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The Big File All issues not easily categorized in the above forums are here. Comments on general health, diet, "getting comfortable," and more are here.


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  #11  
Old 12-09-2008, 11:29 PM
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Terry Terry is offline
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Jason:

I hope that your surgery gets covered on January 29th. Let's hope for some compassionate decision makers in the insurance company. Hang in there and cervical surgeries are much easier to tolerate for the most part than lumbar.

I have two cervical and two lumbar and the cervical has healed up nicely. I hope you have as pain free of holidays as can be and good luck for the upcoming year.

Terry Newton
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1980 ruptured L4-L5
1988 ruptured SI-L5
1990 ruptured C5-C6
1994 ruptured C6-C7
1995 Hemi-Laminectomy C5-C6, C6-C7 Mayo Clinic
Bicycle Accident 2004
MRI, EMG, Facet Injections, Epidural Blocks, Lumbar Discogram.
Stenum Hospital Surgery November 4, 2006
Prestige Disc C5-C6, C6-C7
Maverick Disc S1-L5, L4-L5
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  #12  
Old 12-09-2008, 11:40 PM
JasonR JasonR is offline
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No, we haven't discussed an clinical trials yet. Maybe if my insurance balks at ADR but I'm hopeful that I'll get approved. One thing that may be in my favor is that my company is self-insured so they may have some say in the approval. Considering my level of current and planned responsibilities it's in their best interest to get me back as soon as possible. My job function is currently single-threaded so missing me could hurt. ADR patients seem to return to work a good bit sooner than ACDF and I may be able to work from home at least part time very quickly.

I cringe to think how quickly I'd get bored with my PS3 and Wii games .
__________________
DDD C5/6. Incorrectly diagnosed as tension headaches in September 1997.
Nearly continuous headache since.
Began having pain in wrists in 2000, believed it was onset of carpal tunnel.
In 2005 pain began getting worse.
Diagnosed as DDD in July 2007.
Surgery recommended after 6weeks of PT made the pain worse.
ADR scheduled for Jan 26, 2009. Rescheduled for August 5!
Bryan disc finally FDA approved, and just in time too.
Neck was all jacked up and had to be fused unfortunately.
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  #13  
Old 12-09-2008, 11:52 PM
JasonR JasonR is offline
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Quote:
Originally Posted by Terry View Post
Jason:

I hope that your surgery gets covered on January 29th. Let's hope for some compassionate decision makers in the insurance company. Hang in there and cervical surgeries are much easier to tolerate for the most part than lumbar.

I have two cervical and two lumbar and the cervical has healed up nicely. I hope you have as pain free of holidays as can be and good luck for the upcoming year.

Terry Newton
Thanks Terry! I just noticed I had a typo. It's January 26th. I'm really hoping that the Bryan disc is approved by then. I know I have VERY mild DDD at C4/5(barely noticeable but there) but even so the Prestige might eliminate any chance of taking care of future problems at that level. The Bryan disc would support adjacent level ADR down the road. From my view the basic design of the Bryan disc is better too.

My doc's nurse and I have both been told by the insurance company that the procedure is covered. It just depends on if the medical examiner is willing to accept Dr Heller's reasons as being medically indicated.

I'll tell ya, it was VERY frustrating to see the weakness in my right arm. It was never as apparent as it was today that my left arm, and the lower arm/wrist especially, was so much stronger. That was surprising to me as my right hand is the dominant one.

Your recovery is an inspiration for all of us Terry. I'm keeping my hopes up and the reality check in my back pocket .
__________________
DDD C5/6. Incorrectly diagnosed as tension headaches in September 1997.
Nearly continuous headache since.
Began having pain in wrists in 2000, believed it was onset of carpal tunnel.
In 2005 pain began getting worse.
Diagnosed as DDD in July 2007.
Surgery recommended after 6weeks of PT made the pain worse.
ADR scheduled for Jan 26, 2009. Rescheduled for August 5!
Bryan disc finally FDA approved, and just in time too.
Neck was all jacked up and had to be fused unfortunately.
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  #14  
Old 12-12-2008, 02:09 AM
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KBear KBear is offline
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Quote:
Originally Posted by JasonR View Post
I'm keeping my hopes up and the reality check in my back pocket .
Aren't we all? That is a very good perspective/way to put it. I just read this thread for the first time and I wish you the best of luck in your upcoming surgery. Before long, you will be on the other side of this and telling us about your awesome recovery!
Best Wishes,
Kathy
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  #15  
Old 01-05-2009, 09:13 AM
JasonR JasonR is offline
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Default Insurance denied

Well, not terribly surprised but insurance denied the initial request so it's appeal time. What is surprising is that the procedure they approved was just decompression, not even fusion.
__________________
DDD C5/6. Incorrectly diagnosed as tension headaches in September 1997.
Nearly continuous headache since.
Began having pain in wrists in 2000, believed it was onset of carpal tunnel.
In 2005 pain began getting worse.
Diagnosed as DDD in July 2007.
Surgery recommended after 6weeks of PT made the pain worse.
ADR scheduled for Jan 26, 2009. Rescheduled for August 5!
Bryan disc finally FDA approved, and just in time too.
Neck was all jacked up and had to be fused unfortunately.
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  #16  
Old 01-05-2009, 09:52 AM
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CindyLou CindyLou is offline
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Posts: 627
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I'm sorry Jason that your insurance denied your ADR. Not surprising like you said, but put on your punching bags and get ready for your fight. If we all keep fighting and fighting these appeals, eventually, hopefully, one day they will begin to take notice and change their nonsense denials. Good luck to you in the fight and remember to check out The Insurance Warrior for helpful tips. If you do a search things should pop up for you to read.

