Fast sugery date with Dr Bertagnoli

[steve55]

I think Mark was as amazed as I was at how fast Dr B's people came back with a surgery date. Mark (MMglobal) submitted my films on Thursday 2/12 and my prognosis/surgical recommendation came back on Sunday 2/15. Surgery date assigned on 2/16. Surgery is 2/26.

The great part about all this is that I have beaten the deadline at which my Aetna coverage ends (Feb 28) and my Humana picks up (March1st). I think I have a fairly good chance at winning a 2 level ADR appeal with Aetna. Aetna seems to be the most ADR friendly carrier out there. Many others folks have won 2 level appeals also. Plus, the other great news about such a fast date is that Ive only gotten worse lately. I took 70mg ultracet along with 1 hydrcordone and I still was not able to fall asleep till 7AM saturday morning due to pain. Much of the time, I cant find a comfortable position to sleep . I used to be able to sleep on my sides. Nothing works now. And I cant stand this popping and grinding and grating noice I have all the time! Its so unnatural and unerving, not to mention some below the waste symptoms/irritations that plague me that Im 100% certain are directly associated with my neck pain. I cant have this surgery too soon. Im so miserable at this point Im not even worried about the surgical risks. Im completely stoked that Im getting this in on such short notice. Man its such great news. I was shocked! AT least I can say that this process is starting out on a VERY good foot, hopefully thats a good sign of things to come.

I feel confident Im a straight forward case and that this surgery will work for me.I know Ive got one of the top 2 multi level ADR surgeons in the world, if not the top one. Cant better the odds any better than that.

For anyone who cares to know, I was quoted $26,205 Euros (at today's 1.29 exchange rate, thats $34,000 USD)

[Cheryl]

Steve,

Best of luck to you. Thanks for sharing - your thoughts hit home. You have made the best decision with the information you have and for what its worth I think you've made the right decision. It will be hard to have regrets when you go to the best.

I'll be looking for your posts.

Cheryl

[Cindylou]

Good for you Steve! As someone else said, you know you are in probably one of the top, if not the top, surgeon's hands for multi-levels. That's piece of mind. I hope you have excellent results!

Cindylou

[dshobbies]

Steve,

Yes, things work fast when dealing with Mark. I wish you every luck with your upcoming surgery and know you are in the best hands. His staff is also very caring and very human. I feared 'Germany' but all fears were unfounded.

I flew in and out in business class. If this is beyond your means you might want to try 3 seats in a row. This is Maria's trick for comfort. But you'd better hurry, surgery is just around the corner

Dale

[Maria]

Steve,
Glad to hear you're on the list for surgery ASAP! No time to change your mind

Re the 3 coach plane seats, I'm a short (5'2")/slender female so a taller bigger guy might feel cramped. Some of the seats are uncomfortable this way for any duration so if you would choose to purchase a row or even 5 seats if that's more feasible than biz class then I'd suggest bringing some kind of mat you can lie across the seats for extra cushioning as I only fly nonstop from LAX to Tampa and it's usually a bit short of 5 hours straight (I buy 3 seats/row).

Perhaps you can sit longer than me which is less than an hour or a tortured hour plus in a plane but if not, do what you have to do.. it's well worth the comfort and for me the ability to be mobile once I get somewhere vs. precipitating a huge horrible spinal episode en route to my destination.

Or maybe you will just be "good to go" so to speak re surgery! Ok, wishing you the very best with your surgical outcome and recovery and glad it's so soon and you're that ready

[treefrog]

Great news Steve. That is really quick. I hope you are able to make all the arrangements in time, though I'm sure with Mark's help, it will all come together.

I think you have made the best decision you can make with the available information.

I look forward to hearing future reports.

[SASSY178]

Good luck to you!!! let us know how you make out. It's great to have a doctor that you believe in and that specializes in the technique. I see Dr. Yue at Yale who has worked with Dr. B in Germany. They are among the best in the ADR field.

[fortitudine]

Good luck Steve! It sounds like you are at the end of your rope. I hope this is the answer for you. We'll look forward to a happy post in a couple of weeks!

