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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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#1
12-09-2005, 12:45 AM
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Today my OSS (since '98) said that he thinks I should have the BMD testing done again first, and he is requesting authorization for CT and discogram in terms of doing a fusion at L5S1 and ADR above it w/Charite.
I had told him I didn't want a fusion done at all and wanted to wait until I could get a multilevel ADR/Prodisc done however he said I could be looking at least a 3 year wait for FDA approval of multilevel use of Prodisc (if and when it's approved). He said he's concerned about the advancement of facet problems in someone whose has had back problems for as long as I have and waiting too long. Further, he thinks he can get as good a result with a fusion at L5S1 and ADR above it as with a two level ADR. This is as long as L3 doesn't need replacement too... I asked about Sacroileac joint problems as I had read that a fusion of S1 can enhance these types of problems if one has a tendancy towards this and in PT for my right knee recently, there was a much bigger emphasis placed on my low back and I most definately heard again (as I have every PT session) that I have some SIL probs.. But OSS said SI joints look great on films... This isn't exactly the direction I was planning on taking with what I'm pursuing however, perhaps it makes sense... 
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#2
12-09-2005, 12:57 AM
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Sounds like the OSS is trying to get you to agree to a fusion since he's willing to get updated tests approved. It can't hurt to get a BMD test as those tests aren't approved by private pay insurance at very frequent intervals and it's non invasive. Today I heard about a new FDA approved blood test that detects the amount of osteocalcin, a protein found in the bone and in blood serum, which is an indicator of bone formation. It's supposed to be available to post menopausal women (first priority) by the end of December. How many discograms have you had? Do you want to have that done again if you aren't considering fusion as a possibility but the doctor is?
__________________
7/05 EMG/Nerve Conduction Tests 8/04 Disqualified from ADR clinical trial due to severe osteoporosis -- getting treatment 3/04 updated MRI 11/2000 IDET L 3/4, L4/5 1/2000 Discogram numerous epidural injections physical therapy
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#3
12-09-2005, 08:23 AM
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Maria,
Are you gonna wait for FDA approval for multilevel or are you leaning toward the fusion/ADR combination? Fusion at L5/S1 is not a bad idea at this level--very little movement. However, I completely understand your reservations about fusion. Your surgeon does bring up a good point about facet degeneration playing the waiting game. I would also investigate the SI exacerbation with fusion (SI issues can be elusive, tricky little boogers). Ultimately, it is your spine--do what makes sense for YOU--don't settle for something you are not 100% comfortable doing. Thanks for the update. Please keep us posted as we do care. Justin
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#4
12-09-2005, 09:31 AM
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Spotty,
thanks for info re BMD testing.. I'm not due per Medicare until spring/summer (have to wait 2 years from last one) but am switching to hub's BCBS plan so hopefully can get it done sooner. Before I do anymore testing w/discogram, I want the BMD test done just to make sure I'm even in a ballpark figure for "any" spine surgery~ Most recently the new WC claims manager had said I'd only seen Dr.s doing ADR trials so their desire was to get "trial candidates" and she wanted to refer me to a surgeon that was independant of trials... I refused this since I felt I can access just as much if not more info about who to go to where in LA and surrounding counties, and also my OSS isn't involved in trials and he recommended ADR for at least one level. MY OSS did say that in trials 2 level ADRs are doing as well as one levels, however, WC UR wasn't going to authorize multilevel ADR surgery for probably at least 3 plus years ... At least he voiced concern re the facet issue. I think as these surgeons are exposed over time to more that is being found out about TDR, they are learning what is important to try and r/o prior to offering/performing surgery. I did mention that I'd sought the mail opinions of Dr.Regan and Dr.B (x2) and both said I could have ADR at L5 and he said " WC isn't going to send you to Europe because UR isn't going to approve that trip"~ I had to laugh... so true... Oh yes, had a great PT person evaluate me, and I will find out more about the SIJ potential probs.. I am so sore from my Weds. session which was just an evaluation for rt.knee but much was done to eval. and try to relieve some discomfort in low back... now can't bend, can't squat, and lots of burning in low back, hips, and quads...
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