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  #11  
Old 07-28-2016, 01:58 PM
nasakido's Avatar
nasakido nasakido is offline
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Join Date: Jun 2016
Posts: 127
Default Very True

@Romakis

You're right. And we have made our decision for the most part... just taking care of all the required testing before I go. As of today my Bone Density (DEXA) and x-ray (AP/LAT/EX/FLEX) is scheduled for August 1st, 2016, and my new MRI should be no later than the following week.

My Orthopedic Analysis Kit arrived yesterday, so I am planning on taking my Orthopedic Analysis Kit to my local clinic next week to get my blood drawn... so that will be done.

I paid for expedite service for my passport renewal and have that back.

I have to upload all these new tests so my final diagnosis can be made. All the doctors except Dr. Bierstedt have stated that they want to see these newer tests to make sure nothing in my imaging, etc. has changed. By then my diagnosis should be back from Dr. Zeegers. I am mainly getting diagnosis's from other doctors so I can get a consensus between what all these doctors are recommending, and comparing to what my two orthopedic surgeons here in Cali have stated in their reports. However I am pretty firm on Dr. Zeegers or Dr. Andreas Schmitz (just recently started looking into this man and really like him). Then I expect it will take me another week to wire transfer the funds (at least that is how long the wire transfer took to pay Dr. Zeegers diagnosis fee).

Once the funds clear I plan on leaving/flying out A.S.A.P. and am paying whatever price it costs to fly comfortably. If everything continues to go as is, I believe I can be flying out of here sometime in September... hopefully. I do not like to sit around idly. I pushed Workers Compensation and made appointments before they were approved to force results, and made sure everything got covered. That had it's negatives because they stopped treating me for 10 months, but not without me continuing to see doctors which is what ultimately made them want to reach settlement. I am going to stay on top of things here too.

But, you are right I need to make a quick decision, so I have to keep at this until I get my surgery.
__________________
Injury 31-7-14
MRI w/o con. 30-8-14
RT L5-S1 Discectomy w/ RT S1 Foraminotomy 21-11-14
PT (50) 20-8-14 to 04-24-15
MRI w/ con 13-4-15
XR Pelvis 08-6-15
COR INJ 02-7-15
MRI 14-11-15
Discography w/ CT-Scan 19-1-16
QME 16-2-16
XR LL 29-4-16
Bone Density (DEXA) Scan 01-8-16
XR LL 01-8-16
Metal-LTT 12-8-16
MRI 17-8-16
EKG 21-10-16
2-LVL L4-S1 ADR LP-ESP 08-11-16
XR LL 24-11-16
A-THX (24) 12-12-16 to 24-02-17
XR LL 31-01-17
XR LL 08-5-17
CT-Scan 07-6-17
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  #12  
Old 07-28-2016, 04:56 PM
Cynlite's Avatar
Cynlite Cynlite is offline
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Join Date: Mar 2015
Posts: 666
Default

I purchased my airline ticket with about 10 days notice to Europe this past May. I used a discount broker for business class tickets. Here is the one I used but, you can also Google it and find a couple of others. They should be able to save you about 60% off the price the airline websites will charge. I talked to two discount brokers and they came in exactly the same. Mike dropped his price $100 to undercut his competition. The competition was pretty upset with me but, I didn't have time to mess around with it anymore and I was more impressed with Mike's professionalism. (I started my dialogue and emails with Mike in 2015 but, then my surgery got delayed 10 months.)

Michael Flores
Mobile
(415) 424-8940
Work
(888) 624-6133
Work
Mike@wholesaleflights.com

I'm not sure where you live but, I live on the west coast. Three legs of my trip were definitely business class and very comfortable. Delta put me on an old airline for the 5 hour flight from the east coast to home on the return flight and it was awful. Truly, the experience was pretty comparable to coach and I was in a lot of pain. I recommend you can get the model/age of the aircraft confirmed for all legs of your trip if you have the time and energy when you are ticketing. Also, be sure to tell them you want a transatlantic flight where the seats will lay completely flat. (I just screwed up and forgot to check the domestic aircraft ahead of time.) Delta's transatlantic flight was really nice in the pods where you can lay down. They did give me some money back on the last leg after I complained to them but, I would rather have been comfortable flying home which was the purpose of paying close to $4000 for an airline ticket. The airlines were quoting over $10,000 at the time! I checked prices on a ticket back to Barcelona for April 2017 recently, and Mike's price was still just under $4000 so, I'm not sure advance notice helps at all like it usually does when buying airline tickets from the brokers.

