[Artificial Disc Replacement / Lumbar] Artificial Disc Replacement at L4-5 and ALIF at L5-S1

[Metalneck07]

I started yesterday to put the plans in motion for my ADR at L4-5 and ALIF L5-S1 surgery. But with that said I have more questions than ever that have my nerves shot !!
1st When we went toTBI for my consultation I thought they would be using the Prodisk for the ADR. I was told today by the Surgery Cordinator it would be the Charite.Can anyone give me any information on this ? I thought I had seen information that there was alot of problems with them.I could be wrong since my brain at this point is overloaded and I have had the worst migraines the last couple days from being overloaded and tired.
2nd I was told the surgery is performed in their surgery center and your recovery is also there as well ?? I have never experienced this I have always had surgery and recovery in a complete hospital.I asked what would happen if you needed ICU care ?I was told then you are tranferred to the hospital next door. I don't like to think worst case senarios but my last spine surgery I ended up in ICU.It just seems odd to me they perform major surgery in their surgery center.(I have had small procedures in a out-patient done in surgery centers) Oh again I'm having surgery at TBI , Plano,Texas.
Another hold up for me so far as planning goes will be insurance. Though I have been told Aetna covers ADR at one level we will not know for sure until possibly 2-3 weeks before surgery. I just feel hesitant to make our plans since we are out of town until we get the offical news.Again the coordinator when I asked her if they would call me when Aetna approves the surgery?? She told me no we don't call you but you can call us !! I just was not getting a good feel.I don't know it could very well be just me. I know with all this stress of a 3rd Spine surgery has me on pins and needles.Feel free to tell me I'm over reacting if you think so .
I guess that's all the questions I have for now. I will greatly appreciate any feedback that I can get.Today has been a very rough day for me my emotions are thru the roof.I just keep telling myself to keep the faith and know there are plenty of fellow spineys who have been down this same road too.
Caitlin aka Metalneck 07

[Metalneck07]

Oh and Surgery is set for Setember 28th God willing,Insurance willing and me not changing my mind or chickening out.
Caitlin Metalneck07

[Justin]

I was told today by the Surgery Cordinator it would be the Charite.Can anyone give me any information on this ? I thought I had seen information that there was alot of problems with them.I could be wrong since my brain at this point is overloaded and I have had the worst migraines the last couple days from being overloaded and tired.

Charite is a good artificial disc replacement device. The most important factors for a successful surgery are: 1) experience of the surgeon, 2) proper patient selection, and 3) correct placement of the device.

2nd I was told the surgery is performed in their surgery center and your recovery is also there as well ?? I have never experienced this I have always had surgery and recovery in a complete hospital.I asked what would happen if you needed ICU care ?I was told then you are tranferred to the hospital next door. I don't like to think worst case senarios but my last spine surgery I ended up in ICU.It just seems odd to me they perform major surgery in their surgery center.(I have had small procedures in a out-patient done in surgery centers) Oh again I'm having surgery at TBI , Plano,Texas.

I've been to the Texas Back Institute twice. The main hospital is right next door. With TBIs experience and reputation, I would be most confident in their management of spine patients post-op.

Another hold up for me so far as planning goes will be insurance. Though I have been told Aetna covers ADR at one level we will not know for sure until possibly 2-3 weeks before surgery. I just feel hesitant to make our plans since we are out of town until we get the offical news. Again the coordinator when I asked her if they would call me when Aetna approves the surgery?? She told me no we don't call you but you can call us !! I just was not getting a good feel.I don't know it could very well be just me. I know with all this stress of a 3 surgery has me on pins and needles. Feel free to tell me I'm over reacting if you think so .
I guess that's all the questions I have for now. I will greatly appreciate any feedback that I can get. Today has been a very rough day for me my emotions are thru the roof. I just keep telling myself to keep the faith and know there are plenty of fellow spineys who have been down this same road too.
Caitlin aka Metalneck 07

Caitlin, one of the most stressful aspects to spine surgery is the financial / insurance coverage part. It is normal to be worried about it. However, TBI was really good about being up front with insurance companies that commonly cover surgery (ADR surgery in particular). Everything should fall into place, especially if your insurance covers ADR at one level.

