New to site...need some advice

[Rssooner]

Hello everyone...i hope everyone is doing well. I know there are a lot of great posts on here so I do appreciate you reading mine as well. i will get to the point...I am a 42 yr old male and i injured my back about 10 yrs ago lifting a lawn mower out of the trunk of my car. I would suffer pain when I would strain it only for about 5 years and then the pain was constant for the past 5 years and getting worse as I age. I have had many MRIs, injections, biacuplasty, nerve blocks, discogram showing posterior annular tear and DDD. I recently had another MRI showing more disc protrusion and more severe DDD. I love to play golf and I can do so but suffer a few days after. I am currently taking Butrans patch, Nucynta and anti inflammatory. I just went to TBI and met Dr. Zigler today. He looked over my MRI and did an exam and said that I was the "poster child" for a prodisc ADR. I am in good shape, it's only one level (L5 S1) and the rest of my spine is perfect.

I am relatively able to still be active but pain is always there. I must say that I am now scared to death. Almost all the research I read is so negative on this procedure. I even brought this up to him and also asked him about the M6. He said Prodisc is been around a long time and over 50,000 have been implanted and if it didn't work then their reputation would be horrible and they wouldn't be doing them. Another huge concern is that my insurance does not cover it so the cost is $35K. That is so much money to pay without much guarantee. I just don't know what to do.

Any advise or input would be greatly appreciated.

Thanks,
Rob

[jss]

Rob,

Condolences on your condition and welcome.

Know that Dr Zigler's reputation is second to none. He was on the ProDisc-L IDE team and is extensively published and profusely cited by his peers concerning that implant. He was financially tied to the ProDisc for years; a powerful motivator under which he learned how to turn out a steady stream of long term successful outcomes. I'm not a fan of the ProDisc, and yes bad outcomes are painfully common with them; but have you found any bad outcomes had at Dr Zigler's hands? There is one poster on this site in whom Dr Zigler has implanted FOUR ProDisc-L's; and he is doing very well.

As you noted, there are no guarantees in spine surgery. But a ProDisc at Dr Zigler's hands is as close to a guarantee of a good outcome as one can get. I would encourage you to scour the internet for bad ProDisc outcomes from Dr Zigler. I don't doubt that you'll be able to find one here and there, but observe that they are extremely rare.

Insurance ... ADR coverage is becoming easier, but not all carriers are on board yet. TBI may have a program to help you with your insurance carrier. Anyone know? BTW: when I was considering a double ProDisc-C with Zigler in 2008, they quoted $50,000 per level. Looks like insurance issues and international competition has driven the price way down.

Good luck, Jeff

[NJ Gene]

Dear Rob,

I'm sorry to hear about your condition. I also want to welcome you to the board. I agree with Jeff. You should spend a lot of time on these boards and see different outcomes with the various types of surgeries (fusion vs ADR) and artificial discs.

The majority of people on these boards who have gone to Europe have done quite well with the M6. For one level, the entire cost will probably be less than the $50K Dr. Zigler would charge at TBI. The downside is that when you go to Europe, very few U.S. doctors would be willing to see you for follow-up purposes One of the few exceptions that I know of is Dr Lauryssen of Beverly Hills. From what I understand he is going to spend part of each year in Switzerland putting the M6 in patients. I believe he would see you for follow-up in CA (even if you don't use him).

While I agree with Jeff that TBI is one of the best institutions in the U.S. for ADR, I've heard mixed stories about Pro-Disc. Check out the boards and see for yourself. Also, you might consider fusion for just one level. I've had two levels of fusion in my neck and well as my lumbar spine (L3/L5) and am doing fine. One final thing to consider, while the failure rate of ADR is low, one of the most common places for it to happen seems to be at L5/S1. Don't take my word. Do some reading and research.

Regardless of what type of surgery you have, keep in mind that all non-reimbursed medical expenses that you incur are tax deductible to the extent they exceed 10% of your adjusted gross income. This includes travel costs for you and your spouse if you decide to go overseas. I can give you more details about that if you send me a private message.

Good luck whichever way you decide to go.

Gene

[annapurna]

Originally Posted by NJ Gene

Regardless of what type of surgery you have, keep in mind that all non-reimbursed medical expenses that you incur are tax deductible to the extent they exceed 10% of your adjusted gross income. This includes travel costs for you and your spouse if you decide to go overseas. I can give you more details about that if you send me a private message.

