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Reply With QuoteOh Cindy, what a dam* roller coaster you are onI am so, so sorry.
Hugs my friend. I don't know what else to say.
This is a discussion on Just found out today I was denied for the facet cauterizing within the Pain Management forums, part of the General Spine Discussion Forums category; I am pretty bummed about this. More hurry up and wait has been a steady diet lately. So here I ...
Just found out today I was denied for the facet cauterizing I am pretty bummed about this. More hurry up and wait has been a steady diet lately. So here I sit. Literally. I have gained 20 pounds in the past 6 months with all this "recuperating." My pain management doc is going to write a letter for appeal, so I guess I will find out how long this takes.
January 2000 MVA passenger, used jaws of life to retrieve me, neck injury and months of PT
June 2001 Bicycle accident, 2 compression fractures at T12/L1, Vertebroplasty Sept. 2001
April 2006 right hip, labral tear and repair
April 2007 3 level ProDisc @ L3/4, L4/5 & L5/6✷ ✷Lumbosacral transitional vertebra; Dr. Rudolph Bertagnoli
July 2, 2008 ALIF & Laminectomy @ L6/S1
July 30, 2008 re-opened 28 days later to remove bone cement that had leaked onto S1 nerve root
August 2008 Pulmonary embolism, double pneumonia, collapsed left lung, re-hospitalized 1 week
March 10, 2009 Right SI Joint Fusion
April 27, 2010 2nd right hip arthroscopy to remove adhesions and release psoas muscle
September 30, 2010 lumbar facet rhizotomy
December 9, 2010 12 bilateral lumbar trigger point and steroid injections
December 23, 2010 12 more bilateral trigger point injections w/o steroid
February 15, 2011 ESI bilaterally in lower lumbar...relief only for few days. Considering 1 more.
Did Spinal Cord Stimulator trial from 5/11/11-5/17/11 with excellent results; Spinal Cord Stimulator surgery is Monday,
July 18, 2011
Oh Cindy, what a dam* roller coaster you are on
Hugs my friend. I don't know what else to say.
Severe compression of spinal cord, flaval ligament, etc. at C4/5 & 5/6.
Herniation and compression, at L3/4 to L5/S1 plus spondylosis at the latter level. Severe allergy to most metals.
Three level surgery in Brazil with Dr. Luiz Pimenta on March 17/2010 using non-metal appliances. L5/S1-PEEK cage, ALIF; L4/5-PEEK cage, XLIF; C5/6-NuVasive NeoDisc. Three separate approaches, two minimally invasive. Currently minor residual back pain, from SI ligament and still overdoing things. Therapy and chiropractic treatments helping immensely. Gone from being almost bedridden to near normal activities including gardening. Life is gooooood!
I'm sorry CL. I'm on the 'fat boat' too. I ended up gaining 20-25 lbs since my surgery too. I had lost the last of my 'baby weight' before surgery and gotten down to a size 4 (which is crazy, I'm 5' 10"). Well, surgery ruined all that, I am wearing the clothes that I wore after giving birth, size 12. I'm so bummed. I have managed to lose a little over 10 lbs.; but still need to lose another 20 lbs. I have basically been trying to do it with my diet, since working out vigorous is out of the picture. I'm trying to get my rear motivated to do my pt again. We need to exchange phone numbers and motivate each other on that.
Is your insurance through your hubby's employer? Mine is self-employed insurance, which is the bottom of the barrell, pretty crappy. I have never been denied a rhizotomy, injections, MRI, discogram, nothing. They have only denied me twice, once for the IDET (which I wish I would have listened to their reasoning that it wasn't proven and not had it) and the other was for ADR (which they amazingly did pay parts of it, about 15k). That's crazy that they would deny something so ordinary as a rhizotomy! Crazy, I would definitely appeal.
Sorry life's being crappy to you right now, hang in there, there will be better days (like when we all meet in Canada at Katie's! Are you and hubby coming? I still have to save up money for the plane tickets; but think I can do it)
31 years old-
1/06- In wreck with 18 wheeler at 25 years old; 6/06- Head on collision on Interstate, both wrecks other drivers fault. Numerous MRI's, PT, chiropractic, acupuncture, TENS therapy, massage therapy, facet injections, epidural injections, Nerve study, Discogram, confirms pain in L4/5, IDET, decompression, Bi-lateral neurotomy L3/4/5, denied by insurance twice, in Active L clinical trial, had surgery March 17, 2009 in Miami, FL- received Active L disc at 29 years old. Pain and medication free as of October 2010!
