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  #1  
Old 12-06-2013, 03:23 PM
FranklySir FranklySir is offline
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Join Date: Jun 2013
Posts: 177
Default Many thanks to all on ADR support

Hello all. Its been too long since I have yet to post on this forum. I am in debt to all that have shared their stories which has helped me make an informed decision!

Back on June 5,2013 after much reading and cancelled double fusion, cancelled implant surgery (to remain unnamed) I found through all of you here the right man for me. A wonderful,humble,gracious, etc etc etc. I could go on and on Surgeon from Spain that implanted M6 C's in C5-7.

I met Sonja B while in Spain and wish her continued success since she was in bad shape for a while there. She truly is a trooper!

My surgery went very well. I was up an 1.5 hrs after i got back to my room. I went outside with all the stuff hanging off me and ate (forced down) a sandwich and sucked up four or five espressos with my brother. We walked at least fifty miles while in Spain which kept my mind off of it.

Now I know not everyone is the same and I have a very high tolerance to pain but what I can say is if you are worried about getting fixed DON'T WORRY. Yes it hurts some but what you have been putting up comparative to the surgery is nothing. Yes I too was worried but no more and may need to get two level lumbar done coming soon.

I was pain free from the day it was done other than minor aches and some facet banging.

To Dr. C I cannot thank you enough for giving my life back to me.
To those contemplating you are strong enough to get through this! Believe it and you shall see it.

Good health to all. anyone can feel free to PM me for anything and i will be happy to share.

Frank
__________________
Lumbar issues 18 yrs
herniations lumbar L3-5 multiple Epis etc etc
Annular tears L3-5 cauda equina
Cervical herniation symptoms 2011
C5-7 M6C by Dr Clavel on June 5 2013
L3-5 M6L by Dr. Clavel on 12.18.13
Living life instead of living the condition
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  #2  
Old 12-07-2013, 01:44 AM
Jen93312 Jen93312 is offline
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Join Date: Aug 2011
Posts: 87
Default facets

Well yesterday was your half-year anniversary then! Glad to hear from you and thankful for the information you have shared.

You mentioned your facets--can you please be a little more specific about that? How was the degeneration rated? Can you describe your facet pain or could you tell the difference? Have you had an facet injections post surgery?

Wow, 50 miles! That is truly remarkable. So glad you got to enjoy Spain as well.

Take care and keep us posted when you get the time!
__________________
Jen
C3 Bulge
C4 Bulge
C5 ruptured
C6 Bulge
7/2011 epidural that caused a "fragment to present itself"
10/2011 C5-C6 Foraminotomy & removal of fragment
Positive for left-sided Hoffman's reflex
Effacement of anterior spinal artery
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  #3  
Old 12-07-2013, 11:35 AM
FranklySir FranklySir is offline
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Join Date: Jun 2013
Posts: 177
Default

Hi Jen,

Didn't even realize it was 6 months. For me i was back in work running my company the following day i got off the plane here in PA.

No facet Degeneration or shots. I'm an average height person but pretty muscular or was haha. Back now. At any rate I think if you push too hard prior to being ready then the new flexability enables them to band each other and will cause some pain that lasts.

I think the key for me was that i went in to this in pretty good shape. I was not in an active flare up and was working out hard so could come out faster. I think most people want to believe that this will go away when they feel better and put the decision off including me for many years. i refused this time!

Now its time to fight the insurance company
__________________
Lumbar issues 18 yrs
herniations lumbar L3-5 multiple Epis etc etc
Annular tears L3-5 cauda equina
Cervical herniation symptoms 2011
C5-7 M6C by Dr Clavel on June 5 2013
L3-5 M6L by Dr. Clavel on 12.18.13
Living life instead of living the condition
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  #4  
Old 12-08-2013, 08:15 AM
jss's Avatar
jss jss is offline
Senior Member
 
Join Date: Nov 2009
Posts: 1,411
Default

Frank,

Congratulations on the successful surgery! And here's to a continuing excellent recovery and outcome. I'm glad you were able to enjoy Spain. Wishing you the best with your insurance company. I hope you have better luck than I did.

