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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
08-23-2005, 10:03 PM
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After two denials from MD-IPA (owned by UHC), the US Office of Personnel Management - the final arbiter for patients covered under Federal Employee health plans - determined that MD-IPA did not apply the guidelines correctly as to what constitutes "experimental and investigational" and must provide coverage.
So I'll probably be getting a Charite from Dr McAfee sometime in November - October is booked with family outings, and I'm hoping if I wait a little while longer, the coated endplates will be available. What a relief.
__________________
Stan L5-S1 DDD and herniation 
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#2
08-23-2005, 10:20 PM
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Congrats...and yes smart to wait on the coated endplates. My spine problem was 11 yrs old at implantation!! Certainly you will not be waiting that long.
Laura
__________________
Charite @ L5,S1. W/Zeegers March 11, 05. Successful.
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#4
08-24-2005, 12:19 AM
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AWESOME STAN!!!! i am so proud of you! Nice to hear good news around here!
Way to go!
__________________
Kim Herniated disc L5/S1 2000 Discectomy 10/2003 Rhizotomy 8/2004 and 3/2005Discogram 11/04 grade 7 tear L5/S1 L4/L5 Grade 5 tear with herniation and stenosis Evaluated by Dr Blumenthal at TBI 2/2005 ADR 2 level recommended 2 level lumbar fusion
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#6
08-24-2005, 12:38 PM
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In my case, there are regulations that apply to individuals that are covered under the Federal Employee Health Benefits plan, so they may not be applicable in your case. Simply put, FEHB carriers are not allowed to classify a FDA-approved device as experimental, which is exactly what MD-IPA did - twice.
Laura, do you have any info on actual vs theoretical advantages of the coated endplates?
__________________
Stan L5-S1 DDD and herniation
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#8
08-24-2005, 08:10 PM
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Way to go, Stan! With your patience (more than Job!?) & sense of what's right for your cure, you won the right to reclaim your wellness!
BTW, not sure if the coating thing matters. You may recall all the topics on this we posted earlier. The issue of bio-reactive coatings sounds impressive (from an intellectual & marketing sense), but no one can answer the waiting game question but you. Either way, congrats -- brother Charite'! 
__________________
"Harrison" - info (at) adrsupport.org Fell on my ***winter 2003, Canceled fusion April 6 2004 Reborn June 25th, 2004, L5-S1 ADR Charite in Boston Founder & moderator of ADRSupport - 2004 Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006 Creator & producer, Why Am I Still Sick? - 2012 Donate www.arthropatient.org/about/donate
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#9
08-24-2005, 10:38 PM
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Fantastic news and great in setting a precedent!
Allan
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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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