I know it is easier said than done, but try not to let your nerves get the best of you. TBI is a fantastic facility with world-renowned surgeons that provide exceptional care.

Good luck; we are here to help.

[ajj1001]

it would be the Charite.Can anyone give me any information on this ? I thought I had seen information that there was alot of problems with them.I could be wrong since my brain at this point is overloaded and I have had the worst migraines the last couple days from being overloaded and tired.

hI, i've got two charites and am having problems with them. Whether this is due to design or placement is the million dollar question. I was the perfect candidate in terms of selection. Obviously due to my personal experience I do not have a good opinion of the disc but that does not mean that it isn't the right disc for you and I would not offer this a medical opinion.

There is a debate as to whether unconstrained or constrained artificial disc designs are best. There is load of information to read but the more you read the more confusing it can become if you aren't a medically trained. Did they give a reason for the change of disc?

[Metalneck07]

Hi Alison
Thank you for replying to my thread.So sorry to hear you are having problems. As you said it's for
sure the million-dollar question when having a problem like yours as to what's the cause of this.
Personally I have done the research and if I had the choice it would be to recieve the Prodisc.I'm just not a
fan of the design.Now with that said I know the Prodisc is not as good as some of the others out there right now.
But unfortunately I'm not a candidate for a trial because I have two levels that are in need of surgery.
As far as I know the Charite and Prodisk are the only ones available at this time.I do have a phone call into
my surgeon asking about this but won't hear from him until Monday when he returns to the office.
If it comes down to the Charite or Prodisk and it's up to me I would like to recieve the Prodisc.So for now
it's wait and see. I hope your feeling better soon and take care of yourself.
Caitlin aka Metalneck07

[KBear]

Caitlin- When I thought I was having surgery at TBI and they told me they did it there, it kinda freaked me out too. However, it is like a mini hospital on the bottom floor. There is someone on here who had surgery there through a trial and I believe they had a great experience (I can not remember her name, but will look). Now, as far as needing something more, Presbyterian of Plano is literally across the street. I almost feel like you would get better care being below their offices as they can check on you throughout the day or address any needs immediately.

I agree with Justin that the main factors are the surgeons experience, patient selection and placement. With the trial I was in the controls were the Prodisc and Charite. My surgeon however, preferred the Charite and was only using that as the control, so I had a chance of getting it. I was a little worried about it's reputation, but I don't think it's so much because it's so bad, more from it being the first. More people got the Charite, more long term data, all ADR surgeons had to learn on this one- so their wasn't much experience for some time and probably it also being the first their were probably quite a few people who received them who shouldn't have. All that said, I would still ask why not the Prodisc. They may have good reason for it, like they don't think it will work with your physiology or they feel the Charite is better?? Or it may boil down to insurance paying for one and not the other.

More than anything, trust your gut feeling. We all get chicken, nervous and scared; but I think we would be crazy if we didn't- just shows that you are taking it serious. I'm sure with your previous bad surgical experience and pain control issues, that's a lot more to worry about too. I don't know if I knew how bad it hurt prior, if I would have been brave enough to have it done (ok, I would have, but it would have taken some Valium to get me to the hospital )

Good Luck and I'll be praying for wisdom and confidence in your decision.

[Metalneck07]

Hi Kathy
Thanks for writing me.I hope all is well with you.I feel better about the TBI Surgery Center since writing the thread.
I know you and a couple others felt I would be in the best hands there.My Mom said the same thing as you did that she felt it would probably be even better care than the hospital since it there would be fewer patients.And like you said if the need arises the main hospital is right there across the street.
I do believe the main factors are the surgeon ,the right patient,and placement. I have complete confidence in Dr.Blumenthal and that I'm a good candidate for ADR.And so far as the surgery goes I know he's pretty high up on the list
for being good at what he does.So far as the choice of ADR used I'm questioning this a little.I have a phone call in to
Dr. Blumenthal on this.I should be hearing back from him on Monday as he is out of the office until then.I don't believe it's
a Insurance factor because last night I found a link on another site to Aetna.And Aetna covers both Charite and Prodisc.
I will be curious to hear why.If it was up to me I would prefer the Prodisc though with that said I wish some of the others were available.I don't believe I'm a candidate for a trial because I have two levels of concern.Sorry Kathy I have read some many people's history I cant remember for sure yours.Did you have just one level?
Like I said I will listen to his thoughts on this and go from there.If there is no paticular reasoning then I will ask for Prodisk.:thumpup:
I know deep in my heart moving foward with this is a good thing.I have dealt with the increasing pain long enough.As well as my right leg and foot getting worse.(pain,weakness,numbness) Though like you said with my past history I have to for myself feel like I'm researching this alot so I can be at peace with it. I'm getting there it's like a rollercoaster ride . I really appreciate your thoughts and prayers.As I have said before it's of great comfort to know
that I'm surrounded by so many caring and thoughtful others in this group.
Take care.
Caitlin aka Metalneck07