And ... thanks for the reminder that many people in pain that will never post do troll this forum for help and otherwise useful information.

Good luck, Jeff
__________________
C4/5 - ACDF in 2000
C5/6 - ACDF in 2002
C3/4 & C6/7 - M6 ADR, Nov 2009, Barcelona
Conceded defeat to a manifestly disingenuous BCBS-TX in my quest for reimbursement, Jan 2011
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  #5  
Old 12-09-2013, 12:49 PM
FranklySir FranklySir is offline
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Join Date: Jun 2013
Posts: 177
Default

Jeff,

You are right about some that never post but mostly I would like to believe aren't trolls. I think they get fixed and move on. I found myself wanting to post many times and just get too involved in doing work and never get back to it.

I see many of your posts and am grateful for all of your insights.

One back at you here I found interesting in looking up info on Epidurals. I am finding that these injections ARE NOT FDA approved? Is that so? Is this your understanding also?

This would be a very interesting thing if true to use as ammunition. Lets see one of the steps in getting fixed as far as a stepped approach is to have these injections done routinely as par for the course and the Insurance companies pay out all the time for this. Why then would they dismiss a device that is not FDA approved?

Just food for thought.

Frank
__________________
Lumbar issues 18 yrs
herniations lumbar L3-5 multiple Epis etc etc
Annular tears L3-5 cauda equina
Cervical herniation symptoms 2011
C5-7 M6C by Dr Clavel on June 5 2013
L3-5 M6L by Dr. Clavel on 12.18.13
Living life instead of living the condition
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  #6  
Old 12-09-2013, 01:01 PM
jss's Avatar
jss jss is offline
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Join Date: Nov 2009
Posts: 1,411
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Frank,

I didn't intend the verb "troll" to convey any pejorative; just that there are many look for information here that don't post. Summoning the powers of Google just now I do see that the word "troll" used relative to internet forums is pejorative. Hereafter I will use the verb "surf".

I don't know anything about ESI's being FDA approved or not...

Jeff
__________________
C4/5 - ACDF in 2000
C5/6 - ACDF in 2002
C3/4 & C6/7 - M6 ADR, Nov 2009, Barcelona
Conceded defeat to a manifestly disingenuous BCBS-TX in my quest for reimbursement, Jan 2011
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  #7  
Old 12-09-2013, 01:20 PM
FranklySir FranklySir is offline
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Join Date: Jun 2013
Posts: 177
Default

Jeff,

I did in no way mean you meant it as stated and I know really what you meant for sure. Yes it is negative in context and can be taken wrong.

No worries. Lets all just continue to do well and wish others the same as you always do.

Good health and continued progress! I need to get two lumbar done and am not looking forward to the bill nor the trip but cannot continue in this kind of agony much longer.

Interesting on the EPI's though is it not?

Frank
__________________
Lumbar issues 18 yrs
herniations lumbar L3-5 multiple Epis etc etc
Annular tears L3-5 cauda equina
Cervical herniation symptoms 2011
C5-7 M6C by Dr Clavel on June 5 2013
L3-5 M6L by Dr. Clavel on 12.18.13
Living life instead of living the condition
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  #8  
Old 12-09-2013, 04:34 PM
jss's Avatar
jss jss is offline
Senior Member
 
Join Date: Nov 2009
Posts: 1,411
Default

Frank,

The "FDA approved" title seems somewhat ambiguous. Example: the M6 is not FDA approved and absolutely, positively cannot be implanted on US soil. Multilevel ADR is not FDA approved, but has been done in the US for many years. Now that the Mobi-C has received FDA multilevel approval, does that mean that all ADRs are FDA approved for multilevel application? Even though they've been done in the US for years? Further, insurance companies don't cover things that are not FDA approved. But until recently they didn't cover ADRs that were FDA approved. So I'm not exactly sure what "FDA approved" means. That ESI's are not approved, but are covered is interesting and confusing.

