New Member - Lumbar disc replacement

[sarah206]

Hello -
I'm so glad to have found this forum. Since my surgeon uttered the word "surgery" I've been trying to make sense of all of the information available. It is great to have the chance to learn from "real people" vs. medical (and insurance) jargon!

My condition is listed in my signature. I've only received one surgical opinion so far and that is to get an artificial disc. I am not interested in fusion.


I'm seeking more information about:

• Seattle area surgeons for a second opinion
• Dealing with insurance companies (I'm pretty sure my claim will be rejected; My insurance provider is Regence)
• Going overseas for the surgery (Recommendations on Dr's and any other tips)
• Pregnancy AFTER a lumbar disc replacement

And hopefully at some point I'll need to learn more about recovery!

Thanks,
Sarah

[KBear]

Welcome Sarah. I am currently 36 weeks pregnant after having lumbar ADR at L4/5 almost 2 years ago. I am feeling wonderful and having no problems whatsoever. I am electing to have a c-section as a precaution, since people with healthy backs have ruined discs in labor and delivery. Here is a link to my post op and pregnancy thread: http://www.spinepatientsociety.org/forum/surgical-outcomes/l4-l5-active-l-3-17-09-dr-rolando-garcia-87-27/#post22655 I am typing on my phone right now, so will respond more in the morning when I can get on my laptop.
Kathy

[bigdogchief76]

Hello Sarah -

Welcome to the group. Loads of info here so feel free to ask all the questions.

Your insurance does indeed consider lumbar ADR investigational (reference Regence Medical Policy No: 127). To get you started that simply means Regence doesn't want to pay for it.

I like to call a spade "a spade"; i.e. you have a long road to walk with insurance and this policy. That just adds to the stress and pain you deal with. I will not apologize for the idiots at insurance, but will say I am sorry that you too have to travel this path.

I highly recommend purchasing the book called "The Insurance Warrior" by Ms. Laurie Todd and the Appeal Letter supplement she put together. Last I checked the combo book and letter was 32 bucks. Please PM me if this expense is hard to pay for; I would be willing to help out, that's how much I believe her input can help.

Plenty of folks who have been down this path (and your other mentioned options) are on this forum. Do not be afraid to ask questions.

If you do go down the appeal route, I would love to know about the outcome. My own insurance fiasco has brewed an insatiable fire in me that will not go away. I plan on addressing these BS tactics from insurance company's after I'm recovered from my surgery. Any info you have will simply be fodder for the battle I plan on waging.

Again, welcome and good luck.

MB

[ajj1001]

Hi Sarah and welcome. My main advice is to get a couple more opinions and to rule nothing in or out until you know what will give you the best long term outcome.

alison x

[KBear]

I was just now able to see the signature (for some reason they don't show up on phones). Anyway, I see that you have 2 bad levels, L4/5 and L5/S1. Did the surgeon suggest doing ADR at both levels?

What about a discogram to see if they are both pain generators? Prior to surgery my L4/5 was my worst level, with a grade 4 tear, protrusion, DDD, etc. and L5/S1 & L3/4 both had small herniations. The discogram confirmed that only L4/5 was causing pain and so that was the only level operated on. If both levels need operated on I would definitely think about a hybrid, fusion on bottom and ADR on top. The L5/S1 doesn't have a lot of movement to start with, so some have bad outcomes by putting an ADR there.

If you have just one bad level, you could qualify for a clinical trial, which would pay for surgery. My insurance denied me and my appeal and I just didn't have any fight left in me. I went into a clinical trial and received the Active L disc, which ironically was already being used overseas for a number of years and fellow Americans were paying to go get in these countries. The FDA is notoriously slow, so many if not all of these discs in trials are already available overseas.

I would also definitely get at least 3 surgical opinions. There are reasons that some people aren't good candidates for ADR and you want to make sure that you are indeed a good candidate. I also think by getting multiple opinions and researching your options, that you can make an educated decision that you can be happy with, regardless of outcome. For me that was a big one, I wanted to know that even if my surgery was a failure, that I could look back and have no regrets and know that I made the best decision I could with the information I had. There are domestic and travel forum sections on the forum with many great doctors listed as well as contact information. Many of these you can mail your films and records to and you don't actually have to physically see them for an opinion.

Last, my link didn't work last night, so here it is again: L4/L5, Active L, 3/17/09, Dr. Rolando Garcia

Best of Luck and ask any questions you may have, there are lots of helpful people on here,
Kathy

[sarah206]

Wow - Thank you everyone - lots of great info to get started. I am reading through your comments and will follow up this weekend!

@BigDogChief76 - I just ordered the book & CD - thanks for the recommendation!

Sarah

[Cindylou]

Lots of good advice given already. Just wanted to welcome you to SPS. Make yourself at home here. There is lots of valuable information available in the different threads for you to peruse. Cindylou