British Airlines is supposed to be one of the best international carriers if you have miles or American Express points to offset the cost.

When I wired my funds, I had confirmation from my bank later the same day. I then emailed the confirmation number to Yolanda. Dr. Clavel's office was able to confirm the wire the next day which may have been 48 hours on my end because of the time difference. I can't remember exactly. It should never take a week to wire funds because it's all electronic and that is why you pay a $50 wiring fee.

It will be interesting to see what Dr. Zeeger's diagnosis is for you compared to the other surgeons. Dr. Zeegers has a good track record for his lumbar patients on this board! Good to see Dr. Clavel's opinion is in the pack. I trusted him the most but, I was a cervical patient and that may make a difference. Both Dr. Bierstedt and Dr. Zeegers told me two ADRs while Dr. Clavel said I needed to replace three. Having said that, Dr. Zeegers was not certain I was an ADR candidate! He was extremely conservative when discussing my case. Because he wanted even more than the updated MRI, X-Ray and a nuclear test done, I never did get a final opinion from him. He is definitely conservative in his approach! In the end, I definitely took a leap of faith because I couldn't get any of the surgeons to completely agree on what I needed done. I'm glad you have having better luck with that!

I'll look forward to reading your future posts. You are on the home stretch! Best of luck for an easy recovery.
__________________
2006: epidural shots did nothing; 2 surgeons recommended 2 level fusion, I declined.
2007 - 2010 4 foraminotomy and cord decompression cervical surgeries and 2 endoscopic discectomy T7-T8 surgeries; total 6 with Dr. Jho (Pittsburgh,PA) My C6/C7 autofused around 2009.
2013 - 2015: epidurals 3 times (again did nothing) and 4 Radiofrequency ablation (or RFA) procedures.
2016 more RFAs, hit the 10 year mark of this insanity and pain, 3 level M6-C ADR with Dr. Clavel May 19, 2016
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  #13  
Old 08-12-2016, 02:38 PM
nasakido's Avatar
nasakido nasakido is offline
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Join Date: Jun 2016
Posts: 127
Default Uh oh...

If I am understanding my Orthopedic Analysis Orthopedic Panel 2 Metal-LTT test correctly, I will "most" likely develop issues with Cobalt alloy, Titanium alloy and Nickel. So does this mean any implant with Cobalt alloy or Titanium alloy is a "No-Go" for me? What would be my options then? To make sure the disc is 100% Titanium or 100% cobalt. Or fusion or just deal with implant pain or even do nothing, and live the way I am?

If I were to take a chance, I would say compared to the pain I am in now, the mild reaction would not be as bad. However, it most likely would introduce other issues that I would have no way of gauging the type of pain, if any, I would feel due to the implants. You no what... this will not stop me. I have lived with Leg Perthes since the age of six and have never had a day without pain. From six to seven I spent almost every night crying and in pain. I am pretty tough now, and I can mentally overcome pain. I just can't make my body do what it can't do because of my injury. I wonder...hmmm.

What is the worst this reaction could do to me?