As far as using that as a tool in getting BCBS to pay, I wish you the very best of luck. The people that I dealt with at BCBS were more slippery than a live catfish. The poster that goes by the name 2Confused was successful in getting BCBS to pay for her single level ADR with Dr Clavel. Here is a link to her post.

Any time frame on the lumbar?

Good luck, Jeff
__________________
C4/5 - ACDF in 2000
C5/6 - ACDF in 2002
C3/4 & C6/7 - M6 ADR, Nov 2009, Barcelona
Conceded defeat to a manifestly disingenuous BCBS-TX in my quest for reimbursement, Jan 2011
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  #9  
Old 12-09-2013, 05:51 PM
FranklySir FranklySir is offline
Senior Member
 
Join Date: Jun 2013
Posts: 177
Default

Im with you on that. Do this because we say but don't do that because we won't pay. we won't pay if it is or will pay if is not or vise versa. Crappy part for me is that i spend about 80-90K in premiums for my employees and insulting as it is I have to pay out of pocket for the correct implant (my opinion) out of pocket.

Everyone will wonder what the heck happened when the supposed ACA kicks in full blast. Bad enough now but going to get worse unfortunately. Sorry for the rant.

Lumbar was actually gonna try and fly out yesterday but couldn't get flights. Flights out for 19th or 23rd surgery are insanely costly at 12k+ and thats not even first class. I need to wait to see what the airfares look like after the holidays or reach out to those that may know when they come down in price. seems a waste to spend half the cost of the surgery on flights.

My only quandary is that if I can hold on that long and not go for a micro lamidisco now. My surgeon here can get me in this week if i wanted.
Im not sure of the ramifications of doing so but i wouldn't think it would be preferred and risk scar tissue on posterior then implant after. common sense says to me that it most likely would be counterproductive regardless of a stepped approach.

Frank
__________________
Lumbar issues 18 yrs
herniations lumbar L3-5 multiple Epis etc etc
Annular tears L3-5 cauda equina
Cervical herniation symptoms 2011
C5-7 M6C by Dr Clavel on June 5 2013
L3-5 M6L by Dr. Clavel on 12.18.13
Living life instead of living the condition
Reply With Quote
  #10  
Old 12-16-2013, 03:17 PM
2Confused 2Confused is offline
Senior Member
 
Join Date: Jun 2011
Posts: 322
Default

Hi all,

Just a quick note to say that that I had 2level ADR Surgeryand BCBS did pay approx 60%. Frankly, I do not understand why they paid for my surgery when so many others are denied.

Frank, best of luck to you and as I stated in P. M. I will email you tonight.
Quote:
Originally Posted by jss View Post
Frank,

The "FDA approved" title seems somewhat ambiguous. Example: the M6 is not FDA approved and absolutely, positively cannot be implanted on US soil. Multilevel ADR is not FDA approved, but has been done in the US for many years. Now that the Mobi-C has received FDA multilevel approval, does that mean that all ADRs are FDA approved for multilevel application? Even though they've been done in the US for years? Further, insurance companies don't cover things that are not FDA approved. But until recently they didn't cover ADRs that were FDA approved. So I'm not exactly sure what "FDA approved" means. That ESI's are not approved, but are covered is interesting and confusing.

As far as using that as a tool in getting BCBS to pay, I wish you the very best of luck. The people that I dealt with at BCBS were more slippery than a live catfish. The poster that goes by the name 2Confused was successful in getting BCBS to pay for her single level ADR with Dr Clavel. Here is a link to her post.

Any time frame on the lumbar?

Good luck, Jeff
__________________
50 year old female
Rear-Ended in 2009
Disk rupture cervical 5-6 & 6-7
2 level M6 ADR, Dr. Clavel - Oct. 2012
Insurance paid
Not a day goes by that without me whispering a silent "thank you" to Dr. Clavel
Post Op 2+ years
Cross Fit 3-5 times a week
Running 5ks
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