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#11
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Colorado Babe, I intend to fight! Thanks for taking the time to share your experience and give me your suggestions.
My priority right now is my health because I feel so terrible everyday. I have already resigned myself to the fact that my insurance company will most likely require me to appeal. I've researched their guidelines and while they say they will approve the ADR, in the approval process if I have had a prior surgery, they will use that to decline the request. There is no way I will have a fusion just because it's convenient for them. I would only have a fusion if my body indicated that was my only choice. I already have a surgeon in Germany that believes I need a two level ADR so physically, ADR is my best route IMO. Of course, I will find out what the out of pocket cost is to have my U.S. surgeon do the surgery. If he convinces me that the Mobi-C is a good option for me over the M6-C then of course, I would prefer not to travel to another country to have surgery but, I have to consider all the factors. One European surgeon has implanted over 1000 and the other over 2000 so, there is that to consider too. I will have to do the appeal after I see the U.S. surgeon in a week. But, I know that I can't wait 3 months or longer for an unexpected outcome. I'm extremely concerned about my health right now as it continues to decline. If the insurance company turns me down and turns down the appeal, I will most likely move forward with my plans to have the surgery done in Europe (assuming their cost is less than the U.S) and then fight the insurance company afterwards full knowing that they will probably use surgery in a foreign country to turn me down in future appeals. I have tried to plan out my future for all possible outcomes when it comes to this surgery. I also may speak to a lawyer if it gets too messy later in the appeal process. I just have to take this a step at a time. I need a lot of luck and prayers right now! Thank you so much for your input. I really do appreciate hearing from people who have been through the surgery, won the insurance battle and recovered from debilitating pain! It gives me hope
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2006: epidural shots did nothing; 2 surgeons recommended 2 level fusion, I declined. 2007 - 2010 4 foraminotomy and cord decompression cervical surgeries and 2 endoscopic discectomy T7-T8 surgeries; total 6 with Dr. Jho (Pittsburgh,PA) My C6/C7 autofused around 2009. 2013 - 2015: epidurals 3 times (again did nothing) and 4 Radiofrequency ablation (or RFA) procedures. 2016 more RFAs, hit the 10 year mark of this insanity and pain, 3 level M6-C ADR with Dr. Clavel May 19, 2016 Last edited by Cynlite; 03-15-2015 at 03:07 PM. |
#12
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Cynlite, One thing I'm seriously considering (if I have to pay out of pocket) is using Dr. Blumenthal at Texas Back Institute (in Plano, TX) He uses multiple devices (including the Mobi-C) and his cost out-of-pocket for 2 levels (hospital, anesthesia, surgery, etc) is just under $30K. If you happen to have insurance that has out-of-network benefits, some of that may be covered your policy.
Since you need your surgery ASAP, you could probably pay out-of-pocket with him and if you have the proper insurance, fight with them later. If you go to Europe the cost will be more than $30K (that doesn't even factor in the cost of flights) and follow-up in the U.S. will be more difficult. Finally, there is much less likelihood of insurance covering you overseas. Gene
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Car Accident 2002 - Small Herniated Disc C3/C4 1998 Larger Herniation and Cervical Fusion C3/C4 2005 Herniation C4/C5 - 40 epidural steroid injections from Oct 2005, - Oct, 2007 2008 - Foraminotomy at C6/C7 on left side Feb, 2010 - Cervical Fusion C4/C5 Dec, 2010 - Lumbar Fusion L3/L5 2013 - Bulge on C5/C6; herniation C6/C7 right side Mar 26, 2013 - Foraminotomy at C6/C7 on right side May 5, 2015 - ADR with Dr Blumenthal of TBI for C5/C6 using Mobi-C |
#13
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Thanks NJ Gene! Unfortunately, my insurance does not cover me out of state or overseas LOL. Hopefully, the Barrow Institute will charge roughly the same as your surgeon and the one up in Washington. If that's the case, then I agree with you on most of your points.
One of my reservations is that Dr. Bierstedt mentioned that the M6-C is a better disc than the Mobi-C for protecting the facet joints going forward. It doesn't allow for over extending the natural movement of the body. Sorry, I don't recall the medical terms. Anyway, I don't want my poor facet joints to get arthritis before their time. I'm really curious to see what Dr. Zeegers has to say because he is going to review ALL of my prior medical history before giving me his opinion. It's been quite a job pulling everything together for him. I'm going to send him his consult fee on Monday. He's already started reviewing my case without payment! He's really a wonderful person and surgeon. Check him out on Facebook if you want to read more about his success stories. Right now, he's consulting on my case. Later, we'll see where this leads. Thanks for your thoughts and input. I appreciate all the help I can get figuring out this puzzle.
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2006: epidural shots did nothing; 2 surgeons recommended 2 level fusion, I declined. 2007 - 2010 4 foraminotomy and cord decompression cervical surgeries and 2 endoscopic discectomy T7-T8 surgeries; total 6 with Dr. Jho (Pittsburgh,PA) My C6/C7 autofused around 2009. 2013 - 2015: epidurals 3 times (again did nothing) and 4 Radiofrequency ablation (or RFA) procedures. 2016 more RFAs, hit the 10 year mark of this insanity and pain, 3 level M6-C ADR with Dr. Clavel May 19, 2016 |
#14
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Cynlite, you have our prayers wishing you choose the right surgeon and be pain free very soon.
