girlwithbadankl
05-09-2009, 03:23 AM
I have been on a long journey reading these posts and also finding how to treat my end-stage ankle arthritis. I'm 44 yrs. old with 3 young kids. Last year my ankle started hurting and now it's the size of an elephant and can't walk anymore. Debridement did not work. I'm really miffed because I appealed my case all the way to the state and my doctor who is a pioneer of the procedure, wrote a very compelling letter stating that a fusion would leave me crippled. The decision was to uphold Blue Cross's decision because an allograft would be no more successful than a fusion which I don't want to have due to other foot issues. So, I was wondering if anyone out there can compare/contrast their results of having an ankle allograft vs a fusion. If you've had a fusion, how has your life changed? Thanks.
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krisj5kids
05-09-2009, 09:32 AM
What was the allograft going to be for? I have BC/BS and they at first denied my autograft for OATS. I had to appeal a few times and then finally they would agree after much work on my part. THere was someone on this board that had an allograft and the insurance paid everything Except for the actually allograft, in this case it was bone. So, the majority of the surgery was still covered. That might be an option you could look into.
Man, I thought that at the state level most of these are in favor of the patient. That really sucks.
Man, I thought that at the state level most of these are in favor of the patient. That really sucks.
DPart
05-09-2009, 10:03 AM
I have an ankle fussion and I am certantly not crippled. I can walk fine and am active. It beats being in pain. All os that I saw said that the allogragh would not last and would only lessen pain a bit. With my job (teacher) I would be having the fussion 2 to 3 years down the road anyway. The recovery is long but not as long as OATS. From what I have read on this board I am glad I went with fussion.
Darryl
Darryl
akirka
05-11-2009, 01:14 PM
I'll throw my two cents in. I had an autograph, not allograph but it feels great and I basically have no pain. Yeah, it took 9 months to recover but that's small potatotes really. Reading this board it seems that OATS is not very successful/hard recovery but I would read the posts carefully. A lot of OATS people here have had additional reconstruction of tendons/ligaments and that is was is really hampering their recoveries. Most of the people having problems will not say that their grafts have failed, actually they are well incorporated. It's other ankle issues that are holding them back. So I think a graft is a good option. I had BCBS and they covered it all. Maybe the donor tissue they may not? I think someone paid $7,000 out of pocket for their donor tissue but that not a huge price for getting your foot back. We pay a lot more for a car and that doesn't really compare!! I've heard people who have had fusion say that they were out of pain and felt good so I also know that it is a good last option. But fusion can cause other joints to wear irregularly - like your knee, hip, so I think OATS is a better first option. I would keep fighting BCBS on it. Maybe even go ahead with the surgery and then let the chips fall where they may .... When it's all over, BCBS can't take your foot away!!
Abby :)
I don't know where you are at in CA, but Dr. Bertil Smith in San Diego assisted in my OATS surgery. Maybe he can help you.
Abby :)
I don't know where you are at in CA, but Dr. Bertil Smith in San Diego assisted in my OATS surgery. Maybe he can help you.
girlwithbadankl
05-12-2009, 07:45 PM
I have an ankle fussion and I am certantly not crippled. I can walk fine and am active. It beats being in pain. All os that I saw said that the allogragh would not last and would only lessen pain a bit. With my job (teacher) I would be having the fussion 2 to 3 years down the road anyway. The recovery is long but not as long as OATS. From what I have read on this board I am glad I went with fussion.
Darryl
Darryl,
Did you have a triple athrodesis? That's what I would require.
Darryl
Darryl,
Did you have a triple athrodesis? That's what I would require.
girlwithbadankl
05-12-2009, 07:52 PM
I'll throw my two cents in. I had an autograph, not allograph but it feels great and I basically have no pain. Yeah, it took 9 months to recover but that's small potatotes really. Reading this board it seems that OATS is not very successful/hard recovery but I would read the posts carefully. A lot of OATS people here have had additional reconstruction of tendons/ligaments and that is was is really hampering their recoveries. Most of the people having problems will not say that their grafts have failed, actually they are well incorporated. It's other ankle issues that are holding them back. So I think a graft is a good option. I had BCBS and they covered it all. Maybe the donor tissue they may not? I think someone paid $7,000 out of pocket for their donor tissue but that not a huge price for getting your foot back. We pay a lot more for a car and that doesn't really compare!! I've heard people who have had fusion say that they were out of pain and felt good so I also know that it is a good last option. But fusion can cause other joints to wear irregularly - like your knee, hip, so I think OATS is a better first option. I would keep fighting BCBS on it. Maybe even go ahead with the surgery and then let the chips fall where they may .... When it's all over, BCBS can't take your foot away!!
Abby :)
I don't know where you are at in CA, but Dr. Bertil Smith in San Diego assisted in my OATS surgery. Maybe he can help you.
Can you tell me what was involved in an autograft surgery vs allograft? I am seeing Dr. Bugbee at Scripps in La Jolla. I live in the bay area so have to fly down to see him.
Abby :)
I don't know where you are at in CA, but Dr. Bertil Smith in San Diego assisted in my OATS surgery. Maybe he can help you.
Can you tell me what was involved in an autograft surgery vs allograft? I am seeing Dr. Bugbee at Scripps in La Jolla. I live in the bay area so have to fly down to see him.
girlwithbadankl
05-12-2009, 08:37 PM
What was the allograft going to be for? I have BC/BS and they at first denied my autograft for OATS. I had to appeal a few times and then finally they would agree after much work on my part. THere was someone on this board that had an allograft and the insurance paid everything Except for the actually allograft, in this case it was bone. So, the majority of the surgery was still covered. That might be an option you could look into.
Man, I thought that at the state level most of these are in favor of the patient. That really sucks.
