Cervical Issues (C4-5, C5-6, C6-7): 3-level Fusion Recommended

[willing for adr]

Just wanted to say Hi. I have been diagnosed with Cervical myelopathy and was told by a neurosurgeon that I need a 3-level fusion at C4/5, 5/6, 6/7. Wow what a shock! I have no pain to speak of but I od have numbness in both hands and feet. Spasicity in my gate. Electric shocks going down both arms occasionally. I have been told to do only the things neccessary in my life. I am a carpenter and sole provider for my family of four. I am very interested in any insurance answers out there. I currently have Blue shield+Calpers here in California. I want to know if I seek surgery out of the country will my insurance company not have any other invovlement with any back issues I may have in the future?

Thanks to all. Kent

[KBear]

Kent, I am not sure on the insurance options, as all are different. I have heard of BCBS paying for ADR for a Michigan patient and denying it for another in California. It all depends on where, what surgery and how you have the policy. My insurance, Unicare of Texas, denied me twice, so I was in a clinical trial. Start a thread in the new members and give a little history, what is wrong with each level and so on; and I am sure you will get lots of feedback. Once again, welcome, sorry you have to be here though.
Kathy

[willing for adr]

Thanks for the respones Kathy. My question isn't about if my insurance will cover the surgery or not. It's if I could loose coverage regarding any possible future problems with my spine either at or near the ADR's? I'm hope there is some experience out there. Kent.

[Justin]

Hi Kent,

I'm so sorry about your cervical issues. I have had two spine surgeries in Germany (2003 and 2009) and I have had no issues with follow-up with local surgeons, physical therapy, medications, injections, imaging, etc. I switched insurance companies last year without a problem. They did ask me to "clarify" my spine issues and asked if I thought I would have spine surgery in the future. I responded that the need for future spine interventions is unlikely--they didn't question it.

My wife accepted a new position and her new insurance will go into effect on 12/1. I am on her plan as a dependent (I'm currently in medical school and don't have insurance through our school's plan). There was no pre-approval process or any forms that needed to be filled out in regard to pre-existing conditions (prior surgeries, etc.). Our new insurance is Blue Cross.

I hope this helps and please let us know how we can help you--there are many great SPS Members here that are willing to help.

Once again, welcome and make yourself at home!

[willing for adr]

Thanks Justin for your response.

Kathy had said that maybe I should give a little history so here goes. I am not very computer literate so I am not sure how to set it up.

My MRI report states;

1.Bilateral foraminal stenosis at C3-C4 and C4-C5 with extruded disc at C4-C5 extending posterior to the C4 vertebral body and significantly indenting the cord.

2.Broad based annular bulge causing bilateral sever foraminal stenosis at C5-C6 with flattening of the cord anteriorly.

3. Eccentric annular bulge C6-C7 causing left anterior recesws and left intervertebral foraminal stenosis.

Basically I know that means I need to make some serious considerations regarding my life. I have recieved a diagnosis from a neurosugeon here in the states saying I need Multi-level fusion at C4/5, 5/6, 6/7. I am currently waiting insurance approval for this surgery.

I have recieved a diagnosis from Stenum hospital with states "urgeny" Adr with the M6 implant at C4/5, 5/6, 6/7. I am currently waiting for a patient package providing further information regarding stenum.

I have sent all films and reports to Dr. Bertagnoli and am awaiting a response from him.

I have sent all films and reports to Dr. Delamarter and am awaiting a response from Him.

My life since my diagnosis on 11/5/09 has not been the same. My neck is now controling my life. It has created tension between myself and my wife. It is constantly on my mind. My wife says I need to think about other things. I don't know how to do that when the when the symptoms are constant. I feel that by gathering all the information I can I am actively participation in this process.

Thanks for listening to me. I mean to keep this short but it just flows out.

Kent

[Dave]

Kent,

Let it flow out. That's what this community is all about. People who have never experienced this type of pain do not understand how bad it can be. It at times can be all consuming. We have all been there and can help you through this in a supportive way. We do understand.

