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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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  #1  
Old 01-10-2007, 10:08 AM
Ihateinsurance Ihateinsurance is offline
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I have been reading and monitoring this page for several years now and I cannot find a more educated and knowledgeable group of people. I just recently received approval for a two level Prodisc with Dr. Zigler at TBI. I am VERY excited to have the surgery, as I am so tired of the pain over the past 5 years.

My question for you is this:
1. How long is the hospital stay for a two level? I have been told by TBI, in Thursday out by Saturday or Sunday. That seems quick to me.

2. How long will I be immobile at home? I dont stay still very well.
__________________
Two level herniation 8-02
10 ESI Injections
Medtronic Dorsal Stimulator 7-05
Two level Prodisc TBI Scheduled in March 2007
"THE FDA IS NOT GOD"
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  #2  
Old 01-10-2007, 11:24 AM
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Harrison Harrison is offline
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Wow, good for you for getting approval on a 2 level ProDisc! Where did you get your superpowers!?

The wide range on hospital stays is appr. 2-7 days, with most being 3-4 days. So your expectation of 3-4 days seems rational. Since you’ve been reading the site, you may already know about some of the post-op resources here: http://www.adrsupport.org/post_op.html

The paper I wrote on recovery is based on my own research and experiences. It’s a bit crusty, but you may get a few things out of it to help you through your recovery (e.g., deep breathing).

If you are the type A type, don’t worry too much – you’ll be pretty tired from the major trauma to your body! In the first few weeks, it’s important to walk a little bit; just being vertical helps all of your body systems.

Where you must be careful is in the second, third and fourth months of recovery. This is where you may need to moderate your activities, especially while the implant is “osteo-integrating” into your vertebrae. That means no skydiving, jack hammering, heavy construction, water skiing!

Everyone’s mobility after surgery is a bit different, but you may expect to stumble around awkwardly for 1-2 weeks. Being a 2 level, maybe 2-3. Again, recovery times vary because of many variables: your spine condition, your overall health, the number of levels retracted/implanted, surgery time, etc.

Hope this helps, good luck with all!
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Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
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  #3  
Old 01-10-2007, 01:45 PM
davidj8121 davidj8121 is offline
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Congratulations on your approval. And good luck with your surgery. Just shows you how crazy the world of insurance companies and ADR is because I just got my denial today for a 1 level Charite at TBI with DR. BLUMENTHAL.

Who was your insurance co.? Did you have to go through the appeal process ?

I did find out today that if I chose to I could have the surgery with Dr. Zigler using the ProDisc. I have been leaning that way.

Congrats and Good Luck.

Dave
__________________
David R. Johnson
1996 Disckectomy at L5/S1
12 Months of researching ADR
Surgery 2/8/07 at TBI Prodisc L5/S1 with Dr. Zigler
Feeling Fantastic !!
2009 L3/L4 Finally Went.
6/2009 l3/l4 clean-up surgery, failed miserably
Surgery with Dr. Z again 1/28/2010, L3/4 and L4/5.
That will make 3 Prodisc's. Lumbar feels FANTASTIC!!!!
5/5/10, failed fromanotimy on c5/6.
6/9/10 C5/6 Prodisc replace with the man, Dr. Zigler.
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  #4  
Old 01-10-2007, 02:05 PM
LBP LBP is offline
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yes, please share who your insurance company is and what process you went though to get approved. I'm hoping it's someone other than Aetna or a situation other than workers comp cuz I'd like to get some hope we are making some progress on the coverage front! Esp for 2 levels!

good luck
__________________
Injured 9/01
Annular tears L4/5 & L5/S1
denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5.

New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
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  #5  
Old 01-10-2007, 02:52 PM
Ihateinsurance Ihateinsurance is offline
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Sorry guys/gals...I guess I should have been more exact. Mine is a workcomp case. But that doesnt mean it was easy. For the past four years I have been told by several neuro's that I am a "great canditate" for adr "when it is approved by the FDA". Well even after approval of the Charite and Prodisc at ONE level, I had the same answer.."not FDA approved" or in Workcomp terms.."reasonable and customary". I have been in the court room 10-15 times arguing the points and in Oklahoma the law doesnt recognize any physician not licensed in the state of oklahoma. So Dr. Zigler was out of the question. I finally had to go to TBI on my own dime to get a surgery recomendation from Jack and take it back to my employer. Even then they said no, the courts were still powerless. So then I found a DR. in Oklahoma conducting two level charite. He recommended me for the procedure, still I got a no in the "reasonable and customary" argument. In the end I had to get political and involve the power players (NOT MY ATTNY)and my union. Still a "no". Last week one of their surgeons saw me and stated that I have been getting the runaround and really needed the two level by either doc. I was given a choice and I chose to travel to Texas to see the best. So in closing....no matter which system we poor souls have to deal with....its the entire insurance system as a whole that needs to be re-evaluated. We pay our entire lives and when we need it we are treated like SCUM. Also, in my opinion the biggest misunderstanding in the whole process is the definition of FDA APPROVAL. I think I will write a book on those 11 letters that made the past five years so horrible. LET DOCS BE DOCS AND POLITICIANS BE POLITICIANS!!!!
__________________
Two level herniation 8-02
10 ESI Injections
Medtronic Dorsal Stimulator 7-05
Two level Prodisc TBI Scheduled in March 2007
"THE FDA IS NOT GOD"
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  #6  
Old 01-10-2007, 04:16 PM
LBP LBP is offline
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thanks for the update and info. it's horribly frustrating for all of us. did you happen to read my post under "decision time" re what fda approval means for diff people!
__________________
Injured 9/01
Annular tears L4/5 & L5/S1
denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5.

New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
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  #7  
Old 01-10-2007, 04:58 PM
jf110 jf110 is offline
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Congratulations on your W.C. approval. You are in excellent hands at TBI. Dr. Zigler did a two level cervical ADR on me back in Aug. 2006 and I was out of the hospital the following morning. You will do fine. They are all fine ADR surgeons. Good luck to you, Mark
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  #8  
Old 01-11-2007, 12:58 PM
Bailey Bailey is offline
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Great news! I am awaiting approval from my insurance carrier on 2 level Prodisc and will be having Zigler do it as well. Perhaps we'll be hall-mates and pass each other in recovery! Best of luck!
__________________
1995 L5 S1 laminectomy
2005 2 level herniation L3/L4 and L4/L5
5 epidruals
2006 discogram
2006 - diagnosed DDD - 2/19/07 2 level ADR- on the road to recovery!!
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  #9  
Old 01-11-2007, 02:14 PM
Ihateinsurance Ihateinsurance is offline
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LBP: Great post, I couldnt agree more.
Bailey: I hope your approval goes well and see you at TBI soon.
I called today and although the surgery was approved they have spent the past week negotiating for a price...I tell ya...the mighty green controls the world!!!
__________________
Two level herniation 8-02
10 ESI Injections
Medtronic Dorsal Stimulator 7-05
Two level Prodisc TBI Scheduled in March 2007
"THE FDA IS NOT GOD"
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  #10  
Old 01-31-2007, 10:16 AM
Ihateinsurance Ihateinsurance is offline
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Join Date: Oct 2006
Posts: 12
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Well after all the trouble, I finally have a two level Prodisc scheduled for Dr. Zigler and TBI. I am very axcited and nervous at the same time. I cant wait to come back here and let yall know how it went.
__________________
Two level herniation 8-02
10 ESI Injections
Medtronic Dorsal Stimulator 7-05
Two level Prodisc TBI Scheduled in March 2007
"THE FDA IS NOT GOD"
Reply With Quote
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