Based on all of the information, I so gratefully received on my first post "I am looking for Hope", I am in the process of cancelling my coverage with HMO and am going back to Medicare so that I can proceed getting the help I need to correct my back problem (pain). I intend on getting a new primary doctor, a good Spine Surgeon Specialist, a new MRI, and proceed with plans for surgery. All thanks to Veterans Carol632 and Quietcook. Thank You both. Now to my question. Since it my be a while before I can get everything lined up for surgery, I wanted to know if an Intradiscal Injection is an unharmful method of getting temporary pain relief prior to surgery, or would you consider it a harmful to my current DDD condition. I would like some pain relief, but not if it is going to worsen my condition. I have a prescheduled appointment with the Pain Clinic on 6-22-05 and if this procedure is non-harmful, I was going to inquire about it. If you veterans consider it a bad choice, I will cancel my appointment as soon as I receive feedback. Once again, Thank You for your help. You have no idea how much hope you have given me. I just reviewed my post and now have a "stupid" question. Why do my posts have a blue envelope with an arrow pointing down on them and none of the other posts have them. I must be doing something wrong????????????
Last edited by BumpooBilbe; 06-20-2005 at 05:45 PM.
Reason: Spelling error
I found this, written by Dr. Whitworth, 5 years ago. This is what he had to say about intrdiscal injections. I quote:
"Intradiscal steroids cause necrosis of the vertebral endplate, calcification of the nucleus (triamcinolone), nuclear cellular degeneration (depomedrol), and they just don't work. The studies are below proving these points. It is astonishing there are still doctors that use these injections with the evidence available that they are potentially overtly dangerous."
Unless he has found new evidence, I would not let anyone do this. I'll do a quick "google" on it and see what comes up.
These have been performed over the past few years with marginal success as an extension of prolotherapy into the disc. There is very little science behind it and as noted in the article, it is entirely experimental. There have been no studies demonstrating safety of DMSO, chondroitan, glucosamine, or other chemicals injected into the spine. Patients who do this procedure are accepting it on faith that it will work. I have had marginal success (transient) in most of my patients in which I am doing these injections (performed approximately 50 so far).
I would suggest making a new post and asking the good doctor to clarify for you and comment as to whether or not he would recommend it for you.
Carol632. Thanks for the information. I'm going to cancel my appointment and forget the intradiscal injection as an option. I don't want to worsen my condition any more than I already have by having the steroid injections. I'm going to hang on until surgery. Maybe my new doctor (as soon as I get one) will help my pain with some stronger pain meds to hold me until surgery. Again thank you for all of your help. It means so much to me.
Are these injections the same as those given for facet degeneration; that is, in the lumbar joint? I am scheduled for my second Monday and now I'm worried.
I am also curious as to why you decided to go with only medicare and not a supplemental insurance as I, too, am having to make some new insurance choices. What information led you to this decision?
Now, as for as facet joint injections, for peregrine. Be sure that your spine specialist is going to do the injections and not an anethesologist.
Quietcook,
Thanks for your input! Yes, the spine specialist does the injections and the anestheseologist does only the anestetizing. But I am still concerned. I do have Osteo. When I expressed my concern to the specialist he said it is not like taking a steroid by mouth, which would be detrimental to bones. He reasoned that with the injection system the steroid moves very slowly through the system so is not a risk to the bones. Was he lying? I did get some relief from the first series. I am scheduled Monday for the second and now I don't know what to do . Any words of wisdom?