By reading the MRI results, it is obvious that you are experiencing pain, which can also cause confusion. Are you currently taking anything for your pain and numbness? There are many medications out there that can and will reduce the symptoms you have.

Hang in there and ask all the questions you want. We will help in any way we can.

[willing for adr]

Thanks Dave,

I am currently taking Ibuprofen 800mg. twice a day and one vicoden at night to go to sleep. Thats it. As far as the pain goes it's not that bad. Let me explain, I was involved in a serious car accident in 1990 and I fractured my pelvis, road rash to the bone on my left thigh (looked like a tiger shredded it, broke all the fingers on my left hand, my left patella was dangleing, muliple fractures on left ankle. I spent 3 months in the hospital and much more time than that on rehab. Bottom line is the Dr. said I could no longer work construction, I wouldn't walk right,etc. Those words provoced a response in me to prove him wrong. After alot of pain, rehab, exercise etc I am happy to say that none of those things are true. I live a very active lifestyle as well as the demands I put on my body at work. Compared to the pain levels of that experience this is mild (for me).
The nerve issues are another matter all together. It has affected my sensation, strenght, balance, motor skills, and it appears there's nothing I can do about it. This is different because if there was anything I could do to help or stop these symptoms I would. I am not taking any medication for these symptoms. I'm not sure I should. With compression of the spinal cord I'm not sure I want to "mask" them. At least now I can tell what movements or posture puts strain on my cord.

Thanks for your respose and hopefully at some time I'll be able to get out of my own head and start to offer some thoughts, wishes to others. Kent

[Terry Newton]

I have Blue Cross of Michigan which is a non-profit Blue Cross Health plan. I had four level ADR in Germany and the plan originally denied the surgery a couple of times before paying for it in full. I sued the homeowner, whose dog collided with my bike, causing the injuries to my spine.

Unknown to most is that the only amount you can collect is up to the person's liability limit. Tort reform will help insurance companies make even greater profits as we will take away the right to judicial process. Juries of our peers determine the amount of damages that are levied against the person that was negligent. Most of the cases are appealed, causing the settlement to be negotiated lower. It's unfair to think that many would begrudge some injured person the right to collect damages. I can see it now; a person loses their arm due to neglect and the settlement is limited to $250,000 because, if it hasn't happened to us personally, who cares. But we'll say little when the insurance companies CEO makes $23 million a year in salary as that is capitalism and hurray for him.

We took away our citizens right to vote in Michigan. We set up term limits so that we get rid of our lawmakers no matter what. Good voting in the country gives us a right to vote a person out if we continue to disagree with how they represent us. We decided the voter was an idiot so we took away their ability to vote someone out of office.

Now we want to do the same with our legal system. For the one's that believe tort reform is the answer I will remember this when you lose a family member to negligence on the highway, through carelessness, etc. Some kid is texting while driving, kills your son or daughter and your settlement will be $250,000 or less. Tell me what you think of tort reform then.

The most I could collect was the policy limit so I got $100,000, minus my attorney fees left me with $74,000. When BC reimbursed me I made a whopping $61,000 for three years of pain and suffering.

I am grateful though because many do not even get any of it paid for. They have expensive insurance that they are paying good money for to deny them when they need it most.

If you need some assistance when it comes time to file a claim I will help you with whatever paperwork you need from my insurance company so that they can see there is a precedent of companies that have paid for the surgery.

Let me know if I can be of some help.

[Cindylou]

Ok, how about back to Kent and not tort reform. Terry, your response has absolutely nothing to do with Kent's immediate questions and concerns. It should probably be under health insurance or the new bill or something, but definitely not here. Because if it is moved I would respond to some things, but I don't want to do that on Kent's thread.

Kent, I also had spine surgery overseas and have had no problem with most things getting covered since then. So you should be okay on that. Good luck with your neck, and it sounds like you are under a time crunch so I hope you find the best solutions for it expeditiously. And, oh yeah....... welcome!!

[Terry Newton]

CL:

I believe I'll keep my post where it is at. My comment on payment of my surgery is appropriate to the post, my offer to help is in between my opinion. Thank-you.