Best to you,

Cindylou
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CindyLou
bicycle accident 6/19/01
2 compression fractures, T12, L1;
vertibroplasty @ above levels, 9/15/01
4/06 hip labral tear repair
4/07 Lumbar ProDisc replacement by Dr. B., 3 levels; L3-6
7/2/08 ALIF of L6-S1
7/30/08 Removed bone cement.
8/7/08 Diagnosed with pulmonary embolism, double pneumonia, collapsed left lung, pleurisy, pleural effusion.
3/10/09 right SI Joint Fusion; seeing light at end of tunnel, for first time in 8 years!!
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  #17  
Old 01-05-2009, 05:09 PM
Sandra L Sandra L is offline
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Join Date: Jan 2008
Posts: 111
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Jason,

OUTRAGEOUS !!! AND !!! on them.

And we are only a small group of people who are denied coverage every year. Can't fathom a procedure being approved by the federal government and then insurance companies not paying. There must be something that groups like adrsupport can do??

Sandy
__________________
**Accidents, active life-style, always some back/neck pain controlled w/ibuphrofen
2004 excessive pain, x-ray, PT, MRI diagnosis cervical DDD
**PM recommended, meds, PT, massage therapy, chiropractor, injections
**Dec. 2007 numbness and weakness in left arm/thumb, x-rays, MRI, discs at C4-7 pushing on spinal cord, fusion or ADR out of country
**April 7, 2008, discogram at C3-4, surgery 4 levels, Prodisc-C, Dr. Bertagnoli, Germany
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  #18  
Old 01-05-2009, 07:48 PM
annapurna annapurna is offline
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Join Date: Dec 2004
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Quote:
Originally Posted by Sandra L View Post
There must be something that groups like adrsupport can do??
Talk, post, complain, write letters, write more letters, complain some more. Complain to senators, complain to your employer who's paying most of your health care insurance. Use ADR Support to dig up factual information to support your presentations. Basically make it painful for the insurance companies to justify their refusal.
__________________
Laura - L5S1 Charitee
C5/6 and 6/7 Prodisc C
Facet problems L4-S1
Knee, Shoulder, Toe, Finger, Elbow Problems

Jim - no spine problem but lots of other fun medical challenges

"There are many Annapurnas in the lives of men" Maurice Herzog
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  #19  
Old 01-06-2009, 01:08 PM
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keziah23 keziah23 is offline
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Posts: 104
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Jason,

it sounds like we had similar symptoms, my level was c55/6 as well, i had SEVERE headaches, arm and shoulder pain and increasing weakness in my right hand/arm, tests showed nerve damage as well. I had the prodisc-c on 11/18 (7 weeks ago today), no headaches so far since surgery (*knocks wood*), minimal shoulder pain, weakness seems to be decreasing in my hand/arm as I recover.

Best of luck to you.

Kristi
__________________
Timeline:
1988:sprained neck roller skating
1989:dislocated neck in a freak accident
1993:MVA
1995:diagnosed with bulging disc C5/6
2000:disk herniated
2000-2004:multiple treatments including nerve root block, trigger point injections, epidural steroid injections, pt
2005-2008: pain meds and muscle relaxers only
ProDisc-C replacement on c5/c6 11/18/08
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  #20  
Old 01-09-2009, 09:01 AM
JasonR JasonR is offline
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Join Date: Jun 2008
Posts: 71
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Quote:
Originally Posted by keziah23 View Post
Jason,

it sounds like we had similar symptoms, my level was c55/6 as well, i had SEVERE headaches, arm and shoulder pain and increasing weakness in my right hand/arm, tests showed nerve damage as well. I had the prodisc-c on 11/18 (7 weeks ago today), no headaches so far since surgery (*knocks wood*), minimal shoulder pain, weakness seems to be decreasing in my hand/arm as I recover.

Best of luck to you.

Kristi
Thanks Kristi. I would be in heaven if the headaches went away. I've had one nearly every day since September 1997 and it's something I've just become used to. I manage them now with 800mb of ibuprofen 1-3 times per day or a flexiril if it gets really bad.

I'm sure things will work out. The Dr had already started the appeals process when I called Monday to ask what the next step should be. I was told to call them back today and follow up. No rush though as it doesn't look like the Bryan disc will be aprroved this month and I'll be waiting on that anyway; at least I'll give it a few more months to get approved.

Thanks everyone!

Jason
__________________
DDD C5/6. Incorrectly diagnosed as tension headaches in September 1997.
Nearly continuous headache since.
Began having pain in wrists in 2000, believed it was onset of carpal tunnel.
In 2005 pain began getting worse.
Diagnosed as DDD in July 2007.
Surgery recommended after 6weeks of PT made the pain worse.
ADR scheduled for Jan 26, 2009. Rescheduled for August 5!
Bryan disc finally FDA approved, and just in time too.
Neck was all jacked up and had to be fused unfortunately.
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