely don't want to be one of them.

Thanks,

Cynlite

Cynlite: Hugs -- you have definitely had a long hard journey. I commend you for doing your research thoroughly. You are a strong, intelligent woman and you will have a great outcome. ;);)

Ahhhhhh thanks Colorado Babe! The strength comes from being raised as a military brat LOL. I learned a lot about life way sooner than I would have liked to have but, those lessons came in handy so, I'm not complaining :D

I hope that my threads will someday help others as the ones before me helped me! This is really a great community. I am really DETERMINED to be a success story. Living in constant pain is no way to live life. But, for those of us that do, I learned something along the way and then observed it in my dogs. My dogs don't have any emotional attachment to feeling pain so, they just keep on truckin' after a major surgery. It's pretty amazing. I just try really hard to keep my emotions happy and not let the pain get me down.

BTW, I like your surgeon's slogan. It's something like "friends don't let friends get fused." I love it! I tell everyone I know about the alternatives but, sadly so often it falls on deaf ears. People seem to be really convinced that the surgeons doing the "golden standard" know what they are talking about and that's as far as they look. :eek: :rolleyes:

Zeegers is great and a really nice guy to boot - I would have seriously considered him but he wasn't using M6s at the time of my surgical decision, you are in good hands! :)

Dogs do have a way of providing relief. We had to put down our two dogs before going for surgery. Socrates and Galileo were there names. It wasn't because of the surgery, they were just getting old. Big dogs have a shorter life span. And so now I talked my wife into another pup, like Gali, she's another Bullmastiff.
https://www.dropbox.com/sh/zxmjlnvxp...vIca4lzOa?dl=0

WE do learn being in the military to be tough. You sound a lot like me when I was fighting Tricare last year. Everyone told me I would not win but I didn't give up.
When you walk into Dr. Pettine's office you see his military plaques, and on his wall is a plaque that says: Friends don't give friends fusions. Unfortunately for me, after much discussion and my bone density test, we had no choice. I am not complaining because he promised me 95 percent mobility and I have it. If I had to do over again, you bet I would do it and not get the pro-disc.

You are going to win this...I just know it. Keep on fighting the good fight!

Going alone raises a very interesting dilemma. I think that I could have done it on my own, cervical is easier than lumbar. I do believe that it was better to have someone there when I was doing all of the walking around. I never had a problem and never needed any help, but it does make one feel more relaxed just in case.

Is there a good Mobi-C surgeon in Arizona?
 

Dang, I have gone through the Member List here and didn't find a single person who has had ADR surgery in Arizona. It definitely feels like the wild, wild west! I guess that is what I have to expect since we don't have any top notch medical schools in Arizona. Fusion, fusion, fusion that's all they seem to know ....Sigh.....

I went to the Mobi-C site Surgeon Finder and looked through all the surgeons that are local. I didn't find any surgeon that was truly remarkable. There are three listed at the Barrow Institute (best we have here) and I have a referral to one of them. I'm STILL trying to get the appointment! I wonder why the Mayo in Phoenix never shows up in my searches? Sigh again ....

Well, on a good note, my neck hurts but, the migraine has sort of gone hiding in the distance of my head waiting to rear it's ugly pain. I hope it stays hiding today. I can deal with this low grade headache. The last week has been pretty brutal. I had to spend too much time on the computer and it couldn't be avoided since the IRS waits for no one. I just have to remember to not look down. All hell breaks loose when I do that! :nono:

One of our members here is from Arizona and he said there are no surgeons in Arizona to do ADR. He was going to come here to Colorado but by the time he received estimates, a surgery date, he had already paid for his flight to Spain and was already scheduled with Dr. Clavel. You are better off trying to figure out if you can go out of state. I believe the poster I am referring to had Blue Cross. If they don't cover out of state, then I suggest you go to Europe. However, if you can wait a few months, you could always appeal and hope they will allow you to go to an out of state surgeon.

I can't go out of state because I have a Medicare HMO. They told me if I do go out of state, I would have to get prior authorization and prove medical necessity. They are going to point me right back to my area and fusion. I would bet on that! My other choice would be to wait until January and go on straight Medicare where I'm responsible for 20%. I'll have to look into that again but, I remember thinking that was a dead end a month ago.

There are surgeons doing ADR in Arizona. I have found several that use the Prodisc-C LOL! We don't need to talk about that disc again. I laugh because I feel like I'm chasing my tail like my Labrador puppy. I keep running in circles finding the same ole same ole. Hopefully, I'll get in to see the surgeon at Barrow that trains the other surgeons on the Mobi-C device. I have no idea how much surgery experience he has with it but, he gets decent reviews. I'm pretty sure he's not at the same level as Dr. Pettine or the three surgeons in Europe. I doubt it or I'd be reading about it. There are possibly a few out of network but, what's the point. I might as well go to Europe. I'm just trying to exhaust all options first and I want to see the Mobi-C doctor locally just to get his opinion.

I have spent so many years lining up care for my Mom and Dad who had excellent insurance that paid 100%, that I'm used to finding the "rock star" surgeons and doctors. You know them when you meet them! I'm looking for a rock star in my stupid HMO and I can't find one :( :sus:

I will contact Phil and see why he didn't want anyone from Arizona doing his surgery. Most likely due to the Pro-disc. I'll try to get a hold of him and let you know!

Thank you Colorado Babe!

I'm curious what AZ surgeons/clinics you've consulted. I've been working with Sonoran Spine. They seem to have a positive opinion of cervical ADR, but a negative opinion of lumbar ADR. I'm not sure if their negative opinion is based on experiences with the older generation devices or just because it's not their specialty.

So personally, with L4-5-S1 issues, I hate to shop doctors as if I'm just looking for someone to tell me what I want to hear, but I'm at the point that I want to get a broader range of opinions.

I spoke to Dr. Randall Porter, MD at the Barrow Institute. He is a fusion and a Pro-disc surgeon. Now I'm trying to get in with the Mobi-C specialist also the Barrow Institute. Dr. Yeung is a respected ADR surgeon here however, he only uses the Pro-Disc. The other surgeons I spoke to were quite a few years ago so, they're not relevant. There are a lot of stories of people who have had unsuccessful surgeries with the Pro-disc so, I wouldn't recommend that one since there is better technology today.

I'm looking for someone that has a lot of experience but, that's hard to find in Arizona. Most likely to find a great surgeon, I think you're going to have to travel out of state or to Europe. Dr. Pettine in Colorado is a good one and Dr. Bluementhal in Texas is also recommended. I think the problem we have here in Arizona is because of lack of experience with ADR and probably due to the older technology as you mentioned. The surgeons that participated in the trials are the ones with the most experience and they are all over the country.

In the US, I believe there's a new lumbar disc getting ready to be approved by the FDA. You'll need to talk to the other lumbar patients here on this website as I'm not up on that. Also, fusion and ADR in the lumbar spine is more complicated because of the weight it has to bear. In some cases, I've read that fusion may be the better option but again you need to talk to others about that. It really is patient specific.

hi everybody:beer: