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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  
Old 06-24-2008, 02:30 AM
JasonR JasonR is offline
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7/11
Saw Dr Heller yesterday at the Emory Spine Clinic here in Atlanta and was impressed. He wants another MRI as mine is a year old and an epidural CT scan. He said my case is not clear cut right now because while I clearly have DDD, it's not clear that the nerves at C5/6 are being compressed.

He wants me to keep fusion on the table as an option but I got the impression he was leaning towards ADR. To his credit, he wants as much information as possible before recommending a path. I got the impression that he wants a successful surgery, not just another notch in his disc replacement belt.

My follow-up appointment is August 14. I have the MRI, then the CT scan, then meet with him. He did suggest I contact the insurance company today to find out what their policy on artificial cervical discs now.

Now for the truly great news. I called the insurance company and they said ADR is apporved based on medical necessity! So at least if he recommends ADR, there shouldn't be much, if any, kind of fight.

Side note: Dr Heller indicated that the Bryan cervical disc should get FDA approval in the next 1-3 months.

Regards,
Jason


Hello all. How lucky am I to have found this resource!

After 10 years of believing that I was suffering from tension headaches coupled with carpal tunnel, I was diagnosed last summer as having advanced DDD at C5/6. PT only made the pain worse so the Dr recommended surgery as the last resort.

I've learned which activities I can and can't do based on how I'll feel afterwards. No roller coasters, water skiing, doing house work that requires me to lift my arms above my head and many forms of exercise.

If I avoid the activities then for the most part ibuprofen keeps the pain manageable. 800-1600mg is my normal daily dosage.

I'm torn about getting the surgery. On one hand I'm managing the pain better than I ever have before. On the other, my activities are severely limited and will only get more limited as the kids get older.

I'm making an appointment for a 2nd opinion with a Dr at the Emory Spine Center here in Atlanta. A firend who's a Dr in their pain management group recommended him so hopefully I can get in to see him.

This is a great site and excellent resource though and I'm definitely glad I found it. Thanks to everyone who has shared their experiences!

Forgot to mention, I'm 34 with no other significant health concerns.

Regards,
Jason
__________________
DDD C5/6. Incorrectly diagnosed as tension headaches in September 1997.
Nearly continuous headache since.
Began having pain in wrists in 2000, believed it was onset of carpal tunnel.
In 2005 pain began getting worse.
Diagnosed as DDD in July 2007.
Surgery recommended after 6weeks of PT made the pain worse.
ADR scheduled for Jan 26, 2009. Rescheduled for August 5!
Bryan disc finally FDA approved, and just in time too.
Neck was all jacked up and had to be fused unfortunately.
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  #2  
Old 06-24-2008, 03:47 AM
Dave C Dave C is offline
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Join Date: Mar 2008
Posts: 153
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Jason,

Welcome!
You have a major decision to make regarding your health. This "is" the place for you to do your homework. Tons of friendly people here. Good luck and ask a lot of questions.

Peace,
__________________
Dave

Diagnosed with DDD in Nov, 2007. MRI, EMG
C3/4 C4/5 C5/6 C6/7
Surgery 06.04.08--C5/6 and C6/7 with Prodisc was a success.
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  #3  
Old 06-24-2008, 06:05 AM
JasonR JasonR is offline
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I'm curious if anyone has had surgery done when the primary symptom was headaches? I get pain in my arms and hands too but the headaches are what really get to me.

I've read that fusion was not as successfull at resolving headaches as it was the radiating arm pain. Is ADR the same or has it had better success at reducing the headaches.

Thanks,

Jason
__________________
DDD C5/6. Incorrectly diagnosed as tension headaches in September 1997.
Nearly continuous headache since.
Began having pain in wrists in 2000, believed it was onset of carpal tunnel.
In 2005 pain began getting worse.
Diagnosed as DDD in July 2007.
Surgery recommended after 6weeks of PT made the pain worse.
ADR scheduled for Jan 26, 2009. Rescheduled for August 5!
Bryan disc finally FDA approved, and just in time too.
Neck was all jacked up and had to be fused unfortunately.
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  #4  
Old 06-24-2008, 09:50 AM
Don Don is offline
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Join Date: Jul 2006
Posts: 173
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Jason,

Welcome to the site and good luck. You should get some great advice here.