Hi Kris,
Was this for ankle or knee? My doctor, Dr. Bugbee, says this is not technically OATS so the lingo gets a little confusing. I've seen your postings before. Are you recovered now?
Man, I thought that at the state level most of these are in favor of the patient. That really sucks.
Hi Kris,
Was this for ankle or knee? My doctor, Dr. Bugbee, says this is not technically OATS so the lingo gets a little confusing. I've seen your postings before. Are you recovered now?
krisj5kids
05-12-2009, 08:43 PM
Hey there,
Allograft uses a donor bone to put in the ocd area. An autograft uses a plug or more from your knee to fill in the defect. The procedure in the ankle is the same, it is just where the plugs came from that is different. Autograft= you Allograft= donor.
Mine was called Mosaicplasty because he took more than one plug, but it was the same as OATS, just they use more smaller plugs rather than one bigger one. Same thing, really, just different names.
My OATs surgery did fine. The plug incorporated. It is the other things I had going on and my osteotomy (where they cut through my tibia to get to the defect) that has not healed correctly. I see my dr. tomorrow morning. So, if I only had OATs, then I would say I was doing great, but I had ligament and tendon issues as well and they aren't doing so well.
Allograft uses a donor bone to put in the ocd area. An autograft uses a plug or more from your knee to fill in the defect. The procedure in the ankle is the same, it is just where the plugs came from that is different. Autograft= you Allograft= donor.
Mine was called Mosaicplasty because he took more than one plug, but it was the same as OATS, just they use more smaller plugs rather than one bigger one. Same thing, really, just different names.
My OATs surgery did fine. The plug incorporated. It is the other things I had going on and my osteotomy (where they cut through my tibia to get to the defect) that has not healed correctly. I see my dr. tomorrow morning. So, if I only had OATs, then I would say I was doing great, but I had ligament and tendon issues as well and they aren't doing so well.
DPart
05-12-2009, 08:45 PM
No I have my tibia fused to my talus. I do know some one that had triple done and is very happy and active. I am not sure what allograft or autograft would do for arthritis. But I am not a doctor. You need to do what you feel is right. All three OS's that I saw said they would do the allograft or autograft, but did not recomend them for me.
Darryl
Darryl
girlwithbadankl
05-12-2009, 09:05 PM
Can you tell me what was involved in an autograft surgery vs allograft? I am seeing Dr. Bugbee at Scripps in La Jolla. I live in the bay area so have to fly down to see him.. I did find your doctor when I was doing research and thought about calling him.
My condition: I have no cartilage left in my ankle at all from post-traumatic arthritis. Broke and sprained many times. It is also unstable so they were going to do a ligament tightening.
Melissa
My condition: I have no cartilage left in my ankle at all from post-traumatic arthritis. Broke and sprained many times. It is also unstable so they were going to do a ligament tightening.
Melissa
girlwithbadankl
05-12-2009, 09:09 PM
Hey there,
Allograft uses a donor bone to put in the ocd area. An autograft uses a plug or more from your knee to fill in the defect. The procedure in the ankle is the same, it is just where the plugs came from that is different. Autograft= you Allograft= donor.
Mine was called Mosaicplasty because he took more than one plug, but it was the same as OATS, just they use more smaller plugs rather than one bigger one. Same thing, really, just different names.
My OATs surgery did fine. The plug incorporated. It is the other things I had going on and my osteotomy (where they cut through my tibia to get to the defect) that has not healed correctly. I see my dr. tomorrow morning. So, if I only had OATs, then I would say I was doing great, but I had ligament and tendon issues as well and they aren't doing so well.
What was your initial condition? I don't have great knees (very minimal cartilage) either so I'm not sure they would be able to take it from my knee. I have a condition called hyper-flexibility or lack of strong cartilage throughout. I have tendon issues too. The back of my ankle is killing around the achiles. So many issues which is why a fusion may be the best option but I have middle foot arthritis which will get worse with a fusion.
Allograft uses a donor bone to put in the ocd area. An autograft uses a plug or more from your knee to fill in the defect. The procedure in the ankle is the same, it is just where the plugs came from that is different. Autograft= you Allograft= donor.
Mine was called Mosaicplasty because he took more than one plug, but it was the same as OATS, just they use more smaller plugs rather than one bigger one. Same thing, really, just different names.
My OATs surgery did fine. The plug incorporated. It is the other things I had going on and my osteotomy (where they cut through my tibia to get to the defect) that has not healed correctly. I see my dr. tomorrow morning. So, if I only had OATs, then I would say I was doing great, but I had ligament and tendon issues as well and they aren't doing so well.
What was your initial condition? I don't have great knees (very minimal cartilage) either so I'm not sure they would be able to take it from my knee. I have a condition called hyper-flexibility or lack of strong cartilage throughout. I have tendon issues too. The back of my ankle is killing around the achiles. So many issues which is why a fusion may be the best option but I have middle foot arthritis which will get worse with a fusion.
girlwithbadankl
05-12-2009, 09:12 PM
No I have my tibia fused to my talus. I do know some one that had triple done and is very happy and active. I am not sure what allograft or autograft would do for arthritis. But I am not a doctor. You need to do what you feel is right. All three OS's that I saw said they would do the allograft or autograft, but did not recomend them for me.
Darryl
Hi Darryl,
Lots of questions. Can you be a little more specific regarding "active"? What activities can you do? Do you walk with a limp? Can you walk barefoot in sand or uneven surfaces? Does your ankle still swell after standing a while? Did your leg shorten due to the surgery? I can guess this but guess I will never be wearing anything but flat shoes again after a fusion, right?
