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  #31  
Old 09-19-2011, 02:28 PM
nanfromsactown nanfromsactown is offline
Senior Member
 
Join Date: May 2005
Posts: 145
Default

Quote:
Originally Posted by christinlal View Post
Blue Cross Blue Shield has approved the surgery, I am still in shock and the fact that I will be able to go to Dr. Zeegers is more than I had ever hoped for.
Christine, I am SO excited and happy for you! As you know, I'm also working with Zeegers so I'm excited to find someone else who will get relief in 2011. Please keep me posted on your progress either here or on Facebook, and I will also be excited to hear about travel plans and any advice you can share about that when you get back (or before you go if you have time, but you have some packing to do!)
__________________
3/96 injury, bending over to pick up book and felt a snap.
MRI's show DDD at L45 and L5S1, disc bulge at both levels.
Discogram and CT 1999: posterior annular tears at both levels.
TREATMENT: IDET, ESI's, Radiofrequency, Chiropractic, Pain Management, PT.
No work since 1999.
ADR Surgery at BetaKlinik, Bonn, Germany 11/30/11-Activ-L at L45,STALIF at L5S1--recovery good so far!
http://backtalk2011.blogspot.com/?v=0
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  #32  
Old 09-19-2011, 11:30 PM
Lizard Lizard is offline
Junior Member
 
Join Date: Jul 2011
Posts: 19
Default Hooray!!!!!

Christine,
I am so happy for you!!!! I have to admit, I am also shocked insurance approved it, but could not be happier for you.

I will be praying for you to have a safe trip to Germany, uneventful surgery and a full recovery with a pain-free future!

I know this must be such a weight off your shoulders. Please keep us updated.

I tried to PM you, but you do not except PMs. Please contact me by PM if you want to talk further!
__________________
"Lizard"
Love hiking, biking, anything outdoors. 2005 dx with cervical DDD and radiculopathy, given PT, NSAIDs. Back to regular lifestyle with very few problems until March 2011, hyper extension of neck created the "straw that broke camel's back". C5-6 and C6-7 herniation with compression of the spinal cord. Pain between shoulder blades and mild numbness down L>R arm. No conservative options-only surgery per NS x 3. S/P 2-level ADR surgery with Mr. Nick Boeree in England Aug 31, 2011.
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  #33  
Old 09-20-2011, 06:51 PM
Slackwater Slackwater is offline
Senior Member
 
Join Date: Aug 2007
Posts: 782
Default nice to read, ...

Quote:
Originally Posted by christinlal View Post
Blue Cross Blue Shield has approved the surgery, I am still in shock and the fact that I will be able to go to Dr. Zeegers
Best wishes from California for your path forward..

Good news on BCBS. I am thumbs up+++ on the Blue Cross Blue Shield response for your case.


Revised September 11, 2011
Blue Cross Blue Shield Florida,
Medical Covergage Guidelines :
Total Disc Replacment (TDR) Total Disc Arthroplasty (TDA)

Cervical total disc replacement (TDR) at a single level meets the definition of medical necessity when ALL of the following criteria are met:
...
Lumbar total disc replacement is considered experimental or investigational, as evidence is insufficient to determine whether artificial lumbar discs are beneficial in the short term.

================
MPOV ~
Cervical TDA / TDR two (2) year results are better than ACDF results. Cervical TDR results are better than the historical lumbar results from my limited readings and comparisons.

My neighbor got a Cervical TDR at the suggestion / recommendation of her surgeon (surprised me). She asked me about Cervical TDR and I was conservative. Anyway, my neighbor is expecting another child now.

Lumbar TDA / TDR results are ~better than fusion. The historical Lumbar differences are not as large as the cervical TDR population. Historical lumbar differences are measured by Charite and ProDisc. Maverick v ALIF patient results were very good. I need to go to the source doc on Maverick to see if the rhBMP-2 was the cause of any complications in the ALIF patients causing a skew.
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  #34  
Old 09-22-2011, 11:36 AM
christinlal christinlal is offline
Senior Member
 
Join Date: Nov 2010
Posts: 103
Default Blue Cross Blue Shield Worldwide

reversed the approval and denied the surgery after telling me it was all FDA approved and the plane tickets will not be reimbursed. What an absolute nightmare I am tired of fighting all this, I am tired of having this ruin my life, this is beyond rotten.
__________________
12/2008 early am gym class-something very wrong
2/2009 DDD 4 herniated cervical discs
3/3009-8/2009 8 spinal epidurals, pt
09/2009 C6/7 Prodisc C ADR
11/2010 facet joint inj 12/2010 Rhizotomy TBI Dr. Cottingham months of relief
05/2011 facet Joint Inj 06/2011 Rhizotomy
7/2011 Dr. Zigler TBI, facet block and Discogram
11/18 surgery with Dr/Mr. Boeree..Thank God.
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  #35  
Old 09-22-2011, 03:59 PM
jss's Avatar
jss jss is offline
Senior Member
 
Join Date: Nov 2009
Posts: 1,411
Default

Christine, I'm so sorry to hear that. What next?
__________________
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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  #36  
Old 09-22-2011, 04:42 PM
JKDE302's Avatar
JKDE302 JKDE302 is offline
Senior Member
 
Join Date: Jun 2009
Posts: 236
Default

I'm very upset to hear the bad news, before you give up make sure to use extreme radicalism.
__________________
C4-5: Mild disc height loss with central annular fissure. Small broad-based left paracentral disc protrusion. Moderate central canal stenosis-the disc protrusion abuts and mildly flattens the left ventral surface of the spinal canal.

