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Please All, I Need Your Opinions. I'm Nervous......

caitycccaityc Posts: 268
edited 06/11/2012 - 8:25 AM in Back Surgery and Neck Surgery
OK, so dealing with back pain for years, tried all treatments, bla bla bla. I have a completely collapsed disk at L5 S1. My doc is ready to operate, but here's the thing.... My husband has a new job, and we are switching insurance carriers. This means I have to start all over. :''( Actually, not that big of a deal.
My concern is that when I see the new surgeon, he may want to hold off on surgery, try more conservative treatments, etc. Now I'm probably just worrying for nothing, but I have heard so many people on this message board with surgeons that are refusing to operate, or putting it off. I came so close with my old insurance, and I am just so afraid that for some reason my new surgeon will want to hold off for some reason.
I know I can get several opinions, but here is my real question. You would think that with a completely collapsed disk, pain, no quality of life, ect, that no doc could find a reason not to operate, right?

Thanks!

Caity
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Comments

  • Caity,

    I'm sorry to hear that you have been in pain for so long. I had problems on-and-off for 19 years, so I know where you are coming from.

    Your post is not clear, but I assume your current doctor does not accept the new insurance, correct? If he does take it, all you may need to do is get a referral through the new insurance company.

    If you have to see a new doctor, I suggest that you have clear documentation of all the different treatments you have tried, especially in the past 2-3 years. When you meet with the new surgeon, take this paperwork with you as proof of prior treatments.

    I would think that any good doctor would see your previous attempts and continue the treatment process, without forcing you to re-try the same treatments. Actually, with a collapsed disc, previous treatment shouldn't even come into play, but you may save yourself time if you have documentation just in case.

    In my case, I got a referral from my PCP to a physical medicine specialist who ordered an MRI. I told him all the different things I tried, and after receiving the MRI results, he referred me to a pain specialist who did a series of 3 steroid injections. When that didn't work, he referred me to my surgeon. My disc was partially collapsed, and he didn't need to hear about other treatments - it was either discectomy now and fusion later, or fusion now.

    I just switched insurance to an HMO. I had to switch PCPs because my doctor of 15 years does not take the new insurance. My surgeon takes the new insurance, so all I had to do was see a new PCP and ask them for a referral for my surgeon. They did it without question, so I am now set with my surgeon for another year.

    Good luck - I hope you can get relief soon.
  • caity- It is hard to know what another dr will do as they all seem to have different ideas and treatment plans.
    I don't know if you had a surgery date with the other surgeon or not, but it may help to bring all your records and the surgical plan from the other dr..
    I don't know if Cobra is a choice but you may be able to go ahead with the original surgeon, if you want. Cobra can be pricey, so that may not be an option...not sure though.. :/ jade
  • Hi Caity,
    I would ask your previous surgeon if he would write to your new surgeon letting him know of your past history. Make sure you get all your records sent to the new surgeon, and don't forget to get the records from PT, MRI, and any other treatments you may have tried or any other dr's that may have treated you for anything to do with your back, like you PCP.
    Most dr's understand that you may have to change dr's because of insurance changes. Hopefully you can transition without any further delays. Best wishes for a quick answer.
    Stacey
  • The surgeon ready to operate (old insurance) is with Kaiser. They are completely one network. My new insurance is Blue Shield HMO. Actually, Kaiser is COBRA, which we have been paying since April. The new insurance with my husbands current employer is cheaper than COBRA. Also, COBRA runs out in August of 09, and we wouldn't be able to get insurance with my husbands new employer until Dec of 09. So that would mean 3 months without insurance, which we can't do. We have 2 children. So you see my dilema? :S We have to hop on this insurance now.
    Mark, I hope you are right that a collapsed disk is enough. But you're right, I should get all of my documentation ready just in case. I imagine they will do x-rays at least, if not an MRI to confirm it for themselves.
    And Mark, you did answer my question saying that if it is collapsed, previous treatment shouldn't matter. I know it is just your opinion, :) , but it helps to have the affirmation.
    Jade, your are so right, that is why I worry. You never know what a surgeon might think. Let's hope Mark is right. :)

    Thanks!

    Caity
  • When I was discussing my condition with my new surgeon, he offered different things I could try but then he said "It's not a matter of IF you have surgery, but WHEN." That made my mind up right then.

    Maybe you could ask your new surgeon that question and if he says it's just a matter of when for you, then it could move things along.

    Just a suggestion.
    Cath
  • Caity:

    If you have insurance through Aug. 09, why not go ahead?

