David,
I am also a newbie to this group.
I am a patient of Dr. Mullins. I did not qualify for the study because I also need L4-L5 & L5-S1 replacement( determined via discogram June 2004). I have been through 18 years of back problems.I was treated only by a chiropractor during 16 of those years so the 3 independent weeks during those years that I spent laying on an ice pack, unable to walk, where not documented or investigated with MRI, CAT, just X-ray. Two years ago, I was further injured and chiropractic and PT became useless. My scans most recently show that I have lost 50% of the disk height at both levels with quite a bit of damage to both discs at the levels mentioned above. I am now 5'4" and I was 5'5" six years ago. Don't know exactly when that changed.
Dr. Mullin will not be performing the 2-level replacement for another year because, according to his office staff, "he does not feel comfortable with the data he has seen so far" from the study.
Because of this, I went to Chicago to see Dr. Geisler who has performed 12, 2-level ADR with the Charite. He is willing to do the surgery on me after I have been allergy tested for the metals. Unfortunately, my insurance, BCBS, when questioned by phone said that they would not cover the surgery because it is still considered investigational. They said that the doc would have to convince their approval board that it was medically necessary.
Dr. Geisler said that I needed to be persistant in asking for approval from BCBS, but not how to state my requests. He also incouraged me to NOT spend huge hours creating medical documentation to present to BCBS to convince them to cover this. I am still very confused about how to approach BCBS? Sorry, I am really clueless on this aspect and am quickly trying to figure it out.
After I asked him about going to Europe, the room got considerably "cooler". He discouraged me from attempting this because the insurance would not pay for any subsequent medical procedures related to this surgery.
Has anyone else been told this?
Does any know how a new medical procedure makes its way from "investigation medicine" to the "Gold Standard". Is there a process that is clearly defined?
Patty
Athletic up to 2 years ago.
Now limited to walking - can use steps( slowly ).
Age : 36
Dayton, Ohio
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Patty
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