Control cpm >> 795.3

Positive control (PHA) cpm >> 63632.0

Bone Cement (monomer) >> 1.3

Bone Cement particles >> 0.8

Cobalt alloy particles >> 2.4

Titanium alloy particles >> 3.2

Known Stimulant (PHA) >> 80.0

Aluminum 0.001 mM >> 1.8
Aluminum 0.01 mM >> 0.5
Aluminum 0.1 mM >> 1.4

Cobalt 0.0001 mM >> 0.9
Cobalt 0.001 mM >> 1.0
Cobalt 0.01 mM >> 0.4

Chromium 0.001 mM >> 0.8
Chromium 0.01 mM >> 0.7
Chromium 0.1 mM >> 0.8

Molybdenum 0.001 mM >> 1.1
Molybdenum 0.01 mM >> 1.8
Molybdenum 0.1 mM >> 0.7

Nickel 0.001mM >> 0.8
Nickel 0.01 mM >> 11.0
Nickel 0.1 mM >> 19.2

Vanadium 0.0001 mM >> 1.8
Vanadium 0.001 mM >> 0.8
Vanadium 0.01 mM >> 1.1

Zirconium 0.001 mM >> 0.8
Zirconium 0.01 mM >> 0.8
Zirconium 0.1 mM >> 0.4

Iron 0.001 mM >> 1.0
Iron 0.01 mM >> 0.7
Iron 0.1 mM >> 0.3

- - - - - - - - - - - - - -

Cobalt Alloy Particles @ 2.4 is Mildly Reactive

Titanium Alloy Particles @ 3.2 is Mildly Reactive

Nickel @ 19.2 is Highly Reactive
__________________
Injury 31-7-14
MRI w/o con. 30-8-14
RT L5-S1 Discectomy w/ RT S1 Foraminotomy 21-11-14
PT (50) 20-8-14 to 04-24-15
MRI w/ con 13-4-15
XR Pelvis 08-6-15
COR INJ 02-7-15
MRI 14-11-15
Discography w/ CT-Scan 19-1-16
QME 16-2-16
XR LL 29-4-16
Bone Density (DEXA) Scan 01-8-16
XR LL 01-8-16
Metal-LTT 12-8-16
MRI 17-8-16
EKG 21-10-16
2-LVL L4-S1 ADR LP-ESP 08-11-16
XR LL 24-11-16
A-THX (24) 12-12-16 to 24-02-17
XR LL 31-01-17
XR LL 08-5-17
CT-Scan 07-6-17
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  #14  
Old 08-12-2016, 03:47 PM
nasakido's Avatar
nasakido nasakido is offline
Senior Member
 
Join Date: Jun 2016
Posts: 127
Default AxioMed Freedom Lumbar Disc

This looks promising except it definitely is Titanium Alloy.

http://www.axiomed.com/pdf/WPaperBiocomp.pdf
__________________
Injury 31-7-14
MRI w/o con. 30-8-14
RT L5-S1 Discectomy w/ RT S1 Foraminotomy 21-11-14
PT (50) 20-8-14 to 04-24-15
MRI w/ con 13-4-15
XR Pelvis 08-6-15
COR INJ 02-7-15
MRI 14-11-15
Discography w/ CT-Scan 19-1-16
QME 16-2-16
XR LL 29-4-16
Bone Density (DEXA) Scan 01-8-16
XR LL 01-8-16
Metal-LTT 12-8-16
MRI 17-8-16
EKG 21-10-16
2-LVL L4-S1 ADR LP-ESP 08-11-16
XR LL 24-11-16
A-THX (24) 12-12-16 to 24-02-17
XR LL 31-01-17
XR LL 08-5-17
CT-Scan 07-6-17
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  #15  
Old 08-12-2016, 04:16 PM
nasakido's Avatar
nasakido nasakido is offline
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Join Date: Jun 2016
Posts: 127
Default FH Orthopedics

And for the FH Orthopedics LP-ESP (Elastic Spine Pad) I found the following:

"The prosthesis has raised teeth, making it possible to guarantee primary fixation between the vertebrae concerned. A porous, rough HAP (hydroxyapatite) coating on the undercoat of pure titanium (T40) ensures effective secondary fixation.

Ribs, joined to the metal parts, make it possible to transform any movement of rotation between the two metal parts into compression and traction forces on the deformable inner part."