NJ Gene, I was told about splitting the payment with the insurance acouple of years ago for a 2 level ADR, but since the Mobi-C has been received FDA approval since, I would think the insurance should pay for both levels,at least when done here in US. Though I think some people here had success with insurance covering ADR's done in Europe. Dema & Raouf
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7/2007 Whiplash injury 11/2009 Cervical disc herniation C3-C6 (C5-C6 worse) 2010-2013 Conservative treatments (drugs, PT, epidurals, prolotherapy, acupuncture...etc), little effect on pain Considering surgery (typical questions, which type & which surgeon!) |
#15
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cervical
If this is the cervical, the US FDA last August, approved the two level Mobi-C
So the insurance should not refuse this treatment.
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Jerry, Somewhere Ohio L2-3 herniation, two days before Thanksgiving, 2012, Discectomy/Laminectomy, 3/13 Numbness in the right leg, lateral femoral, gone, July 10, 2014 L45 M6 ADR, July 15 PLIF L5-S1, Not able to access L51 Anterior. |
#16
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Spinal Nerve Functions Picture
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2006: epidural shots did nothing; 2 surgeons recommended 2 level fusion, I declined. 2007 - 2010 4 foraminotomy and cord decompression cervical surgeries and 2 endoscopic discectomy T7-T8 surgeries; total 6 with Dr. Jho (Pittsburgh,PA) My C6/C7 autofused around 2009. 2013 - 2015: epidurals 3 times (again did nothing) and 4 Radiofrequency ablation (or RFA) procedures. 2016 more RFAs, hit the 10 year mark of this insanity and pain, 3 level M6-C ADR with Dr. Clavel May 19, 2016 |
#17
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Some of the Top ADR Docs
This has been posted on ADR Support before but, I thought I would put it on my thread for those looking to stay in the states for ADR surgery. Some of the surgeons names show up on this site so, first hand experience from their patients can be read about here if you do some looking around.
36 Spine Surgeons Performing Artificial Disc Replacement
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2006: epidural shots did nothing; 2 surgeons recommended 2 level fusion, I declined. 2007 - 2010 4 foraminotomy and cord decompression cervical surgeries and 2 endoscopic discectomy T7-T8 surgeries; total 6 with Dr. Jho (Pittsburgh,PA) My C6/C7 autofused around 2009. 2013 - 2015: epidurals 3 times (again did nothing) and 4 Radiofrequency ablation (or RFA) procedures. 2016 more RFAs, hit the 10 year mark of this insanity and pain, 3 level M6-C ADR with Dr. Clavel May 19, 2016 |
#18
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Thanks for posting a current list. Will keep it for my files!
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1998- Injured neck and back in USAF 2011 - Started experiencing Severe Symptoms, Migranes, numbness, spasms in legs and feet and sciatica. Feb 2014 - Received upper Lumbar Injection - Severe Allergy to injection Mar 2014 - MRI of Cervical and Lumbar, protruding disc in C3-7, Herniated Disc in L5/S1, placed on STD and FMLA ) July 2014 - Stem Cell Procedure performed Oct 20, 2014 - ADR (MOBI-C) at C5-7 and Anterior Fusion at L5/S1 by Dr. Pettine and Dr. Techy |
#19
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You are most welcome
It appears that Dr. Pettine did a two level Mobi-C on your neck. He seems to be one of the more experienced surgeon's in the country. I just finished looking at his website. I'm curious how the stem cell injections helped you with your fibromylagia and surgery. Did you continue with them? I read that you thought it improved your healing process at the time. I hope you are continuing to recover well from your surgery and that life is good. Take care,
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2006: epidural shots did nothing; 2 surgeons recommended 2 level fusion, I declined. 2007 - 2010 4 foraminotomy and cord decompression cervical surgeries and 2 endoscopic discectomy T7-T8 surgeries; total 6 with Dr. Jho (Pittsburgh,PA) My C6/C7 autofused around 2009. 2013 - 2015: epidurals 3 times (again did nothing) and 4 Radiofrequency ablation (or RFA) procedures. 2016 more RFAs, hit the 10 year mark of this insanity and pain, 3 level M6-C ADR with Dr. Clavel May 19, 2016 Last edited by Cynlite; 04-07-2015 at 01:49 AM. |
#20
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Quote:
I will be interviewed once again by channel 9 next week. The reporter is coming to interview me at my house. I'm hoping it doesn't snow again before the visit. If you haven't seen the first TV interview, you can view it at: http://link.brightcove.com/services/...=4072872709001
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1998- Injured neck and back in USAF 2011 - Started experiencing Severe Symptoms, Migranes, numbness, spasms in legs and feet and sciatica. Feb 2014 - Received upper Lumbar Injection - Severe Allergy to injection Mar 2014 - MRI of Cervical and Lumbar, protruding disc in C3-7, Herniated Disc in L5/S1, placed on STD and FMLA ) July 2014 - Stem Cell Procedure performed Oct 20, 2014 - ADR (MOBI-C) at C5-7 and Anterior Fusion at L5/S1 by Dr. Pettine and Dr. Techy |
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