Mommy to Emma- 8 years, Ava- 5.5 years & had baby Eli after ADR, via c-section on March 25, 2011, completely pain free still!
I freaking HATE insurance companies!
I hope that the appeal goes in your favor. This is insane that you have to be held hostage by your insurance company.
Disc Bulge C4/C5, Disc Degeneration T11/T12, Bi-Lateral tears L5/S1, Diagnosed w/ Lumbar Disc Derangement w/ Radiculopaphy. Treatment: IDET, Percutaneous Discectomy, SI Joint Injection, Facet Block. All failed. Empire BC/BS Denied Coverage for ADR-lost all of my appeals. MVP also denied coverage.
Anterior/Posterior Fusion L5/S1 -1/20/09 - I'm not 100% but I'll take the 85%! When the weather co-operates, it's 95% woohoo!
USA health system is really strange, but who am I to comment on that.
For example here in Croatia my first 3 surgeries were covered, 4th will also be covered, around 20-25 travels to our capital city to see a neurosurgeon were covered, all medications are covered.
I only pay 10 USD monthly.
Just a digression about Your and our system.
Hey CL,
Your pain management doctor should be able to get approval when he files an appeal. Insurance companies like to "deny out of the gate" and then approve a procedure / intervention when they get a letter of appeal. This is how this backwards system works.
BTW: artificial disc replacement surgery is an exception to all of the insurance hoops...the insurance companies have continually changed their tune to ensure that they can keep the train on the "deny, deny, deny no matter what" railway.
Justin Averna
Founder & President, Spine Patient Society
www.SpinePatientSociety.org
A 501(c)(3) Tax-Exempt Nonprofit & Charitable Organization
I'm here to help.
- 1994: Football Injury, Severe Hyperextension
- 1997: Snow Skiing Injury
- 3/7/1997, 17 years old: Laminotomy L4/L5
- 1999 & 2003: Motor Vehicle Accidents (not at fault both times) --> Grade V Annular Tears L4/L5 & L5/L6
- 11/15/2003, 23 years old: 2-Level ProDiscฎ L4/L5 & L5/L6*, *lumbosacral transitional vertebra --> Dr. Rudolf Bertagnoli
- 4/2008: 4.5 years pain-free before "new" leg pain
- 5/14/2009, 29 years old: Dynamic Stabilization System L4/L5, Dr. Rudolf Bertagnoli
Questions? Suggestions? Need help with registering, creating a signature, etc.?
justin (at) spinepatientsociety.org
Disclosure: I have no financial relationships with any surgeons, spine clinics, device manufacturers, pharmaceutical companies, hospitals, etc. -- the SPS Board of Directors serve without compensation.
I'm moving to Croatia, that's it! ha haThanks Katie, Justin, Kathy, Karin, and Keano16. And I hope you are right on that Justin. I think you are. First, deny, deny, deny.....and wait and see how persistent the doc and patient are.
January 2000 MVA passenger, used jaws of life to retrieve me, neck injury and months of PT
June 2001 Bicycle accident, 2 compression fractures at T12/L1, Vertebroplasty Sept. 2001
April 2006 right hip, labral tear and repair
April 2007 3 level ProDisc @ L3/4, L4/5 & L5/6✷ ✷Lumbosacral transitional vertebra; Dr. Rudolph Bertagnoli
July 2, 2008 ALIF & Laminectomy @ L6/S1
July 30, 2008 re-opened 28 days later to remove bone cement that had leaked onto S1 nerve root
August 2008 Pulmonary embolism, double pneumonia, collapsed left lung, re-hospitalized 1 week
March 10, 2009 Right SI Joint Fusion
April 27, 2010 2nd right hip arthroscopy to remove adhesions and release psoas muscle
September 30, 2010 lumbar facet rhizotomy
December 9, 2010 12 bilateral lumbar trigger point and steroid injections
December 23, 2010 12 more bilateral trigger point injections w/o steroid
February 15, 2011 ESI bilaterally in lower lumbar...relief only for few days. Considering 1 more.
Did Spinal Cord Stimulator trial from 5/11/11-5/17/11 with excellent results; Spinal Cord Stimulator surgery is Monday,
July 18, 2011
Oh, I forgot: yes Kathy, our insurance is thru my hubby's employer, which is still a self insured company policy. Having a brain fart...I think that's what you call it.
