ADRSupport Community  

Go Back   ADRSupport Community > General Discussion > New Member Introductions

New Member Introductions If you just joined, please introduce yourself here. Please add a signature describing your spinal history (use the "User CP) and ask us how we can help you get started.


Reply
 
Thread Tools
  #11  
Old 03-15-2015, 12:31 PM
Cynlite's Avatar
Cynlite Cynlite is offline
Senior Member
 
Join Date: Mar 2015
Posts: 666
Default

Colorado Babe, I intend to fight! Thanks for taking the time to share your experience and give me your suggestions.

My priority right now is my health because I feel so terrible everyday. I have already resigned myself to the fact that my insurance company will most likely require me to appeal. I've researched their guidelines and while they say they will approve the ADR, in the approval process if I have had a prior surgery, they will use that to decline the request. There is no way I will have a fusion just because it's convenient for them. I would only have a fusion if my body indicated that was my only choice. I already have a surgeon in Germany that believes I need a two level ADR so physically, ADR is my best route IMO.

Of course, I will find out what the out of pocket cost is to have my U.S. surgeon do the surgery. If he convinces me that the Mobi-C is a good option for me over the M6-C then of course, I would prefer not to travel to another country to have surgery but, I have to consider all the factors. One European surgeon has implanted over 1000 and the other over 2000 so, there is that to consider too.

I will have to do the appeal after I see the U.S. surgeon in a week. But, I know that I can't wait 3 months or longer for an unexpected outcome. I'm extremely concerned about my health right now as it continues to decline. If the insurance company turns me down and turns down the appeal, I will most likely move forward with my plans to have the surgery done in Europe (assuming their cost is less than the U.S) and then fight the insurance company afterwards full knowing that they will probably use surgery in a foreign country to turn me down in future appeals. I have tried to plan out my future for all possible outcomes when it comes to this surgery. I also may speak to a lawyer if it gets too messy later in the appeal process. I just have to take this a step at a time.

I need a lot of luck and prayers right now! Thank you so much for your input. I really do appreciate hearing from people who have been through the surgery, won the insurance battle and recovered from debilitating pain! It gives me hope
__________________
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

Last edited by Cynlite; 03-15-2015 at 03:07 PM.
Reply With Quote
  #12  
Old 03-15-2015, 03:06 PM
NJ Gene NJ Gene is offline
Senior Member
 
Join Date: Feb 2013
Posts: 376
Default

Cynlite, One thing I'm seriously considering (if I have to pay out of pocket) is using Dr. Blumenthal at Texas Back Institute (in Plano, TX) He uses multiple devices (including the Mobi-C) and his cost out-of-pocket for 2 levels (hospital, anesthesia, surgery, etc) is just under $30K. If you happen to have insurance that has out-of-network benefits, some of that may be covered your policy.

Since you need your surgery ASAP, you could probably pay out-of-pocket with him and if you have the proper insurance, fight with them later. If you go to Europe the cost will be more than $30K (that doesn't even factor in the cost of flights) and follow-up in the U.S. will be more difficult. Finally, there is much less likelihood of insurance covering you overseas.

Gene
__________________
Car Accident 2002 - Small Herniated Disc C3/C4
1998 Larger Herniation and Cervical Fusion C3/C4
2005 Herniation C4/C5 - 40 epidural steroid injections from Oct 2005, - Oct, 2007
2008 - Foraminotomy at C6/C7 on left side
Feb, 2010 - Cervical Fusion C4/C5
Dec, 2010 - Lumbar Fusion L3/L5
2013 - Bulge on C5/C6; herniation C6/C7 right side
Mar 26, 2013 - Foraminotomy at C6/C7 on right side
May 5, 2015 - ADR with Dr Blumenthal of TBI for C5/C6 using Mobi-C
Reply With Quote
  #13  
Old 03-15-2015, 04:22 PM
Cynlite's Avatar
Cynlite Cynlite is offline
Senior Member
 
Join Date: Mar 2015
Posts: 666
Default

Thanks NJ Gene! Unfortunately, my insurance does not cover me out of state or overseas LOL. Hopefully, the Barrow Institute will charge roughly the same as your surgeon and the one up in Washington. If that's the case, then I agree with you on most of your points.

One of my reservations is that Dr. Bierstedt mentioned that the M6-C is a better disc than the Mobi-C for protecting the facet joints going forward. It doesn't allow for over extending the natural movement of the body. Sorry, I don't recall the medical terms. Anyway, I don't want my poor facet joints to get arthritis before their time.

I'm really curious to see what Dr. Zeegers has to say because he is going to review ALL of my prior medical history before giving me his opinion. It's been quite a job pulling everything together for him. I'm going to send him his consult fee on Monday. He's already started reviewing my case without payment! He's really a wonderful person and surgeon. Check him out on Facebook if you want to read more about his success stories. Right now, he's consulting on my case. Later, we'll see where this leads.

Thanks for your thoughts and input. I appreciate all the help I can get figuring out this puzzle.
__________________
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
Reply With Quote
  #14  
Old 03-15-2015, 10:12 PM
Dema Dema is offline
Senior Member
 
Join Date: Jul 2013
Posts: 169
Default

Cynlite, you have our prayers wishing you choose the right surgeon and be pain free very soon.

NJ Gene, I was told about splitting the payment with the insurance acouple of years ago for a 2 level ADR, but since the Mobi-C has been received FDA approval since, I would think the insurance should pay for both levels,at least when done here in US. Though I think some people here had success with insurance covering ADR's done in Europe.