Gene, you've commented about travel costs for your spouse a couple of places. In general, those expenses were not tax deductible unless your spouse is licensed to provide medical care and you had been ordered by your doctor to get that medical care. The general rule of thumb is $50 per night for the hotel and the travel costs for the person receiving the medical care but nothing for the companion accompanying them.

[Rssooner]

Thank you both for your replies. I am employed by Johnson and Johnson and talked to the actual rep for Synthes/Depuy Spine that is also a company of J&J. If I decide to go forward with the ADR with the Prodisc I may be able to get the device at no charge. That would be a $14K reduction overall. I will let you all know about that.

Like everyone on here...if I had a crystal ball and I knew that by doing this I would reduce my pain then I would do it tomorrow. So many things that are uncertain.

Everyone is very helpful on this site and I do appreciate it very much.

Rob

[TPatti]

Originally Posted by annapurna

Gene, you've commented about travel costs for your spouse a couple of places. In general, those expenses were not tax deductible unless your spouse is licensed to provide medical care and you had been ordered by your doctor to get that medical care. The general rule of thumb is $50 per night for the hotel and the travel costs for the person receiving the medical care but nothing for the companion accompanying them.

My accountant told us "companion" costs were deductible as long as it was stated by the doctor that a "companion" was necessary, which it really is! He also said that if there is any gray area deduct it and only worry about it if it becomes a problem.

[adrigail]

Welcome,
My name is Mike N and I have a Prodisc. Reading your bio I almost thought I was reading my own. Only difference is, I'm a little older, my damage is L4-5 and instead of a lawn mower, ruined my low back with athletics.
As NJGene previously posted, much of the information on here is focused on overseas surgeries/outcomes. Prodisc on here gets a bad rap from most of the posters on here for 2 reasons: 1. Currently, overseas Dr's are using other discs, although some may still use the Prodisc in some instances and 2. Many recipients of any disc, who have successful surgeries move on with life and stop posting. As with anything, bad press far outweighs success stories.

If you are going to choose the PD, I would advise a bone density scan, as was the case for me, the keel on the PD requires bone to be removed and can only be successful if you have good bone density. Also, make absolutely certain that your surgeon has performed dozen's (if not hundreds) of Prodisc surgeries. Surgeon skill I believe is as crucial to success as the device itself.
Bear in mind that everyone's anatomy and history's are different. None of us presented to our Dr's with the same symptoms. Also, bear in mind when reading the posts here, that everyone MUST believe that the disc they chose was THE BEST CHOICE as none of us would want to worry that we made a mistake after the fact (human nature I suppose)
You will find many posts from people advocating for a specific disc. None of these people are surgeon's or Dr's and none have access to your specific information.

It took a year, there were many times in that year I thought I made a mistake, but now that I'm 14 month's out, I'm feeling good, stronger and in less pain than I was for the last 10 years.

Just know that all the folks here wish you well, many of us walked a similar path, and some of us have been lucky enough to improve because of ADR.

Good luck, and I'm always available for a private chat.

Mike

[adrigail]

edited duplicate post

Mike

[annapurna]

Originally Posted by TPatti

My accountant told us "companion" costs were deductible as long as it was stated by the doctor that a "companion" was necessary, which it really is! He also said that if there is any gray area deduct it and only worry about it if it becomes a problem.

The extract below comes from the IRS online discussion and is the reason why I'm not sure an unskilled companion's travel expenses count. I'm not a tax expert so take my comments as a suggestion to investigate further, not something to trust outright

Transportation

Include in medical expenses amounts paid for transportation primarily for, and essential to, medical care. You can include:

• Bus, taxi, train, or plane fares, or ambulance service,
• Transportation expenses of a parent who must go with a child who needs medical care,
• Transportation expenses of a nurse or other person who can give injections, medications, or other treatment required by a patient who is traveling to get medical care and is unable to travel alone, and
• Transportation expenses for regular visits to see a mentally ill dependent, if these visits are recommended as a part of treatment.

[Karger]

Ever thought of going over seas to have it done? I know it will cost out of the pocket, but the surgeons are more experienced in Germany then in the US.

I thought about getting mine done in the US, but they have only been doing them since 2008, where as Germany 89.

I had mine done in Germany and had a very good experience along with successful outcome. I won't be retiring anytime soon, but the quality of life is so much better and having a very good surgeon was also another peace of mind.

Just some food for thought.