I am so sorry to hear that news. I hope things can get worked out quickly
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Doreen,
I was just getting caught up on your thread. I was sharing your excitement about your November surgery date and then was crushed to read your last post.
However, I am confident that Dr. Lenke's office will be able to get your surgery approved. You are in pain. You have documented progression. Surgery can and will help in your situation. Let them go to bat for you. I'm sure that they have fought this battle before and that they know what to do!
Sorry that you were not forewarned about the bending x-ray. It's no fun. I was surprised that Kelly herself was the one to push on my side. That somehow made it a little better.
Good Luck. I know it will work out and you'll be on the 7th floor of Barnes Jewish in no time recovering!
Kathy
p.s. Have you found the Starbuck 's in the Barnes and Noble between the CAM and the hospital?Kathy
46 yrs at surgery, now 50
71 degree thoracolumbar curve corrected to 34 degrees
8/2/2010 surgery with Dr. Lenke
posterior T9 to sacrum with pelvic fixation
4 osteotomies and 1 cage
http://s1066.photobucket.com/albums/...athK_08022010/
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Originally posted by Doreen1 View PostI was also surprised when I had to lay on my stomach for the last x-ray and two people pushed my spine straight.
Sorry about the insurance issue. In the last few months, it seems that insurance companies have really tightened down, and more and more surgeries are being denied. I don't remember that any of our scoliosis surgeries are getting denied, but I'm sure that will happen eventually. I know that they're pushing for patients to go through at least 8 weeks of physical therapy, followed by an injection if necessary, before agreeing to surgery. I'm guessing it's because they're facing a lot of opposition to rate hikes, and they need to make their ridiculous profits one way or the other. I don't know if you can afford it, but usually a letter from an attorney will turn the insurance company around quickly. Unfortunately, they may give your surgery date away quickly, as Dr. Lenke won't want to be idol during that time.
Hope you get this worked out soon.
--LindaNever argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
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Surgery 2/10/93 A/P fusion T4-L3
Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
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[QUOTE=Doreen1;129434 I was also surprised when I had to lay on my stomach for the last x-ray and two people pushed my spine straight.
Doreen[/QUOTE]
I have never had to have a xray done like that. Neither with my NC surgeon or with Dr Bederman. What are they looking for in an xray like that?Melissa
Fused from C2 - sacrum 7/2011
April 21, 2020- another broken rod surgery
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Doreen, I'm so sorry for this being sprung on you at the last minute & I pray that everything gets resolved quickly so that you can get to a better quality of life w your back.Mom of 14yo son diagnosed Oct 2011
Surgery 1/3/12 w Dr. Geof Cronen,
Tampa General Hospital T3 to L1
Jacob's pre surg curves: T58 & L31 12/28/11
photos & xrays in "First-Time Surgery" thread "Before & After"
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Linda,
I've had two x-rays done like that, one at Dr. Lenke's request and one when I had a consult with Dr. Boachie back in '08. I thought they were fairly standard and were called bending x-rays.
No?
KathyKathy
46 yrs at surgery, now 50
71 degree thoracolumbar curve corrected to 34 degrees
8/2/2010 surgery with Dr. Lenke
posterior T9 to sacrum with pelvic fixation
4 osteotomies and 1 cage
http://s1066.photobucket.com/albums/...athK_08022010/
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Doreen,
I am praying that this insurance issue can be quickly resolved for you.
DonnaFemale - 49 yrs old at surgery
Surgery 5/5/11 - Dr. Bridwell, St. Louis
Fused T3-L3
60 degree thoracic curve corrected to 30 degrees
Tennis player & returning to the courts!
http://s1050.photobucket.com/profile/walkingmom1/index
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Doreen, I can't imagine that this won't be worked out...what insurance do you have?Stephanie, age 56
Diagnosed age 8
Milwaukee brace 9 years, no further treatment, symptom free and clueless until my 40s that curves could progress.
Thoracolumbar curve 39 degrees at age 17
Now somewhere around 58 degrees thoracic, 70 degrees thoracolumbar
Surgeon Dr. Michael S. O'Brien, Baylor's Southwest Scoliosis Center, Dallas TX
Bilateral laminectomies at L3 to L4, L4 to L5 and L5 to S1 on April 4, 2012
Foramenotomies L3 through S1 in August 2014
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Doreen
Try not to panic. Let Dr Lenke explain things to the insurance company first.....the doctors are experts at it.
Halting progression of large curves is important.
I think your insurance company will approve....
Ed49 yr old male, now 63, the new 64...