This information was found http://www.fhorthopedics.com/lombar-disc-lp-esp.html

OR

http://www.fhorthopedics.com/index.p...action=Display
__________________
Injury 31-7-14
MRI w/o con. 30-8-14
RT L5-S1 Discectomy w/ RT S1 Foraminotomy 21-11-14
PT (50) 20-8-14 to 04-24-15
MRI w/ con 13-4-15
XR Pelvis 08-6-15
COR INJ 02-7-15
MRI 14-11-15
Discography w/ CT-Scan 19-1-16
QME 16-2-16
XR LL 29-4-16
Bone Density (DEXA) Scan 01-8-16
XR LL 01-8-16
Metal-LTT 12-8-16
MRI 17-8-16
EKG 21-10-16
2-LVL L4-S1 ADR LP-ESP 08-11-16
XR LL 24-11-16
A-THX (24) 12-12-16 to 24-02-17
XR LL 31-01-17
XR LL 08-5-17
CT-Scan 07-6-17
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  #16  
Old 08-12-2016, 04:59 PM
Cynlite's Avatar
Cynlite Cynlite is offline
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Join Date: Mar 2015
Posts: 666
Default

Wow, I feel for you. I and Old Codger are the only ones I know of that have gone through the metal allergy nightmare!

I spoke to the "PhD in Immunology" in the lab at Orthopedic Analysis about their test before I sent them my blood. (Sorry, I don't remember his name. I left him a message through the receptionist there and he called me back.) He was very knowledgeable and helpful! I think it would be worth giving him a call. I can thank him for me getting my M6-C's! I was in the same situation as you for about 10 months before I figured out that my first MELISA metal allergy blood test was crap. It was the PhD that pointed me in the right direction because he understood the results of my first test. You need to understand the test results as they relate to the implant you want to get and the only way I was able to puzzle this out was by talking to the PhD plus, seeing an orthopedic surgeon who looked at the titanium I already have in vivo.

Your test is non reactive for Chromium, Molybdenum and Cobalt which is what the Mobi-C is made out which is a cervical ADR that is not Titanium. The same metals are in the Prodisc ADR. I don't know what is in the "Cobalt Alloy Particles" that they grind up for their test but the PhD will know. You are more reactive to Titanium so, I would be considering discs that don't have much of it or none of it in them. I am mildly reactive to Aluminum (2.1) but, since the M6-C has so little of it in the end plates, I wasn't concerned about it. The M6's are made up of primarily Titanium. So, in the end, even though I was mildly reactive to one of the metals, I made the decision to get the surgery. It was a judgment call. My last thought on this is that for Titanium they had to use the particles because Titanium is not liquid so, they couldn't just put it in a dropper and drop some on the blood. They had to use particles. This takes me back to wondering what is in the "Cobalt Alloy Particles."

http://myspineassociates.com/wp-cont...ient_Guide.pdf

I'm not sure what the composition of metals are for the Activ L but, I would check before you call Orthopedic Analysis and ask to speak to the PhD there. It has titanium in it but, the question is how much? The manufacturer will be able to give you the breakdown. Dr. Clavel had the breakdown from the manufacturer for the M6's so, that's how I got that information.

https://www.aesculapimplantsystems.c...n_Brochure.pdf

Have you spoken to Dr. Zeegers about the Activ L or your test results? One thing I learned when my first metal allergy test came back positive for me being reactive to Titanium is that the surgeons will drop you like a hot potato, so do not show them the test results until you completely understand it yourself. They don't understand these tests because metal allergies are rare according to them but, at the same time, they don't want to take a risk on you. They have other patients lining up for surgery! Dr. Zeegers and two other surgeons in the U.S. dismissed me pretty fast after they saw my first blood test and that was the end of that.

It took me months to research and figure out the problem with the first test. Once I proved to myself that I was not allergic to Titanium, I went back to Dr. Clavel. However, I had doctor's notes from an orthopedic knee surgeon from where I live that said it was his opinion I was not allergic to that metal. I have titanium screws in my knee and had to have an MRI of my knee, x-rays of my knee and several appointments with the doctor before we came to that conclusion. Do you have any metal already in your body?

This is not an exact science and it was very hard for me to find doctors that knew anything about it. I even went to an allergist who basically said the blood tests for metal allergies are worthless. Don't give up and don't share the test with the surgeons yet. I think you need to know what is in the "Cobalt Alloy Particles" first.