    Ellen
  • Because when the COBRA runs out in Aug of 09, then we won't have insurance for 3 months. If we don't take the new insurance now, we can't get insurance with my husbands current employer until Dec 09. That's when open enrollment is. We have 2 children and can't go 3 months without insurance. See what I mean? Ugggg! :)
  • So I talked to my surgeon (from Kaiser), told me they will do the back surgery, told me I need to quit smoking, and he wants to order an MRI. =D> I said that's great, but we are switching insurances. I told him how apprehensive I was to leave him and find a good surgeon. He said keep COBRA til December, and in December try to find a good doc with my new insurance. :S
    So then my hubby and I started talking. I said "Look, I trust this surgeon, he's operated on me once before, let's just pay the dual coverage until I have my surgery, then we will drop COBRA". My hubby agreed to this. <:P Rememeber, I spoke to my surgeon on Thursday, just two days ago. So I'm all relieved, 2 insurance payments is gonna be tough, but worth it cuz it's for my back, bla, bla, bla. TODAY, I get a letter from my COBRA company saying they no longer offer Kaiser, and are switching to another carrier. OMG!!!! :& I wanted to die! I had this hysterical crying fit that if I had only lost weight a year ago like I was told, my surgery would be done, and I would be recovering. L) Now I have totally blown my chance to be operated on by someone I completely trust. I fee like such a failure! I know there are other good surgeons out there, but now it is just finding one. I have to start all over. :''(
    Just wanted to give you all an update. Thanks for listening!

    Caity
  • Get all the Dr's notes to give to the new surgeon. Perhaps he'll give the okay. There's a time for everything. Try not to be hard on yourself because you haven't lost the weight. It's hard to excercise while you're in pain. Have you ever heard of Deserata? Be gentle with yourself. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Ask your Kaiser doctor for a referral. Take all your paperwork, office notes, films, etc to the new doctor. If the Kaiser doctor and the new doctor have a good relationship and such then you should be ok. It stinks when you lose a doctor that you really like. But you should be able to find a good doctor through BC since most doctors take it. >:D< >:D< >:D< >:D< >:D<

    I've been through insurance purgatory over the last year and a half so I know how you feel on this. But a collapsed disc and all the other issues you've got with supporting paperwork and films should show a new doctor that you've done everything and need the surgery. I hope it goes well for you.
  • Hi Caity,

    I am glad you are resolving your problem with the double coverage. I myself have Blue Shield of Ca HMO (on top of Medicare) and I had absolutely no problem with them including when I had my three-level fusion. I even got a little extra in the form of a bone fusion stimulator implanted at the time of the surgery.

    If you make the switch due to your husband's job change, they have to accept you without questioning any preexisting conditions. So if you find a good surgery for your post-surgery care, there should not be any problem. Where do you live? If you are in N. California and if you pm me, I have the name of an excellent OS (my surgeon), who accepts Blue Shield of Ca HMO.

    Good luck,

    Kin
  • Hi again:

    I would think you could get a referral from your Kaiser doctor. As far as getting a new surgeon, maybe he can give you a name, if you have an MD, he can refer someone.

    Sit back, count to 10, take a breath, it will work out!

    Ellen
  • Please don't look back and be too hard on yourself.There may be other reasons,better reasons,for you not to have had your surgery earlier.Since we never know and we can't go back in time I believe in most cases it works out for the best.

    Wishing you ALL the best ☺
  • Robin, I have a girlfriend that today told me that maybe this whole issue with the insurance is a blessing in disguise. I think you guys might be on to something.... :)

    Oh Kin, I wish I was in Northern CA, but I'm in South CA. Thanks for offering though.

    Kaiser is very in network. Meaning, I don't think my doctor would be familiar with any doctors outside of Kaiser. However, there is a possibility. I will ask him.

    I will get all documentation, and a letter from my Kaiser surgeon, that way I can be armed and ready when I get to the new surgeon.

    Thank you all again for your responses. I really appreciate it. I love this message board.

    Caity
  • system really sucks :''( . I cant believe that you cant choose your own Dr or surgeon!

    I am sorry you are going through this Caity. I suppose the only thing you can do is prepare yourself for this surgery when ever it comes. Stop the smoking, exercise as much as you can (water is great) and try to loose weight (I know tha this SO hard when you are in pain and not active.)

    Blessings Sara O:)

  • Caity, sorry you are going through these difficulties. Unless your surgeon has worked locally outside of the Kaiser system I doubt he will know anyone. Do you live near any teaching hospitals, like UCLA or ? Sometimes those are a good place to start. I am in the Central Valley and have had friends go to UCLA for specialty surgeries (not spine). Do you know any hospital nurses? I am a nurse and I selected my surgeon after talking with many nurses who work with him in my facility.

    I am having a little issue myself. My employer is changing to Anthem(Blue Cross's new name) for the new year, and my surgeon is not listed as a provider. I am hoping he just hasn't signed up yet, since he works for my employer, does all his surgeries there, and we are an Anthem provider. Makes sense that he would take it. I think I am covered under my surgery for a while, but not sure how long. I see him Weds, so I am gonna find out. I shouldn't think about it, but if I have any more trouble I want to be able to go back to him.