Have the doctors said if they feel that inflammation from the bad disc is what causes the headaches? I think it would be good to talk to several surgeons that have a lot of spinal surgery experience and see if any of them have any experiences that can help determine if surgery could help relieve the headaches.

Your concern is the same as all of ours. Will surgery help with my condition and relieve the symptoms or will it make things worse or permanently the same? If there were only a way to know in advance. Good luck with getting in for the second opinion.

Don
__________________
Don G.

3 level DDD L5-S1 through L3-L4.
"Compressed" L5-S1 in ~1992.
Herniation at L3-L4 and L4-L5
Fusion or ADR in near future
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  #5  
Old 06-25-2008, 06:21 AM
LBP LBP is offline
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Posts: 446
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Be very careful of how long you take larger doses of Ibuprofen every day! Has any dr frowned upon this? There is a reason.

Before I really knew what was wrong I was taking a lot of it and PT and PCP's told me not to do it but I felt like I had to and they weren't giving me any options.

Well as a result, I started poping Tums like candy and it turned out that I had damaged my esophagus (chronic GERD with a hiatal hernia) and now require one of the Protien Pump Inhibitor medicines every day. My med is called AciPhex. It's not cheap medicine!

There are other pain meds that are much more gental for long term chronic pain while you contemplate surgery.

I ended up using Tramadol daily, sometimes with Neurontin and for break through pain days I took Vicodin. No more NAISD's! Just a heads up. You might be hurting your body in the long run.

Also, just one question...do you go to the dentist on a regular basis? I didn't make the connection with my headaches until after I found out I needed a root canal. As soon as that was treated, my headaches went away. I realize cervical disc issues can be very different than lumbar disc problems but it's a possibility. I was blamming the headaches on my lack of sleep from back pain. I was wrong.
__________________
Injured 9/01
Annular tears L4/5 & L5/S1
denied adr by insurance for 2 level charite as well as hybrid fusion at L5/S1 with Charite at L4/5.

New ins paid for 2 level lumbar prodisc surgery on 4/7/08 (at age 39) with Dr. Westerlund, at Core Orthop
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  #6  
Old 06-25-2008, 08:34 AM
Twiz77 Twiz77 is offline
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Hi Jason- welcome to the board. Good luck on your search for answers.

I too am going through the round of meeting with drs.

My 2 cents worth is - get as many opinions as you can on this - as I figure more eyes on the films and my questions - the better.

Best of luck to you.

Lisa
__________________
Aug 2007 - diagnosed with DDD at C5-6 - herniated disk with mild stenosis at right/central of cord - but pain/occasional numbness mostly on the left side - and down into the leg/foot - which has puzzled doctors - even had a lumbar puncture - but thankfully all clear!
May 2008- after many months of no symptoms and issues- flare up- and new MRI shows moderate stenosis.
L4-5 small annular tear with some DD
Big fan of massages and acupuncture to help with muscle tightness/pain.
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  #7  
Old 07-11-2008, 06:11 AM
JasonR JasonR is offline
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Posts: 71
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Updated.
__________________
DDD C5/6. Incorrectly diagnosed as tension headaches in September 1997.
Nearly continuous headache since.
Began having pain in wrists in 2000, believed it was onset of carpal tunnel.
In 2005 pain began getting worse.
Diagnosed as DDD in July 2007.
Surgery recommended after 6weeks of PT made the pain worse.
ADR scheduled for Jan 26, 2009. Rescheduled for August 5!
Bryan disc finally FDA approved, and just in time too.
Neck was all jacked up and had to be fused unfortunately.
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  #8  
Old 08-15-2008, 07:14 AM
JasonR JasonR is offline
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Join Date: Jun 2008
Posts: 71
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Another update:

I had a CT and MRI yesterday before meeting with my doc again. No problems with the facets and clear single-level DDD between C5/6. He said there was very slight cord impingement but nothing severe.

He pushed fusion fairly hard since i complain mostly about neck pain/headaches. But I explained to him that I just don't do the activities anymore that aggravate my arm pain with the exception of exercise. Even then, I limit which exercises I do.