Here is my post #169 regarding metal allergies. Not sure if it has anything in it that will help you but, it has some of my research in it. https://www.adrsupport.org/forums/sh...=13049&page=17

Here is what I ended up with:

Particles: all were Normal

Ions:
Aluminum 2.1 (Mildly Reactive)
Chromium 2.1 (Mildly Reactive)
Nickel 47.7 (Highly Reactive)
Zirconium 2.3 (Mildly Reactive)
__________________
2006: epidural shots did nothing; 2 surgeons recommended 2 level fusion, I declined.
2007 - 2010 4 foraminotomy and cord decompression cervical surgeries and 2 endoscopic discectomy T7-T8 surgeries; total 6 with Dr. Jho (Pittsburgh,PA) My C6/C7 autofused around 2009.
2013 - 2015: epidurals 3 times (again did nothing) and 4 Radiofrequency ablation (or RFA) procedures.
2016 more RFAs, hit the 10 year mark of this insanity and pain, 3 level M6-C ADR with Dr. Clavel May 19, 2016
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  #17  
Old 08-12-2016, 06:16 PM
nasakido's Avatar
nasakido nasakido is offline
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Join Date: Jun 2016
Posts: 127
Default @cynlite

@Cynlite

I did email Dr. Zeegers my results and he replied with this:

"http://www.healio.com/orthopedics/journals/ortho/2016-5-39-3-supplemental/%7B92d802e1-1cb3-4b04-9394-08d84e60916e%7D/influence-of-surface-coating-on-metal-ion-release-evaluation-in-patients-with-metal-allergy

http://www.orthopedicanalysis.com/about-us/testimonials

http://www.kreuzschmerzen.org/en/pre...sufferers.html

http://www.spineart.com/product-plat...era%C2%AEl/128

etc. etc. etc.
the clinical relevance of your mild reaction is not clear at all !"


But I don't think I have a real issue, yes with Titanium Alloy, but not with pure Titanium... the allergic reaction is not necessarily because of the Titanium alone, it is because Titanium is mixed with metals such as Aluminum, Tin, Vanadium, Palladium, Molybdenum, Chromium, etc.

I may be all wet here, but pure Titanium should not be an issue for most people.

FH Orthopedics LP-ESP uses pure CP Grade 2 Ti40 Titanium, and it is not mixed with any other alloys to my knowledge. Adding to what I already stated above about the LP-ESP, Hydroxypatite is found in our teeth and bones so it is naturally a good choice as the top coating over the Ti40 undercoating. This is my first choice. And any chances of corrosion from occurring when introduced into my body should be negligible.

I have looked into the other discs, and I do not want the ProDisc or Activ-L (bio-mechanics are not that great... one can cause hyper-flexion, and the other limits your range of motion to not being able to go side to side), nor the M6-L because it does not cover the entire surface of the bone, and can potentially result in facet joint issues later on.

I will continue to do more reading, and check out the links you provided. And I will call first thing Monday morning to get a better understanding of what my results imply.

And "no" I do not have any metal in my body as far as implants or screws go unless it was done without me knowing... queue eerie music...

Well actually everyone does from what they eat... hahaha.
__________________
Injury 31-7-14
MRI w/o con. 30-8-14
RT L5-S1 Discectomy w/ RT S1 Foraminotomy 21-11-14
PT (50) 20-8-14 to 04-24-15
MRI w/ con 13-4-15
XR Pelvis 08-6-15
COR INJ 02-7-15
MRI 14-11-15
Discography w/ CT-Scan 19-1-16
QME 16-2-16
XR LL 29-4-16
Bone Density (DEXA) Scan 01-8-16
XR LL 01-8-16
Metal-LTT 12-8-16
MRI 17-8-16
EKG 21-10-16
2-LVL L4-S1 ADR LP-ESP 08-11-16
XR LL 24-11-16
A-THX (24) 12-12-16 to 24-02-17
XR LL 31-01-17
XR LL 08-5-17
CT-Scan 07-6-17
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  #18  
Old 08-12-2016, 06:39 PM
nasakido's Avatar
nasakido nasakido is offline
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Join Date: Jun 2016
Posts: 127
Default Baguera-L

