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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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Old 05-26-2006, 11:59 AM
Mariaa Mariaa is offline
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Latest has been that per WC it was suggested I change my Primary Treating Physician to the doctor I was sent for a consultation to in San Diego. He was very nice. If I lived there still I'd definately want him to be my PTP.

Trouble is I live in LA county again and don't have the ability to get around much.

Why was it suggested that I change PTPs? According to the Claims Adjustor, the SD doc would be able to write an "admissable letter" re the letter that the surgeon from the Spine Center sent to UR that wasn't really a request for authorization to do surgery.

The surgeon at the SpineCenter was sent this very formal "good faith dispute letter" telling him exactly what was needed to continue the process for requesting authorization for surgery. He didn't send it in yet and deadline time has arrived.

This puts me in a precarious position.

I saw my regular OSS/Primary Treating Physician as he has been my treating doctor for the last nearly 8 years. Told him of the consulting visits I had with the other surgeons, their recommendations.

My OSS said he agreed with the surgeon at the Spine Center and he still recommends a discogram to figure out if L3 is problematic.

Said my BMD is still ok now (t -2.2) but may not remain so for much longer (years) and then there is the possibility of subsidence so he asking for authorization for a discogram.

He said Charite implant would be better for me, I believe he was referencing my end plates and condition of surface of my discs ...

I asked about what about the constrained vs.semi constained characteristic about the implants tho he stated the Charite would be a better implant for me.

Ok, the surgeon at the Spine Center says Prodisc would be better but I've had unreturned phone calls, no answers to questions asked, and not working with WC paperwork in a timely fashion.. even tho I had called and spoken to the surgeon's PA.

At this point WC is probably going to just try to settle my benefits out in terms of least amount of levels/problems can be linked to original injury. This means seeing a QME/AME or whomever deals me the low blow..

I've tried to get the attorney/law firm that handled my case originally but I guess because the case is too old they aren't interested.

So far, this is where things stand.. I'm not sure I will even be able to continue to see the same PM in San Diego if I don't agree to switch PTP to the doc in SD. But this would be someone that hasn't worked with my case all the years that my OSS did and he is completely WC saavy.
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Old 05-26-2006, 06:18 PM
Mariaa Mariaa is offline
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WC Nurse Case Manager called me, asked if my PTP was going to write "admissable letter" to back up the surgeon's plan from the Spine Center...

Nope, he's asking for a discogram as he's still my PTP..

She said she thought it would be denied..

I asked if I could then get an ESI with my PM..
She said that would be something the Claims Adjuster would decide..

Sounds like I'm heading toward however things are settled out, tho she did say she thought my PTP (my OSS) would have my best interests in mind and be able to write up a good plan that would cover my needs now and for the future.

I was thinking the same thing since he's seen me longer than anyone else and seems to be the only person that's determined to find out if L3 is a pain generator since there is a tear and a bulge there..

Like I used to ask my father while we were driving along.. Are we *there* yet??
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Old 05-26-2006, 07:13 PM
sahuaro sahuaro is offline
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Maria:
Your head must be reeling...Wish I had some words of wisdom or magic but all I can offer is support...
Is Germany still an option?
Barbara
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2001 MVA; C5-C6 disk extruded
ongoing physical therapy, exercise and massage
ESI's, oral prednisone, trigger point injections
foraminal and central stenosis C5/C6 and c6/C7
2007 EMG/nerve conduction shows pattern of chronic radiculopathy
January, 2008: Prestige ST Artificial Disk Replacement, C5/6
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Old 05-26-2006, 08:51 PM
ans ans is offline
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Maria,

This is a bummer Merry-Go-Round ride. Hope it gets straightend out in your favor.

ans
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Severe, extensive DDD, considered inoperable by Dr. Regan, Lauressen, & some guy at UCLA. Severe foraminal stenosis (guess they can't operate!) and some spinal cord compression that Lauryssen would fix if gets outta hand.
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Old 05-26-2006, 09:57 PM
letteski letteski is offline
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Hi Maria,

There is something to say for history with your doctor. Great news about your bone density and I agree a discogram will give you the answers you need. I have the name of some one at the Spine Institute you may want to write a letter to.

As your Dad would answer ……..

“Not quite there yet but getting closer.”
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Paulette
ProDisc L5-S1 W/Dr Delamarter Aug 23, 2005
L5-S1 DDD Diagnosis 12/04
T-12 Compression Fracture 10/04
C-7 Spines Process Fracture 5/99
http://prodisc2.blogspot.com/
You are my Rock God in you I can do anything
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