Once I made it clear that I preferred ADR he was supportive. I think the fact that he's involved in the Bryan disc makes him push fusion so there's no chance that he gets accused of a conflict of interest. I respect him for that.

Anyway, I call first week of September to schedule surgery. Insurance approval may be tricky since neck pain is the chief complaint. I guess I'm not the "ideal" ADR candidate. Dr Heller did say though that some of his european colleagues have had success treating neck pain with an ADR.

I'm hoping that at worst I can resume a normal life and level of activities even if the neck pain isn't resolved. I can live with the neck pain if it means I can resume normal activities.

I do wonder though if I'm jumping the gun on surgery. While the pain is real it's become more of a quality of life issue than anything else. I can still work full time and the pain rarely incapacitates me. Compared to others on this site who had significant radiculopathy mine seems very minor considering I can avoid it most of the time.

I guess my question is whether surgery is worth it just for a lifestyle change. Or have I become so used to the pain over the last 11 years that I don't know how nice it would be to not have it? I'm still inclined to do the surgery and would rather do it now when I'm 35 and relatively healthy vs waiting until it could become debilitating.

Opinions?
__________________
DDD C5/6. Incorrectly diagnosed as tension headaches in September 1997.
Nearly continuous headache since.
Began having pain in wrists in 2000, believed it was onset of carpal tunnel.
In 2005 pain began getting worse.
Diagnosed as DDD in July 2007.
Surgery recommended after 6weeks of PT made the pain worse.
ADR scheduled for Jan 26, 2009. Rescheduled for August 5!
Bryan disc finally FDA approved, and just in time too.
Neck was all jacked up and had to be fused unfortunately.
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  #9  
Old 12-09-2008, 06:00 PM
JasonR JasonR is offline
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Join Date: Jun 2008
Posts: 71
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Ok, another update.

My surgery is tentatively scheduled for January 29. I've been getting more pain shooting down into both arms but still primarily the right arm. This matches the MRI results. My Dr also said that my right arm is definitely weaker than my left. This worries me since I'm right-handed. So the insurance battle now begins.

The Dr has said that in his opinion I fit the criteria for ADR and do not fit any of the exclusion criteria. I'm hopefull this will make insurance approval easy but realize that's probably a pipe dream. My insurance company has said that the procedure is supported as long as it's medically indicated. My Dr's nurse, though told the same thing, was also told it's approved on a case-by-case basis and wasn't terribly optimistic. Maybe she's just making sure I'm prepared .

Now, I'm hoping the Bryan disc gets approved shortly. I may delay the surgery as far back as July/August if necessary but apparently there is movement on the FDA front so it might be approved as soon as Jan-March.

Thanks again to everyone who's been posting their surgical outcomes!
__________________
DDD C5/6. Incorrectly diagnosed as tension headaches in September 1997.
Nearly continuous headache since.
Began having pain in wrists in 2000, believed it was onset of carpal tunnel.
In 2005 pain began getting worse.
Diagnosed as DDD in July 2007.
Surgery recommended after 6weeks of PT made the pain worse.
ADR scheduled for Jan 26, 2009. Rescheduled for August 5!
Bryan disc finally FDA approved, and just in time too.
Neck was all jacked up and had to be fused unfortunately.
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  #10  
Old 12-09-2008, 10:33 PM
trkdoc714's Avatar
trkdoc714 trkdoc714 is offline
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Join Date: Nov 2008
Posts: 137
Default Cervical ADR

Jason,

I noticed your doctor is listed on an FDA clinical trial with the Kineflex disc. Has he offered you a spot in that trial? It might offset any insurance lapse of coverage.

Good luck neighbor,

Bob
__________________
04/06 L5/S1 Rupture
05/06 MRI shows DDD @ L2-S1
06/06 Diskectomy/ Laminotomy L5/S1
04/07 Recurrent Disc L5/S1
4 Ortho and 1 Neuro Surgeon, 5 MRIs, 1 EGM, 1 Myleogram & 11 EDIs later:
03/27/09 L4/5 & L5/S1 Maverick disc at Stenum
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