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any thoughts?

gdilulloggdilullo Posts: 1
Hi everyone,

My name is George and I am 41 years old and I hope some one out there has some ideas for me... Thanking you in advance :)
I have been diagnosed with rediculopathy, degen, disc disease.
January of 2008 I had severe and excruciating pain in my low back radiating down my legs that left me totally sidelined, flat on my back. After an MRI scan it was obvious that my L5-S1 disc was torn. As per my orthopedic doctor at that time I began a series of 4 cortisone (steroidal) painful shots to my hips, after no success there, my doctors then began cortisone epidurals to the L5-S1 low disc. I had approximately 12 over a 16 month period of time, with minimal relief. Sometimes I could get up to 2 weeks relief, and other times no relief at all…

After exhausting all minimally invasive options, my orthopedic surgeon then informed me that I was a perfect candidate for a full disc replacement surgery. He stated further that if he were me, he would not settle for anything less. Unfortunately, my insurance company (Independence Blue Cross) deemed this option as exploratory, and after two (full) three tier refusal appeals they (Blue Cross) denied my surgeons advice and just flat out refused to cover a full disc replacement period. My Orthopedic surgeon at the time seemed to loose interest in my case and my appeal. Believe it or not, this was the only in network surgeon I could find in my area.

Still in a lot of pain, and unable to work, I had no choice but to go out of network to find a new orthopedic surgeon. This new orthopedic surgeon was not so friendly, not at all, but, his surgical reputation was very good, despite his definite God complex. Anyway, he ordered a nerve conduction test, and that’s when we discovered that I had definite nerve damage in addition to the bad L5-S1 disc.

The new ortho surgeons plan was an L5S1 discectomy, fusion, with instrumentation. The surgery was anterior and posterior, so I was cut on both sides, and suffered urine retention for the first 5 days post surgery.

It’s been about 5 months or so since surgery, and while the old pain in my back is definitely reduced, the pain and spasms in my hips and down my legs is insane and constant. I have completed 5 months of physical therapy and still have this pain in my hips and legs. Its so tender to even just sit down on my butt. And even then I can only do it for a short time… Blue Cross says no more physical therapy period.

At my 4 month post surgical visit or check up at the surgeons office which ever you call it, I began to explain this all to my surgeon. His response was shocking.. His reply was to point at the xray of my back showing the fusion and then he said that the fusion is beginning to take, which is a good sign and therefore I have lived up to my end of the deal. He never addressed any (not one) of my additional issues or concerns regarding the hip and leg pain..

Two weeks ago, my long term disability carrier (Prudential) cut my benefit because although no doctor said I could go back to work, no doctor said I couldn’t, and that’s why they stopped my payments verbatim … There is absolutely no doubt in my mind that I am not ready to return to work.. Im lucky if I can stand for more then 15 minutes at a clip, and I cant sit for much longer either.

What am I gonna do?


  • You have definitely come to a place where you'll get some support. Hopefully someone familiar with LTD can be of help here.

    Do you have a regular physician? My advice is to ask him/her to contact your insurance company stating you are unable to return to work at this time. Paperwork will need to be filled out. I also would ask for more testing to be done of your hips, such as an MRI, to rule out a problem there.

    I am shocked you got so many epidural steroid injections in such a short period of time. My understanding is that 3 is the standard amount in one year.

    Another thought is for you to seek help at a pain management clinic. Are you taking pain medication? If it is nerve pain, are you taking something to help with that?

    Keep us posted. I'm so sorry your experiences with medical professionals has not been good.

    Best wishes,

  • That's my first thought. Sorry but you seem to have found some of the most unfeeling doctors around.

    Disk replacement is very difficult to get approved. Most insurances will fight to the end to not pay for it. That first doctor sounds like he was only interested in getting guinea pigs for the surgery.

    The second doctor is correct actually but should have referred you back to a neurologist. Surgeons take two roads. Some like yours just do surgery. When the surgery is complete so is their job. THis is actually appropriate. My best example of this is when you have a root canal. The dentist sends you to a surgeon. Once the root canal is done you go back to the dentist. However some surgeons keep treating their patients and even go so far as diagnosing new problems. THis is not necessarily a best practice.

    You need a neurologist who will order the correct tests and diagnose your condition. He can then refer you to a surgeon or a pain management doc for further treatment. Skipping this step is only cheating yourself. The neurologist is also the one who would submit a report to your LTD stating your ability to work. Surgeons and PM are not qualified to do this.

    I hope you take my advice. I think you will find that within a week the neurologist can having you feeling much better and on a path to treatment.
  • dilaurodilauro ConnecticutPosts: 9,859
    The whole thing about spinal problems and pain is a very difficult thing to tackle. It is so much harder when it is first presented.

    You can easily get confused about which doctor to see, who can tell you what, where you should go, what you should do, etc

    Trust in yourself, trust in the doctor that you are currently seeing. Talk to them about your problem, discuss it in detail. If they feel you need to go see a specialist, I am sure they will recommend that.

    I never like the approach to go in guns-firing and telling the doctor that you want this and that, and that you demand to see a neurosurgeon or have a MRI or whatever.

    I believe your best course of action is to talk everything over with your doctors, your MRI, your other diagnostic tests... Find out what they think the next step should be. And if it doesnt make sense to you, talk it over.

    Show me, show me show me. You never have to tell them tell them tell them.

    Working within your current environment is your first best course of action. And if that proves not to work, then you can move on to another plan.

    One step at a time.

    And please remember , we are here to try to help you in which ever way we can. We are not doctors, so for anyone to tell you to see this or that or have this or that do, take it for a grain of salt.

    We are all laymen here, probably experiencing what you have been through at one time and are trying to help out.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I can relate to your feelings of helplessness. After my surgery (rods,screws,cages etc..) did the prescribed PT but found myself in a similar state as yourself. Went back to my surgeon twice and he was happy with x-rays but I was not able to stand or walk without ++pain and muscle spasms.Asking for his help as to what to do next to improve my physical condition he sent me to a different style of PT. Rehab is now my main occupation for 12 weeks and they teach you that pain will always be hovering but learning ways to strengthen and minimise pain flare-ups is their specialty.Understanding why my body is not behaving and learning how to cope using medication and physical exercise is so far making sense. Don't give up asking questions, all you want is to build on the surgical improvements.I hope this makes sense but maybe try again with the surgeon or your family doctor. Sorry but living in a different country I am not up with insurances. Good Luck and PM me if you ever want to have a good vent. Hugs n' Loves - Paula
  • hi and welcome to the forum! :H we are here to offer you support and answer what questions we can. i hope you get some ideas through the forum to help you with some of your problems. you have already been given some great advice! please take it easy till you find yourself feeling better. stop by the forum anytime! Jenny :)
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