Newbie questions (Moved & Merged)

[lkkoh]

Hello,
I am a newbie on this forum. After reading many threads here, I decided to post for the 1st time and hopefully someone will be kind enough to assist me.

I live in Phoenix, AZ. I have been diagnosed with at least 2 level of cervical DDD, including spondylosis, stenosis and bulging discs. I was really devastated given my young age. Not sure how it got to this point especially I had no previous injuries or accidents.

I saw a local surgeon and he recommended 2- to 3-level ACDF when time comes. After reading many threads here, it seemed like ACDF is a very scary treatment and has its disadvantages. I am going to see Dr. Delemarter (in LA) in the coming weeks for a second opinion.

I work for a company whos medical insurance is self funded and is managed by Mountain States Administrative Services using BCBS of AZ network. The review board is done by American Health Group.

Here are my questions:
1) Do any of you know of any AZ surgeons do multi-level disc replacements?
2) Do you have any encounters with this insurance administrator and American Health Group?
3) I read a lot of the horror stories about the insuranec denials on this forum, when should I start prepare the appeal letter?
4) How much will it cost me (roughly) if I choose to have a 2- or 3-level ADR surgery in Germany?
5) Do you have any other suggestions what I should do?

Thank you so much for your kind help. I appreciate it.
LK

[lkkoh]

Hello,
I am a newbie on this forum. After reading many threads here, I decided to post for the 1st time and hopefully someone will be kind enough to assist me.

I live in Phoenix, AZ. I have been diagnosed with at least 2 level of cervical DDD, including spondylosis, stenosis and bulging discs. The discs are compressing my spinal cord. I was really devastated given my young age. Not sure how it got to this point especially I had no previous injuries or accidents.

I saw a local surgeon and he recommended 2- to 3-level ACDF when time comes. After reading many threads here, it seemed like ACDF is a very scary treatment and has its disadvantages. I am going to see Dr. Delemarter (in LA) in the coming weeks for a second opinion.

I work for a company whos medical insurance is self funded and is managed by Mountain States Administrative Services using BCBS of AZ network. The review board is done by American Health Group.

Here are my questions:
1) Do any of you know of any AZ surgeons do multi-level disc replacements?
2) Do you have any encounters with this insurance administrator and American Health Group?
3) I read a lot of the horror stories about the insuranec denials on this forum, when should I start prepare the appeal letter?
4) How much will it cost me (roughly) if I choose to have a 2- or 3-level ADR surgery in Germany?
5) Do you have any other suggestions what I should do?

Thank you so much for your kind help. I appreciate it.

I also posted on the Insurance Hell section because there is a question about insurance.

LK

[Harrison]

I merged the two topics as to encourage more feedback. I'll try to respond over the weekend...

Maybe some other members can comment in the meantime....

[rhatzy]

hi,

I know that my company (self funded, administered by bcbs)has approved a one level cervical ADR. Two level anything ADR in the US is your dollar. You have to be sure your discs are your problem. The spondylosis might be a problem depending on how bad it is. A two level here in the US will cost you I'd say more than $70,000. I had a two level in Germany and now the cost is 27,000 Euros for a two level and 30,000 Euros for a 3 level.

Mark

[lkkoh]

Hello Rhatzy,
Thanks for your reply. According to the local doctor, the compression to the spinal cord was due to disc bulging and bone spur from the vertabraes at C3-4 and C4-5. That's why he recommended an ACDF. I understand that the ACDF will remove the bulging disc but will the procedure also include removing the bone spurs from the vertabraes?

Also, which German doctor should I consider if I choose to go this route? I heard about Stenum and also Dr Bertagnoli. Any others I am missing?

The strange thing is given my moderately severeness of my condition, I don't have any symptoms other than discomfort on my neck and occasional aching. I can manage that. Should I wait 'til the symptoms show up later or should I take care of it now? If I wait, will my cervical condition deteriorate to the point where I can't do ADR?

Harrison, I appreciate your kind advice...

Thank you.
LK

[rcphx]

Hi there
I used to live in phoenix and moved to Twin cities last year. I had my surgery here in Minneapolis but now I am returning back to Phoenix. Lost job and have to get back to AZ and look for another one. When I was in AZ I saw several ortho docs and neurosurgeons and some were doing multi level discs, on a trial basis. Let me know if you want some names or exchange info.
PM if you like
Rob

[Harrison]

Hey, you guys, thanks for helping out LK!

LK, can you add a signature when you get a chance? Use the "User CP" in the upper left to add 3-6 lines about your condition.

We cannot answer your question about waiting, and no one can. You can play a key role in this, however. I don't have any answers, but starting & addressing a list of spine health questions that you decide are important can help! That may sound nebulous, but each person defines and prioritizes their health exigencies a little bit differently.

Back to you. I would be wondering:

- What is the rate of degeneration (DDD) in the cervical spine?
- What does the series of imaging studies show? Does it answer the above question?
- If it is rapid degeneration, what is the mechanism of degeneration?

Most (if not all) docs are avoiding the spine disease issue, so it may be a fool's errand to go there. In the meantime, keep researching, looking for answers, seeing different kinds of doctors. Is the rest of your health picture good?

If I had a dollar for every time I heard from a young patient who had serious DDD in their cervical and/or lumbar spine (without traumas) I would be a rich man. This is a tragedy and is not "normal." I hope the new non-profit can tackle this widespread, terrible problem.

Email or PM me if you think I can help.

[annapurna]

Originally Posted by lkkoh

Also, which German doctor should I consider if I choose to go this route? I heard about Stenum and also Dr Bertagnoli. Any others I am missing?

The strange thing is given my moderately severeness of my condition, I don't have any symptoms other than discomfort on my neck and occasional aching. I can manage that. Should I wait 'til the symptoms show up later or should I take care of it now? If I wait, will my cervical condition deteriorate to the point where I can't do ADR?

First question, Zeegers is still practicing at Starmed as far as I can tell. He'd be a third to try.

Second question, move out now on understanding what you'd do and where you'd get it done. Put together your plan and make sure you've got the basics covered (I'd hate to be waiting for weeks for a passport if I decided it was time to go for surgery). Don't pull the trigger on actually getting surgery until you're comfortable with that decision but do the research and make the decisions so you'll be ready once you become comfortable or if your pain flares and suddenly pushes you for a much faster action.

[lkkoh]

Hello Harrison,
Thanks for your help. With regards to your 1st question, I compare the Mar 2009 MRI with the 2006 Oct MRI (1st MRI) and it seemed like they look quite the same. So, I think my condition is a slow progression. I have listed my condition in my signature, so hopefully, it provides some answers to your 2nd question. I am not sure how to answer your 3rd question though.

I am 41, 5'10", weigh 167 lbs and generally in very good health.

Hello Annapurna,
Yes, I agree with your advice that I should put a plan together.

Do any of you have any comments on Stenum, Dr Bertagnoli, Dr Zeegers, including my priorities and their relative cost?

I am trying really hard to get over the shock phase and start figuring out what I should do. I am really worried as I am a father of 1 toddler and a newborn.

[rhatzy]

They are all good but different prices and they use different discs. I went to Stenum because I wanted the Maverick disc and they happen to be a little cheaper that the rest. I am 16 months with my discs and completely pain free.

Mark