Darryl
Hi Darryl,
Lots of questions. Can you be a little more specific regarding "active"? What activities can you do? Do you walk with a limp? Can you walk barefoot in sand or uneven surfaces? Does your ankle still swell after standing a while? Did your leg shorten due to the surgery? I can guess this but guess I will never be wearing anything but flat shoes again after a fusion, right?
krisj5kids
05-13-2009, 08:23 AM
Melissa,
I also have hyper-mobility. I have had previous surgeries for shoulder instability, need one for my hips because of torn cartilage since they sublux, and have had my ankle fixed for instability twice now.
My history in a condensed version.
I'm active, a karate instructor and a runner.
I did have a grade 3 sprain back in 2006 from karate. I landed on it sideways from a jump in the air. It had issues before, but that pretty much sealed the deal on the ankle.
Surgery #1 fixed a torn peroneal tendon, a subluxating peroneal tendon, found 2 OCD lesions and had then drilled (stage 4), had a Brostrom-Gould procedure for the instability, and then had joint cleaning up of synovitis, bone spurs, and other arthritis type stuff.
Recovered from surgery 1 and had a good year before things went down hill fast again.
Surgery #2- exactly 23 mos after surgery #1. I had a Brostrom again, with a periosteal flap reconstruction (they took a sheath around my fibula and made ligaments because mine were not good anymore). I had 2 tears in my peroneal tendon repaired, I had the OATs procedure where they took plugs from my knee (they take the parts from a non-weight bearing part of your knee that doesn't need the cartilage.) I had tenosynovitis and had that cleaned out with a tendon release, and then had more synovitis cleaned out. I had other cleaning up type stuff as well for my ankle was full of scar tissue. I also had my 2nd OCD area drilled and microfractured as they could only do the OATs procedure on one of my ocd's. I think that was it....
Do you have diagnosed OCD lesions or talar dome fractures? That is what the OATS procedure is for. If too much cartilage is gone, then it may not be possible to do that. You need to ask your dr. about that.
As for the hypermobility, my dr. said he had to do the perosteal flap repair (first they were going to use an allograft (cadavar tendon) to use as my ligaments) because if the instability wasn't fixed then the OCD areas on my talus would never get better because of the movement in the joint. So, that is why I had both done at the same time.
I was told after my surgery that I would be able to return to all activities except for sparring in karate.
I also have hyper-mobility. I have had previous surgeries for shoulder instability, need one for my hips because of torn cartilage since they sublux, and have had my ankle fixed for instability twice now.
My history in a condensed version.
I'm active, a karate instructor and a runner.
I did have a grade 3 sprain back in 2006 from karate. I landed on it sideways from a jump in the air. It had issues before, but that pretty much sealed the deal on the ankle.
Surgery #1 fixed a torn peroneal tendon, a subluxating peroneal tendon, found 2 OCD lesions and had then drilled (stage 4), had a Brostrom-Gould procedure for the instability, and then had joint cleaning up of synovitis, bone spurs, and other arthritis type stuff.
Recovered from surgery 1 and had a good year before things went down hill fast again.
Surgery #2- exactly 23 mos after surgery #1. I had a Brostrom again, with a periosteal flap reconstruction (they took a sheath around my fibula and made ligaments because mine were not good anymore). I had 2 tears in my peroneal tendon repaired, I had the OATs procedure where they took plugs from my knee (they take the parts from a non-weight bearing part of your knee that doesn't need the cartilage.) I had tenosynovitis and had that cleaned out with a tendon release, and then had more synovitis cleaned out. I had other cleaning up type stuff as well for my ankle was full of scar tissue. I also had my 2nd OCD area drilled and microfractured as they could only do the OATs procedure on one of my ocd's. I think that was it....
Do you have diagnosed OCD lesions or talar dome fractures? That is what the OATS procedure is for. If too much cartilage is gone, then it may not be possible to do that. You need to ask your dr. about that.
As for the hypermobility, my dr. said he had to do the perosteal flap repair (first they were going to use an allograft (cadavar tendon) to use as my ligaments) because if the instability wasn't fixed then the OCD areas on my talus would never get better because of the movement in the joint. So, that is why I had both done at the same time.
I was told after my surgery that I would be able to return to all activities except for sparring in karate.
girlwithbadankl
05-13-2009, 05:03 PM
Melissa,
I also have hyper-mobility. I have had previous surgeries for shoulder instability, need one for my hips because of torn cartilage since they sublux, and have had my ankle fixed for instability twice now.
My history in a condensed version.
I'm active, a karate instructor and a runner.
I did have a grade 3 sprain back in 2006 from karate. I landed on it sideways from a jump in the air. It had issues before, but that pretty much sealed the deal on the ankle.
Surgery #1 fixed a torn peroneal tendon, a subluxating peroneal tendon, found 2 OCD lesions and had then drilled (stage 4), had a Brostrom-Gould procedure for the instability, and then had joint cleaning up of synovitis, bone spurs, and other arthritis type stuff.
Recovered from surgery 1 and had a good year before things went down hill fast again.
Surgery #2- exactly 23 mos after surgery #1. I had a Brostrom again, with a periosteal flap reconstruction (they took a sheath around my fibula and made ligaments because mine were not good anymore). I had 2 tears in my peroneal tendon repaired, I had the OATs procedure where they took plugs from my knee (they take the parts from a non-weight bearing part of your knee that doesn't need the cartilage.) I had tenosynovitis and had that cleaned out with a tendon release, and then had more synovitis cleaned out. I had other cleaning up type stuff as well for my ankle was full of scar tissue. I also had my 2nd OCD area drilled and microfractured as they could only do the OATs procedure on one of my ocd's. I think that was it....
Do you have diagnosed OCD lesions or talar dome fractures? That is what the OATS procedure is for. If too much cartilage is gone, then it may not be possible to do that. You need to ask your dr. about that.
