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Insurance Hell All insurance-related matters are here: Medicare, worker's compensation, appeals, denials, insights, wins, losses. PRICING is here too. Note: This forum has posts from 2006 forward. Older ones are in the Big File.


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  #11  
Old 12-27-2008, 03:57 PM
Adrienne Adrienne is offline
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Yeah, I'm beginning to think fusion is the way to go for me. Apparently I have an extra vertebrae that can't decide if it's lumbar or sacral and doesn't move. The disc above it takes the extra stress, which is why it's spewing its guts out now.
I also have a healed fracture (don't know how that happened) and a little arthritis at that level so the surgeon thinks it's best to get in there and get 'er done. He also added that the other discs are in great shape, so hopefully they will hold up well.
So at this point, I'm leaning towards the fusion but I'm seeing the surgeon who recommended the ADR next Monday so I might be whistling their tune after that appointment. I tend to go with whomever I consulted last.

Too bad there aren't professional logicians for hire to help you make a decision like this. Or better, a professional stunt woman to have the surgery for me.

This is driving me nuts.
__________________
Minimal DDD L4/L5
Minimal DDD L5/S1
Disco 4/07 : Large tear: @L5/S1
Idet 4/08 No improvement
Now looking at ADR vs. Fusion
ALIF Fusion 2/10 Stanford
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  #12  
Old 01-29-2009, 09:39 PM
graphicsliz graphicsliz is offline
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Join Date: Jan 2009
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Adrienne, Did they do a facet block on you? I have mild arthritis in facet joints. Many will still do ADR is there is mild problem with facets. The facet block is the only way they will be able to really pinpoint this. I've dealt with Kaiser for years and have finally gotten much of the drill down. A lawyer taught me a lot. They tend to start moving when they get other letters from big docs (mine from UCSF). Just because they turned you down doesn't mean it's over....I'd go to someone else, maybe someone at UCSF, get their opinion. If they say ok for ADR have them write a big letter to Kaiser. This is how I've gotten what I need at Kaiser. The Squeaky wheel gets the grease at Kaiser.
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  #13  
Old 01-30-2009, 11:34 PM
Adrienne Adrienne is offline
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Join Date: Sep 2007
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You're right about Kaiser, you have to squeak loudly. UCSF did give me the green light for an ADR but I've decided to have a fusion anyway (at Stanford) for a number of reasons, some brought up to me by the Kaiser surgeon. I think, out of all of those with whom I consulted, he took had the broadest perspective and was the least biased.

They didn't do a facet block because the hypertrophy is minimal and also because the L5/S1 disc was a hands-down pain generator and the dye spewed everywhere. That seems to be the ticket.
__________________
Minimal DDD L4/L5
Minimal DDD L5/S1
Disco 4/07 : Large tear: @L5/S1
Idet 4/08 No improvement
Now looking at ADR vs. Fusion
ALIF Fusion 2/10 Stanford
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  #14  
Old 03-24-2009, 01:45 AM
racheleddie racheleddie is offline
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Join Date: Feb 2009
Posts: 24
Default Kaaiser Paying for Fusion at Stanford

Is Kaiser paying for your fusion at Stanford? Do you have the option of going to another surgeon/facility when you have Kaiser insurance. I am waiting for an ADR surgery date,k but am told it will likely be another 4 months, and I am tired of this pain and want it done sooner! When is your surgery scheduled for? Best of luck to you...I hope you have the best outcome possible!
__________________
Karla
Age 47
Constant Back Pain since Jan 2008
PT, Traction, MRIs, CT Scan, Epidural Injections, Discogram
Herniated disc at L4-L5, spinal stenosis
Slight DDD and bulging discs at T6-8
Surgery June 12, 2009 - Scheduled for ADR, ended up with Fusion
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