[steve55]

Thanks everyone.

Fortunatley, my mom had 300,000 miles on her AA miles account. It cost her 125,000 miles for the following routing:

I have business seats on AA on a 737 for the DFW /Toronto routes and First class on British Airways on a 777 between Toronto and London, and Business class on a British Airways A320 between London and Munich.

I think the 1st class goes all the way flat, and business probably half way between up and flat, like 90 degrees recline Im guessing?

[Justin]

I flew home at 2 weeks from Munich, Germany --> Atlanta --> New Mexico in coach and I was fine.

First Class should be relaxing. The key, no matter where you are sitting on the plane, is to make sure you get up every so often to help avoid a deep vein thrombosis.

Good luck and keep us posted. Drs. Bertagnoli and Fenk-Mayer are incredible surgeons.

[fuzzy]

I am pretty sure that business class should be fine but if you can get first class then go for it.

The less stop overs the better. If you can get non stop then go for that!

I stayed in Germany for 5 weeks after the surgery and I have to say I am glad I did. I would have been fine at 2 weeks but I really was still hurtin really good and didn't like the idea of changing planes in frankfurt (omg) but a 4 weeks I was pretty fit.


I wish you the best and I agree that is what I really like about the German teams. They can get you in quicker then over here in US. It all seems a little less cluttered.

I am pretty sure now I will be seeing them again as well, my neck is next.

[trkdoc714]

It depends on the aircraft. Most of the long business class flights I've taken had full reclining seats.

I took BA to Manchester from Chicago in coach once. It was comfortable enough but I still felt the need to get up and walk once in a while. Those are long flights!

[Maria]

In the past I was able to stand much of flights or get up frequently but now it seems the airlines desire more control over how much people are up and about so even tho I know you will look and act the spiney part due to pain maybe you'd want to wear a brace or something on the outside just to reinforce the appearance of needing to get up (if you've much trouble sitting en route).

Wishing you a very comfortable flight and all that follows

[Terry Allen Blackburn]

I had my surgery done November 4th and flew home November 17th from Germany. I took Ativan for making the flight more comfortable and the pain medication I was on. Ativan made the trip bearable even with flying regular coach class. Like Dr. J said, get up and walk as it is a long flight and you don't want to clot. They had us self administer Heparin shots daily until the flight home to prevent clotting. I would also recommend support hose for the flight. The Ativan put me in a dream like state and I don't remember anything of the flight. It sometimes has the amnesiac symptoms. Make sure someone else gives you the medication so you don't overdose.

Good luck with everything.

Terry Newton

[Cheryl]

Look like a spiney. I actually got scolded in first class for getting up and about. My companion had "words" with the flight attendant. I think we have some free vouchers over it.

In any case, the more you look like a patient the more sympathetic the staff will be.

[mmglobal]

Be very careful when talking to the airlines. Set up wheelchair assistance in advance. I've seen several people who have tried to talk their way into a free upgrade or other consideration by saying, "I just had surgery and I need help." The answer to that will be, "we cannot let you on the airplane without a release from the doctor saying you are fit to fly."

[fuzzy]

Now Mark, that is very valuable advice!

[SandyW]

Good luck Steve, you are in good hands.

Take your own pillow, you can use it on the airplane, hotel, hospital - it was a life saver for me. One of the pluses on business/first class is the food. I had yummy lamb chops, as good as any 5-star restaurant, the whole ball of wax beautifully presented, desserts, chocolate, and all I wanted to drink - had to turn down the wine however.

I have to admit I used the "poor me" along with honest tears, really!!!, to get my hubby moved from coach to be with me. We couldn't afford both first-class tickets, there were so many vacant seats I had to ask. At first they told me they would take a drink to him and tell him I was ok, then they came back and said they were allowing him to move up. Yeaaa! Doesn't hurt to ask!