January 2000 MVA passenger, used jaws of life to retrieve me, neck injury and months of PT
June 2001 Bicycle accident, 2 compression fractures at T12/L1, Vertebroplasty Sept. 2001
April 2006 right hip, labral tear and repair
April 2007 3 level ProDisc @ L3/4, L4/5 & L5/6✷ ✷Lumbosacral transitional vertebra; Dr. Rudolph Bertagnoli
July 2, 2008 ALIF & Laminectomy @ L6/S1
July 30, 2008 re-opened 28 days later to remove bone cement that had leaked onto S1 nerve root
August 2008 Pulmonary embolism, double pneumonia, collapsed left lung, re-hospitalized 1 week
March 10, 2009 Right SI Joint Fusion
April 27, 2010 2nd right hip arthroscopy to remove adhesions and release psoas muscle
September 30, 2010 lumbar facet rhizotomy
December 9, 2010 12 bilateral lumbar trigger point and steroid injections
December 23, 2010 12 more bilateral trigger point injections w/o steroid
February 15, 2011 ESI bilaterally in lower lumbar...relief only for few days. Considering 1 more.
Did Spinal Cord Stimulator trial from 5/11/11-5/17/11 with excellent results; Spinal Cord Stimulator surgery is Monday,
July 18, 2011
Cindylou, I believe it all started with the Health Maintenance Organization (HMO) Act of 1973.Originally Posted by Cindylou
At what point, how many years ago Justin, did things go so awry with our healthcare system? Where the insurance companies, not the doctors, get to decide what tx a patient needs???!!! WTF? I long for the days when a doctor really gets to be a doctor and treat his patients as he sees fit, like the old days.
Physicians practice with their hands tied behind their backs these days.Something needs to be done.
Justin Averna
Founder & President, Spine Patient Society
www.SpinePatientSociety.org
A 501(c)(3) Tax-Exempt Nonprofit & Charitable Organization
I'm here to help.
- 1994: Football Injury, Severe Hyperextension
- 1997: Snow Skiing Injury
- 3/7/1997, 17 years old: Laminotomy L4/L5
- 1999 & 2003: Motor Vehicle Accidents (not at fault both times) --> Grade V Annular Tears L4/L5 & L5/L6
- 11/15/2003, 23 years old: 2-Level ProDiscฎ L4/L5 & L5/L6*, *lumbosacral transitional vertebra --> Dr. Rudolf Bertagnoli
- 4/2008: 4.5 years pain-free before "new" leg pain
- 5/14/2009, 29 years old: Dynamic Stabilization System L4/L5, Dr. Rudolf Bertagnoli
Questions? Suggestions? Need help with registering, creating a signature, etc.?
justin (at) spinepatientsociety.org
Disclosure: I have no financial relationships with any surgeons, spine clinics, device manufacturers, pharmaceutical companies, hospitals, etc. -- the SPS Board of Directors serve without compensation.
Amen to that Justin. Something does need to be done.
January 2000 MVA passenger, used jaws of life to retrieve me, neck injury and months of PT
June 2001 Bicycle accident, 2 compression fractures at T12/L1, Vertebroplasty Sept. 2001
April 2006 right hip, labral tear and repair
April 2007 3 level ProDisc @ L3/4, L4/5 & L5/6✷ ✷Lumbosacral transitional vertebra; Dr. Rudolph Bertagnoli
July 2, 2008 ALIF & Laminectomy @ L6/S1
July 30, 2008 re-opened 28 days later to remove bone cement that had leaked onto S1 nerve root
August 2008 Pulmonary embolism, double pneumonia, collapsed left lung, re-hospitalized 1 week
March 10, 2009 Right SI Joint Fusion
April 27, 2010 2nd right hip arthroscopy to remove adhesions and release psoas muscle
September 30, 2010 lumbar facet rhizotomy
December 9, 2010 12 bilateral lumbar trigger point and steroid injections
December 23, 2010 12 more bilateral trigger point injections w/o steroid
February 15, 2011 ESI bilaterally in lower lumbar...relief only for few days. Considering 1 more.
Did Spinal Cord Stimulator trial from 5/11/11-5/17/11 with excellent results; Spinal Cord Stimulator surgery is Monday,
July 18, 2011
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