Alternatives to US, Spain & Germany

[joewtny]

Hi folks. After 4 years of widespread central nervous system issues, I was recently diagnosed with a herniated C4/5 and C5/6 with accompanying osteophytes. Unfortunately, my COBRA ran out a year ago, and the top rated local Virginia Spine Institute wants $32k total (which I don't have) for fusion: $20k cash up front for Reston Hospital (for one night?!?), $10k cash up front for the surgeon and $2k for anesthesiologist. They also offer a hybrid fusion w/Brian artificial disc, but that would have been even more out of my reach financially.

Nerdwallet has a tool to search various operations at over 1,000 hospitals nationwide and learn how many patients they do each operation on per year, how much they charge and patient satisfaction percentage. In searching for "surgical spinal fusion of the neck without complications", of the cheapest 24 hospitals nationwide, 14 of them were in Maryland. Unfortunately, a lot of people have reported problems with Maryland spine surgeons, including some on this site, so I'm a little leery there. I did contact one who operates through Johns Hopkins, but he wanted $750 just for the first visit.

Of course, if I had $30k-40k dollars, I'd be looking at the oft-mentioned Dr. Bierstedt in Germany or Dr. Clavel in Spain. I did contact "Gelenk Klinik" in Germany, and a Dr. Haberstroh sent back a "cost prediction" for two ADR's of 15,444 euros for the klinik ($20,588), 2,500 euros for anaesthesia $3,333), 3,000 euros for the doctor ($4,000), 4,000 euros down payment ($5,333) for a grand total of 20,944 euros ($27,920). Better, but still out of my range.

One option is to wait four months until Obamacare kicks in, and the insurance companies have to stop rejecting me for this pre-existing condition. But who knows what a mess that will be starting out, and how many more months I may have to wait after January 1 to get approval from my new insurance company. I would still be looking at a high deductible and 20 percent co-pay. And then approval for what? Fusion? ADR's? Hybrid? What do you think the odds are that they will have to cover artificial discs, or whether they will continue to point to the "gold standard" of fusion? Probably fusion.

So if I want discs over fusion anytime soon, I have to look at other alternatives. Has anyone heard of any experiences recently, positive or negative, of ADR's in other countries, such as Thailand, Singapore, or India? The rupee is plunging (69 to 1 as of today), so I'm especially looking at India. Getting 2 discs from the best surgeons in India for less than $10k sounds good. Friends and relatives freak out when I mention it, but apparently some of their hospitals are world class, and it seems one-fourth of the local doctors here in DC are Indian anyway, so it can't be that different.

Looking at online resumes of the 2 or 3 top Indian surgeons who are advertised through medical tourism sites and YouTube clips, they claim extensive experience with ADR operations. One claims over 2000 spine operations (1500 primary and 500 revisions--not sure what he was revising, but I've asked him) and 150 ADR's. So I'm asking, has anyone heard anything positive or negative about ADR surgery in India? Thanks for your help!

Joe

[jss]

Joe,

The only person I know of that's had spine surgery in India is on this site and goes by the handle, jmichaeldail. He doesn't post much, but he's very helpful and would probably reply if you PM'd him.

Good luck, Jeff

[joewtny]

Thanks. I'll try to contact him.

[Jerry5]

Artificial Spinal Disk Replacement Abroad | Cost of Artificial Spinal Disk Replacement in India, Mexico, Spain & Costa Rica

These are possibilities, my wife is from Thailand, and I have done searches, but I am not sure this M6 has made it there, they are doing some M6C in Korea.

Do your research.

Jerry

[joewtny]

Thanks, I never thought of Korea. As for these medical tourism companies, I've heard bad things about some. Are any better or more honest than the others? Is it better than finding the best surgeon yourself and making your own arrangements? I assume being a middleman, they must add to the cost somehow.

[jss]

Joe,

I don't know the answer to you question but do know of two reputable firms that hook patients up with international doctors; planethospital.com and healthbase.com

Be aware that these firms make money by scheduling you for services by an international provider. They are reputable in that there is little or no possibility that you'll wire money into a non-traceable black hole and receive no services. However, I very much doubt that they can assure you an excellent healthcare provider. It will be your responsibility to verify that provider's quality. They only see that you get services for your money.

Make sense?

Good luck, Jeff

[Harrison]

I would urge you to NOT go to any hospital in SE Asia. See this page:

An introduction to The American Medical Money Machine and the Rise of Medical Tourism

What the author endured with his son's unspeakable death is heartbreaking. But the investigative journalism that he performed benefits all of us. Take a look at this page.

[joewtny]

I think I read through that page a while back, and I found several other similar pages about patients who experienced nightmares, such as a woman whose face was disfigured by a plastic surgeon in Thailand. It can certainly be difficult to interface with foreign surgeons, find good ones and be fairly assured of satisfaction with language barriers, differences in customs, and the effect of peoples' opinions around the world in general about Americans at any given time.

It just seems that with 7 billion people on this planet, and many of them experiencing aging and injury to their necks and spines, there should be more qualified surgeons to do this surgery than the tiny handful of names we normally hear about here. This would also help keep that handful from becoming totally overloaded, maintain a high level of quality, as well as help keep the cost of the operation from going even further through the roof. But it looks like there's no such type of international list or registrar for this specialty (yet).

[Jerry5]

There are bad surgeries in EVERY country, and it would do one well to get a referral, or get to know the doctor.

Personal Experience, I have had surgery in Thailand, and it was top rate, full anesthesia, and so on, so this may not be a fair assumption, the biggest problem, is after care, if you cannot stay for several days, to make sure you are healed, then don't do it, personally, I would not have plastic surgery anywhere.

Next point, ADR, I sent my discs (MRI Flexor xrays) to Dr Clavel and Bierstedt, there are others, but you need a Dr, that has more than a few of these under their belts, to get insurance on board, and to let them know this has established efficacy.
Make sure you document all care in the USA, get a letter from the Dr you are consulting with, how many of these they have done, the ICP (diagnoses) and the CPT (treatment) codes, then make sure that the Insurance company knows this ADR (M6 L or others) is "NOT" Investigational in the EU.

There have been tens of thousands of the M6 disc put in with no complications, maybe I should start a thread here to see if anyone can document, any problems with the M6 from Spinal Kinetics.

All the best,

Jerry

[Surprised 1]

Joetwny,

Given your situation you might try looking at clinicaltrials.gov. Someone just posted that two level cervical with the Mobi C was just approved and I would strongly suspect that this will open the door for other devices to get approval to start clinical trials. Best of luck to you.