So far, so bad...the continuing insurance saga...

[Justin]

I know I shouldn't borrow trouble, but here's another doozie of a question:

What happens if I am allergic to all the hardware? That isn't so far fetched as it sounds....so far every one I have asked has nickel. If I react to that, and/or heaven forbid, one of the other metals as well, then what?

I can't have ADR or fusion. That's when a tall bridge looks great That would just be the monkey's uncle...I win my appeal and then can't take them up on any of the surgeries

For the time being, we'll assume that you are not allergic to nickel. We will cross that bridge at a later date--if we get there. The "what ifs" are always hard not to focus on. There are many brilliant minds in the field of orthopedics and many devices at their disposal, so don't give up hope just yet.

[Katie]

The voice of reason Is this a husband thing??

I can worry a little bit OK?! I'm hoping the fact that I'm allergic to nickel & other metals on my skin will not translate to an internal allergy.

Thankfully the ProDisc has a much smaller amount than the Medtronic cervical. I haven't heard back about the Maverick lumbar. I guess I'll find out soon about everything. The allergy blood kit will be here in a couple of days, with the results coming back in about two weeks.

Oh crud, I just got off the phone with the Canadian rep for Medtronics. She refuses to tell me the stats on metal quantities on any of their products, in case it seemed like she was 'promoting' their product. I have to get my surgeon to call and request it. I was trying to save him the effort, knowing how busy he is and how concerned he was about my allergy.

The Maverick was my first choice, but she is the only one who won't cooperate. Maybe they don't need the business.

[Justin]

The voice of reason Is this a husband thing??

I can worry a little bit OK?!

The allergy blood kit will be here in a couple of days, with the results coming back in about two weeks. :thumpup:

Oh crud, I just got off the phone with the Canadian rep for Medtronics. She refuses to tell me the stats on metal quantities on any of their products, in case it seemed like she was 'promoting' their product. I have to get my surgeon to call and request it. I was trying to save him the effort, knowing how busy he is and how concerned he was about my allergy.

The Maverick was my first choice, but she is the only one who won't cooperate. Maybe they don't need the business.

Maybe try calling a US rep--sorry you are getting the run around.

[Katie]

Thanks Justin, but I did call the US rep already. She said she couldn't give me any info on the Maverick because it was not approved in the States yet. She was trying to get a Canadian rep to give me the information though, but if she reaches the same one I just spoke to, it won't go well

So much for trying to do my homework. Good thing I'm so stubborn, or I would have given up eons ago.

[Justin]

My head still hurts from our conversation the other day about your insurance saga. The words "unbelievable," "stupidity," "moronic," "incompetent," and come to mind.

I really wish you weren't dealing with this tangled mess. We'll get it cleaned up soon.

[Katie]

This has been a very full week. We traveled to the new surgeon on Monday for a Tuesday procedure, the discogram and dye injection that is supposed to relieve my lumbar pain.

The day surgery itself was horrendously painful, all the way through till the following morning. By noon though, I had it under control and we were on the road home. The following day, Thursday, I felt pretty darn good and had an appointment with a local neurosurgeon who I was referred to a year ago. He was known through friends to not be familiar nor friendly to ADR, so I didn't expect good things from this. Then Friday I had an appointment with a cardio clinic for an initial checkup because of family history. Getting to be 'that age'

Unfortunately, I had to see the neurosurgeon to fulfill the letter of the law for the insurance appeal. That being an Ontario doctor has to state that this surgery is urgent and that it also is appropriate for me, plus the doctor is unable to do it quickly enough to prevent permanent damage.

So far, all the surgeons I have contacted earlier this month have said that they are unable to see me because of long patient lists, no matter how urgent I may be. None have confirmed nor denied that I am urgent either.

The last letter I got said that my symptoms, not the images (MRIs) tell whether or not I am urgent. That's it. All of them have Dr. B's letter saying that I have hyper-reflexia and positive Hoffman's, which is the indication that my cervical spinal cord is compressed, but he went no further. So that could be translated any way the insurance wants. And that letter cost me $100. $35/paragraph. Oh yes, and that he can give me a consult at the end of September. Now, his wait time is normally six months, so maybe I can make a case with the fact that I got one in two.

The surgeon on Thursday was as bad as he could be for me. He refused to discuss my severe lumbar pain after a year's wait for an appointment, and said that nothing he could do would get rid of any pain in my neck. I pointed out that it was the symptoms, the numbness in the arms and hands, the bladder and bowel problems, the falling down from lack of coordination, etc, etc. that I was concerned about, not the pain, which was quite bearable. He still stalled on how things were not bad, just that someday I may have 'problems'. And what, may I ask, do I have NOW?

Well, apparently the numb hands and arms are caused by....drum roll please....carpal tunnel syndrome. Which magically showed up on both sides just a few weeks ago. He was adamant that it wasn't from my compressed spine. There were a few more gems that I won't go into.

So my chances of winning the appeal just fell through. Even if any of these guys agreed to do surgery, I would not let them touch me. I have no faith in the system. None whatsoever. I will probably go through with the appeal, just on the off chance that the people on the board will see through the mud, but I am not hopeful. They have to follow the law...I need a doctor from here to agree with Dr. B, and they are just not going to do it. Why does every last surgeon (seven in total) from outside Canada say that I am urgent, that my spine is compressed and that the present damage is only going to get worse, while none within this province can see that?

Thankfully I have the one I saw earlier this week outside the province, and he is very good. I just have to jump through a few more hoops, but then we should be on track for a permanent solution soon.

I just wanted to break through the beauracracy, the insane system here, and be the one to set a precident for out of country surgery, so every other spine patient could get treated more easily. As much as I hate to admit it, it looks like they have won. We'll make a small vacation out of the Appeal trip to the big city and make lemonade. C'est la vie.

I thought I should give you an update after all the support you have given me here throughout this saga. The disturbing thing is that there were a number of friends/patients who were hoping that I would help carve a way for them. I hate to admit that I have let them down. At least I have found a new wonderful doctor who will help me, and have learned much more than I wanted to about this system.

Thanks again for the positive thoughts and support. While it's not quite over, I think I'm going to have to move on to a new chapter.

[KBear]

That sucks!