As for the hypermobility, my dr. said he had to do the perosteal flap repair (first they were going to use an allograft (cadavar tendon) to use as my ligaments) because if the instability wasn't fixed then the OCD areas on my talus would never get better because of the movement in the joint. So, that is why I had both done at the same time.
I was told after my surgery that I would be able to return to all activities except for sparring in karate.
Thanks Kris - are you still expecting to make a full recovery? Did they ever recommend fusion for you but decided to go this route instead?
I also have hyper-mobility. I have had previous surgeries for shoulder instability, need one for my hips because of torn cartilage since they sublux, and have had my ankle fixed for instability twice now.
My history in a condensed version.
I'm active, a karate instructor and a runner.
I did have a grade 3 sprain back in 2006 from karate. I landed on it sideways from a jump in the air. It had issues before, but that pretty much sealed the deal on the ankle.
Surgery #1 fixed a torn peroneal tendon, a subluxating peroneal tendon, found 2 OCD lesions and had then drilled (stage 4), had a Brostrom-Gould procedure for the instability, and then had joint cleaning up of synovitis, bone spurs, and other arthritis type stuff.
Recovered from surgery 1 and had a good year before things went down hill fast again.
Surgery #2- exactly 23 mos after surgery #1. I had a Brostrom again, with a periosteal flap reconstruction (they took a sheath around my fibula and made ligaments because mine were not good anymore). I had 2 tears in my peroneal tendon repaired, I had the OATs procedure where they took plugs from my knee (they take the parts from a non-weight bearing part of your knee that doesn't need the cartilage.) I had tenosynovitis and had that cleaned out with a tendon release, and then had more synovitis cleaned out. I had other cleaning up type stuff as well for my ankle was full of scar tissue. I also had my 2nd OCD area drilled and microfractured as they could only do the OATs procedure on one of my ocd's. I think that was it....
Do you have diagnosed OCD lesions or talar dome fractures? That is what the OATS procedure is for. If too much cartilage is gone, then it may not be possible to do that. You need to ask your dr. about that.
As for the hypermobility, my dr. said he had to do the perosteal flap repair (first they were going to use an allograft (cadavar tendon) to use as my ligaments) because if the instability wasn't fixed then the OCD areas on my talus would never get better because of the movement in the joint. So, that is why I had both done at the same time.
I was told after my surgery that I would be able to return to all activities except for sparring in karate.
Thanks Kris - are you still expecting to make a full recovery? Did they ever recommend fusion for you but decided to go this route instead?
krisj5kids
05-13-2009, 06:54 PM
Melissa,
I saw my dr. today and he was not optimistic. The OATs did well, but he was very short with me and told me that basically my ankle was going to suck forever. No mention of fusion ever. I'm supposed to go back in 6 weeks but I have a 2nd opinion appt. tomorrow afternoon with a DPM. My regular dr. is an Ortho surgeon. There is only one other ankle specilist here and he demands to read your records first before he decides to take your case. I'm frustrated and depressed right now. My dr. has obviously given up on me even though I haven't.
Like I said though, the autograft is doing well, it is the osteotomy and tendons, both PTT and peroneal that are doing poorly as well as my foot is stuck at 90 degrees now due to scar tissue. My dr. told me that is what happens with more than one surgery.
I saw my dr. today and he was not optimistic. The OATs did well, but he was very short with me and told me that basically my ankle was going to suck forever. No mention of fusion ever. I'm supposed to go back in 6 weeks but I have a 2nd opinion appt. tomorrow afternoon with a DPM. My regular dr. is an Ortho surgeon. There is only one other ankle specilist here and he demands to read your records first before he decides to take your case. I'm frustrated and depressed right now. My dr. has obviously given up on me even though I haven't.
Like I said though, the autograft is doing well, it is the osteotomy and tendons, both PTT and peroneal that are doing poorly as well as my foot is stuck at 90 degrees now due to scar tissue. My dr. told me that is what happens with more than one surgery.
girlwithbadankl
06-07-2009, 04:27 PM
Melissa,
I saw my dr. today and he was not optimistic. The OATs did well, but he was very short with me and told me that basically my ankle was going to suck forever. No mention of fusion ever. I'm supposed to go back in 6 weeks but I have a 2nd opinion appt. tomorrow afternoon with a DPM. My regular dr. is an Ortho surgeon. There is only one other ankle specilist here and he demands to read your records first before he decides to take your case. I'm frustrated and depressed right now. My dr. has obviously given up on me even though I haven't.
Like I said though, the autograft is doing well, it is the osteotomy and tendons, both PTT and peroneal that are doing poorly as well as my foot is stuck at 90 degrees now due to scar tissue. My dr. told me that is what happens with more than one surgery.
Hi Chris,
Sorry I haven't been on here in a few weeks. I know how you feel. Now that my insurance has denied me, it's like I've been written off by the Dr.'s office. I have contacted an attorney to help me and that is going to be my last hope. At least I hope he can get them to pay for part of the surgery and we will have to pay for the rest. I've spoken to a number of Dr. Bugbee's patients and they are doing extremely well - one even playing tennis so I really want to try the allograft surgery before fusion. I know everyone is different. Are you considering fusion at some point? Maybe you should travel to find a new doctor that can help you? I know it's pricey. Dr. Bugbee is fairly good on email and may respond if you tell him your situation to see if he can help you. That's what I did first, then flew down to get a consultation.
Melissa
I saw my dr. today and he was not optimistic. The OATs did well, but he was very short with me and told me that basically my ankle was going to suck forever. No mention of fusion ever. I'm supposed to go back in 6 weeks but I have a 2nd opinion appt. tomorrow afternoon with a DPM. My regular dr. is an Ortho surgeon. There is only one other ankle specilist here and he demands to read your records first before he decides to take your case. I'm frustrated and depressed right now. My dr. has obviously given up on me even though I haven't.