    When does the new Cobra start? Is there time to get the surgery at Kaiser first? All of my follow up so far has been covered under the surgical fee. Not sure if Kaiser works that way of not. I have been a nurse for 20 years, and I know the majority of physicians in my area. We have a new Kaiser hospital in town, and have had a Kaiser medical center for like 8 years,and I don't know a single Kaiser doc. My mom (who has Kaiser) had eye surgery and it was hard not to be able to make sure she had a great doc since I know no one from Kaiser. Then she had complications and had to go to surgery again the next day. So actually, maybe it is a good thing that your insurance is changing ;)

    Good-luck to you, let us know how it turns out, >:D< Sue
  • First, I want to tell you I'm so glad your first day at work went well. Good for you!

    I don't know what the heck I'n gonna do. :S Actually, my new insurance is Blue Shield. We no longer have Kaiser as of 12/1, so surgery before then is not a possibility. :(
    St Jude. Heritage is the medical center around here that takes Blue Shield, so I'm gonna do some investigating. :) I'm sure everything will be fine. Just so disappointed in myself. L) LOL!

    Caity
  • Caity, don't be disappointed in yourself. You can't change the past. Why not focus on one thing at a time. I would think the smoking is the most important. Work on that while you get this insurance thing figured out. Loosing weight is extremely difficult. Some of us just have the metabolism of a turtle :D. Do you have access to a heated pool? It is a way to get in a little exercise without causing pain. It was the only exercise I could do before my fusion, as I couldn't even walk because of pain and limping. I still go now a couple times a week along with walking and PT.

    I am going to send you a PM. Take care, >:D< >:D< Sue
  • I haven't smoked since Thursday!!!! <:P I could use the excuse to smoke, since I am probably not going to use Kaiser now, and there is a chance I could find a doc that would operate even tho I smoke. But nope! I'm not gonna do it! I really want to quit.
    Unfortunately I do not have access to a heated pool. We have a cold one in our backyard, and I've tried exercises in it, but I do wind up hurting. :(
    I've already picked my PCP with my new insurance, so I am going to call tomorrow and get and appt with her as soon as possible in December and go from there.
    Thank you all for your kind words and support. It's been a crazy couple of days. #:S

    Thanks!

    Caity
  • Caity:

    I've never been a smoker, but if you have stopped, DON'T start again! Give yourself CREDIT for stopping and keep going! No matter when you have surgery, smoking is so BAD for you! You said you have two small children, get healthy for them and yourself!

    I know Kaiser is a world of it's own, your previous doctor may not know of a referral doctor.

    Where are you located in Southern CA?

    Ellen
  • I am in Orange County. I still have not smoked. <:P It's weird, because it is hard, but not as hard as I thot it would be.


    Thank you so much for your support!

    Caity
  • Caity:

    I am glad that you are doing well since you quit smoking. I have never been a smoker so I don't know what you are feeling. I have been a "food addict", I still am. I don't think you ever get past something like that.

    I live in Murrieta, so I am south of you. I would think you could find a good doctor in Orange County, it's a big place. You aren't too far from UCLA, I have heard good things about it but nothing specific. Do you have a local GP that can refer you to a surgeon?

    Ellen
  • have a GP. I am going to schedule an appt. with her in December once the insurance kicks in. I have seen her many years ago, and very good friends of mine have seen her for 20 years.
    My nephew and wife live in Murrieta! I love it out there!
  • So I have an appt with my new PC on December 24th. I am going to gather all of my info in the mean time (medical records, letter from my old surgeon, etc.) just in case she is hesitant in giving me the referral. I can't imagine she will be, but you never know.
    I just keep telling myself that everything happens for a reason, and one day I will get my surgery and get fixed! <:P

    Caity
  • caity- I would ask if you have a deductible and when it begins and ends. I once switched insurance that you had to meet the deductible beginning in Jan thru Dec. So when I went to the dr, I had to pay the yearly deductible in Dec and then again in Jan. I did not know this until it happened to me....just something to check into....jade
  • Fortunately, I don't have a deductible. Otherwise, yes, that would be costly. :)

    Caity
  • I found out on Monday that with the type of insurance I have, a referral to an Orthopedice surgeon does not require a referral from my PC!!! <:P I can go straight to a specialist. I am sooo stoked! That's all the more quicker I can get my surgery scheduled. That is, trusting the doc that I see will agree I need it. I can't imagine he won't agree, but you never know. I have to get my medical records from my previous group so the new doc can review it.
    I am just sooo happy! On the road to recovery again!!!! :) :) :)

    Thank you all again for your responses and your kind words!

    Caity
  • It probably won't be an issue--but when I tried a new doctor, he sent me for a discogram. Turns out--that test really wasn't needed considering my back is fine except for L5/S1. Discogram was very painful and useless--with the collapsed disc, they really couldn't get the dye in place--although it did recreate the pain.

    I know you read my other post, but I will say it again unapologetically--be careful with surgery. I am 3.5 weeks post-op, so I am probably not a good gauge--but so far I wouldn't say I have a rosey feeling about the surgery--and our problems seem pretty similar. Everyone is different. Some docs will not operate for DDD unless there is nerve damage or instability--I can see why. Boy, there are no easy answers. Just be careful, my friend.

    Chuck
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