Peregrine: I am a brand new member of the "board", and made my first post,"I am looking for Hope", 5-6 days ago. I think if you read my original post, and replies by veterans Carol632 and Quietcook, you will better understand my position. I am in no position to give advise, but am basing my decisions to quit my HMO and go back to Medicare soley on the advise I have received from the veterans. It is crystal clear to me now that the HMO doctors would never have help me if it involved spending any money. At the moment, I am in the very beginning stages of planning my move out of HMO to Medicare and I do plan to look into having some supplemantal insurance in addition to the Medicare, but first need to weigh the costs of varies plans to determine what is best for my situation ( for instance my monthly prescriptions are approximately $200 at present. If I can get full prescription coverage for $175 a month, I'll get it). As far as your question regarding the intradiscal injection, I am not qualified to give you any suggestions one way or the other, however, Dr. Whitworth and Carol632's response above is very compelling to me and my paticular problem. The Social Security Adminitration told me, yesterday, that the Medicare rep. would be able to help me with alternative supplemental insurance options. I hope one of the other veterans responds to your question. Sincerely, Gregory
Peregrine: I am a brand new member of the "board", and made my first post,"I am looking for Hope", 5-6 days ago. I think if you read my original post, and replies by veterans Carol632 and Quietcook, you will better understand my position. I am in no position to give advise, but am basing my decisions to quit my HMO and go back to Medicare soley on the advise I have received from the veterans. It is crystal clear to me now that the HMO doctors would never have help me if it involved spending any money. At the moment, I am in the very beginning stages of planning my move out of HMO to Medicare and I do plan to look into having some supplemantal insurance in addition to the Medicare, but first need to weigh the costs of varies plans to determine what is best for my situation ( for instance my monthly prescriptions are approximately $200 at present. If I can get full prescription coverage for $175 a month, I'll get it). As far as your question regarding the intradiscal injection, I am not qualified to give you any suggestions one way or the other, however, Dr. Whitworth and Carol632's response above is very compelling to me and my paticular problem. The Social Security Adminitration told me, yesterday, that the Medicare rep. would be able to help me with alternative supplemental insurance options. I hope one of the other veterans responds to your question. Sincerely, Gregory
Hi Gregory,
I was actually addressing only the insurance question to you (thanks for your reply.) The rest was meant for Quietcook.
There are 8 standard policies which may be supplemental to Medicare. If you get info from several companies you can sit and compare as I did for my Mother. What surprised me was the vast differences that each company charged for the same policy. A simple spread sheet can make the answer just pop out once you narrow the type policy down to a couple, then chart what each company charges for the same class of policy.
We wound up getting a policy from AARP as it was so much less expensive, but we did not cover her meds. At that time she didn't take a lot of meds, and now that has proven a wise decision for us even though she now takes lots of meds. The reason is that with medicare subscription card last year and as medicare kicks in to begin covering so many meds, the difference in taking any policy which covered meds was still above the break-even point for her. Thow in the fact that the cost of the policy as well as cost of meds can be deducted if you itemize on taxes, then that had to be considered, as her cost of meds dropped significantly with the changes in Medicare.
Here's what has happened in the many years since we switched. The previous company paid a low percent of the balance that Medicare approved but did not pay. I was still paying out of pocket for the Medicare deductible and meds. Then when we switched, the plan we took pays even the Medicare deductible, the deductible for each time she is hospitalized, and doctor visits. They pay the balance of what Medicare approves but does not pay, so that I've not had to shell out a single$$ except for her meds. Ik still get the policy information packets from several companies, including AARP every 2 years and recheck prices, etc, but we haven't found any policy that works better for our situation, and frankly, without having to shell out $$ for any co-pay medical visits, hospital etc., it is a lot easier for me to convince my mother to get to the doc when something first goes wrong with her BP or heart instead of waiting to see if things get worse.
Suggest you contact several companies and do a comparison to see what will work best for you. The good thing too was that with it being supplemental to Medicare, the policy went into affect quickly and we had no non-coverage for pre-existing conditions, because Medicare doesn't do that.
I have an excellent, but expensive policy for myself as a Federal Retiree, but have always had to pay into Medicare as well. I'm about 3 years away from Medicare and a supplemental policy, myself.
Now, as to the injections and what your doc said. ALL steroid medications do affect the body, whether injections, oral or inhaled. If you got relief from the first injection, it makes sense to have a second, but I would not recommend more than 3 within a 12 month period. I've had way, way, too many doc's tell me that there should be no more than 3 injections within 12 months, because of the impact on bones. I just wish one of them had told me that same information back years ago, before the bones in my arm shattered like glass when I took a simple spill. I did know by the time I became asthmatic, but had to take the daily steroids and use inhalers or die from not getting oxygen. So, just be cautious and maybe even discuss the steroid issue even with your primary doc. I know that my primary DO certainly gets concerned when I have to take steroids in any form, especially with my osteoarthritis and all the problems I've had with my back.