Went well. I liked him more this time than the last, and when asked how many multiple level Pro disc surgeries he's done, he said "over 100".. so that sounded good to me.

However, what he recommended for me is a "hybrid" surgery with fusion at L5S1 and Prodisc at L4 (discogram pending).

Reasoning for fusion is that now I am so collapsed at L5S1, he felt he would have to jack that level up too much and the distraction pain would be much worse than if he put in a cage with no screws, no rods, using BMP.. (or do I have that backwards)..

He said he wouldn't put a Charite in at L4 because of the load it would put on the facets (too much movement) and Pro disc would be a better choice for me.

My current OSS wants to do Charite at L4 and fusion at L5S1. He did mention using pedicle screws which I didn't want... I don't believe he's done nearly as many ADR's tho has certainly done as many and more fusions (he's older and practicing longer)..

My Nurse Case Manager said that the one level Prodisc and one level ADR would be authorized as soon as Prodisc is FDA approved which Dr.Bae said should be very soon..

He did add that he "could" put in the Prodisc most likely tho again, he thought the distraction pain would much more significant for me..

Re my past issue with burning pain lasting 5 years and bilateral.. he said yes, that I'd probably experience that again, altho he couldn't say if would be as painful or as long lasting..

He would use ESIs, nerve root blocks, and the same medication I'm on (Neurontin) or maybe something else to combat that..

My bone density is something that he said needs to be better than my '04 report. He'd rather see it at -2.0 (was -2.2) and if it's -2.5 or below he will put me on Forteo for a year or two..

So most likely I will go with his treatment as it sounds the most comprehensive at this point...

Tho I had to use a transportation service WC provided last yesterday and they sent out a person driving a regular small to mid size vehicle and I need something more like SUV to travel in as my arse was killing me on the way back stuck in rush hour traffic for over 2 hours!

Ok, that's it I think...

Well Maaria--

Congrats on wading through two different surgeons and approaches and coming to a tentative decision!

I'm finding the different discs appear to be more of a surgeon's personal preference than any real distinguishing factors (speaking for my case alone).

'Soon'. Another one of those vague, elastic words. Any idea of a range in your case?

Hoping things will clear soon and you'll see your route clearly paved!

Trace

Trace,
thanks for the reply!
Soon re FDA approval for Prodisc .. he thought it might be as early as "next week or next month".. but he was adament that it's soon~

I've actually had opinions from Dr.Bertagnoli via mail twice, Dr.Regan (LA by mail) once, Dr.Bae twice, Dr.Bradford in SF once (first time seen for ADR in '03) and my OSS who when I first mentioned ADR to him back in '98 he guffawed about it.. saying I'd never be a candidate.. then about a year ago, he even agreed that I might be a candidate for 2 levels, or at least one ADR and one level fusion..

First things first, schedule Bone Density test..then weigh in on results..either way both surgeons wanted to see that with a t score for lumbar spine of -2.0 versus anything below...

Maria,
You have really done your homework. It's great to see you making progress. I'm keeping my fingers crossed that your bone density is okay.

Mariaa,

Before my 3 level, Dr. B, Dr. Regan and Dr. Delamarter all agreed that S1/L5 was too narrow for an adr.

Dr. B ultimately did the adr instead of a fusion and I had and still have severe distraction pain.

Can't say for sure but if I had to do it over again, I'd definitely consider the fusion.

Dale

Was wondering about you the other day Mariaa. Good to see your post.

Was reading article today I think from NY Times(tore article from paper and pretty sure from the print it was Times, but can't tell for sure now if it was) about Medicare Aid and the Charite and in it they stated "Prodisc-1 from Synthes, a Swiss Company, is expected to receive final approval by Septemeber." For what its worth, hopefully for those waiting its sooner.

Article was critical of the study used to compare the Charite to fusion, saying it was comparing to a spinal fusion that is no longer state ofthe art and was only showing the Charite to be equivalent, not an improvement. Further stated, the data did not provide information on how well the disc would perform over two decades or more.

Other thing found interesting are some stats on insurance companies approving Charite surgery presently. Says about 60 insurers according to J & J, but only 2 are nationwide. About 25 percent of the regional coverage comes from worker's compensation companies. Our firm is likely going to be taking one WC carrier to a hearing shortly, we'll see where that goes.

Good luck and hope you can get moving on getting your problems resolved once and for all!!

Bill

Take care, and

Maria:
Have been thinking about you and your appointment but this is the first time I've been able to log in in a few days--glad to hear that you are still being supported for ADR but all these permutations must be confusing. Here's hoping your bone density results are good.
Barbara

Maria, I went to see Dr. Yue for my follow-up on Wednesday and he told me ProDisc was approved that day.
I would check it out, I would think he would know and I had expected to read something about and have seen nothing as of yet.
Judy

Thanks for your responses all..
Getting this last denial/non certification for 2 level ADR that shouldn't have even been sent in as the doctor who saw me doesn't do ADRs and referred me back to Delamarter's practice in Santa Monica where I had already seen Dr.Bae 2 years ago.

Now Dr.Bae feels I would be a better candidate for the fusion with BMP at L5S1 and Pro disc at L4 should L3 be Ok... however, I grow weary of the length of this process w/ WC and feel like packing it in and going to Europe~

To do so, I'd have to close out my case w/WC and lose my future medical benefits..

I've had a cold the last few days and am feeling run down and where I originally said I was disgusted not deflated re the UR 5 page non certification, I'm now deflated... just so tired and weary with all the crap.

Oh well, I'll get a new wind once the cold is over and spring weather hits... thanks for your replies... the non certification took the least supportive Charite evidence and used that as a basis for non cert.. plus wanting years more studies/doc as in fusion (failure?).

Maria, Termination of future medical benefits appears common in Workers Compensation. I wouldn�t give in to their hostage situation last year. They denied me 2 level even before I made up my mind not to give up future medical. Does it make sense that these people who have not done the right thing all along should be able to demand a �We�re Even� settlement. I just spoke last night with one of Connecticut�s� worse WC cases. As seasoned as I think I am, I could hardly believe what he told me. I was shocked to learn they really are corrupt. He was injured in 1984 and settled in 1997, waiving future medical. Maybe the message is, �They will get you in the end�. I know you have held onto your WC medical benefits all these years. Where would you be today if you gave them up? My question I guess is: Does anyone know what we can do to maintain our future medical benefits which we certainly are entitled to?