Like I said though, the autograft is doing well, it is the osteotomy and tendons, both PTT and peroneal that are doing poorly as well as my foot is stuck at 90 degrees now due to scar tissue. My dr. told me that is what happens with more than one surgery.
Hi Chris,
Sorry I haven't been on here in a few weeks. I know how you feel. Now that my insurance has denied me, it's like I've been written off by the Dr.'s office. I have contacted an attorney to help me and that is going to be my last hope. At least I hope he can get them to pay for part of the surgery and we will have to pay for the rest. I've spoken to a number of Dr. Bugbee's patients and they are doing extremely well - one even playing tennis so I really want to try the allograft surgery before fusion. I know everyone is different. Are you considering fusion at some point? Maybe you should travel to find a new doctor that can help you? I know it's pricey. Dr. Bugbee is fairly good on email and may respond if you tell him your situation to see if he can help you. That's what I did first, then flew down to get a consultation.
Melissa
heinselrunner
06-08-2009, 04:09 PM
I live in SoCal, and my dr. recently relocated to the Sacramento area. He's on the forefront of all this stuff, and perhaps he can help you out. Check out Dr. Eric Giza. If nothing else, he's closer to home for you!
girlwithbadankl
06-16-2009, 02:05 PM
I live in SoCal, and my dr. recently relocated to the Sacramento area. He's on the forefront of all this stuff, and perhaps he can help you out. Check out Dr. Eric Giza. If nothing else, he's closer to home for you!
Thank you for the referral. Have you had a transplant?
Thank you for the referral. Have you had a transplant?
techmom63
09-08-2009, 02:46 AM
Melissa, not sure if you are still reading the boards or if you have made a decision regarding your surgery. I am in the same boat as you -- my OS in Denver recommends ankle fusion but I am really opposed to going that route. I am scheduled to see Dr. Bugbee in November to discuss possible allograft.
Can you post an update to your situation?
Thanks! Chris
Can you post an update to your situation?
Thanks! Chris
girlwithbadankl
09-09-2009, 12:27 PM
Melissa, not sure if you are still reading the boards or if you have made a decision regarding your surgery. I am in the same boat as you -- my OS in Denver recommends ankle fusion but I am really opposed to going that route. I am scheduled to see Dr. Bugbee in November to discuss possible allograft.
Can you post an update to your situation?
Thanks! Chris
HI Chris,
I am waiting to have my surgery by Dr. Bugbee. Bottom line is that I lost all of my appeals with Blue Cross. Surgery will cost me $30k out of pocket - all payable upfront so we are trying to get the money together. That was reduced from initial quote of $65k. I definetly want to have this surgery. My issue is I have chronic ankle instability so he will also have to shore up the tendon and that part is convered by BC. I am hoping to go on the donor list in the next month or two, then it is a 1-3 month wait for a donor. I think very highly of Dr. Bugbee but I have some suggestions if you are dealing with Yvonne, his asst. She was not very helpful in dealing with the ins. companies. If I had to do it all over again, I would have asked for a case manager at BC to walk it through. Yvonne doesn't want to place phone calls on your behalf. The issue is going to be your insurance company. These days they are trying not to cover this surgery because it is classified as "experimental" and they are denying anything they can. 5 years ago they were covering it more frequently. This is true of almost all the major carriers. There are only a handful of Dr.'s doing this procedure. Dr. Bugbee has done the most I believe. He is worth the trip for sure!
Can you post an update to your situation?
Thanks! Chris
HI Chris,
I am waiting to have my surgery by Dr. Bugbee. Bottom line is that I lost all of my appeals with Blue Cross. Surgery will cost me $30k out of pocket - all payable upfront so we are trying to get the money together. That was reduced from initial quote of $65k. I definetly want to have this surgery. My issue is I have chronic ankle instability so he will also have to shore up the tendon and that part is convered by BC. I am hoping to go on the donor list in the next month or two, then it is a 1-3 month wait for a donor. I think very highly of Dr. Bugbee but I have some suggestions if you are dealing with Yvonne, his asst. She was not very helpful in dealing with the ins. companies. If I had to do it all over again, I would have asked for a case manager at BC to walk it through. Yvonne doesn't want to place phone calls on your behalf. The issue is going to be your insurance company. These days they are trying not to cover this surgery because it is classified as "experimental" and they are denying anything they can. 5 years ago they were covering it more frequently. This is true of almost all the major carriers. There are only a handful of Dr.'s doing this procedure. Dr. Bugbee has done the most I believe. He is worth the trip for sure!
akirka
09-09-2009, 05:48 PM
Hey Mellisa,
Isn't it frustrating these insurance companies? The most confusing thing is - I have BCBS and they covered my autograft surgery no questions asked. Others here who have BCBS have gone through denials but eventually had some appeals work out. I hope that happens for you. It's sad that there's no real consistency even within the same insurance company! :dizzy: I have to mention I have Federal BCBS since I'm a federal employee and it has added benefits over the regular BCBS. But I have had a GREAT outcome and it was very worth it. My surgery cost $9,000 for the procedure, $13,000 for the hospital. I'm surprised you would have to come up with $30,000 on your own. You do have the extra cost of the donor tissue and ligament tightening, but I had the addition of donor knee surgery ..hmmm.... So people have been denied the actual surgery but BCBS has picked up the hospital tab. I would think the hospital and ligament surgery would be covered and you may have to pay $10,000 for the surgery and let's say $7,000 for the graft? Anyway, I would keep appealing. My OS that had no problems with BCBS is in Boise, ID. Dr. Michael Coughlin if that helps! He's a top ankle surgeon!