Dema & Raouf
__________________
7/2007 Whiplash injury
11/2009 Cervical disc herniation C3-C6 (C5-C6 worse)
2010-2013 Conservative treatments (drugs, PT, epidurals, prolotherapy, acupuncture...etc)
, little effect on pain
Considering surgery (typical questions, which type & which surgeon!)
Reply With Quote
  #15  
Old 03-16-2015, 07:50 AM
Jerry5 Jerry5 is offline
Senior Member
 
Join Date: May 2013
Posts: 363
Default cervical

If this is the cervical, the US FDA last August, approved the two level Mobi-C

So the insurance should not refuse this treatment.
__________________
Jerry, Somewhere Ohio

L2-3 herniation, two days before Thanksgiving, 2012, Discectomy/Laminectomy, 3/13 Numbness in the right leg, lateral femoral, gone, July 10, 2014 L45 M6 ADR, July 15 PLIF L5-S1, Not able to access L51 Anterior.
Reply With Quote
  #16  
Old 03-19-2015, 02:46 PM
Cynlite's Avatar
Cynlite Cynlite is offline
Senior Member
 
Join Date: Mar 2015
Posts: 666
Default Spinal Nerve Functions Picture

__________________
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
Reply With Quote
  #17  
Old 04-04-2015, 01:53 AM
Cynlite's Avatar
Cynlite Cynlite is offline
Senior Member
 
Join Date: Mar 2015
Posts: 666
Default Some of the Top ADR Docs

This has been posted on ADR Support before but, I thought I would put it on my thread for those looking to stay in the states for ADR surgery. Some of the surgeons names show up on this site so, first hand experience from their patients can be read about here if you do some looking around.

36 Spine Surgeons Performing Artificial Disc Replacement
__________________
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
Reply With Quote
  #18  
Old 04-06-2015, 09:09 AM
colorado babe's Avatar
colorado babe colorado babe is offline
Senior Member
 
Join Date: Aug 2014
Posts: 345
Default

Thanks for posting a current list. Will keep it for my files!
__________________
1998- Injured neck and back in USAF
2011 - Started experiencing Severe Symptoms, Migranes, numbness, spasms in legs and feet and sciatica.
Feb 2014 - Received upper Lumbar Injection - Severe Allergy to injection
Mar 2014 - MRI of Cervical and Lumbar, protruding disc in C3-7, Herniated Disc in L5/S1, placed on STD and FMLA )
July 2014 - Stem Cell Procedure performed
Oct 20, 2014 - ADR (MOBI-C) at C5-7 and Anterior Fusion at L5/S1 by Dr. Pettine and Dr. Techy
Reply With Quote
  #19  
Old 04-06-2015, 12:01 PM
Cynlite's Avatar
Cynlite Cynlite is offline
Senior Member
 
Join Date: Mar 2015
Posts: 666
Default

You are most welcome

It appears that Dr. Pettine did a two level Mobi-C on your neck. He seems to be one of the more experienced surgeon's in the country. I just finished looking at his website. I'm curious how the stem cell injections helped you with your fibromylagia and surgery. Did you continue with them? I read that you thought it improved your healing process at the time.

I hope you are continuing to recover well from your surgery and that life is good. Take care,
__________________
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

Last edited by Cynlite; 04-07-2015 at 01:49 AM.
Reply With Quote
  #20  
Old 04-08-2015, 09:05 AM
colorado babe's Avatar
colorado babe colorado babe is offline
Senior Member
 
Join Date: Aug 2014
Posts: 345
Default

Quote:
Originally Posted by Cynlite View Post
You are most welcome

It appears that Dr. Pettine did a two level Mobi-C on your neck. He seems to be one of the more experienced surgeon's in the country. I just finished looking at his website. I'm curious how the stem cell injections helped you with your fibromylagia and surgery. Did you continue with them? I read that you thought it improved your healing process at the time.

I hope you are continuing to recover well from your surgery and that life is good. Take care,
Yes, Dr. Pettine performed my two-level Mobi-C and all is going very well. He also did the stem cell procedure on me as well (for chronic pain and to help with healing after surgery) a few months prior to surgery. I am doing great and all my symptoms previously with the chronic pain is gone and I truly believe the stem cells helped speed up the healing process.
I will be interviewed once again by channel 9 next week. The reporter is coming to interview me at my house. I'm hoping it doesn't snow again before the visit. If you haven't seen the first TV interview, you can view it at:
http://link.brightcove.com/services/...=4072872709001
__________________
1998- Injured neck and back in USAF
2011 - Started experiencing Severe Symptoms, Migranes, numbness, spasms in legs and feet and sciatica.
Feb 2014 - Received upper Lumbar Injection - Severe Allergy to injection
Mar 2014 - MRI of Cervical and Lumbar, protruding disc in C3-7, Herniated Disc in L5/S1, placed on STD and FMLA )
July 2014 - Stem Cell Procedure performed
Oct 20, 2014 - ADR (MOBI-C) at C5-7 and Anterior Fusion at L5/S1 by Dr. Pettine and Dr. Techy
Reply With Quote
Reply

Bookmarks

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
If I pay out of pocket, is the ins co responsible for anything? mmarsh Insurance Hell 19 06-17-2008 02:05 PM


All times are GMT -4. The time now is 06:16 PM.


© Copyright 2006-2023 ADRSupport.org All rights reserved.