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Getting overwhelmed with ADR surgery
Hello,
I have rapidly progressing DDD in my L5/S1 disc and I am in disabling pain all the time. I was denied coverage by BCBS (Federal Employee Program) and I am fighting for an urgent appeal. My surgeon in Miami has all but abandoned me after the initial denial, so I am on my own. Retained an attorney to help be with the appeal but I don't know if this will help. Also contacted my senator and he sent me a release form to look into my case also. However, I am also looking for alternative options because I really, really, really don't want a fusion! I've started two evaluations with German surgeons (Dr. Bertagnoli and Dr. Dasai) but the first price-estimate was a tad discouraging: $32,000 EUROS excluding travel expense. I am still waiting for the second eval. Thirdly, I am looking at getting a quote from the Texas Back Institute here in the US...What really confuses me more are all the different implants that are being used! I was supposed to have an activL ADR, TBI I believe uses the ProdiscL, and Germany uses ADR models I never heard of (Bertagnoli didn't mention a model just "a semi-constrained artificial disc replacement, and Dr. Dasai uses the LP-ESP) I am an active ER nurse and work is getting almost impossible to do anymore but I don't have enough leave to stay home either. Getting overwhelmed and discourage a bit but it is nice to see that I am not alone. Any advice is welcome :) |
I went to Bertagnoli he is best in world I'm one year out n doing back flips on my Dirtbike again I hurt my l4-5 n l5-s1 theyyre crushed n I worked like that for years just eating pain killers all the time.
I wouldn't say I'm 100 percent but I would say like 98 percent better. Some days I forget I ever had a bad back but old age did creep up on my I'm 52 n my stamina isn't where I would like. But I can go full blast for two hours on a Dirtbike which is a God send to me My experience w Bertagnoli was first class all the way. He is a great scientist and even better surgeon. And his opinion is free. Just send him your pictures and a few weeks later prospine will send you his opinion. Also he is cheap I had two levels for 55k |
I almost forgot bcbs will pay there's a lawyer in San Fran he gets 10 percent he frequently gets Adr approved n in Germany for u cause federal bcbs works there plus it's 120k cheaper the lawyer is posted on pro spine I think otherwise Bertagnoli USA liaison can guide u. But you still got to pay up front as even when pre approved Ins companies take months to actually pay. Germany is socialized medicine. Once u pay no matter what that's the most you pay.
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Just throwing this out there, but if you are going to get a fusion l5/s1 is the level you want to get it on.
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Activ-L is basically an upgrade of Prodisc-L (improvement of several features). If you can get Activ-L, you should absolutely go for it.
LP-ESP is a completely different type of design, but it sounds promising. If I would not have gone for Activ-L, I would have chosen LP-ESP. I recommend continuing the fight for the ADR. The results are really impressive. I don't even remember having surgery most of the time. |
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You can get them to reinberse you. These surgeons need cash up front insurance companies even when preapproved take months to pay
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