Peggy's Scoliosis Surgery: the journey begins on 10/27!

[jackieg412]

As you approach your surgery date take a walk for strength and get a good book to read for when you can stay awake long enough to do so. Good luck and we are all on your side .Jackie

[PeggyS]

BMP denied by Medical Mutual

Have most of you had your surgeons use BMP? My insurance company has denied coverage. Dr. Buchowski told me not to take out a second mortgage. He'll use bone from my hip. Ack - I don't want to deal with potential additional pain or longer healing! He has ordered 6 large kits of BMP for a whopping total of $46,433! A peer-to-peer appeal is scheduled with the insurance company. I have paperwork for financial aid, but I don't think we'll qualify - at least not enough to actually help!

My husband had lumbar fusion last winter that involved 2 vertebrae, so it was probably 1 kit. Insurance denied him, too, but his surgeon wrote it off. According to Dr. Buchowski's nurse, nothing gets 'written' off.

Any opinions? Thanks.

[golfnut]

Peggy,
I had my surgery at Barnes, too, but with Dr. Lenke. Healthlink denied coverage for BMP which upset me since I thought it would increase the odds of fusion and didn't want to pay it out of my pocket. I called Dr. Lenke's office and was told not to worry about it because Barnes would absorb the cost, which they did. I hope it can be worked out for you.

[Irina]

My surgeon did not use bmp. She said I did not need it and there is some study that shows that bmp might increase your chance of cancer. They used one of my ribs for bone graft.

[LindaRacine]

Hi...

I got a PM from someone who is concerned about the reference to BMP and cancer. It appears that there is a small, but significant, increased risk of cancer.

http://www.ncbi.nlm.nih.gov/pubmed/25187579

I think many surgeons are still using BMP when they feel the situation warrants it. As always, I encourage everyone to find a professional that you can trust, and let that person, with all of their experience, determine the procedure and the materials to use.

--Linda

[PeggyS]

BMP update

My surgeon is going to use 2 kits of BMP, instead of 6. We're going to cover the cost ourselves. $15,000+ is much more do-able. Dr. Buchowski will use the BMP at the top and at the bottom of the fusion, the most stressed areas. He'll still need bone from my iliac crest, but this seems like a very good compromise.

My mom generously offered to pay for the other 4 kits, but I'm concerned about too much bone growth.

[tae_tap]

Out of pocket? Is Barnes not going to absorb it or Dr. B write off the application fee? I feel for you because that is a tough one to afford.

Tamena

[PeggyS]

Out of pocket? Is Barnes not going to absorb it or Dr. B write off the application fee? I feel for you because that is a tough one to afford.

Tamena

That's correct, Tamena. One of the financial managers for BJH told me that nothing gets written off. She sounded a bit offended when I asked! Nurse, Megan, has been very helpful with making the decision about BMP.

[green m&m]

My surgeon didn't use BMP, and I did not want him to. we both agreed in my case it was safer to not use BMP due to a tumor near my spine which has a chance of turning malignant.

[Susie*Bee]

Mine didn't either, but he did use something else with initials.. I think it started with a G... My op report is at the other house. For my own bone he used the facets, I think. Did not need to use rib or hip material. My fusion is solid.

[fifa]

Hi, Peggy!

I've been so busy with preop and other stuff that I have not had as much time to post of late. I, too, have spoken with Megan by phone just two days ago. Dr. B has recommended four large kits - the financial office has quoted me $7,738.85 each for a total of $30,955.40 (that is roughly half price). Megan said the exact same thing to me about "not taking out a second mortgage." LOL I'm in the processing of filling out the financial forms and compiling all the information (tax forms, paychecks, bank account statements). I don't want the iliac crest graft if I can avoid it, so we are going to proceed with the paperwork and see what happens. I figure the worst that will happen is we'll make payments on what we owe. My husband said, "there's no debtors' prison anymore." HA! As long as they don't come for our house or cars, we will figure out a way to pay it back. You have to decide what is right for you. I can't remember if it was Megan or the financial counseling officer - have spoken with both this week plus e-mails to and from both, but one of them said that the success rate of fusion with the BMP is 90-95% and around 75-80% without it. You might ask about this if you are still on the fence. I want the extra security, but that's just me and it may be a pipe dream. Honestly, I've been quite depressed this week on top of everything, especially the money and some of the test results that have come back, but am just trying to push forward. Whatever you decide will be fine. Having worked in a hospital for 20+ years, they won't tell you what they'll write off up front - you'll have to take your chances. I don't know anything about the cancer risk or any of that, but I know in my heart that what I've decided is right for me.