Steve, hope you get to talk to Mike. Will keep both of you in my thoughts and prayers. Say hello to Dr. B and Dr. FM for me. Sandy

[Roblin]

Steve,
I wish you the best. I flew home after 10 days from a 2 level cervical ProDisc surgery and some lady in business class came back and gave me her 3seats in business class and took my coach seat. I believe she was an angel. It is doable. Best wishes for a great surgery and quick recovery. We actually did a little sight seeing the last few days we were there. I was amazed at how much better I felt almost immediately.
Bless you,
Roblin

[mmglobal]

I just spoke to Steve. It's Friday late afternoon, he had the surgery Thursday noon. He's still in quite a lot of discomfort, but did not seem in distress when we spoke. Interoperative discography showed the 3rd disc to be wide open, so he's one of the few people I know who got more discs than expected.

He sounded good... I hope he turns that corner soon.

More as I hear it.

Mark

[Cindylou]

Thanks for the update on Steve, Mark. So, did he end up getting 3 discs or 2?

Cindylou

[mmglobal]

He got three... he also got a new version of the ProDisc-C called the Nova. I'll have more about this soon.

[Kathy]

I'm so glad to hear that Steve is on the 'other side'. That is great news! Good thing he had a great dr. who saw the need for 3 and did it and that he didn't end up having to go back after the fact for another surgery. That's great. I hope to hear more soon.

[mmglobal]

I spoke to Steve again this morning. He had a pretty tough week recovering from his 3-level cervical ADR surgery. However, he said that yesterday, he suddenly turned the corner and was feeling very well. His old pain is gone and some nerve issues that his home doctors said could not be related to his c-spine are also gone.

He's leaving for the US on Saturday am and he should be in the air already. It's a shame that he turned the corner so recently and I hope the trip doesn't set him back too much. He should be around soon to give us the first hand report.

All the best,

Mark

[Terry Allen Blackburn]

Amazing story and outcome. To get three discs is a big surgery. It will be interesting to hear the first hand account of the experiences over there. I will pray for a continued good recovery and continued relief of your symptoms Steve.

Hang in there.

Terry Newton

[steve55]

Thanks for the well wishes everybody. Well, as mark said I finally turned the corner and was able to fly back home. But prior to that, I couldnt hardly go walk anywhere(like going to eat) without having really bad pain. It was agony just sitting at the dinner table with my friend. Even the smallest head movements could send pinched nerve sensations through my neck. I spent a week just laying in bed day and night. I could not sleep for more than an hour or two at a time so I just got whatever sleep I could get in small doses. But overall It wasnt too bad I guess. Odd thing was that I was feeling much better upon hosiptal discharge than what I felt later in the week at the hotel.

Nevertheless, this post op pain I have been having is only from the shoulders on up, due to muscle stretching that occurs during surgery. The old pain between my shoulder blades and my below the waste symptoms are all gone!! I could feel that from day one after surgery. These stupid US doctors dont seem to know squat! Im still aggravated and frustrated that they dropped the ball on my below the waste symptoms. They said it was "IMPOSSIBLE" that my below the waste symptoms were related to my cervical spine issues because the spinal cord doesnt go down that far. Ya see, I got several second opinions from 2 top surgeons , one orthopedic and the other a neurologist. One sent me to a urologist for gods sake, I knew it was a waste of time but I did it anyways just to prove to him it wasnt anything related to a seperate urology issue. However, to his credit, Dr Ziglar was the only "US" one who said it was a possibility". Of course, as I suspsected, Dr Bertagnoli said it was not uncommon to have cervical patients have below the waste symptoms and he expected ot to clear up with this surgery. And it did. These US doctors still have a long ways to to go to get to the level of EXPERTISE of the german doctors.

ANyways, back to my surgery,........