Abby :)
Isn't it frustrating these insurance companies? The most confusing thing is - I have BCBS and they covered my autograft surgery no questions asked. Others here who have BCBS have gone through denials but eventually had some appeals work out. I hope that happens for you. It's sad that there's no real consistency even within the same insurance company! :dizzy: I have to mention I have Federal BCBS since I'm a federal employee and it has added benefits over the regular BCBS. But I have had a GREAT outcome and it was very worth it. My surgery cost $9,000 for the procedure, $13,000 for the hospital. I'm surprised you would have to come up with $30,000 on your own. You do have the extra cost of the donor tissue and ligament tightening, but I had the addition of donor knee surgery ..hmmm.... So people have been denied the actual surgery but BCBS has picked up the hospital tab. I would think the hospital and ligament surgery would be covered and you may have to pay $10,000 for the surgery and let's say $7,000 for the graft? Anyway, I would keep appealing. My OS that had no problems with BCBS is in Boise, ID. Dr. Michael Coughlin if that helps! He's a top ankle surgeon!
Abby :)
techmom63
09-10-2009, 08:58 PM
Thanks for the update, Melissa. I have spoken with Yvonne several times so far, and I do get the feeling that I will have to be my own advocate. Even getting her to schedule my appointment, after I had already communicated with Dr. Bugbee by e-mail, was a bit of an exercise.
I REALLY appreciate the cost estimate you provided. I have already checked my insurance, Aetna, and while they will cover allograft for knee-related procedures, ankles are out of the question. They just reviewed that particular policy in June of this year, so they will probably not be inclined to make any changes. Of course, I will appeal, but expect to end up in the same boat as you ... paying out of pocket. The numbers you provided are all more "reasonable" (boy, that's a relative term) than the crazy stuff I was imagining in my head. :) I was worried it might be over six figures. It's upsetting to me that the insurance companies will jump at the chance to pay for you to lose your ankle altogether (fusion), but don't want anything to do with a chance for you to get a new one.
I would love to keep in touch with you as you go through this process if you're open to it. We are about the same age, and seem to have a similar diagnosis. My end-stage ankle arthritis stems from a trimalleolar fracture with dislocation that I suffered 26 years ago when I was in college. I've always had some difficulty when the weather changes, no high heels or running, etc. over the years, but I'm now having a lot of difficulty walking and am in constant pain.
I'm new to these boards, but I think I noticed an option to add a board member as a "contact". I'll send you a request.
Thanks again. You've been a big help!
Chris
HI Chris,
I am waiting to have my surgery by Dr. Bugbee. Bottom line is that I lost all of my appeals with Blue Cross. Surgery will cost me $30k out of pocket - all payable upfront so we are trying to get the money together. That was reduced from initial quote of $65k. I definetly want to have this surgery. My issue is I have chronic ankle instability so he will also have to shore up the tendon and that part is convered by BC. I am hoping to go on the donor list in the next month or two, then it is a 1-3 month wait for a donor. I think very highly of Dr. Bugbee but I have some suggestions if you are dealing with Yvonne, his asst. She was not very helpful in dealing with the ins. companies. If I had to do it all over again, I would have asked for a case manager at BC to walk it through. Yvonne doesn't want to place phone calls on your behalf. The issue is going to be your insurance company. These days they are trying not to cover this surgery because it is classified as "experimental" and they are denying anything they can. 5 years ago they were covering it more frequently. This is true of almost all the major carriers. There are only a handful of Dr.'s doing this procedure. Dr. Bugbee has done the most I believe. He is worth the trip for sure!
I REALLY appreciate the cost estimate you provided. I have already checked my insurance, Aetna, and while they will cover allograft for knee-related procedures, ankles are out of the question. They just reviewed that particular policy in June of this year, so they will probably not be inclined to make any changes. Of course, I will appeal, but expect to end up in the same boat as you ... paying out of pocket. The numbers you provided are all more "reasonable" (boy, that's a relative term) than the crazy stuff I was imagining in my head. :) I was worried it might be over six figures. It's upsetting to me that the insurance companies will jump at the chance to pay for you to lose your ankle altogether (fusion), but don't want anything to do with a chance for you to get a new one.
I would love to keep in touch with you as you go through this process if you're open to it. We are about the same age, and seem to have a similar diagnosis. My end-stage ankle arthritis stems from a trimalleolar fracture with dislocation that I suffered 26 years ago when I was in college. I've always had some difficulty when the weather changes, no high heels or running, etc. over the years, but I'm now having a lot of difficulty walking and am in constant pain.
I'm new to these boards, but I think I noticed an option to add a board member as a "contact". I'll send you a request.
Thanks again. You've been a big help!
Chris
HI Chris,
I am waiting to have my surgery by Dr. Bugbee. Bottom line is that I lost all of my appeals with Blue Cross. Surgery will cost me $30k out of pocket - all payable upfront so we are trying to get the money together. That was reduced from initial quote of $65k. I definetly want to have this surgery. My issue is I have chronic ankle instability so he will also have to shore up the tendon and that part is convered by BC. I am hoping to go on the donor list in the next month or two, then it is a 1-3 month wait for a donor. I think very highly of Dr. Bugbee but I have some suggestions if you are dealing with Yvonne, his asst. She was not very helpful in dealing with the ins. companies. If I had to do it all over again, I would have asked for a case manager at BC to walk it through. Yvonne doesn't want to place phone calls on your behalf. The issue is going to be your insurance company. These days they are trying not to cover this surgery because it is classified as "experimental" and they are denying anything they can. 5 years ago they were covering it more frequently. This is true of almost all the major carriers. There are only a handful of Dr.'s doing this procedure. Dr. Bugbee has done the most I believe. He is worth the trip for sure!