Pre surgery curves T70,L70
ALIF/PSA T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
Dr Brett Menmuir St Marys Hospital Reno,Nevada
Bending and twisting pics after full fusion
http://www.scoliosis.org/forum/showt...on.&highlight=
My x-rays
http://www.scoliosis.org/forum/attac...2&d=1228779214
http://www.scoliosis.org/forum/attac...3&d=1228779258
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Doreen--
I'm with Ed. This is awful but if anyone can get the insurance company to understand the necessity of your surgery, it's Dr. Lenke. Good luck--hang in there. JanetJanet
61 years old--57 for surgery
Diagnosed in 1965 at age of 13--no brace
Thoracic Curve: 96 degrees to 35 degrees
Lumbar Curve: 63 degrees to 5 degrees
Surgery with Dr. Lenke in St. Louis--March 30, 2009
T-2 to Pelvis, and hopefully all posterior procedure.
All was posterior along with 2 cages and 6 osteotomies.
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Doreen,
this is unacceptable! We are pulling for you... I agree that Dr Lenke and his staff must have dealt w/ this before - I just cannot believe that they will ultimately deny the surgery.
Hope you can find some peace while you are waiting.
NancyAge 58
Surgery w/ Dr Lenke August 23, 2010
original curves 91 thoracic, 86 lumbar
fused T1 to sacrum, new curves 50 and 45
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not any bending x rays i ever heard of!!
i had bending X rays with Dr Lonner..
on my back...i just had to try to bend to each side while laying down on the table...it is to see how flexible you are
without the help of gravity that helps you when you bend to the side while standing up...
i was really shocked at how UNflexible i am without the help of gravity!! pretty scary!
but i never heard of the X rays on one's stomach while anyone is pushing on any part of the spine...
sounds miserable....
Doreen, i hope the insurance company can be told that you need the surgery for all kinds of
reasons having nothing to do with pain, as they can always claim that no surgeon will guaantee pain reduction from
the surgery, though the surgeon may expect pain reduction....they just cannot guarantee it, and i am sure insurance
companies know that....
especially if you have any other things besides the scoli...like bad discs...? or your spine collapsing with listheiis?
or obvious hypokyphosis...? or stenosis...?
but then i am sure Lenke's office knows what to tell the insurance people...
best of luck with getting it approved!
jess
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My bending x-rays were also on my back. I just looked up bending x-rays in the Radiograph Measurement Manual for the Spinal Deformity Study Group, and it states that bending x-rays are supposed to be taken supine (face up). I'll ask around and see if I can find out what they're doing.Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
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Surgery 2/10/93 A/P fusion T4-L3
Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
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As the Cookie Crumbles...
I met with Dr. Lenke this morning and he said, "I have NEVER had this problem with an insurance company before..." It seems there are 3 different versions of what the insurance company is telling everyone, but now it boils down to this. They are denying the entire surgery because Lenke plans to use BMP. They aren't denying the just BMP portion but the entire kitnkaboodle (sp?). Lenke told me back in September to expect our insurance to deny the BMP portion because most insurance companies won't pay for it, so I was prepared for that, but I certainly was not prepared for this.
We have literally 4.5 hours to find out if Lenke can change their mind and obtain approval for the surgery without BMP. Due to the holiday tomorrow and Lenke's office being closed on Friday, if we don't receive the approval by 5p today, we go home tomorrow. Dear hubby has escalated as far as he can, but now everything is waiting at the peer-to-peer level. Since this is still in the "review" process with the insurance company, we cannot appeal until the final decision is made. The appeal process is 10 days. So if we get to this stage, I'm back on a waiting list for a new surgery date.
I asked Dr. Lenke today about the pushing x-rays. I did do bending x-rays laying on my back, but the pushing x-rays (two people pushed against both curves) was to give him an idea of how much flexibility I have. So my thoracic 70* was pushed to 40*. He said I have good flexibility.
Warmly,
Doreen44 years old at time of surgery, Atlanta GA
Pre-Surgery Thorasic: 70 degrees, Pre-Surgery Lumbar: 68 degrees, lost 4 inches of height in 2011
Post-Surgery curves ~10 degrees, regained 4 inches of height
Posterior T3-sacrum & TLIF surgeries on Nov 28, 2011 with Dr. Lenke, St. Louis
2 rods, 33 screws, 2 cages, 2 connectors, living a new life I never dreamed of!
http://thebionicachronicles.blogspot.com/
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Survey Says...
INSURANCE APPROVED SURGERY! Dr. Lenke's office just called and said the insurance changed their stance, approved the surgery and denied the BMP. Dr. Lenke will move forward and use BMP as planned. Can I relax now? :-)
Warmly,
Doreen44 years old at time of surgery, Atlanta GA
Pre-Surgery Thorasic: 70 degrees, Pre-Surgery Lumbar: 68 degrees, lost 4 inches of height in 2011
Post-Surgery curves ~10 degrees, regained 4 inches of height
Posterior T3-sacrum & TLIF surgeries on Nov 28, 2011 with Dr. Lenke, St. Louis
2 rods, 33 screws, 2 cages, 2 connectors, living a new life I never dreamed of!
http://thebionicachronicles.blogspot.com/
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