And there is also the Baguera-L

http://www.spineart.com/product-plat...era%C2%AEl/128

This should also be an excellent choice because it uses pure Titanium. Dr. Zeegers just pointed this one out to me.
__________________
Injury 31-7-14
MRI w/o con. 30-8-14
RT L5-S1 Discectomy w/ RT S1 Foraminotomy 21-11-14
PT (50) 20-8-14 to 04-24-15
MRI w/ con 13-4-15
XR Pelvis 08-6-15
COR INJ 02-7-15
MRI 14-11-15
Discography w/ CT-Scan 19-1-16
QME 16-2-16
XR LL 29-4-16
Bone Density (DEXA) Scan 01-8-16
XR LL 01-8-16
Metal-LTT 12-8-16
MRI 17-8-16
EKG 21-10-16
2-LVL L4-S1 ADR LP-ESP 08-11-16
XR LL 24-11-16
A-THX (24) 12-12-16 to 24-02-17
XR LL 31-01-17
XR LL 08-5-17
CT-Scan 07-6-17
Reply With Quote
  #19  
Old 08-13-2016, 09:52 PM
phillyjoe phillyjoe is offline
Senior Member
 
Join Date: Jan 2013
Posts: 286
Default Comparison of ADRs

I found this referenced site as marketing materials on the web. They appear to have been part of Spinal K's training of its sales force to show the benefits of the M6 over other ADRs. Maybe someone finds it useful in looking at various ADR's


http://www.spinalkinetics.com/wp-con...ompetition.pdf
__________________
Pre Surgery:
C3-C4:Mild disc osteophytes. Mild-moderate right facet arthrosis. Mild right foraminal stenosis.
C4-C5:Midline central disc protrusion, significant. Mild canal stenosis.
C5-C6:Moderate disc osteophytes. Mild-moderate canal stenosis. Moderate-severe bilateral foraminal stenosis.
C6-C-7:Mild-moderate disc osteophytes. Mild canal stenosis. Moderate left and moderate-severe right foraminal stenosis.
June 29,2016-3 level M6 (C4-C7) Dr. Clavel Barcelona
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  #20  
Old 08-19-2016, 03:00 PM
nasakido's Avatar
nasakido nasakido is offline
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Join Date: Jun 2016
Posts: 127
Default M6 or not

I received a response from Dr. Zeegers after sending him the referenced document / marketing of the M6 disc. Before I post his response I wanted to add that I completely agree with his initial assessment as I too have concluded what he asserts. The M6 is not a bad disc, it is just not superior to other choices out there. It appears that Dr. Zeegers really likes the Activ-L. But, there is the LP-ESP, the Freedom and the Baguera-L that are excellent choices as well.

"
HAVE TO STUDY all 64 pages pdf doc, but in a glimpse i do not see any superiority of M6L over Activ L
- the so called compression=damping effect has never been proved as significant.
- cannot find really custom sizes of M6 implant, 2 sizes medium 35mm W x 27mm and large 39x30 only! (undersizing risk !)
- no special M6 implant design for L5S1 (remnant L5S1 problems !)
- the instrumentation tools from M6 are absolutely inferior to Activ L (no oblique approach, no reliable revision tools)
+ for example see superior size offer in Activ L discs in brochure pdf
+ for example see superior instrumentation offer in Activ L brochure pdf
regards zeegers
"

Regards,
Nathan

Note: This hour of suffering... Part 32 - The End in Sight
__________________
Injury 31-7-14
MRI w/o con. 30-8-14
RT L5-S1 Discectomy w/ RT S1 Foraminotomy 21-11-14
PT (50) 20-8-14 to 04-24-15
MRI w/ con 13-4-15
XR Pelvis 08-6-15
COR INJ 02-7-15
MRI 14-11-15
Discography w/ CT-Scan 19-1-16
QME 16-2-16
XR LL 29-4-16
Bone Density (DEXA) Scan 01-8-16
XR LL 01-8-16
Metal-LTT 12-8-16
MRI 17-8-16
EKG 21-10-16
2-LVL L4-S1 ADR LP-ESP 08-11-16
XR LL 24-11-16
A-THX (24) 12-12-16 to 24-02-17
XR LL 31-01-17
XR LL 08-5-17
CT-Scan 07-6-17
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