45cat
11-08-2009, 10:22 PM
I have an ankle fussion and I am certantly not crippled. I can walk fine and am active. It beats being in pain. All os that I saw said that the allogragh would not last and would only lessen pain a bit. With my job (teacher) I would be having the fussion 2 to 3 years down the road anyway. The recovery is long but not as long as OATS. From what I have read on this board I am glad I went with fussion.
Darryl
Darryl
45cat
11-08-2009, 10:23 PM
Hi
I'm looking into a ankle fussion. Can you dance, golf, bowl & walk when you have on?
I'm looking into a ankle fussion. Can you dance, golf, bowl & walk when you have on?
45cat
11-08-2009, 10:27 PM
Hi
The doctor told me I'm to young to have a ankle replacement, so he suggested a ankle fussion. He told me I can dance, bowl, golf & walk if I get on. I'm asking anybody out there if that is true or not. I would like to know if there is anything else I can look into.
Thank You :wave:
The doctor told me I'm to young to have a ankle replacement, so he suggested a ankle fussion. He told me I can dance, bowl, golf & walk if I get on. I'm asking anybody out there if that is true or not. I would like to know if there is anything else I can look into.
Thank You :wave:
stepbystep89
11-09-2009, 09:55 AM
I have had an ankle fusion and I know for sure I can walk and bowl. As for golfing, I don't see why not although I am not a golfer. Dancing? It all depends on what kind of dancing you are talking about. If you want to dance like we do at weddings and such you will be able to, but ballet and anything where you need to raise up on your toes is out of the question.
girlwithbadankl
11-10-2009, 05:19 PM
Thanks for the update, Melissa. I have spoken with Yvonne several times so far, and I do get the feeling that I will have to be my own advocate. Even getting her to schedule my appointment, after I had already communicated with Dr. Bugbee by e-mail, was a bit of an exercise.
I REALLY appreciate the cost estimate you provided. I have already checked my insurance, Aetna, and while they will cover allograft for knee-related procedures, ankles are out of the question. They just reviewed that particular policy in June of this year, so they will probably not be inclined to make any changes. Of course, I will appeal, but expect to end up in the same boat as you ... paying out of pocket. The numbers you provided are all more "reasonable" (boy, that's a relative term) than the crazy stuff I was imagining in my head. :) I was worried it might be over six figures. It's upsetting to me that the insurance companies will jump at the chance to pay for you to lose your ankle altogether (fusion), but don't want anything to do with a chance for you to get a new one.
Hi chris and all
I had the allograft surgery yesterday so Im still down here at Scripps. Dr Bugbee is simply amazing. If he can't fix it no one can! I can't wait to prove all the other docs wrong- the ones thT said my only option was to fuse. The procedure was $23k and blue cross covered only the ligament Reconstruction. My ankle was very unstable but Bugbee fixed 6 ligaments while in there. He said my ankle was very far gone, but he's seen far worse. I'll keep you posted. I have to go bCk in 2 weeks, 6weeks 3 mos, etc. Won't know how well it worked for 6-12 mos so long recovery. Melissa
I would love to keep in touch with you as you go through this process if you're open to it. We are about the same age, and seem to have a similar diagnosis. My end-stage ankle arthritis stems from a trimalleolar fracture with dislocation that I suffered 26 years ago when I was in college. I've always had some difficulty when the weather changes, no high heels or running, etc. over the years, but I'm now having a lot of difficulty walking and am in constant pain.
I'm new to these boards, but I think I noticed an option to add a board member as a "contact". I'll send you a request.
Thanks again. You've been a big help!
Chris
I REALLY appreciate the cost estimate you provided. I have already checked my insurance, Aetna, and while they will cover allograft for knee-related procedures, ankles are out of the question. They just reviewed that particular policy in June of this year, so they will probably not be inclined to make any changes. Of course, I will appeal, but expect to end up in the same boat as you ... paying out of pocket. The numbers you provided are all more "reasonable" (boy, that's a relative term) than the crazy stuff I was imagining in my head. :) I was worried it might be over six figures. It's upsetting to me that the insurance companies will jump at the chance to pay for you to lose your ankle altogether (fusion), but don't want anything to do with a chance for you to get a new one.
Hi chris and all
I had the allograft surgery yesterday so Im still down here at Scripps. Dr Bugbee is simply amazing. If he can't fix it no one can! I can't wait to prove all the other docs wrong- the ones thT said my only option was to fuse. The procedure was $23k and blue cross covered only the ligament Reconstruction. My ankle was very unstable but Bugbee fixed 6 ligaments while in there. He said my ankle was very far gone, but he's seen far worse. I'll keep you posted. I have to go bCk in 2 weeks, 6weeks 3 mos, etc. Won't know how well it worked for 6-12 mos so long recovery. Melissa
I would love to keep in touch with you as you go through this process if you're open to it. We are about the same age, and seem to have a similar diagnosis. My end-stage ankle arthritis stems from a trimalleolar fracture with dislocation that I suffered 26 years ago when I was in college. I've always had some difficulty when the weather changes, no high heels or running, etc. over the years, but I'm now having a lot of difficulty walking and am in constant pain.
I'm new to these boards, but I think I noticed an option to add a board member as a "contact". I'll send you a request.
Thanks again. You've been a big help!
Chris
techmom63
11-10-2009, 07:42 PM
Melissa, congratulations on your surgery! Your post is dated 11/10, so I assume when you say you had the surgery yesterday, that was 11/9. I only missed you by a couple of day! I was in to see Dr. Bugbee for my first consult on Thursday of last week, 11/5. Yvonne was supposed to be submitting the paperwork to my insurance company early this week. With any luck, I'll be on "the list" in about a month.