My 3 level surgery should have taken about 3 hours but Dr B says it took 6 hours because my case was "technically complilcated and challenging". Dr B said" We had to do alot of remodeling and restructuring". He went on to explain that he checks every single nerve at each level to make sure there are no other compressions occuring. In my case it sounds like finding all the nerves was a bit tough and then he had to further decompress some of the nerves ,....I guess that besides the bulging discs, I probably had bone spurs and other structures that were pressuring my nerves that he had to "restructure" to uncompress them. I do recall that I had some stenosis mentioned in my MRI reports, so yea, maybe he cut away some bony out growths or stuff like that. He sure went all the way for me by doing a 6 hour surgery. I looked him in the eye and gave him a heart felt "Thank you" for spending all that time on getting me done right, to which he replied "it was my pleasure". Ive heard (though dont know if its true or not) that not all doctors will do that, many will just put in the discs and not get too involved in looking for or cleaning up other issues as there are other patients waiting for the surgery room after yours is done.

If I had done the 2 level here in the US with Dr Ziglar, I bet we'd have never discovered the 3rd faulty level. Dr Zig was just going off the discogram and saw that only 2 levels were causing pain. However Dr B came into my room 1 day preop and discussed his suspicions about the 3rd level possibly being bad. He asked me how I felt about doing the 3rd level if it looks bad once he is in there. I told him to go for it, and that his decision making on ths issue is better than mine. So, he did a discogram while he had me cut open and he witnessed the dye material was leaking into the spinal channel!! So, Im glad I got all 3 done after all. I really love dr B's approach. He visited at least 3 times in my patient room. It was real nice to be laying in the hospital bed watching TV and to have him just swing on by from time to time discussing things with me. Of course, the final meeting was more formal in his office and we had our picture taken together and he asked me if I was interested in serving as a reference for other patients which I am very happy to do. As we got up to leave, he again restated how much he is worried for patients who are getting multi level fusions here in the US. He seems to think that the risk of fusion gets exceedingly riskier the more levels that get done. The risk, of course, is needing more fusions done in the future due to a cascading effect of a stiff fused spine.

So, bottom line is that I am 100% "Old" pain free!! Just dealing with the surgical pain of course. Dr B is a incredible person!! I chose him based on the fact that 99.9% of the patients who posted having surgery with him all came out great.I didnt see as high of a success rate with US doctors ADR's. Plus, the fact he has done more multi level surgeries than any other doctor in the world played a part in my decision also My next step is to prepare for going to war with Aetna. Ill beposting for help from you guys on that later. (i.e. people sending me proof of their insurane co approving their multi level ADR)

Ill post my X ray showing the 3 discs (and the new keel arrangmenet of the prodisc NOva clearly shows) once I get my computer back from my friend in the next few days). Or Maybe Ill send it to mark to post for me or in my signature avatar or whatever.

[trkdoc714]

Steve,

Congratulations on your "new neck"!!! I'm sure you've already gotten this but I'll run it past you anyway. Aetna's Clinical Policy Bulletin for ADR is numbered 0591. You can find the 18 page document on their site aetna dot com and use their search engine for clinical policy bulletins by number.

I had to get my HR department involved in getting approval for ADR surgery at Stenum. They relented to "out of netwok" coverage of 50%. Hopefully you'll get better results as far as percentages go.

I certainly hope your battle with them is much less taxing than the one you fought with the US medical community.

Bob

[dshobbies]

Steve,

Sounds like you're doing great. Glad Dr. B discovered that 3rd level. Right about now I'm wishing he had done my 4th.

Anyway, it's still pretty early in your recovery and any residual pain should subside with time.

Good luck with insurance!

Dale

[Terry Allen Blackburn]

Steve:

Your surgery sounds fascinating. What an amazing miracle of modern medicine. He sounds like a wonderful surgeon who goes the extra mile for his patients. I hope your recovery goes well. Take it slow and enjoy the new lease on life.

Terry Newton

[Cheryl]

Steve,

SO glad to hear your "old pain" is gone. That should help you get through the recovery processs. I hope you see a light at the end of the tunnel.

Best of luck.

I'll be reading your story as we have recently switched to Aetna and I have cervical pain.

Thanks for sharing.

Cheryl

[mmglobal]

Greetings from Lake Minnitonka, MN! Steve asked me to post this...

3-level ProDisc-C Nova:

[Kathy]

That is so cool to see how ADR looks implanted. I am still in awe everytime I see an x-ray. I can't believe that I will soon have my own. How is Steve doing?