C5-6: Disc desiccation with mild height loss.Diffuse discosteophyte bulge and uncovertebral joint hypertrophy, moderate central canal stenosis- Severe neuroforaminal stenosis bilaterally, right greater than left.
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  #37  
Old 09-22-2011, 05:31 PM
christinlal christinlal is offline
Senior Member
 
Join Date: Nov 2010
Posts: 103
Default beg

for my job back and try to save the $$ to pay for this myself or fuse and live like crap. I am now down to about 118, I am miserable and spend most of my time sleeping because the pain is so bad. why I ever got a prodisc and trusted ANY us surgeon or insurance makes me feel like an idiot. I have lost pretty much everything and have a ton of bills due to the disc being in wrong and another level just being left because the us surgeon wouldn't have gotten paid, so this is what I am left with.....
__________________
12/2008 early am gym class-something very wrong
2/2009 DDD 4 herniated cervical discs
3/3009-8/2009 8 spinal epidurals, pt
09/2009 C6/7 Prodisc C ADR
11/2010 facet joint inj 12/2010 Rhizotomy TBI Dr. Cottingham months of relief
05/2011 facet Joint Inj 06/2011 Rhizotomy
7/2011 Dr. Zigler TBI, facet block and Discogram
11/18 surgery with Dr/Mr. Boeree..Thank God.
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  #38  
Old 09-22-2011, 05:39 PM
christinlal christinlal is offline
Senior Member
 
Join Date: Nov 2010
Posts: 103
Default I

am so tired of this, I cannot believe after working and paying insurance my whole life they treat you like a joke.
__________________
12/2008 early am gym class-something very wrong
2/2009 DDD 4 herniated cervical discs
3/3009-8/2009 8 spinal epidurals, pt
09/2009 C6/7 Prodisc C ADR
11/2010 facet joint inj 12/2010 Rhizotomy TBI Dr. Cottingham months of relief
05/2011 facet Joint Inj 06/2011 Rhizotomy
7/2011 Dr. Zigler TBI, facet block and Discogram
11/18 surgery with Dr/Mr. Boeree..Thank God.
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  #39  
Old 09-22-2011, 05:45 PM
nanfromsactown nanfromsactown is offline
Senior Member
 
Join Date: May 2005
Posts: 145
Default

Christine, I am so, so sorry about this turn of events. I wish I had an easy answer for you. I have been in similar shoes, and know how it feels to be treated this way. Do you have any recourse, since they said it was approved? I know you may not feel in the mood at the moment, but have you considered writing a letter to the president/CEO outlining what has happened, a chronological order of events, asking them to reconsider? Writing to the highest up person can often solve a lot of problems. Just a thought. I will keep you in my thoughts.
__________________
3/96 injury, bending over to pick up book and felt a snap.
MRI's show DDD at L45 and L5S1, disc bulge at both levels.
Discogram and CT 1999: posterior annular tears at both levels.
TREATMENT: IDET, ESI's, Radiofrequency, Chiropractic, Pain Management, PT.
No work since 1999.
ADR Surgery at BetaKlinik, Bonn, Germany 11/30/11-Activ-L at L45,STALIF at L5S1--recovery good so far!
http://backtalk2011.blogspot.com/?v=0
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  #40  
Old 09-22-2011, 05:52 PM
christinlal christinlal is offline
Senior Member
 
Join Date: Nov 2010
Posts: 103
Default Thank you

for you kindness, I am beyond consolation.....I know every single person on here knows how this is.
Everything was summarized and sent to a healthcare attorney, I have pretty much zero hope though, I found a ton of others that the insurance companies have denied, although to approve, then say "hey sorry we had bad information from their own company, so we are denying"
ahhh, I am considering just fusing and forgeting it all, Blue cross will probably deny that as well somehow.
__________________
12/2008 early am gym class-something very wrong
2/2009 DDD 4 herniated cervical discs
3/3009-8/2009 8 spinal epidurals, pt
09/2009 C6/7 Prodisc C ADR
11/2010 facet joint inj 12/2010 Rhizotomy TBI Dr. Cottingham months of relief
05/2011 facet Joint Inj 06/2011 Rhizotomy
7/2011 Dr. Zigler TBI, facet block and Discogram
11/18 surgery with Dr/Mr. Boeree..Thank God.
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artificial disc replacement complications, cervical ddd, cervical degeneration, lumbar arthroplasty, synthes prodisc

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