Sending you warm wishes for a speedy recovery. Please keep us posted on how things are going.
Chris
Sending you warm wishes for a speedy recovery. Please keep us posted on how things are going.
Chris
girlwithbadankl
11-11-2009, 10:24 AM
Chris yes we just missed each other. Where do you live again? It only took about 3 weeks for the donor do u shouldn't have to wait that long. Do you have any ligament issues as well or just deteriorated joint? Good luck with insurance. If I could make a suggestion, you will need a string letter from Bugbee and other docs to submit with the first appeal. Provide research papers by Bugbee as well. I feel I didn't do that until it went to the state and even then was late and they were already reviewing my case. Seems like they overturn INS companies only 30% of the timebuti know 2 others that did get it overturned. Keep me posted!!
girlwithbadankl
11-11-2009, 12:36 PM
I say try to do the allograft before fusion but only a hanful of docs do it. I know there is one in Chicago. I have the name at home if you can't find him.
techmom63
11-11-2009, 08:22 PM
Hi Melissa,
I'm in Denver, so I flew in for the consult last week. I stayed at the Mission Bay Hilton, but do have friends in the area if I need to do an extended stay when it's time for surgery. You mentioned that you have a follow-up visit at 2 weeks -- are you flying back home between now and then, or just staying in San Diego until then? I think you mentioned that you have younger kids, so it's probably hard for you to be away from them. I have two kids, but they are 14 and 16, and the oldest drives, so they are somewhat self-sufficient.
I don't have any ligament issues at all, just a completely deteriorated joint. Thanks for the suggestions on what to provide the insurance company. What is a "string letter" and what other docs should I be getting letters from? (I do have an OS that I saw in Denver who said my only option was a fusion.) I've started bookmarking Internet sites with research that I want to print out, etc. I figure I'm in for a pretty big battle, but I'm lucky to have time during the day to get as much information together as possible. My sister-in-law is also a doctor, so if I need to get access to medical journal articles, I can do that, too.
I'm so grateful that you are on these boards and I'm able to follow your progress. You're an inspiration!
Chris
Chris yes we just missed each other. Where do you live again? It only took about 3 weeks for the donor do u shouldn't have to wait that long. Do you have any ligament issues as well or just deteriorated joint? Good luck with insurance. If I could make a suggestion, you will need a string letter from Bugbee and other docs to submit with the first appeal. Provide research papers by Bugbee as well. I feel I didn't do that until it went to the state and even then was late and they were already reviewing my case. Seems like they overturn INS companies only 30% of the timebuti know 2 others that did get it overturned. Keep me posted!!
I'm in Denver, so I flew in for the consult last week. I stayed at the Mission Bay Hilton, but do have friends in the area if I need to do an extended stay when it's time for surgery. You mentioned that you have a follow-up visit at 2 weeks -- are you flying back home between now and then, or just staying in San Diego until then? I think you mentioned that you have younger kids, so it's probably hard for you to be away from them. I have two kids, but they are 14 and 16, and the oldest drives, so they are somewhat self-sufficient.
I don't have any ligament issues at all, just a completely deteriorated joint. Thanks for the suggestions on what to provide the insurance company. What is a "string letter" and what other docs should I be getting letters from? (I do have an OS that I saw in Denver who said my only option was a fusion.) I've started bookmarking Internet sites with research that I want to print out, etc. I figure I'm in for a pretty big battle, but I'm lucky to have time during the day to get as much information together as possible. My sister-in-law is also a doctor, so if I need to get access to medical journal articles, I can do that, too.
I'm so grateful that you are on these boards and I'm able to follow your progress. You're an inspiration!
Chris
Chris yes we just missed each other. Where do you live again? It only took about 3 weeks for the donor do u shouldn't have to wait that long. Do you have any ligament issues as well or just deteriorated joint? Good luck with insurance. If I could make a suggestion, you will need a string letter from Bugbee and other docs to submit with the first appeal. Provide research papers by Bugbee as well. I feel I didn't do that until it went to the state and even then was late and they were already reviewing my case. Seems like they overturn INS companies only 30% of the timebuti know 2 others that did get it overturned. Keep me posted!!
girlwithbadankl
11-13-2009, 03:11 PM
I meant "strong letter" not string letter!
girlwithbadankl
11-13-2009, 03:27 PM
I'm going to fly back down in 2 weeks. My flight home was 1.5 hrs and I'm not in too much pain.
techmom63
11-13-2009, 03:32 PM
I'm so glad you aren't in too much pain, Melissa. Thanks for the clarification on the "strong" letters I will need. :)
Keep posting -- love hearing your story!
Chris
I'm going to fly back down in 2 weeks. My flight home was 1.5 hrs and I'm not in too much pain.
Keep posting -- love hearing your story!
Chris
I'm going to fly back down in 2 weeks. My flight home was 1.5 hrs and I'm not in too much pain.
girlwithbadankl
11-13-2009, 09:07 PM
Another travel tip- we booked a 4-star hotel in La Jolla through the internet and got a $90 rate at the Estancia spa which is 4 blocks from the hospital. Awesome place. It was a great deal. My husband stayed there for 2 nights during my recovery.
techmom63
11-15-2009, 07:35 PM
Hope you're still feeling OK since your surgery, Melissa. Thanks for the travel tip! When you feel up to it, would love to hear what your restrictions are for these first two weeks. I'm sure you are totally non-weight-bearing. Are you using crutches? Are there any other things you are finding necessary to your recovery? Do you have someone at home with you during the day to help you? I'm hoping to plan ahead and get anything I will need ready before it's time for surgery. My mom lives on the east coast, but has offered to come to Denver to stay with our family for a short time after my surgery. I'm not sure how long to tell her I will need her, but I'm thinking at least until after my 2 week follow-up visit.