Been thinking of you quite a lot this week and hoping you are well. We are in this nearly together! HA!

Take care of yourself - you have a friend in Columbia. I'll message you soon. SO MUCH to do here (will post that in my thread).

Sending you pain-free hugs!
Fifa

[PeggyS]

Control freak!

I'm realizing how much of a control freak I really am!
I took pictures of the inside of our freezer, that's in the garage. I expect to finish wrapping Christmas gifts today and prepare just a few decorations to set out. Birthday cards, through Nov, are ready to mail. The spare room is filled with stuff for a month's stay in St. Louis, including little packets of coffee creamer! Next, I'm going to take pics of stuff in the basement, so I can tell our daughters where to find stuff I might 'need'. I have a list of banks & groceries, with directions for St. Louis. This is pure craziness!! It's even crazier when I write about it! We leave a week from Saturday.

[PeggyS]

Hi, Peggy!

I've been so busy with preop and other stuff that I have not had as much time to post of late. I, too, have spoken with Megan by phone just two days ago. Dr. B has recommended four large kits - the financial office has quoted me $7,738.85 each for a total of $30,955.40 (that is roughly half price). Megan said the exact same thing to me about "not taking out a second mortgage." LOL I'm in the processing of filling out the financial forms and compiling all the information (tax forms, paychecks, bank account statements). I don't want the iliac crest graft if I can avoid it, so we are going to proceed with the paperwork and see what happens. I figure the worst that will happen is we'll make payments on what we owe. My husband said, "there's no debtors' prison anymore." HA! As long as they don't come for our house or cars, we will figure out a way to pay it back. You have to decide what is right for you. I can't remember if it was Megan or the financial counseling officer - have spoken with both this week plus e-mails to and from both, but one of them said that the success rate of fusion with the BMP is 90-95% and around 75-80% without it. You might ask about this if you are still on the fence. I want the extra security, but that's just me and it may be a pipe dream. Honestly, I've been quite depressed this week on top of everything, especially the money and some of the test results that have come back, but am just trying to push forward. Whatever you decide will be fine. Having worked in a hospital for 20+ years, they won't tell you what they'll write off up front - you'll have to take your chances. I don't know anything about the cancer risk or any of that, but I know in my heart that what I've decided is right for me.

Been thinking of you quite a lot this week and hoping you are well. We are in this nearly together! HA!

Take care of yourself - you have a friend in Columbia. I'll message you soon. SO MUCH to do here (will post that in my thread).

Sending you pain-free hugs!
Fifa

Hi Fifa!

No wonder you're feeling down, with trying to work extra hours & getting ready for surgery/recovery. Any possibility for short term disability?
Let us know how the myleogram CT went.
I got the financial aid rep to give me an idea of what I might qualify for - I didn't want to do all that paperwork, if it wasn't even close. Last year's adj gross income was 'over the top' unusual & they won't look at previous years, which would give a realistic picture for future years.
I'm ok with 2 BMP kits, instead of 6. I like the idea of putting it at the most stressed areas.
I accept your pain-free hugs with gladness! Sending you the same!

[tae_tap]

I'm realizing how much of a control freak I really am!
I took pictures of the inside of our freezer, that's in the garage. I expect to finish wrapping Christmas gifts today and prepare just a few decorations to set out. Birthday cards, through Nov, are ready to mail. The spare room is filled with stuff for a month's stay in St. Louis, including little packets of coffee creamer! Next, I'm going to take pics of stuff in the basement, so I can tell our daughters where to find stuff I might 'need'. I have a list of banks & groceries, with directions for St. Louis. This is pure craziness!! It's even crazier when I write about it! We leave a week from Saturday.

Not crazy at all! I had surgery in November last year and had my Christmas tree set up and decorated with the kids in October because I did not want to miss out on that experience with them. You do whatever is going to give you peace of mind. Praying for safe travels.

Tamena

[Irina]

I am a control freak too, but this surgery made me be less so, HA! We really learn how to let things go while going thru recovery. I bought so much non-purishables before the surgery that some of them lasted a year. My husband was laughing at the amount of curry paste, canned chicken broth and coconut milk that I bought, but I wanted to spare him from looking at these items at the grocery store.

So, you are not crazy at all. If taking pictures of a freezer makes you feel better, do it!