[KBear]

Caitlin- I did only have one bad level, L4/5. L5/S1 & L4/3 had small herniations but were not bad nor pain causing. You are obviously one tough cookie having 2 previous surgeries. And did I read a mom to 5. What ages, if you don't mind me asking. Mine were 3 & 5.5 when I had surgery.

[runagain]

Dear Caitlin,

I do believe it is perfectly normal for you to have questions or concerns before a major surgery.
To answer your questions in the best way I can:

1) IMHO, there are lots of people walking around with Charites and are fine and then there are the opposite. From what I have read/learned, the Charite is a little bit more technically challenging in its placement. However, TBI docs have done several (I mean lots) and he may prefer that disc for you like Kathy said. Or he may be more comfortable with it. Dr. Bitan of New York, and other prominent doctors use the Charite. Like you, before surgery, I preferred the ProDisc. It looked more stable. I would just ask why your surgeon prefers the Charite for your particular surgery.

2) I would not worry about TBI, "not being a hospital". From the picts I have seen, they have full-functional operating theatres. Those are not the same as ones at a surgery center. Plus the hospital is adjacent, that is no further than having to go down a flight in an elevator or get pushed down a long hallway in a hospital. Plus again, I am sure with the amount of surgeries they do, they have encountered patients that needed to have intensive care.

3)The insurance. I wish i had Aetna--things would be a lot easier. Aetna approves ADR with most of their policies. They have approved multiple ADR levels before (and I know this as fact) but not for everyone. It sounds like the office is not worried about them approving the surgery. And usually, the patient gets notice of approval about the same time as the doctor and sometimes sooner. I do not see why they would disprove your surgery. However, it can be a "nail-biting" time until the approval arrives in the mail. I have read that Aetna's approval for a single level ADR does not have to be determined, rather as long as the surgery is needed, people get it. It is an "approved" surgery with Aetna, not what any of those ding dongs at the other insurances do.
With TBI's background, a hybird (ADR/fusion) is not unusual.

4) I have a question for you. You are not by chance momwithfivekids. in another site?? I am just asking because I knew a person that had five kids and spineys with five kids are not that common.

You know what, don't worry too much. But I know that is kinda difficult. Just keep us informed and we will help you along.

Runagain

[Metalneck07]

Runagain:
Thank you for the reply.I'm feeling somewhat better with everything that was on my mind.
I have got plenty of feedback with lots of positive feedback.I'm still waiting to hear from
the doctor on the ADR choice.I should be hearing this afternoon.I'm just taking things one
step at a time and trying not to let things get to me.It only makes everything worse on me.
At this point it's in God's hands and I know it will all work out somehow ,someway.I just
have to make sure I have the information I need . And I truely believe TBI is the best place
for me.Thanks again for your thoughts.
Oh Runagain and Kathy(kbear)
Yes I have five kids Though to your question Runagain no I'm not the person on another site whose momwithfivekids. I'm kaitiedid on spinehealth. The kids range from 19,16,14,11,10.At the time of my 1st surgery they we're three years younger.But with that said they we're old enough to be very helpful and able to be independant.But with that said I won't say it hasn't been hard for them.I have carried an extreme amount of guilt that the last 4yrs.has denied them
the Mom they needed.I have tried very hard not to let this take over our lives.But I know it has to some extent.
I pray so hard this will be last of my spine issues so I can pick up the pieces of our lives and move on.So I can be a wife again and the Mom I need to be for my kids.
I'll keep you updated on what I hear from the doctor.Talk to you soon.
Caitlin aka metalneck07